I know a couple of surgeons refused to operate on pancreatic cancer without PET results when the cancer was shrunk to 1-2 centimeters. Even if there are metastatic sites and the metastasized cells grow, the original cancer would still be removed, we’d have fewer cancer cells overall. What is the reason that doctors don’t do it?
Every type of cancer is different. Metastatic pancreatic cancer is statistically associated with a poor prognosis whether or not you operate. A pancreatic resection is an extremely invasive surgery because you wind up taking part of the duodenum, the first part of the small intestine, and part of the stomach and hooking that up to the jejeunum, which is the second part of the small intestine. Putting someone through an operation like that for no benefit would be unethical.
Other cancers can be treated with surgery if they’ve spread, but pancreatic isn’t one of them.
Once you’ve been “staged” in Stage IV metastatic pancreatic cancer, surgery can no longer remove the cancer. It has already spread to other organs. At that point, surgery (which is invasive and traumatic to the body to begin with) is an ineffective treatment option. It does not improve a patient’s prognosis to put them through surgery at that point. That is why most doctors wait to see what stage you are in to form a treatment plan. Stage IV patients are considered ineligible for surgical intervention.
The reason that doctors don’t operate on pancreatic cancer without PET results is because PET scans can help detect if the cancer has spread to other organs or tissues. This is important to know before starting surgery because it can help determine the extent of the surgery needed and the best approach to take. In addition, PET scans can also help detect if the cancer is responding to treatment and if there is a risk of recurrence.
The reason that doctors don’t operate on pancreatic cancer without PET results is because the PET scan helps them to determine the extent of the cancer and the likelihood of successful treatment. The PET scan also helps to identify any metastatic sites that may be present, which could be missed in a physical exam or imaging. If metastatic sites are present, the surgeon may need to perform additional surgery to remove them, which could increase the risk of complications or even death. Additionally, a PET scan can help the surgeon to determine if the cancer is inoperable, and if so, to recommend alternative treatments.
The premise of your question is false. I know this because I personally had a tumor removed, the biopsy of that tumor revealed cancer cells within the lymph vessels. This place me in stage to be, which is the beginning phase of metastatic spread. This was determined AFTER removal of the mass by surgery, and was the reason chemotherapy was deemed necessary. As far as why these particular doctors made that decision regarding this particular tumor, that is a different question they may have something to do with the location of the tumor. Metastatic spread however, in and of itself, is not a reason to prevent removal of a tumor by surgery