Dr. Contreras is a distinguished surgical oncologist renowned for integrative cancer care. He completed his specialty in surgical oncology at the University of Vienna in Austria, where he graduated with honors.
Surgical oncology is a specialty that focuses on the surgical treatment of a variety of tumors. It is used to diagnose, stage and treat cancer. As Medical Director of Oasis Hospital, Dr. Francisco Contreras has performed thousands of surgical oncology procedures. Together with his medical team, Oasis of Hope has treated over 100,000 patients from all over the world.
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Types of Surgical Oncology
The goals of the surgical oncologist are to remove the cancer and an area of healthy tissue surrounding it, also known as a clear margin or clear excision, in order to prevent the cancer from recurring in that area (which is called a local recurrence). Sometimes it is not possible to remove the whole tumor, and a surgery known as “debulking” may be done to remove as much of the tumor as possible and to relieve symptoms such as pain, airway obstruction, or bleeding. However, the contribution of the surgical oncologist goes beyond what is done on the day of surgery itself.
As part of the multidisciplinary care team, he or she provides expert opinion about biopsy techniques, optimal image guidance, the likelihood of achieving clear margins (especially in borderline resectable cases), and what role there is, if any, for surgical management of more advanced disease.
The types of surgeries that are done for cancers depend on the stage and location of the tumor and the fitness of the patient for surgery, and will continue to evolve as surgical techniques advance. Your surgeon will discuss with you the surgery that is appropriate for your situation and the risks and benefits of the procedure.
Surgical options to remove cancerous and noncancerous tumors of the breast include:
- Lumpectomy or partial mastectomy — removal of a tumor and some surrounding normal tissue.
- Total mastectomy — removal of the entire breast, including the nipple and areola.
- Skin-sparing mastectomy — removal of breast tissue, preserving the skin of the breast but not the nipple or areola.
- Nipple/areola-sparing mastectomy — removal of breast tissue through an incision that preserves the nipple and areola.
- Sentinel lymph node biopsy — minimally invasive removal of the first few lymph nodes in the underarm to check for cancer cells.
- Axillary lymph node dissection — removal of lymph nodes in the underarm.
*Plastic and reconstructive breast surgery options are also available.
- Lymph node dissection
- Minimally invasive thyroid surgery
- Coloanal J-pouch — surgical removal of the rectum.
- Esophagogastrectomy — surgical removal of the esophagus and part of the stomach. Surgeons then replace the esophagus using a section of the colon, or by moving the remaining part of the stomach up.
- Ileoanal J-pouch — removal of the entire colon and rectum, with connection of the small intestine to the anal canal.
- Laparoscopic colon resection — minimally invasive resection of part of the colon.
- Small bowel resection — removal of part of the small bowel.
- Sphincter-sparing surgery — surgery that preserves bodily functions.
- Total gastrectomy — removal of the stomach.
- Transanal endoscopic microsurgery — minimally invasive removal of rectal tumors.
- Total hysterectomy — removal of the uterus, including the cervix.
- Radical hysterectomy — removal of the uterus, cervix, and part of the vagina. In some cases, also removal of the ovaries, Fallopian tubes, or nearby lymph nodes.
- Unilateral salpingo-oophorectomy — removal of one ovary and one Fallopian tube.
- Bilateral salpingo-oophorectomy — removal of both ovaries and both Fallopian tubes.
- Omentectomy — removal of the omentum (a piece of the tissue lining the abdominal wall).
- Lymph node biopsy — removal of all or part of a lymph node.
Traditionally, surgeries to remove cancer from these areas have resulted in large scars. They also diminished ability to breathe, swallow, or speak. Minimally invasive and robotic surgical advances allow qualified surgeons to perform head and neck cancer surgery with minimal scarring and disruption to functions.
Some tumors are too large or too entrenched for minimally invasive procedures. In these cases, our surgeons perform traditional open surgery. They keep incisions as small as possible to maximize the preservation of speaking, breathing, and swallowing.
- Complex open liver resections — removal of cancerous tissues of the liver through an incision in the belly.
- Lung cancer resection — removal of lung cancer using small incisions and a tiny camera, when possible. This helps minimize injury to the ribcage.
- Bronchoplastic lung-sparing techniques — removal of a tumor with little damage to healthy tissue. This preserves lung function without compromising cancer care.
About 80 percent of our pancreatic cancer patients undergo the Whipple procedure. Appleby operation — resection of locally advanced cancers of the body of the pancreas that have infiltrated the celiac or hepatic artery.
- Distal pancreatectomy — resection of the tail and some of the body of the pancreas in an open surgery.
- Laparoscopic pancreatectomy — minimally invasive resection of the tail and body of the pancreas through small incisions.
- Pancreas-sparing tumor resection — removal of the tumor without removing the pancreas.
- Portal vein resection and reconstruction — resection of the top of the hepatic portal vein, with construction of a new blood pathway to the liver.
- Whipple (pylorus preserving pancreaticoduodenectomy) — open or minimally invasive removal of a tumor in the head of the pancreas, along with the attached duodenum, bile duct, gallbladder, and part of the stomach.
- Inguinal lymph node dissection — removal of one or more lymph nodes of the groin.
- Laparoscopic and open partial nephrectomy — minimally invasive or traditional removal of a kidney tumor.
- Laparoscopic and open radical nephrectomy — minimally invasive or traditional removal of a kidney.
- Nerve-sparing radical prostatectomy — removal of the prostate with sexual function preservation.
- Nerve-sparing retroperitoneal lymph node dissection — removal of abdominal lymph nodes near the testes, with sexual function preservation.
- Radical cystectomy with continent urinary diversion — removal of the bladder, nearby lymph nodes, part of the urethra, and nearby organs, with rerouted urinary function.
- Radical cystectomy with neobladder reconstruction — removal of the bladder, nearby lymph nodes, part of the urethra, and nearby organs, with creation of a new bladder from part of the small intestine.
- Radical nephrectomy with caval thrombus excision — removal of a kidney along with a clot within the inferior vena cava.
- Radical orchiectomy — removal of one or both testicles.
Our orthopedic surgeons use limb-sparing techniques to remove sarcomas when appropriate. This approach spares healthy surrounding tissue allowing for a quicker recovery with less postoperative pain.