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?
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“Fewer cancer cells over all” generally isn’t considered a worthwhile trade for such an invasive surgery. If the remaining cancer cells are metastatic, they’ll just keep spreading right back into the areas you operated on. You’ll wind up missing a chunk of your organs without any significant benefit to show for it.
Overall, your chances of doing better with the surgery (rather than getting no benefit or even ending up worse than you started) are so low that the doctors don’t consider it a worthwhile option.
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