Historically, surgery was the only treatment for cancer with pioneering surgeons pushing the boundaries of knowledge down through the millenia . Only in the last century have non surgical means provided an adjunct or more rarely, an alternative to surgery . Despite the advances in medical and radiation oncology, surgery is still the only modality with the potential to cure most solid cancers. Surgeons have a pivotal role in cancer treatments and research, leading the diagnostic and treatment pathways for most cancers from counselling patients about their diagnosis through to surgery and aftercare. They have also led many of the great advances in cancer research.
However, cancer care has evolved very rapidly over the last few decades and therefore a new type of surgeon is needed to keep pace with these changes. No longer is surgery alone the only treatment for most solid malignancies but a combination of surgery and multi-modal therapies (with highly focussed radiotherapy, targeted molecular therapies and poly-chemotherapy) becoming the modern standard of care.
As a result, the surgeon, who 40 years ago would often be the only specialist to have contact with most cancer patients, can no longer work in isolation but must lead a multi-disciplinary team. They must be more than just a technician and must understand the biology and natural history of the disease as well as the contributions made by other disciplines to the cancer patients’ treatment. It is at this point that the surgeon becomes a surgical oncologist.