Surgery in children with cancer has a major role in same tumors like Wilms Tumor, Neuroblastoma, Bone Tumor, Soft Tissue Sarcoma, Gonadal Malignancies, Brain Tumor etc and it has a supportive role in Leukemias and Lymphomas where main stay of treatment is Chemotherapy. All surgical procedures are performed by surgeons who are specifically trained in the field of Pediatric Oncosurgery. Pediatric Cancers are potentially curable in the modern era. The focus is to formulate treatment plans with minimum complication and suffering. Pediatric Oncosurgery plays a major role in decreasing the morbidities of cancer treatment.
Initially the treatment of long bone tumors was amputation of the limb but now most of the tumors can be resected without sacrificing limb especially if tumor is detected in early stage. We want to cure, but not by performing mutilating surgery. This is made possible by multimodality approach and working in close association with Pediatric Oncologist, Orthopedic Surgeons and Radiation Therapist.
While treating a pediatric cancer patient a lot of stress is laid down on maintaining the reproductive abilities of these patients. Pelvic tumor like PNET, Rhabdmyosarcomas which require Radiation Therapy to pelvis, may impair the ovarian functions and minimally invasive surgery can be undertaken, to move the ovaries out of the radiation field and thereby saving the ovaries from radiation.
Most of the pediatric patients are afraid of needle sticks. We deal with this problem by placement of central vascular access devices like PICC line, Hickman Line and Portacath. These devices make the oncology treatment acceptable and to a great extent painless. All the blood sampling can be done through these devices and all the IV medications can be given through these devices.
We work as a team throughout the treatment. Whenever the patient goes to operation theatre, an experienced Anesthesiologist provides Anesthesia to the patient. One of the parents is allowed to come with the patient to Operation Theatre, after wearing OT clothes. This process alleviated the anxiety of the patient to a great extent.