Like if you detect it early enough, I know you can remove it. But what is the point that it can’t just be removed, and why?
In: Biology
I can give you my experience. I went into the ER 2.5 years ago and found out I had Stage IV cancer in my colon and liver.
They were able to remove a sizable tumor from my colon right away, but it was too risky to also cut out the half my liver that was riddled with cancer at that point. Also, since they knew the cancer somehow went from my colon to my liver, they knew it must’ve travelled between the two somehow. But you can’t just surgically remove your lymphatic system because you need that to live.
So, after the first surgery they attacked the cancer with chemo. After that eliminated a significant amount, they were able to surgically remove some of my liver (though, again, it wouldn’t have been safe for them to remove everything that the cancer touched).
And now they’re continuing with chemo to get the stubborn stuff that’s too small to cut out or even really pinpoint with a CT or an MRI.
Long story short, at some point cancer spreads out so much across your system that you just can’t cut out where it’s at. If you catch it early, though, you might get it all by cutting out the initial tumor and some stuff around it.
Risk vs benefits.
For certain cancers, you can’t filter out the cancer. Like blood cancers. You can’t surgically remove blood cancer cells. You can irradiate the bone marrow. However, irradiation bone marrow effectively destroys all blood making ability. So the person becomes anemic and immunocompromised. So if they detected blood cancers, but the patient is not symptomatic yet, they will take the lowest risk approach. Like drugs.
If it’s cancer confined to an area or an organ, again, they weigh the risks and benefits. If removing the tumor is a risky procedure, then they won’t do it until absolutely necessary. For example, esophageal cancer. Removing a tumor on the esophagus is a very risky procedure and has potential to cause a lot of complications. So they leave it alone and treat it with chemo until they fail chemo treatments. Same thing with brain tumors. Going into the brain is dangerous. So they’ll treat it with chemo and radiation before surgery. Even then, if the patient is asymptomatic, they may leave the tumor alone because chemo and radiation can be risky as well.
For other types of cancer, like prostate cancer, is slow growing that many men will die of something else before they die of prostate cancer. So they’ll often just monitor it.
Some skin cancers are localized and can easily be removed without much problems, so they’ll often do that.
Basically, doctors weigh risks and benefits and decide if the cancer treatment will be more harmful than the cancer itself.
I do research on curing cancer.
1) Cancer is a broad term for many different diseases. In what organ cancer develops and what type it is matter a lot.
2) In most cases, we *can* remove it completely as soon as it is detected. Today we have good treatment outcome for most cancers.
3) The difficult cases usually means that the cancer has spread. The cancer cells from the original tumor has spread into the bloodstream and settled all over the body. Now the cancer is no longer concentrated into a small volume, but spread all over (metastases). You can attempt to treat this, but the thing is, this is symptomatic of metastatic activity, implying that clonogenic cancer cells are everywhere and abundant. For every 1 tumor you manage to fight, 2 more will pop up within months. And we have no idea where these tumors will pop up. This is a difficult battle and usually ends with death of the patient.
Sometimes it’s a part of something that can’t be removed. Think pancreas, or you can’t reach it like the middle of the brain. Sometimes it’s spread so much it’s on so many places that you can’t get them all or can’t handle that much surgery. Also sometimes they do remove it and think its gone, but a new tumor pops up somewhere else because a teeny clump we couldn’t see hung out in a lymph node and found a new spot to grow.
In a perfect situation, you would just cut it all out, but rarely is it a perfect situation. Sometimes they do chemo anyway after cutting it all out to make sure that a teeny clump doesn’t hide somewhere.
Cancer isnt one disease, its thousands of diseases with thousands of different variations, no two cancers is the same, this is why scientists, some of them, say we will never cure it.
Beyond that, often when cancer is detected its too late and it has spread to other organs, some cancers may be stuck to something vital like your brain or heart, complicating things, usually when you get sick from cancer its already too late, when cancer is detected in early stages its more manageable.
Without reading the whole thread, cancer is just Wrong Meat when we’re made of meat if that makes sense. The dangerous thing might be a small part of something else which is difficult to detect. I’ve had a couple of polyps removed from my bowel that I wouldn’t even know existed if it wasn’t for my gender and age. Cancer growing in an organ becomes part of the organ, and if you cut tumors out of your heart or bowels or lungs, your body thinks you’re murdering the actual organs themselves
It can. When we detect cancer we either cut it out, bombard it with radiation until it dies, or we give the body a dose of chemicals that kill any weak cells (chemotherapy).
This works really well if the cells are lumped together in a group (such as a tumor) but it’s not always that straightforward.
Some cancers tend to spear themselves thinly over a big area (e.g lung cancer). And cancers which develop in certain places are prone to end up all over your body (lymph nodes and pancras).
Typically, it is no longer amenable to surgical cure once the tumour cells get too close to important anatomy, or grow into important anatomy. For example, an abdominal tumour that is wrapped around the nerves, vessels and tissue of the liver, pancreas and kidneys cannot be surgical removed – you’d kill the patient in the process. You need what’s called “gross total resection” for a surgical cure, which is a fancy way of saying the surgeon cut out all the tumour they could see, and, a further cut of health tissue 1-2cm around the visible tumour, and, a pathologist who reviews the tissue confirms the margins contained no tumour tissue.
However.
Not all tumours are equal.
There are tumours like diffuse astrocytomas, which have sub-microscope tendrils, perhaps only a few cells wide, that extend out into the healthy tissue. Even if the surgeon and pathologist think they’ve got all the tumour, there is almost always missed cells that will regrow.
There are tumours that “seed”, little clumps of cells have already left the main tumour body, so a full resection of the tumour won’t be curative.
There are tumours that are adjacent to critical structures, like perhaps the brain stem. You can remove the tumour tissue that’s outside the stem, but you cannot remove the tissue in the brain stem, so you cannot achieve gross total resection.
Then there are the blood cancers, which cannot be surgically removed at all.
They often do. But remember cancer isn’t some foreign infection growing inside of you. It is you. It’s cells refusing to die when they ought. If you have brain cancer, cutting it out means cutting out part of your brain.
> But what is the point that it can’t just be removed, and why?
Once it starts spreading throughout the body (metastasize), then there can simply be too much to cut out. And there’s a bunch of different types of cancer just as there are different types of cells. Some tumors aren’t cancerous and don’t spread. We typically just leave those alone, they’re not really harming anything. Skin cancers can be easy to cut out and obvious and lumpy and discolored. Others are more… goopy and are spread throughout the body. Leukemia and lymphoma don’t have a single lumpy mass to remove.
Cancer is made of cells almost identical to the rest of your body’s cells. The biggest difference is that cancer has gone rogue and is trying to grow more of itself like a yeast, whereas healthy cells are trying to cooperate with the rest of your body. Medicine often works by exploiting a difference between disease and healthy flesh to kill the disease without harming you, but it’s hard to do that with a disease that only differs from healthy flesh by where it is and how it behaves.
When you detect cancer, you’ve detected a location where some cells are misbehaving. You can tell a surgeon to remove a chunk of flesh from that location and hope for the best, but you can’t be sure they got all the bad cells and you can’t keep them from removing some healthy tissue in the process. If you have a cancer that’s likely to kill you if untreated, only in one place, and surrounded by tissue you can afford to lose, like a dark colored skin cancer that hasn’t spread yet, that’s a great tradeoff. If your cancer is unlikely to kill you (like prostate or thyroid cancer with no symptoms), or if it’s in more than one place, or if it’s surrounded by tissue you can’t afford to lose (like brain cancer), surgical removal might not be worth it.
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