When we talk about surgery in the context of cancer, many people automatically think of a curative procedure aimed at completely removing the tumour. However, in many cases, surgery can have another equally valuable purpose: to relieve symptoms and improve quality of life. This is the goal of palliative surgery, an essential tool in the comprehensive treatment of many cancer patients.
What is palliative surgery?
Palliative surgery is a type of surgical procedure that does not seek to cure the disease, but rather to improve the patient’s quality of life by reducing the impact of the symptoms it causes. Its purpose is to provide relief, comfort and, in many cases, allow the patient to maintain greater autonomy in their daily life.
It is important to emphasise that palliative surgery does not represent a refusal of treatment, nor is it synonymous with ‘doing nothing’. On the contrary, it is an active and strategic decision aimed at improving the patient’s overall condition and even allowing other treatments such as chemotherapy or immunotherapy to continue.
What are the objectives of palliative surgery?
In oncology, this type of surgery can have several specific objectives:
- To relieve symptoms that seriously affect quality of life: persistent pain, bleeding, digestive or urinary obstructions, organ compression, etc.
- Improve vital functions, such as facilitating feeding (e.g. through gastrostomies), breathing (tracheotomies or resection of masses pressing on the lungs) or intestinal transit.
- Increase patient autonomy and comfort, allowing greater mobility, reducing the need for constant care or improving rest.
When is palliative surgery indicated?
Each case is unique, but there are clinical situations in which palliative surgery may be particularly useful:
- Intestinal obstruction caused by colorectal, gastric or gynaecological tumours.
- Spinal cord compression due to vertebral metastases that threaten mobility or sensitivity.
- Active or recurrent bleeding that is difficult to control, such as in certain gynaecological or bladder tumours.
- Drainage of accumulated fluids, such as ascites (in the abdomen) or pleural effusions (in the chest), which make breathing difficult or cause discomfort.
It may also be indicated in advanced cases of lung, pancreatic, ovarian or breast tumours, when the symptoms of the disease seriously interfere with the patient’s daily life.
Who decides if palliative surgery is appropriate?
The decision to perform palliative surgery must be individualised and carefully assessed by a Tumour Board with a multidisciplinary team, including:
- Surgical oncologists
- Medical oncologists
- Anaesthetists
- Palliative care specialists
- Specialised nursing staff
Multiple factors are taken into account: the general condition of the patient, their life expectancy, the predominant symptoms, and, above all, the expected impact on their quality of life.
The patient and their family also play a key role. At IVOQA, we firmly believe in shared decision-making, where clear information, active listening and support are essential.
What are the benefits and risks of this type of surgery?
Benefits
- Effective relief from disabling symptoms.
- Improved overall functional status.
- Possibility of restarting or continuing other cancer treatments.
- Greater personal independence.
Risks
Like any surgical procedure, palliative surgery carries certain risks: bleeding, infection, anaesthetic complications, etc. However, these are always weighed against the potential benefits for each patient. The fundamental premise is that the expected benefit must clearly outweigh the risk involved.
Palliative surgery at IVOQA: experience and a humanised approach
At IVOQA, we approach palliative surgery from a comprehensive, patient-centred perspective. Our team combines technical expertise with a humanised approach, seeking not only to alleviate symptoms, but also to closely accompany each person and their family throughout the process.
We have seen how a well-indicated intervention can make all the difference: patients who regain digestive function after overcoming an intestinal obstruction, others who can eat normally again, or who are able to restart systemic treatments thanks to clinical improvement after surgery.
Palliative surgery is not a last resort, but a highly valuable therapeutic tool when used at the right time and with clear objectives. At IVOQA, we are committed to offering treatments tailored to each situation, with scientific rigour, humanity and respect.
The Spanish Association of Surgeons (AEC) dedicated a chapter to palliative surgery in the latest edition of its Clinical Practice Innovation Manual. This chapter was written by Dr Delia Cortés Guiral, an oncological surgeon at IVOQA.
