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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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.
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