​With over 2 million new diagnoses every year, cancer is common in the United States. Roughly 60 percent of people with cancer have a surgical procedure to treat their condition.

In a recent webinar, several experts in cancer care and cancer surgery from The Christ Hospital Health Network in Cincinnati shared details about the importance of a patient-centered approach to cancer surgery and how recent advancements have improved outcomes. Together, Justin Cox, MD, a urologist specializing in urinary tract cancers; Julian Guitron, MD, a thoracic surgical oncologist; Jennifer Manders, MD​, a breast surgeon; and Janice Rafferty, MD, a colorectal surgeon, offered their insights and addressed important questions.

Here’s what they want you to know.

Multidisciplinary, personalized cancer care

Hearing the word “cancer” can feel like being pulled into another dimension, and patients often have a hard time focusing on anything the doctor says after the diagnosis. It’s a naturally overwhelming experience, which is why providers at The Christ Hospital Health Network work together in real time to coordinate your treatment.

“Cancer is potentially a whole-body problem. When we think about the treatment, it's not just the tumor itself, but really the potential for it to spread elsewhere,” Dr. Manders says. “That’s why we take a multidisciplinary approach to deliver specialized, personalized treatment based on the particular characteristics of your tumor.”

Your care team may include your surgeon, medical oncologists, and radiation oncologists. Together, they analyze your tumor to understand how it behaves, how advanced it is, and where it may show up in the future. Based on that evaluation, they create a treatment plan customized to your needs.

But complete cancer care takes more than an accurate diagnosis and comprehensive treatment planning. It also requires patient education and support. The Christ Hospital Health Network meets those needs through a robust nurse navigator program. As an experienced partner, your nurse navigator can coordinate your appointments, connect you with valuable resources, and answer your questions, Dr. Guitron says.

“Our nurse navigators are the quarterback of every patient’s care team. They coordinate between many physicians and bring a lot of information to the patient and their families,” he says. “They are a patient’s go-to person for everything they need to help them through the cancer treatment process.”

Advanced technology for better outcomes

In the past, open procedures were the first-line options for most cancer surgeries. But these techniques often involved large incisions, significant amounts of pain medication, and long hospital stays. Thanks to technological innovation, minimally invasive and robotic procedures are now the gold standard for many types of cancer surgery. The benefits of these approaches can include:

• Faster return to normal activity

• Lower complication rates

• Same-day or next-day hospital discharge

According to Dr. Cox, The Christ Hospital Health Network is the region’s leader with single-port robotic surgery. This one-incision approach improves a patient’s surgery experience and recovery time, he says.

“At The Christ Hospital Health Network, we are pioneers when it comes to single-port robotic surgery. We’re the first hospital in the city to use this approach for urinary cancers,” he says. “By making one incision instead of five for prostate cancer surgery, we can operate in an entirely different body cavity space, limiting the impact on your intestines. Your recovery and return to normal function are quicker.”

Surgeons at The Christ Hospital Health Network also use minimally invasive and robotic techniques to improve outcomes in other types of cancer surgery.

Breast

Robotic techniques are a newer trend in breast surgery. Surgical experts are exploring using these procedures to perform nipple-sparing mastectomies that remove the breast but reattach the nipples. Additionally, The Christ Hospital Health Network’s surgeons use robotic approaches with oncoplastic breast surgery. During these procedures, they remove your tumor and move your remaining breast tissue around to maintain or improve your breast shape.

“It’s no longer one-size-fits-all with cancer surgery. There’s no cookbook way of approaching this type of care,” Dr. Manders says. “It’s very specific to the patient. It’s our job to make sure they understand which approach is the best one for them.”

Colorectal

Most patients who need colon or rectal surgery for cancerous or noncancerous conditions are eligible for a robotic procedure, Dr. Rafferty says. With these techniques, patients can go home within one to two days after surgery and recover in their own space.

Lung

Robotic techniques make lung cancer surgery an option for more patients. Historically, lung surgery increased the risk of blood clots and pneumonia for patients with cancer who also have chronic obstructive pulmonary disorder (COPD) or emphysema. With single-port surgery, surgeons remove tumors through an incision in the patient’s diaphragm instead of cutting muscles between the ribs. As a result, patients can walk around on the same day as surgery, reducing the risk of complications.

Prostate

In addition to a quicker return to normal function, patients who undergo robotic procedures also enjoy shorter hospital stays. For example, most patients of robotic prostate surgeries go home the same day and can resume regular activities within two weeks instead of six.

Robotic surgery offers several advantages, but it may not always be your best option. Your surgeon will discuss all available techniques and procedures so you can choose the right one for you.

“For prostate cancer specifically, I think it’s important for people to know that not every prostate cancer is made the same,” Dr. Cox says. “There's not necessarily one right treatment answer for every patient. That's what we try to focus on – what’s going to make the most sense for this cancer and for this patient based on their current lifestyle.”

Early detection improves results

Early detection is vital for all types of cancer. It often leads to less invasive treatments and better outcomes. For decades, screening tests like mammograms and colonoscopies have helped physicians identify early-stage disease. The introduction of the low-dose CT scan offers the same opportunity for patients at high risk of developing lung cancer. However, according to Dr. Guitron, many patients who need this screening aren’t getting it.

“Until 10 years ago, lung cancer – the number one cancer killer – didn't have a screening test,” he says. “We still have significant underutilization of this test because patients simply aren’t aware that it’s out there.”

But screening is often successful for patients who do get the test. Doctors routinely detect small tumors, leading to more effective treatment and higher survival rates. The message, he says, is not to delay getting the scan.

“It’s very important that you don’t hesitate. If you qualify, proceed with your screening,” Dr. Guitron says. “Then, meet with your doctor and consider all your options.”

Common fears and misconceptions

Cancer surgery can be complex. So, it’s common for patients to have misconceptions about procedures or the surgery process. Fortunately, many of these concerns are rooted in misunderstandings rather than facts. Others are based on outdated practices now replaced by advanced techniques.

According to the cancer experts at The Christ Hospital Health Network, these are some of the most common patient fears and misconceptions.

Myth: Air exposure spreads tumors

“Imaging nowadays is so detailed that a situation with undetected tumors doesn’t happen often,” Dr. Guitron says. “Tumors get blood flow that carries all the oxygen, sugars, and nutrients a tumor needs to grow. Exposure to air has no role in terms of cancer spread.”

Myth: All colorectal cancers lead to a colostomy

Fear of a colostomy is a common worry for people diagnosed with colon cancer. A colostomy is a surgically created opening in your abdominal wall that allows your intestines to push waste into an external bag. This concern frequently leads patients to delay cancer treatment. But, according to Dr. Rafferty, most patients don’t need a colostomy.

“Patients often put off discussing their diagnosis because of fear over the ‘what ifs,’” she says. “But it’s important to have the conversation so we can talk about all available treatment options. You have a condition that’s unique to you. You can trust us, as your team, to lead you in the right direction and give you the best advice possible.”

Myth: Prostate surgery leads to permanent sexual or urinary problems

Prostate cancer surgery can impact the blood vessels, muscles, and nerves that contribute to sexual and urinary function. As a result, many patients worry they may leak urine or lose intimacy with their partner. With advanced techniques and tools, Dr. Cox says the experienced surgeons at The Christ Hospital Health Network minimize these risks and help you regain your normal functions faster.

“With our new technologies, like single-port robotic nerve preservation surgery, we’re able to traumatize the pelvic floor muscles much less,” he says. “We also connect our patients with pelvic floor therapists before and after surgery. So, our rates of incontinence are dropping, and 95-plus percent of men regain full control of their sexual function.”

Myth: Biopsies before surgery can cause cancer to spread

To diagnose breast cancer, doctors often perform a core needle biopsy. They use a small needle to remove some of your tumor’s cells for analysis. According to Dr. Manders, some patients worry that puncturing the tumor may cause it to leak and spread.

“There’s no risk of a biopsy spreading cancer elsewhere in your breast or to the rest of your body,” she says. “There’s a multi-step process that cells go through to become metastatic and spread throughout your body.”

On a larger scale, it’s commonly believed that tumor removal can lead to disease spread by agitating it – a process known as “tumor seeding”, or when cancer cells flake off and lodge into the surgical site. To eliminate this risk, surgeons now use specialized containment strategies.

"As the tumor is resected, we place it into a special pouch that is immediately closed and sealed," Dr. Guitron explains. "We then extract the bag so the tumor never touches any other tissues, ensuring the cancer is removed safely and completely."

Less invasive procedures preserve your organs and tissues

The biggest shift in cancer surgery is the move toward less invasive procedures, Dr. Manders says.

“The philosophy used to be that the bigger the operation, the higher the survival and the larger the decrease in recurrence,” she says. “The idea was that if you could just get one step ahead of the cancer and prevent it from getting elsewhere in the body, you could cure the patient.”

Today, surgeons understand that a cure or recurrence doesn’t depend on removing part or all of an organ. Instead, the tumor’s behavior, location, and genetics play a larger role. Consequently, surgeons can recommend less invasive procedures that deliver the same good outcomes. For example, Dr. Manders says, a lumpectomy – surgical removal of a cancerous tumor in the breast – is often as effective as a mastectomy.

Additionally, a sentinel node biopsy is a more conservative, less invasive technique to determine if your cancer has spread. When cancer spreads, it first travels to your sentinel nodes. If a biopsy doesn’t find cancer cells in your sentinel nodes, there’s a high likelihood your cancer hasn’t spread. Your doctor can use this information to create a targeted treatment plan that may not require surgery.

Improvements in rectal cancer treatment may also help you avoid surgery, Dr. Rafferty says. Total neoadjuvant therapy (TNT) delivers full-dose chemotherapy and radiation before surgery. Many patients who receive TNT see their tumors completely go away. It’s important to note that these individuals still need extensive long-term follow-up, including blood tests, CT scans, colonoscopies, MRIs, and rectal exams.

Patient-focused care

Your experience with cancer is unique, and you deserve a patient-centered approach to care designed around your specific needs. When you come to the cancer experts at The Christ Hospital Health Network for surgery, you can count on:

• Clear communication on what to expect from your procedure

• Compassionate support at every stage of your care journey

• Pre-surgery education, such as catheter training or exercises to reduce postsurgical swelling

On your surgery day, your coordinated care team will follow a strict routine. You will meet with your surgeon, nurses, and anesthesiologists to review your procedure and start an IV for your medications. During your surgery, someone from your care team will frequently update your family on your condition and the progress of your procedure. Once your surgery is complete, you will be monitored in the post-anesthesia care unit (PACU) until you wake up.

Surgery teams at The Christ Hospital Health Network are also committed to enhanced recovery after surgery (ERAS), Dr. Guitron says. This protocol supports your faster, safer recovery through:

• Better pain control: To limit the use of narcotic pain relievers, anesthesiologists use long-acting regional blocks. These injected medications offer localized postoperative pain control for up to 24 hours.

• Early mobility: As soon as you are able, your care team will help you start walking around.

Long-term, post-treatment support

Your cancer journey at The Christ Hospital Health Network isn’t over when your surgery is complete, Dr. Rafferty says.

“Your team is there for you to help guide you, not only before surgery, but after it, as well,” she says. “We don’t do an operation and then say, ‘Great. Good luck.’ We follow our patients over time to make sure their good outcome persists.”

That follow-up care will differ depending on your type of surgery.

Urology cancer surgery

After prostate surgery, your doctor monitors your level of prostate-specific antigen (PSA), a protein produced by your prostate gland, Dr. Cox says. Starting six weeks after surgery, your provider will check your PSA every few months, gradually spacing out tests as time passes. If your PSA level rises, an MRI or PET scan may be recommended. Based on those images, your surgeon may reach out to medical oncology or radiation oncology specialists for collaboration.

For monitoring after bladder cancer or kidney cancer surgery, you will undergo frequent CT and MRI scans as there is not a blood test associated with these cancers. These tests examine high-risk areas where your cancer may return and are done at intervals set by the National Comprehensive Cancer Network’s guidelines [NCCN].

Breast cancer surgery

Follow-up care depends on your procedure, Dr. Manders says. You may undergo:

• A blood test to detect CA 27-29 proteins that indicate advanced or metastatic disease

• A blood test to detect cell-free DNA that indicates early-stage breast cancer

• A physical exam after a mastectomy

• Routine mammograms after a lumpectomy

If you undergo a mammogram, you may also need a breast MRI. Your doctor will recommend this additional imaging if you have a genetic mutation that increases your breast cancer risk or if you have dense breast tissue. MRIs can detect early-stage breast cancers in dense breast tissue.

Colorectal cancer

Long-term follow-up for colorectal cancer can include blood tests and imaging, Dr. Rafferty says. Blood tests can reveal fragments of tumor DNA in your bloodstream. Test results help your doctor determine if you need additional treatment. Your surgeon may also recommend frequent screening with CT, MRI, and PET scans.

“The frequency and duration of those surveillance scans depends on the patient's initial stage, what they presented with, and what their final pathology specimen showed after their surgery,” Dr. Rafferty says.

Lung cancer

After lung cancer surgery, patients are monitored according to the NCCN [National Comprehensive Care Network] guidelines for this procedure. This follow-up includes CT scans every six months for two years and annual CT scans after that. But work is underway to improve this long-term care.

“We’re in an exciting phase of finding additional ways to identify patients at higher risk for a lung cancer relapse,” he says. “We’re developing blood panels that can detect even the smallest levels of tumor DNA. This could help us determine if patients need additional treatment like chemotherapy or immunotherapy.”

Schedule your consultation

When you have breast, colon, lung, urinary, or some other type of cancer, the cancer surgery team at The Christ Hospital Health Network is here for you. These experts can evaluate your condition and help you find the best treatment option.​​​

If you’re seeking a second opinion or if you’d like to schedule an appointment with one of the cancer surgery specialists at The Christ Hospital Health Network, call 513-640-9746 or complete this form to request a call back.