I know there’s a reason, but I don’t know what it is.
In: Biology
You *can* cut off cancer cells and thousands of people undergo successful surgery without their cancer ever returning. However it’s tricky. Many times you can cut off the original cancer and yet a new cancer can grow somewhere else. Also you could cut off 99.9% of the cancer and leave a few cells behind, which then grow back into new cancer. Lastly, sometimes cancer tissue looks like normal tissue and it might be hard for the surgeon to differentiate the two.
My mother has been battling primary peritoneal cancer for 10 years. When they found it, it was dozens and dozens of tumors all throughout her lower abdomen. They removed her peritoneal membrane as much as they could (so her abdominal organs are no longer anchored properly), removed as many small tumors as they could find attached to organs, and resected 6” of her bowel. Even then, they couldn’t get it all. She had intense chemo and longterm regular chemo treatments, a second round of chemo last year when it came back strongly, followed by infusions. It’s about controlling the number of cancer cells when you cannot remove them all. And it’s really hard to control them because cancer is, by definition, uncontrolled cell growth.
Basically, many of your cells go through the cell cycle where they grow, divide in two, and then those two grow again, repeat repeat repeat. However, this needs to be a carefully controlled process so that cells don’t multiply themselves unless they are needed by the body.
This is regulated by really complex processes that check many, many things to get it right. The cell has to get a signal that it needs to divide. Then it has to copy all the cell stuff (not DNA) to make sure the new cells each have enough of it. Then it has to copy all its DNA. Then it has to check over all the newly made cell stuff and the DNA to make sure there are no mistakes. If mistakes are found, they need to be corrected. If they can’t be corrected, a different process is triggered (apoptosis) where the cell will commit suicide so that it doesn’t become cancer. If it passes all the checks, it is allowed to divide and then one or more of those new cells will fully differentiate (grow into a certain cell type) to do its job for the body until it dies and needs replaced by the same process.
There are many biological process that regulate this very, very complicated process. The most common are effectively gas pedals (signals to grow and divide) and brakes (signals to stop diving and/or check for mistakes and/or fix mistakes and/or commit cell suicide.) Those are all regulated by various other molecules your cell makes. If there is a mutation in the DNA that creates any one of those gas or brake molecules, then you might end up with too much gas (too much cell growth) or not enough brakes (too much cell growth.)
When you get too much cell growth, that cell grows and divides quickly without differentiation, which means all it does is make more cells just like it (with mutated DNA that causes the same problem), take up lots of energy and resources, but never does a job the body needs. That’s a tumor (or many tumors), aka cancer.
When you are trying to get rid of cancer, you have to get rid of every single cells that has the broken gas or brakes in order to stop the cycle. But it’s really, really hard (often impossible) to tell broken cells from good cells at the individual cell level. So getting every broken cell means killing LOTS of cells — including good ones. That’s why chemotherapy is so hard on people… you are killing massive numbers of cells, good and bad, taking a person right to the edge of poisoning themselves to death, in hopes of killing all the bad cells but leaving enough good cells that can replenish and rebuild the body without cancer.
You can imagine how tricky and hard that is. That also doesn’t take into account that there was a reason that DNA mutated to cause cancer in the first place. In many cases, it means you are at high risk of that happening again. Or of leaving just one broken cell. It only takes one and if your body doesn’t find and kill that one in time, you have cancer.
Many kinds of cancer simply can’t be just cut out for all these reasons. It’s not an foreign invader that is distinct from yourself and easily rooted it. It is your own cells that have one teeny, tiny mistake and that manage to make it past all your body’s safeguards and then suddenly take off. Then that growth(s) becomes a massive energy sink that demands to be fed, shoulders out good cells, and takes energy and resources needed for the cells actually doing the jobs that need done.
You can sometimes, and they do. Especially for things like skin cancer, my dad had surgery a few times to remove the cancerous parts of his skin. Nothing else, no radiation, just cut out the cancer.
You can and often do. Whenever someone has cancer and they go to the operation room, that’s what they’re having done.
My mom was diagnosed with stage 4 glioblastoma was very sudden one day everything was normal and then she started having severe spasms in her arm. Everyone thought it was some pinched nerve but she finally found a doctor that saw some weird movement in her hand and wanted to do a brain scan.
2 tumors stacked on top of each other had to be removed within a few days of that scan. That was almost a year ago now so far the chemo is working and no signs of growth 🙂
You can
Many tumors are treated surgically, the issue is they’re not always perfectly circunscripted, making cutting them hard
So ok, they’re cells right? And cells are obviously smaller than you can see, when you cut a tumor off, you send it to pathology, and check margins to be 0,12, or 3, basically meaning if there’s healthy tissue or cancer cells in the margins. Ideally you want to have a good couple mm’s of healthy tissue to make sure you got it all. However, after that, cancer tends to spread, so you could cut a prostate cancer easily, but what if it spread to brain, lungs, bone, and colon? Patient would probably die before you can cut all those tumors, assuming you could even access them
There’s also the fact that some are wrapped around structures that make excisions hard. So if say, a lung tumor is too close to your aorta (thick artery that carries most of your blood, no sane surgeon will risk trying to cut it, since if you Nick the aorta, patient will bleed out in seconds, which is why they might try chemo before, during or after surgery, to shrink tumors, along with radiotherapy
Thing is, that many cancer types doesn’t have a sharp edge where there are no cancer cells after that. Testicular cancer is actually one of those where there is a sharp edge, which makes surgery very promising for this. However, given enough time, cells will travel, in turn creating metastases in other areas of your body. So when removing, or radiating, tumours, you often removeø/treat an extra region around the tumour itself, where people know from experience, that some extra tumour cells might exist.
And one of the first thing you learn when going into Oncology is, that cancer is easy to kill. However, the question is always if you kill the patient from excess treatment on areas that doesn’t need treatment, or just excess treatment in general. That is and will always be the sweet spot. Killing the cancer while killing as little as possible healthy tissue.
Cancer treatment usually consists of surgery (where they basically cut out the tumor containing cancer cells), chemo or radiotherapy or a combination of both – depending on the type of cancer and it’s progression when it is detected
Imagine having a dandelion and blowing all the spores off. Now go find all the spores. It will be difficult because cancer can spread to different areas of the body rapidly, and if every single piece isn’t removed, it can grow back.
Your instinct is absolutely correct. If the tumor is small and has clean boundaries and is not embedded in some vital spot, the surgeon is the hero of your story. She cuts it out and you recover and go on with the rest of your life.
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