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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I’m a histopathology doctor so the spread and staging of cancers is one of my core areas of work.
It’s a hugely complicated topic you could very easily write a 100,000 word PhD thesis on, so here’s a very reductive and brief ELI5.
You have vessels that collect waste from your tissues and vessels that supply blood to your tissues. Once malignant cells have entered these vessels, they have a free ride to (almost) every part of your body.
There are quite a few exceptions where surgeons may perform palliative surgery to try and extend life, or remove involved lymph nodes if the spread is very limited. But largely, playing catchup by trying to remove the primary tumours and any new ones that pop up doesn’t extend life or improve health outcomes. It can even do the opposite.
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