3 ways we're revolutionising cancer surgery

By Nisharnthi Duggan

Cancer surgery has been around for thousands of years. There are even records of ancient Egyptians attempting to cut out brain tumours or cauterise (burn) breast tumours. These operations were painful and risky and had mixed results.

Since then, we’ve come a long way.

Ancient Egyptian scroll

The Edwin Smith Papyrus, the world's oldest surviving surgical document.

The Edwin Smith Papyrus, the world's oldest surviving surgical document.

Scientists developed anaesthesia, antiseptics and antibiotics. These advances have helped transform surgery from a barbaric procedure to the life-saving cornerstone of cancer treatment that it is today.

Old metal spray bottle.

Joseph Lister's carbolic spray apparatus, the first antiseptic used during surgery. From the Wellcome Trust collection, M0015165

Joseph Lister's carbolic spray apparatus, the first antiseptic used during surgery. From the Wellcome Trust collection, M0015165

It's one of the most effective ways to cure cancer - cut it all out, and it can’t come back – but it’s not always that simple.

Tumours can be hard to find and even harder to remove completely. Then there are the side effects of surgery, which can be life-changing.

And while other cancer treatments like radiotherapy, targeted drugs and immunotherapy have seen huge leaps forward in the last 100 years, the fundamentals of cancer surgery have pretty much stayed the same.

But that could be about to change.

We’re funding cutting-edge research that’s revolutionising cancer surgery, making it smarter, more precise, and kinder to patients.

Here are three key projects.

We’re lighting up cancer cells so surgeons can find and remove them

One of the biggest challenges in cancer surgery is spotting and removing every cancer cell. Tumours don’t always have clear edges, and they can spread into surrounding tissues in ways that are hard to detect.

That’s why our researchers at the University of Oxford have developed a fluorescent dye that makes prostate cancer cells glow, giving surgeons a clearer view in real time.

The dye is linked to a targeting molecule that binds to a protein on the surface of prostate cancer cells. Once injected, it highlights cancerous tissue under a special imaging system developed by Oxford engineers.

“We are giving the surgeon a second pair of eyes to see where the cancer cells are and if they have spread,” explains Professor Freddie Hamdy, who led some of the first studies into this technique.

In early trials, the dye revealed clusters of cancer cells that standard imaging couldn’t detect, helping surgeons remove more of the tumour while preserving healthy tissue. “It’s the first time we’ve managed to see such fine details of prostate cancer in real-time during surgery,” says Hamdy.

This precision could reduce side effects like incontinence and erectile dysfunction and improve the chances of curing the cancer. “We want patients to leave the operating theatre knowing that we have done everything possible to eradicate their cancer and give them the best quality of life afterwards,” Hamdy adds.

Although the current focus is prostate cancer, the technique could be adapted for other types by swapping in different targeting molecules. Larger trials are now underway to test how well this approach works in broader patient groups, and whether it could become a routine part of cancer surgery in future.

We’re using lasers and robots to make surgery more precise

We’ve made huge strides in understanding cancer biology in the last few decades. But much of that insight hasn’t yet reached the operating table.

Funded through our Stand Up to Cancer campaign, Professors Burak Temelkuran, Sadaf Ghaem-Maghami and Zoltan Takats are working to change that.

“Our ambition is to bridge the gap and bring all this biological information into surgery,” says Temelkuran. “We want to move towards targeting single cells, to have surgery with the highest precision.”

Their project combines robotics, lasers, and real-time molecular analysis.

The laser, originally developed by Takats and his team at Imperial College London, plays a dual role. It can vaporise tiny amounts of tissue, releasing a smoke rich in biological information. That smoke is analysed instantly by a technique called mass spectrometry to determine whether the tissue is cancerous. Guided by the real-time feedback, the same laser can destroy the tumour precisely while avoiding healthy tissue.

“It’s really important to know exactly what to take,” explains Ghaem-Maghami, a leading gynaecological cancer surgeon and researcher “We want to avoid as many side effects as possible.”

Now the team want to make Takats’ laser suitable for treating more cancers. That means combining it with a flexible fibre robot developed by Temelkuran. The robot is a tiny, tube-like device that can reach places traditional surgical tools can’t. Controlled precisely by surgeons, it's able to deliver a simple laser to treat tumours.

The team are now redeveloping the robot and investigating whether it could carry Takats' special laser and channel the diagnostic smoke back out for analysis. If it works, the new tool could allow surgeons to diagnose and treat tumours in hard-to-reach places that they’d normally avoid operating on.

The team will first test their device on head and neck and womb cancers, with the aim to expand into other hard to reach places in the future.

It's still early stages, but this project could transform how we detect and remove cancer, making surgery more precise, more personalised and less invasive.

We’re taking a ‘less is more’ approach

Cancer surgery shouldn’t be a ‘one-size-fits-all’ approach. But for many cancers, it has been.

In the early 1900s, women diagnosed with breast cancer would generally have a radical mastectomy, a type of surgery which lived up to its name. It involved removing the entire breast, underlying chest muscles, and lymph nodes.

But in 1961, we funded research that showed this shouldn’t be the default treatment. The trial proved that for women with early-stage breast cancer, the same positive survival outcome could be achieved with a lumpectomy – removing just the tumour and a small margin of tissue – as with the more severe, radical mastectomy.

Now our researchers are asking the same questions for other cancers.

Professor Stephen Bach is leading the STAR-TREC trial, which is investigating whether some patients with early-stage rectal cancer can avoid major surgery, and the significant side-effects that come with it, like the need for a stoma bag. Instead of automatically removing the bowel, the team are testing whether a combination of radiotherapy, chemotherapy and microsurgeries could be as effective.

For Judy, this research made all the difference. She was diagnosed with bowel cancer, in 2019, 13 years after her husband, Trevor, had been treated for the same disease. Back in 2006, Trevor underwent the standard treatment: chemotherapy, radiotherapy, and radical surgery, which left him with a permanent stoma bag.

But Judy had the opportunity to join the STAR-TREC trial, funded through our Stand Up to Cancer campaign. She received five weeks of radiotherapy and chemotherapy tablets, which eradicated her tumour, meaning she didn’t need any surgery at all.

Judy is now cancer-free and, thanks to this new approach, doesn’t face the same long-term side effects that Trevor did before he sadly passed away in 2024 after being diagnosed with pancreatic cancer.

“I'm very grateful for the advances in medical science,” she says. “I'm even more grateful for the very existence of trials like this that continue to improve people’s outcomes and people’s lives, like mine.”

This study shows that sometimes less truly is more, and personalising treatment can change lives.

Looking to the future

Surgery has always been an effective tool against cancer, but it’s about to get even better. With glowing dyes, smart lasers, tiny robots and a shift toward more personalised care, we’re making surgery more precise, less invasive, and better tailored to each patient. These breakthroughs won’t just change how we treat cancer, they’ll change lives.

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