Medical Oncologist
CION Cancer Clinics
Why is the spleen removed in cancer? | CION Cancer Clinics
A cancer surgeon removes the spleen for one of three reasons: the cancer is in it, a cancer of the stomach, pancreas or colon has grown into it, or the spleen is destroying blood cells so fast that treatment cannot go ahead. This page explains each reason, what the team weighs before recommending it, and the questions worth asking your surgeon. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Why would a cancer surgeon remove the spleen?
- The four situations where the spleen comes out
- Words on the scan or surgical plan, in plain language
- What the team weighs before recommending it
- What families often assume, and what is actually true
- How the decision usually reaches you
- Common questions about why the spleen is removed
The short answer
Why would a cancer surgeon remove the spleen?
The spleen is removed in cancer care for one of three reasons: the cancer is in it, the cancer is growing into it from a neighbouring organ, or the spleen is destroying blood cells so fast that treatment cannot go ahead. Your surgeon should be able to say which one applies to you in a single sentence.
What the spleen does, and why that matters here
The spleen sits under the left ribs and works as a filter. It pulls worn-out red cells and platelets out of the blood, and it helps fight a small group of bacteria. In some blood cancers the filter goes into overdrive. In some belly cancers the spleen is simply in the way. Either way, the reason for removing it is about the cancer, not the spleen.
When it is not removed
Most people with cancer never have this operation. Lymphoma and leukaemia are usually treated with medicines, not surgery. Stomach and pancreas cancers that sit away from the spleen leave it alone. Whether it should come out in your case is for your treating team to weigh with you, and this page cannot settle that.
If the word "splenectomy" appears on your plan and you do not know why, ask. It is a fair question and a short answer.The reasons
The four situations where the spleen comes out
The first two are about where the cancer sits; the last two are about what the spleen is doing to the blood.
The cancer is in the spleen
Some lymphomas, and rare tumours of the spleen itself, settle mainly in the spleen. Removing it can be both the treatment and the way to a firm diagnosis, because the whole organ goes to the laboratory.
A neighbour's cancer has reached it
The spleen shares blood vessels with the tail of the pancreas and sits against the stomach and the left bend of the colon. A cancer in any of those can reach it, and the surgeon removes them as one piece.
Usually seen with
- Cancer of the tail of the pancreas
- Stomach cancer high on the greater curve
- Colon cancer at the splenic flexure
The spleen is destroying blood cells
In some blood cancers the enlarged spleen destroys platelets and red cells faster than the marrow can make them. If medicines do not settle this, removing it lets the counts recover so chemotherapy can go ahead.
It is too big to live with
A hugely enlarged spleen can press on the stomach so you fill up after a few mouthfuls, cause a dragging pain, and be at risk of tearing. When medicines cannot shrink it, removing it is about comfort and safety.
The surgeon will usually say so: the aim is relief, not treatment of the cancer.Not sure whether this applies to you?
Ask an oncologistOn your report
Words on the scan or surgical plan, in plain language
- Splenomegaly
- An enlarged spleen. The scan report usually gives its length in centimetres. Enlarged is not the same as cancerous.
- Hypersplenism
- The spleen is overactive and removing too many blood cells. It shows on a blood count as low platelets or a low haemoglobin.
- Distal pancreatectomy with splenectomy
- The tail of the pancreas and the spleen removed together in one operation, usually for a pancreas cancer.
- En bloc
- Several organs, or parts of them, removed in one connected piece so the cancer is not cut through on the way out.
- Splenic hilum
- The point where the artery and vein enter the spleen. Lymph nodes here are often removed in stomach cancer surgery.
- Spleen-preserving
- An operation planned so the spleen stays. Ask whether this was considered for you, and if not, why not.
Behind the decision
What the team weighs before recommending it
Every splenectomy is a trade. On one side is what removing the organ achieves for the cancer plan. On the other is a lifelong, small but real rise in the risk of serious infection, plus the operation's own risks.
Can the same result be had without surgery?
For many blood cancers, yes. Chemotherapy, targeted tablets or a short course of radiotherapy to the spleen can shrink it without an operation. Surgery is usually offered when those have been tried or are not suitable, or when a diagnosis cannot be reached any other way.
Can the spleen be spared?
In stomach and pancreas surgery the surgeon will often try. It depends on whether the cancer sits close to the spleen's vessels and whether the lymph nodes at the hilum need clearing. Ask your surgeon directly whether a spleen-preserving operation was considered.
Are you fit for it?
Age alone does not decide this. The heart and lungs, other illnesses, and how well the body would cope with an infection afterwards all matter. Someone who is very frail may be offered a different plan.
Nothing on this page tells you whether you or your parent should have the operation. That comes from the team who has seen your scans.Leave a number, we will call you
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Did you know
Some people are born with one or more small extra spleens, called splenunculi, tucked into the fat nearby. When the spleen is removed for an overactive-blood reason, the surgeon looks for these and removes them too, because a leftover one can grow and take over the same job.
Commonly believed
What families often assume, and what is actually true
"If the spleen is coming out, the cancer must be in the spleen."
Often it is not. In stomach and pancreas surgery the spleen is removed because it shares blood vessels with the tumour, not because the cancer has spread to it. Ask which reason applies to you.
"Removing it means the cancer is advanced."
Not necessarily. A small, contained tail-of-pancreas cancer is still removed with the spleen, simply because of where it sits. Stage, meaning how far the cancer has spread, comes from the scans and the pathology report, not from which organs were removed.
"An enlarged spleen on the scan means it has to come out."
Many enlarged spleens are treated with medicines, or simply watched. Size alone is not a reason for surgery. What matters is what it is doing to the blood counts, whether it causes symptoms, and whether the cancer sits inside it.
"Once it is out, the blood problem is solved for good."
The counts usually improve, but the underlying blood cancer still needs its own treatment. The operation clears the way for it; it does not replace it.
The pathway
How the decision usually reaches you
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The scan or blood count raises the question
A CT or PET-CT shows the spleen is enlarged or involved, or a blood count keeps falling. The treating oncologist asks a surgeon to look.
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The tumour board discusses it
Medical, surgical and radiation oncologists sit together and ask whether medicines or radiotherapy could do the same job, and whether the spleen can be spared.
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The surgeon explains the reason to you
You should leave this appointment able to say, in one sentence, why the spleen is being removed. Bring the family member who will be looking after you.
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Vaccines and fitness checks
Because the operation raises infection risk for life, vaccines are given before it where time allows, along with blood tests, an ECG and the anaesthetist's review.
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The operation, then the report
The spleen and anything removed with it go to the laboratory. The report, discussed at follow-up, is what confirms the diagnosis and shapes what comes next.
Questions we are asked
Common questions about why the spleen is removed
Which cancers most often lead to a splenectomy?
Cancers of the tail of the pancreas and of the upper stomach, because the spleen shares their blood supply. Among blood cancers, certain lymphomas and leukaemias where the spleen is the main site of disease or is destroying blood cells. Colon cancer at the left bend of the bowel occasionally involves it.
Can the spleen be removed just to make a diagnosis?
Sometimes, when a needle biopsy of the spleen is unsafe because it bleeds easily, and no lymph node elsewhere can be sampled instead. Removing the whole organ gives the pathologist everything they need. It is done only when no gentler route exists.
Could radiotherapy shrink the spleen instead?
For some blood cancers, yes. A short, low-dose course of radiotherapy to the spleen can shrink it and ease symptoms in people who are not fit for surgery. The effect can wear off, since the organ stays. Your team will say whether it is an option for you.
Why is the spleen removed with the tail of the pancreas?
The splenic artery and vein run along the back of the pancreas tail. Removing that part of the pancreas usually means those vessels go too, and the spleen cannot survive without them. In cancer surgery they are often taken anyway, to clear the lymph nodes around them.
Does removing the spleen treat the lymphoma?
For a few lymphomas that live mainly in the spleen, removal can control the disease for a long time. For most, surgery is only part of the picture and medicines do the main work. Your haematologist will tell you which group you fall into.
What happens if we choose not to have it removed?
That depends entirely on the reason it was suggested, and it is a question for your team, not one a page can answer. Ask what the alternatives are, what would be watched, and what would make the team revisit surgery later. A second opinion is reasonable for a decision of this size.
Is the spleen ever removed after an injury during another operation?
Occasionally. The spleen is delicate and sits close to the stomach, colon and pancreas. If it tears during a big belly operation and the bleeding cannot be stopped, the surgeon may have to remove it. You are told afterwards and given the same vaccines and precautions as after a planned splenectomy.
Is this operation covered by Aarogyasri or insurance?
Usually yes, when it is part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Call the helpline with your card details and we will check your cover before you travel.
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Spleen problems and spleen removal
- National Cancer Institute — Splenectomy (NCI Dictionary of Cancer Terms)
- Cancer Research UK — Surgery for cancer
- American Cancer Society — Cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Splenectomy: What the Operation InvolvesWhat happens before, during and afterPartial Splenectomy and Spleen PreservationWhen the spleen can be keptCan You Live Without a Spleen?What changes afterwards, and what does notDeciding on Cancer SurgeryHow to weigh an operation with your teamThe Pathology Report After SurgeryWhat the laboratory report will tell you
Talk to us
Not sure why a splenectomy is on your plan?
Send us the scan and the report, or call the helpline. A surgical oncologist will explain the reason in plain words and what the alternatives were. One helpline serves every CION centre.