Oncologic Surgery

Cancer is uncontrolled cell proliferation. Due to the difference in the response of the tissues and structures in the body to this uncontrolled structure, the behavior of cancer is also different. The uncontrolled cells reported to be present in the human body are formed daily. However, the immune system is designed to destroy foreign elements. Cells with the uncontrolled proliferation ability are destroyed by the proper functioning immune system, and our body resists cancer. In the case of immune system failure, unhealthy processed (refined) foods lead to the development of cancer.

Breast Cancer

It is easy to check breasts compared to other organs due to their location in the anterior-upper part of the body and being easily accessible under the skin. Breast cancer can be observed at any age. Its incidence increases, especially after the thirties.

As age progresses, its incidence increases. Breast cancer may develop in young people. The number of patients has increased in recent years. It is difficult to ensure complete protection. However, measures can be taken by performing examination and observations in time. Usually, healthy lifestyle, ideal weight, and regular exercise are important, a balanced diet should be followed, and consuming foods poor in trans fat reduces the risk of breast cancer.

Some of the foods in the stomach, which is located in the upper quadrant of the abdomen and is one of the main elements of the digestive system, leave the stomach immediately (such as water) and others leave the stomach hours later (such as fatty foods) and advance to the duodenum.

Thyroid Cancer

It occurs when the cells in the thyroid gland are transformed into cancer cells. In the case of the accurate diagnosis and treatment, good results can be obtained. It appears as a mass in the neck or a nodule in the thyroid. The nodule’s size ranges from a chickpea to a chestnut, and it emerges with the accumulation of cells. There are two types of nodules: a cold nodule (not secreting hormones) and a hot nodule (secreting hormones). The important type is the cold one. The possibility of its conversion to cancer is 15% on average. Patients with a cold nodule are recommended to have a thyroid needle biopsy urgently. The purpose of the biopsy here is to confirm the presence of cancer in the nodule. Staying away from alcohol, cigarettes and other carcinogenic substances, undergoing thyroid ultrasonography examination and consuming healthy foods can protect us from cancer.

It may occur in the form of goiter disease, difficulty in breathing, swelling in the neck, irritability, fatigue, weight gain, weakness in hair, difficulty in swallowing, and skin dryness, and it may be observed from outside when overgrown.

Disruption of thyroid hormone balance leads to a change in metabolism. It has an impact on cholesterol level, body systems, osteoporosis, and sexual desire. Thyroid gland-related diseases are thyroid inflammation, goiter, thyroid cancer. Goiter disease is commonly observed among thyroid diseases. In the studies conducted, 60% of people report the presence of goiter in the initial period. Women are 5 times more at risk. Nodular goiter can grow as one or more nodules.

Thyroid Cancer Diagnosis

If the goiter is small, the diagnosis is made by measuring T3, T4, TSH blood levels and conducting thyroid scintigraphy tests after palpation. The growth of the thyroid gland may cause malformation in the form of a nodule in the throat. This situation is described as nodulation. Nodulation may also occur in patients with untreated goiter in later periods. The cancer rate is 5% in nodules. 95% of people with thyroid cancer maintain their normal lives.

‘Thin-needle aspiration biopsy’ is used in the examination of thyroid nodules; patients suspected of and diagnosed with cancer are operated. Surgery is recommended for patients in whom nodules known to be benign grow to the extent to cause discomfort during the follow-up.

Treatment Approach in Thyroid Cancer

There are 4 types of cancer in the thyroid gland.

Papillary Type: This type makes up 80% of thyroid cancer. It usually manifests itself between 20-50 years of age. It is observed 3 times more in women than in men. It is the most common thyroid cancer in young children (BELOW 14 YEARS OF AGE). It may stay of the same size for many years (sometimes 30 years), smaller than 1 cm and be asymptomatic. Accidental incidence rates increase when the gland is surgically removed due to goiter or hyperthyroidism.

This type of cancer is observed in 2% of our country’s population. The frequency of cancer increases in some countries near the sea. High frequency is associated with the fact that excessive amounts of seafood are consumed and the excessive amount of iodine taken leads to the inflammation of the thyroid gland and cancer emerges on the basis of this inflammation.

Treatment: It is treated with a surgical technique. The thyroid gland is completely removed (total thyroidectomy). After surgery, if the patient has “micro-cancer” smaller than 1 cm, no treatment other than the administration of the thyroid hormone is applied. If cancer also involves the lymph nodes, enters the capsule surrounding the thyroid and the cancer diameter is greater than 1 cm, radioactive iodine treatment is administered 6 weeks after the surgery.

This treatment reduces the likelihood of disease recurrence both locally in the neck and in the form of distant metastasis. If there is lymph node involvement in the neck of patients, the thyroid glands should be removed together with the thyroid as a block. If this condition is suspected before surgery, the lymph node is not surgically removed under no circumstances. At this stage, if necessary, the diagnosis is made by needle biopsy, and the patient’s thyroid gland is removed with the lymph nodes without deteriorating tissue integrity. This surgery is called total thyroidectomy + modified radical or functional neck lymph node dissection.
The follow-up of patients is performed with TSH values and thyroglobulin values. TSH shows the amount of the hormone taken by the patient, and the thyroglobulin value around “0” indicates that the disease has been treated. However, in some cases, disease recurrence is possible without the elevation of thyroglobulin level. 90% of patients maintain healthy lives after treatment.

Follicular Type: Patients in this group are mostly women aged 40-60 years. This type of cancer makes up 10% of thyroid cancer. Follicular cancers are the most difficult to diagnose among thyroid cancers. In this group, it is not possible to understand whether the lesion is cancer both in thin-needle biopsy performed before surgery and in frozen section performed during surgery because in order to understand whether there is cancer in this type, it is necessary to see whether the cells penetrate and come outside the capsule surrounding this mass that consists of cells with normal structure at any place.

Kapsülün bu şekilde bir istilası durumunda folliküler kanser, kapsülün sağlam kalması halinde iyi huylu folliküler tümör tanısı konuyor.

Treatment: As for papillary type, treatment is total thyroidectomy and radioactive iodine treatment after surgery regardless of tumor size in case of invasive cancer. 80% of patients maintain healthy lives after treatment.

Medullar Type: While familial types exhibiting genetic transition are observed between 1-20 years of age, non-familial types usually emerge as lymph metastases after 40 years of age. This type of cancer makes up 5% of thyroid cancer.

Treatment: Treatment is in the form of total thyroidectomy (complete removal of the thyroid) and lymph dissection on the side of the tumor. In this type, radioactive iodine treatment is not applied after surgery because the tumor cell cannot hold iodine since it is different from other thyroid cells. Calcitonin value is measured in the blood during follow-ups. 60% of patients maintain healthy lives after treatment.

Anaplastic Type: This type makes up 5% of thyroid cancer. It generally occurs with the rapid change of the biological behaviors of papillary or follicular cancers that have not been treated for a long time and with their rapid growth after 60 years of age. In this case, surgical methods can not be applied. However, in order to relieve the patient, radiotherapy treatment is applied to the neck.

Gastric Cancer

The stomach takes charge in the digestion process that we describe as the intake of the eaten foods into the body and transforming them into a useful form. The taken foods are treated with the juice of the stomach here. The content is crushed by the agitation movements of the stomach muscles with their rhythmic contraction and brought into the form of slurry. Due to its strong muscle structure, the stomach breaks down the food and brings it into a paste (chyme).

Hydrochloric acid in the stomach juice is a strong chemical for breaking down protein content in foods. The inner membrane of the stomach is protected from the burning and destructive effect of acid by mucus. As a result of the damage of this mucus layer (painkiller drugs, etc.) in the ulcer disease, damage to the inner lining of the stomach occurs. Cancer develops with the uncontrolled proliferation of cells in the stomach.

Helicobacter pylori infection is reported as the cause of 60% of stomach cancers. Intense salty foods and smoking are also indicated as the reasons for increasing gastric cancer. An association between the consumption of smoked food (fish) and gastric cancer development has been reported in Japan. The predominance of genetics in gastric cancer is 1-3%.

Both gastric cancer and gastric ulcer occur with similar complaints. Therefore, the diagnosis of gastric cancer may be delayed, and sometimes it is difficult for our colleagues to recognize it early.

In the early period, gastric cancer presents with non-specific complaints such as epigastric burning, pain in the upper abdomen, nausea, and the loss of appetite. In the following process, complaints, such as anemia, yellowing of the skin, difficulty in swallowing, weight loss, tar-colored blood with a foul odor in the stool, whitening of the eye sclera due to vomiting or not apparent occult bleeding, may be observed. Individuals with such complaints should consult a healthcare organization, undergo gastroscopy (examination of the inside of the stomach using a light camera), and the presence of lesions such as tumor or ulcer should be determined. For the definitive diagnosis of gastric cancer, a biopsy from the mass and pathological examination accompanied by endoscopy are essential.

It is important to determine the grade of the diseases after diagnosis. Gastric cancer spreads to the liver, lungs, and bones, especially through the lymph. Staging is the process of showing up to where and to what extent it has been spread. For this purpose, advanced examinations are performed for both the liver and lungs in individuals in whom biopsy has been conducted. High-resolution magnetic resonance imaging (MRI) is performed for the liver, and high-resolution computerized tomography (CT) is performed for the lungs. PET CT shows invisible masses well.

In the PET CT (positron emission tomography) film, radioactive fluorine-labeled sugar (glucose) is administered intravenously. This examination has been created based on the fact that rapidly proliferating cells (as in cancer) will consume a lot of sugar. However, its effectiveness is limited in the case of gastric cancer types (such as signet-ring cell mucinous adenocarcinoma, and neuroendocrine tumors). In these types of cancer, high-resolution magnetic resonance imaging and computed tomography are effective/valuable examinations.

Gastric cancer is frequently observed in Far Eastern societies where smoked and pickled foods are widely consumed. People in that region undergo endoscopy every 6 months. Thus, gastric cancer can be diagnosed at an early stage in Japan and South Korea.

Gastric cancer is prevented by the avoidance of the consumption of pickled and smoked foods, by the Mediterranean type of nutrition, quitting smoking, and the control of Helicobacter pylori infection. Reducing the consumption of refined foods and obtaining food naturally are among the measures to prevent cancer.

Pancreatic Cancer

Symptoms of pancreatic cancer include fullness in the stomach, feeling of discomfort, loss of appetite, early symptoms of pancreatic cancer. However, the symptoms of the disease are perceived as normal stomach complaints, the possibility of early diagnosis decreases.

Can we be protected from pancreatic cancer?


Symptoms of pancreatic cancer are there?

Usually begins with the actual findings. Fullness in the stomach region, discomfort, loss of appetite is seen throughout patients in the early period.But istisnaen which can be used to diabetes, early signs of pancreatic cancer and may be the stimulus. This form of diabetes is not a disease in the family.

An attack of pancreatitis such as alcohol abuse and gallstones passed for no reason again may be the first symptom of pancreatic cancer. In later disease stages, severe abdominal and back pain, jaundice, weight loss, abdominal pain can present with symptoms such as. Unfortunately, these findings also indicate that the disease has passed the treatment limits.

Risk factors

The exact factor that causes the disease is still not clear. Cigarette smoking is known to increase the risk. In addition, family history, genetic factors and some mutations facilitate the occurrence of the disease has been identified. The intense consumption of alcohol has been blamed for not being fully clear.

Diagnostic Methods

Cancer diagnosis, blood tests and imaging methods are used. In the blood tests of patients, tumor markers, such as CA 19 9 and CEA, are mostly high. Bile duct obstruction in patients with high bilirubin values and liver function tests can be found. The methods used in imaging are ultrasound, computed tomography, or magnetic resonance imaging. With these methods, the disease can be detected at a large extent. Patients with severe jaundice may be required to put stents on the gallbladder while preparing the treatment.

Treatment methods

Priority method, the surgical procedure is the removal of the mass. After surgery, chemoradiotherapy is needed in almost all patients. Surgical removal of the tumor is impossible with chemo-radiotherapy in the local advanced stage of mass size can be reduced and surgical cure can be provided. Chemotherapy is the only method used when the disease is spread to distant organs, such as the liver.

And many settled on the back wall of the abdomen, the pancreas, the flow of blood and lymph vessels is situated on the road. Therefore, the possibility of recurrence of the disease increases after treatment. It is possible that the patients who are treated may experience this disease again within 3 years on average. Long-term success rates are expected to increase only with the discovery and use of more effective chemotherapy agents.

Liver Cancer

Liver tumors that develop in patients with hepatitis B and hepatitis C or cirrhosis may not manifest themselves in the early period. Therefore, it is recommended that people with hepatitis viruses in their blood should undergo a regular health check.


Hepatitis B and Hepatitis C are common health problems. The presence of hepatitis virus is considered to be a very important risk factor for the development of liver cancer. Thus, patients with a virus in their blood or chronic liver disease should be followed up from time to time because they are at risk for liver cancer.

Cancer Prevention

Cancer prevention includes avoiding cancer-making substances such as cigarettes and alcohol, not eating foods that play a role in fatty liver, taking precautions in the form of vaccination against hepatitis viruses.


It may not give any signs in the early period. Widespread pain emerges on the right side of the abdomen in proportion to the increasing mass diameter. As the stage progresses, severe abdominal pain is accompanied by weight loss and abdominal distention.

Risk Factors

Liver tumors are prone to recurrence after treatment in individuals with hepatitis, cirrhosis. Therefore, close follow-up is important after treatment. Computed tomography and magnetic resonance imaging are performed. If there is a new mass, re-surgery or one of the local treatments is planned. Patients with transplanted liver are closely monitored for relapse.

Diagnostic Methods

Diagnosis is made by imaging methods. The liver tumor can be visualized by ultrasonography, computed tomography, and magnetic resonance imaging. Furthermore, the blood is collected, and alpha-fetoprotein (AFP) is considered as an elevating marker in liver tumors.

Treatment Methods

Diagnosis is made by imaging methods. The liver tumor can be visualized by ultrasonography, computed tomography, and magnetic resonance imaging. Furthermore, the blood is collected, and alpha-fetoprotein (AFP) is considered as an elevating marker in liver tumors.

Systemic Treatment of Cancer

The term “advanced” or “metastatic” liver cancer comes into question if cancer is spread to lymph nodes or other organs other than the liver or if cancer progresses or is spread despite the use of other treatment methods available. At this stage, it is not possible to provide a permanent and complete cure in liver cancer and to eliminate the disease completely. The aim of all treatments to be performed is to reduce the patient’s complaints due to cancer and to slow down the progression of the disease if possible.

In metastatic advanced liver cancer, “systemic treatment” that is effective not only on the liver but on all tissues and organs in the body is planned. This treatment includes chemotherapy drugs and targeted therapy.
Liver cancer is mostly resistant to chemotherapy, no chemotherapy drug prolongs life. Targeted drugs inhibit the vascularity and the production of certain proteins, which are important in tumor growth and dissemination. Some studies have shown that these drugs prolong the life span up to an average of 3 months in advanced or metastatic liver cancer. Drugs may be effective in patients who do not have cirrhosis or do not have severe cirrhosis. Drug-related side effects include the loss of appetite, fatigue, diarrhea, weight loss, redness and/or rash on the skin, peeling on the palms and the soles of the feet.

Targeted drugs are taken continuously in the form of a pill orally 2 times a day. It is important to check the liver tests and blood count values by performing blood tests at certain intervals while taking drugs. If there are excessive side effects, the liver function is gradually deteriorating, or blood tests indicate abnormalities, the drug may be interrupted, or the dose is reduced.

Colon (Large Intestine) Cancer

Is the last 2-meter section of the digestive system that ends with the anus. Rectum last 15 cm.it’s the liquid part, the rest is the colon. The diagnosis and treatment of bowel cancer has improved over the last 10 years. Currently, colon cancer is a very important problem all over the world for millions of years and lives are at risk.


prior to defecation through the anus with the stool or blood come, weakness, fatigue, or shortness of breath, change in bowel habits, stool diameter thinning , defecation after the operation, inability to relax, still feeling like he had the stool, constipation, periods of diarrhea, feces with sumugumsu fluid discharge, abdominal pain, abdominal swelling, nausea and vomiting.

Hemoroidal disease(hemorrhagic) – related cancer?

Stool, is one of the most common symptoms of bowel cancer. Unfortunately, a large proportion of patients with these complaints of complaints thinking that is the reason the hemorrhoids goes to a doctor for a long time. However, it can also occur in many other diseases, including colon cancer, as well as hemorrhagic stroke. If cancer is suspected in patients over the age of fifty, colonoscopic examination should be planned even if the patient has a known haemorrhoidal disease.

Risk Factors

Place of residence of the patient: incidence of colon cancer varies depending on the country and the region. Lifestyle: colon cancer, associated with cigarette smoking and alcohol use, less fibrous foods (vegetables, fruit) in the areas of diabetes, obesity and a sedentary lifestyle are more common in Persons with those problems. Age: although it is seen at very young ages, the frequency of the disease increases with age. Polyps: the most important risk factor. Most cancers begin on the polyps floor. The presence of colon cancer in the Family: Mom, Dad, or brother increases the risk of developing bowel cancer in people with cancer. The risk of developing breast cancer increases with age. In some cases, there is a genetic predisposition to bowel cancer. Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. Women with uterine and ovarian cancer. Radiation therapy for other reasons. However, in 75% of people developing cancer in the colon, none of these risk factors are present.

Diagnostic method

Colonoscopy and biopsy as well as examination for the diagnosis of colon cancer is sufficient. However, in order to decide the treatment method, the degree of spread of the disease must be determined. For this purpose, tests such as computed tomography, ultrasound, Endo ultrasound, MRI and pet may be used.

Treatment method

The main treatment of colon cancer is surgery. Chemotherapy and/or radiation therapy may be used before or after surgery.

Goal of treatment?

The disease to be treated completely or if this is not possible, the life expectancy is extended. Especially in the last 10 years thanks to advances in diagnosis and treatment, patients with cancer of the large intestine is long and paved the way for a quality life.

the other aim is to improve the quality of life by eliminating the patient’s complaints. Some of the methods used for this purpose are:

Minimal Invasive Surgery

In the treatment of colon cancer surgery the patient’s abdomen in the past the only way to can reach up to 40-50 CM in length is made and they’re sure. Today laparoscopic surgery, single port surgery and robotic surgery, such as methods used in the treatment of bowel cancer.

Ostomy (from the abdomen the faeces – faeces Bag)

the rectum is called the large intestine the last section of the last 3-4 cm of the intestine has been removed during surgery, except for the part of a certain part are connected to each other after every two or three again. In some cases, the small intestine may be removed temporarily (6-8 weeks ) until the combined site is healed. Patients can do their big wudder in the normal way. If the cancer is very close to the anus, the anus is removed and put into the abdominal wall. Thus, the patient’s abdominal wall is adhered to a bag feces (colostomy) is provided. Surgery to far fewer patients today than in the past ( all colon cancer in 5% of cases) is needed, the majority of patients stool the normal way.

Only the removal of the tumor in the colon in colon cancer will not be sufficient. If the cancer has spread to other parts of the body, the lymph nodes may also be removed. If there is a small amount of cancer in the area of the operation (palliative resection), the disease recurs after a period of time in most of the patients (local recurrence ). Therefore, it is very important to have a curative resection done to the patient.

What is the prognosis for colon cancer?

There are three main factors that determine the course of disease in colon cancer:

1. Cancer-related factors
Cancer is a general concept. But each cancer has different degrees of aggressiveness that vary according to different macroscopic and microscopic properties. When all of the cancer of the colon is considered, treatment of the last 12-15 CM part of the colon called rectum is a little more difficult than other parts of the colon. Stage: the cancer has spread inside the wall the degree of recommended to receive the surrounding organs, lymph nodes or distant metastases, determines the stage of the disease factors such as. If colon cancer is caught early, it can be treated completely.

2. Treatment-related factors
colon cancer treatment methods are applied for ranking and the way is extremely important. The oncological radicalism of the operation is important.

3. Patient factors that are associated with:
causes the patient’s age, associated diseases, immune system, genetic factors etc.
liver and/or lungs to Spread(metastasize) there is a chance to cure disease?
arteries can spread to the lungs or liver . As a number of metastases, patients with Ede prevalence are given chemotherapy. Non-common metastases are excluded by surgery. Chemotherapy may be given before or after surgery. Again, appropriate RF, take, such as Cyberknife methods can be preferred in patients.

Spread(intra-abdominal) of the large intestine cancer is treated?

if the cancer has spread to the lymph nodes in the abdomen, the patient may be treated with radiation therapy, chemotherapy, hormonal therapy, or a combination of these treatments.
what is the shape blocking in the treatment of colon cancer?
if the cancer has spread to the lymph nodes in the abdomen, the patient may be treated with radiation therapy, chemotherapy, hormonal therapy, or a combination of these treatments.

what is the shape blocking in the treatment of colon cancer?

bowel obstruction leading to bowel cancer Some after opening are detected. These patients are either operated as an emergency or placed in a stent in the blocked area and the blockage is eliminated. After completion of pre-treatment for tumors (such as chemoradiotherapy), surgery may be performed under more appropriate conditions if necessary.

Can Cancer be prevented?

When caught in the early stages, colon cancer is one of the possible treatment of diseases. The most common type of cancer is adenocarcinoma. However, most of the bowel cancers that have formed a complaint unfortunately miss the early stage. Therefore, if you do not complain, healthy people from the age of 50 should take screening tests at regular intervals. For this purpose, stool tests such as blood test, sigmoidoscopy, colonoscopy and colonoscopy are used.