Surgery

Prostate cancer is the most common cancer in men across Europe, accounting for almost one in four cancer diagnoses in males. Today, surgery to remove the prostate in its entirety is one of three treatment options for early-stage prostate cancers, and some locally advanced prostate cancers – the other options being radiotherapy and active surveillance.

Breast cancer surgery has a central role in the long history of cancer. The story of how operations became radical – with all that entailed in disfigurement and distress – and then conservative in line with new scientific understanding, is a mainly European one but with the insight too of one outstanding American.

How can breast tumours that have no ‘palpable’ lumps be located precisely during surgery? A radiotracer injected into the lesions guides the surgeon to the site and results in a higher rate of excision of all the cancer.

The idea that lymph nodes can be guarded by a single ‘sentinel’ node proved to be correct and in breast cancer the status of this key node has played a pivotal role in avoiding unnecessary lymph node surgery without compromising on further treatment decisions. But it’s an evolving story.