SURGICAL TREATMENT OF SECONDARY GROWTHS – CLONCLUSION
Why is surgery recommended at all for extensive cases of these types of cancer if they are so sensitive to chemotherapy or radiotherapy? Basically the chance of chemotherapy or radiotherapy completely eradicating every cancer cell depends very much on the number of cancer cells there are to start with. It also depends on the size of the individual growths. Surgery can improve the chances of cure by reducing the number and size of cancer growths. The less cells there are to start with, the less likely that some of them will be resistant to the chemotherapy or radiotherapy treatment. The smaller the individual cancer growths, the less likely that the cancer cells in the middle of them will escape being killed by the chemotherapy or radiotherapy. Cancer cells can escape being killed by these treatments if they are situated where there is a poor blood supply and very little oxygen—conditions which occur in the middle of large tumour growths.
Occasionally surgeons recommend the removal of blood-borne secondary cancer growths when the cancer is one that is not sensitive to chemotherapy or radiotherapy treatment. The chance of being cured in these circumstances is minute. Blood-borne secondary deposits are usually multiple. The very fact that one is detected is proof that cancer cells have been in the bloodstream and are likely to be lying hidden in tiny clumps in other parts of the body. Simply removing detectable blood-borne secondary deposits without doing anything else is very unlikely to cure any cancer.
There is one very special set of circumstances where removal of secondary growths may produce a long remission, although very rarely a cure. These are the conditions. There should be no more than two or three secondary growths. They should have appeared a long time, several years at least, after treatment of the primary. They should be proved to be slow growing by observation over several months. These conditions very rarely occur. Examples I have seen include melanoma, Grawitz tumours (kidney) and slow growing soft tissue sarcomas.
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May 18, 2009 - 7:01 AM