Surgery & Interventional

For low-risk prostate cancer, monitoring with PSA, MRI, and repeat biopsy instead of treating, because most such cancers never cause harm.

Watching very small papillary thyroid cancers with ultrasound instead of operating, because most never grow and almost none cause harm.

People with severe obesity who have weight-loss surgery develop about a third fewer cancers over the following decade, especially womb and other hormone-related cancers, than similar people who do not.

A small tube placed by endoscope or through the skin reopens a blocked bile duct, relieving jaundice so chemotherapy can be given.

Looking at the cervix with a magnifier after a positive screen, then removing the abnormal patch with an electric wire loop in a clinic visit.

Cystoscopy and TURBT mean looking inside the bladder with a camera and shaving off tumours through the urethra. Blue-light dyes make flat tumours easier to see.

Brief electric pulses applied to a tumour open pores in cell membranes so that a tiny dose of bleomycin or cisplatin floods in; used for skin metastases and, increasingly, for deep tumours.

Removing very early cancers of the oesophagus or stomach from the inside with an endoscope, so the organ is kept intact.

Instead of starving patients before and after an operation, modern surgical pathways feed them early, give carbohydrate drinks the night before, and get them walking the next day. Complications and hospital stays fall.

Pleurectomy and decortication are operations that strip the tumour-bearing lining from the lung and chest wall. They were long assumed to help; the MARS 2 trial showed they do not.

For young women with the earliest, low-grade endometrial cancers, progestin pills or a hormonal IUD can clear the cancer and allow pregnancy before a later hysterectomy.

Injecting a dye that makes tumour glow so the surgeon can see exactly where to cut.

Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.

Sound waves plus microbubbles briefly open the brain's protective barrier so chemotherapy or antibodies can get to the tumour.

Washing the abdominal cavity with heated chemotherapy during surgery to kill microscopic peritoneal deposits.

Destroying a tumour mechanically with sound, rather than heat, leaves the debris intact enough for the immune system to learn from it.

Drinks enriched with arginine, omega-3 fats and nucleotides for a week before a big operation seem to reduce infections afterwards, though the trials are old and mostly industry-funded.

Giving a single large dose of radiation directly to the tumour bed during surgery, with normal organs moved out of the way; used mainly in breast cancer as an alternative to weeks of external radiotherapy.

Irreversible electroporation uses short high-voltage pulses that punch permanent holes in tumour cells while sparing nearby vessels and ducts.

Isolating the blood supply of an arm or leg so that chemotherapy doses 15-20 times higher than the body could tolerate can be circulated through it, to save limbs with melanoma or sarcoma that would otherwise be amputated.

Laser interstitial thermal therapy guides a laser fibre through a small skull hole, monitored by real-time MRI, to heat and destroy deep brain tumours a surgeon could not safely reach.

Removing a bone or soft-tissue sarcoma while keeping the arm or leg, rebuilding with metal implants, bone grafts or growing prostheses in children.

Replacing the whole diseased liver cures both the cancer and the cirrhosis underneath it, for patients whose tumours are small enough.

Dyes that glow under special light, so surgeons can see tumour edges and nerves in the operating theatre.

Most small kidney tumours found on scans grow slowly. Options range from watching them, to freezing or heating them, to removing just the tumour and keeping the kidney.

Isolating the liver's circulation with catheters and balloons so that high-dose melphalan can be pumped through it and filtered out before it reaches the rest of the body; approved in 2023 for eye melanoma that has spread to the liver.

Gold nanoshells that accumulate in a tumour and cook it when a near-infrared laser is shone on them.

Prehabilitation is a few weeks of structured exercise, nutrition and psychological preparation between diagnosis and surgery to make patients fitter for the operation and speed recovery.

Brighter, longer-lasting fluorescent particles and targeted microbubbles that make tumours visible during surgery or on an ultrasound scan.

Removing the fallopian tubes, where most ovarian cancer starts, during other pelvic surgery or in women at inherited risk.

Surgeons operate through small incisions using robotic arms with tremor-free precision and 3D vision.

A robot-guided flexible scope that reaches small lung nodules through the airways to biopsy them without a needle through the chest wall.

Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.

Thermal ablation kills a tumour with heat or cold delivered through a needle, with no incision required.

Destroying precancerous cervical cells with a heated or frozen probe in under a minute, the tool that makes screen-and-treat possible where there are no surgeons.

A catheter threaded into the artery feeding a liver tumour delivers chemotherapy and then blocks the vessel, starving the tumour from inside.

Removing throat tumours through the mouth with a robot instead of splitting the jaw, allowing many patients to avoid or reduce radiation.