Ten years ago, when I spoke to a patient about cancer surgery, the conversation often revolved around how much we needed to remove. Bigger operations were seen as safer. Remove more tissue, remove more lymph nodes, remove the entire organ — that was how we believed we could beat cancer.
Today, the conversations sound very different. Modern cancer surgery is no longer about doing the biggest operation possible. It is about doing the right operation — one that removes the cancer effectively while preserving as much normal tissue, function, and quality of life as possible.
This shift did not happen overnight. It came from years of experience, research, and — most importantly — listening to our patients.
What has changed
Earlier, aggressive surgery was the norm. Large incisions, prolonged hospital stays, and permanent changes to daily life were often accepted as unavoidable. While many patients were cured of their disease, they paid a heavy price in terms of pain, slow recovery, and long-term disability. Over time, it became clear that more radical surgery may not be always necessary to treat cancer.
What has changed today is our understanding of cancer itself. With better imaging, advanced pathology, and a deeper knowledge of tumour biology, we can now assess how aggressive a cancer is and how far it has spread before we step into the operating theatre. This allows us to tailor surgery to the individual patient, rather than applying the same extensive procedure to everyone with the same diagnosis.
Take gastrointestinal cancers as an example. A patient with early-stage colon cancer can now often be treated with minimally invasive laparoscopic surgery. We remove the diseased segment of the bowel with adequate margins and the necessary lymph nodes — no more, no less. Two decades ago, this same patient would have undergone a large open surgery. Today, patients walk sooner, recover faster, and return to normal life earlier — with cancer outcomes that are just as good.
Tech advancements
Technology has played a major role in this transformation. Laparoscopic and robotic surgeries give surgeons better vision, finer precision, and greater control. For patients, this means smaller incisions, less pain, reduced blood loss, shorter hospital stays, and quicker recovery — without compromising cancer care.
Similarly, techniques such as sentinel lymph node mapping have spared many patients from extensive lymph node removal. This has significantly reduced complications such as lymphoedema, while still providing accurate staging and guiding further treatment.
Multi-disciplinary care
Perhaps the most important change, however, is philosophical. Cancer surgery today is part of a multidisciplinary approach. Surgeons now work closely with medical oncologists, radiation specialists, radiologists, and pathologists to decide when surgery is needed, how much surgery is needed, and when less is truly more. Patients with breast, head and neck cancer and several other tumours benefit from this organ conservation approach.
The success of cancer treatment is now measured by long-term disease control, functional preservation, and the patient’s ability to live well after treatment.
What patients must know
A word of caution though. In India, a fair percentage of our patients have advanced cancers where radical surgery may be required, and this may sometimes require large incisions. Economic constraints also are a hindrance in using robotic or minimal access technology, which come at a cost.
When surgeons remove less today, it is not because we are doing less. It is because we understand more — and that understanding has allowed us to save not just lives, but livelihoods and dignity as well.
(Dr. Amit Parasnis is head of department and consultant surgical oncology & surgery, Manipal Hospital, Baner, Pune amit.parasnis@manipalhospitals.com)
Published – February 10, 2026 12:41 pm IST