Surgical Oncologist Dr Piyush agrawal

09/10/2026

Surgery in cancer , is it curative?? y

08/10/2026

Cancer of few organs when spread only to the peritoneal surface is now clubbed in peritoneal surface malignancies as in current era there is an entirely different approach for the treatment of these cancers
An extensive surgery called cytoreduction is done which entails removal of all visible disease and then followed by a special schedule of chemotherapy which is heated at 43 degree celcius and circulated in abdomen ̇pec

08/10/2026

08/10/2026

We all relate shoulders with responsibility , stronger shoulders @ bigger responsibility , what do u say?

06/10/2026

What do u do when u face a unexpected difficult surgery ???
U get rattled out?? Or u try to finish things off in whatever way keeping ur best for other day
Or u keep ur calm

Anatomy had a curious way of throwing surprises more often than not , anatomy contribute to some and other are coz of the wrong plane identification

Every surgeon faces is a quite a no of times in his career and each has his own unique way of dealing with it

My way is to pause , cool ur mind, reassess , relook and define the anatomy
Coz this is the day when u need to define anatomy perfectly not leave the things for some other day
There will be months on end where u will have the things the way u want and-then comes a
Month where everything will be the way u dislike

Happens to all of us isnt it ??
Those are the months i am slowest and cool like cucumber keeping a tab on my speed , and my head and hands

What do u do??

06/10/2026

Why weights training?? Why so much of pain and sweat ?? Coz i need to be there as there are miles to go before i sleep and miles to go before i sleep

05/10/2026

What is more important
Not to have complications at all or to be able to identify and take action in time and prevent complications arising out of complication??

Do u tell ur patient ur a surgeon without complications or u r a surgeon who is capable of managing the known complications arising out of surgery??

What do u define as experience and seniority??
Zero complications or ability to manage them?

When u operate significant no and difficult cases morbidity and complications are bound to happen. Only way to avoid them completely is to stop operating and play safe

Whatever is described in books has happened before and will happen again
U can only take precautions and manage them early when it happens

And how do u do that?? By identifying complications early !
How to manage that?? only by being vigilant and stop being in denial!!!

Complications cause major morbidity and mortality when surgeon stays in denial for long and to avoid that u have to accept that there are factors beyond a well done surgery which can cause a complication.

Good surgeons are those who know and understand that they can have complications
The only thing they do better than others is reduce the chances and take early and effective action!!!

03/10/2026

What do u do when u get tired , humbled by life??

I look back , i see where have i reached , how far from where i started

I see what has become of me , good , bad , ugly but yet standing tall , taking it on the chest

I look at the people who depend on me , who look towards me as beacon of hope , strength and perseverance

And when nothing works i hit my gym and talk to the weights and see again where have i come and what it took to be there
The pain , the trauma , the injuries but am still there , building me up , something which will never be perfect but yet better than what it was yesterday

What about u ?? Who do u talk to when nothing works ?? Who do u look up to ??
What makes u tick constantly even when u r tired down and out ????

02/10/2026

Have u as a surgeon ever abandoned the procedure just before u were going to complete it For sake of saving patients life from unrelated complications??
How does that look like to you

As a personal failure or a relief ??

If u r a surgeon who operates to make a difference in someones life u will feel both
Relief that a life is saved , failure coz u couldnt complete the procedure as it would have benefited the patient

Recently we were operating a case of cytoreductive surgery for a case of low grade mucinous ca with significant upper abdominal disease, were supposed to do HIPEC along with the CRS but just before we could complete the CRS pt unexpectedly developed cardiac complications includimg arrhythmia and hypotensiom which eventually was diagnosed to be a stress cardiomyopathy
We had to abandon the procedure much to the whole team’s disappointment as barely few minutes of CRS was left .

When i look back today to the smiling pt who is recovering well from the whole thing i realise that whatever we are doing is to improve the quality and quantity of life and sometimes being less heroic achieves both outcomes and that is the most important part

As i always say do no harm , we all strive for stopping when we feel a harm is coming to person who is lying on the table

In oncology i have always maintained this throughout my career , only a patient who survives a surgery can enjoy the fruits of a well done procedure !!!
̇pec

20/09/2026

What do u wish to be known for / famous for

For me as a surgical oncologist that would be operating and giving hope to the patients where surgeries are often daunting tasks for the surgeon and quite a few would refuse to put a hand

I have been always interested in those surgeries where u have to put ur heart and mind into the task and many a times u urself are not even sure if u will be successful but trust me everytime i have planned such surgery how ever difficult it may have been we have come out triumphant

But at same time it doesnt mean that we need to operate every patient and disease that is difficult , there has to be logic and guidelines behind it justifying the procedure and the hard work intended

The planning is the most important part , more than confidence the imaging and the planning matter , confidence can onlh let u make a choice to proceed ahead, whether u will be able to complete the surgery as it should be done depends on other factors

Most important is the patient, daring are not the surgeons but the patient who make that choice,
As a surgeon to be confident and responsible is easy but when a patient has to make a choice of surgery it needs immense strength and will

I have always observed one thing in my practice , if ur intent is to make a difference in someones life 99% of times u can never go wrong and there is barely any chance at failure🙏 ̇pec