Will I need to have surgery?
Although most patients will have a biopsy performed, however, not all cancers require surgical treatment.  Some cancers are best treated with radiation therapy or chemotherapy. In some instances, the cancer may be too big or difficult to remove with surgery. Your healthcare team will work with you to determine whether surgery is part of your overall treatment plan. If surgery is necessary, you will undergo a number of tests to determine whether you are an appropriate candidate for surgery.

What is the operation (procedure) that is recommended?
Ask your surgeon for a simplified explanation of the type of operation, technique used, and why it should be performed. (Pictures and drawings tell patients and family a great deal.)

What is the surgeon’s experience with this procedure?
Ask the surgeon about his experience with this procedure, its outcome, and the hospital or setting in which the operation will be performed.

What is the reason that this procedure is necessary at this time?
Is the procedure being done to relieve pain, diagnose a condition, correct deformity, for cosmetic reasons, or what exact purposes?

What are the options if this procedure is not done?
What are the non-surgical or medical treatments available? What will/might happen if the operation is not done at this time? If the operation is not done at this time, can it be done later? What are the advantages and disadvantages?

Are there alternatives to surgery?
Surgery may be the only treatment available or one of several choices or part of an overall treatment strategy that includes other treatments, such as radiation or chemotherapy. Ask your doctor how the recommended surgical treatment compares to other non-surgical treatment options and why surgery is best for you.

What is the goal of surgery?
What exactly are the expected or possible benefits of doing the procedure? Is the goal of surgery to cure the cancer, prolong life, or relieve symptoms and improve quality of life?

What should I know about the risks of surgery?
Surgery does involve risks and side effects, depending on the type of surgery you have, and the expertise and experience of the surgeon and hospital.  Generally, the more invasive or complicated the surgery, the greater the risk of side effects.  Additionally, research has indicated that hospitals and surgeons that perform more surgeries like yours have better outcomes. Before you have your surgery, you may want to get a second opinion from another surgeon and inquire as to the track record of his/her hospital.

Should I get a second opinion?
It is very common and appropriate to seek out a second opinion.  This will not be a problem with the first surgeon who will recognize this as commonplace.  If you choose to have surgery, the surgeon will tell you about all of the risks, side effects and benefits associated with your specific surgical procedure.  Second opinions can reassure anxious patients (and family members) to make the whole process easier for all involved.

Where should I get surgery?
Several prior publications have indicated that outcomes of patients undergoing surgery may be significantly improved if they are treated in a hospital that has performed a large volume of such procedures. These results are presumed to be due to a more skilled and dedicated healthcare team that has experience with high-risk situations, as well as the attendance of skilled surgeons in such hospitals. However, the role of an individual surgeon in terms of surgical volume and patient outcome has been less well-defined in medical literature.

Patients undergoing complex surgical procedures have a significantly reduced risk of operative mortality if their surgeon has performed a large volume of the specific procedure compared to patients whose surgeon has performed a low volume of the procedure. Patients who are to undergo a complex surgical procedure should speak with their surgeon about their particular risks or ask their physician to refer them to a surgeon who performs a large number of the surgical procedure in which they are to undergo for treatment of their disease.

What are the specific risks of anesthesia?
What are the risks of the type of anesthesia to be used? What are the possibilities for anesthesia methods (local, regional, general, etc.)?

What is the recovery process after this procedure?
Procedures each vary in terms of wound recovery and rehabilitation programs. It is very important for patients to know the long-term program ahead of time for the best planning.

Should I have surgery before or after chemotherapy?
Chemotherapy that is administered before surgery is referred to as neoadjuvant therapy and chemotherapy that is administered after surgery is referred to as adjuvant therapy. Patients should ask their doctor if the treatment of their disease typically involves neoadjuvant or adjuvant chemotherapy.