Why is resection of tumour not done in metastatic disease?

[scilearner]

Hello everyone,

 

Let's take a woman with a breast lump for example and it is malignant. I know that stage 3 and 4 disease, eg advanced/metastatic disease treatment is chemotherapy/radiotherapy. Then after it is downgraded they surgically resect the lump (stage 1 and 2). While this makes sense my question is why don't they still remove the lump in advanced disease and then give chemotherapy/radiotherapy. Reason been if the tumour is not resected and you give chemotherapy, since the primary tumour is still there it would keep producing metastasis. Is the reason that surgical resection is too dangerous when metastasis present. Why is that? Thanks

[pwagen]

It's most likely because once there are metastasis, the cancer is already in the lymph nodes or blood system, meaning it has already spread and will continue to do so.

 

Also, if there are metastasis, there is a high chance the original tumor has spread into the surrounding tissue, possibly making it very hard to remove.

[scilearner]

Thanks for the reply pwagen. But what I don't understand is

 

But since the primary tumour is still there, wouldn't it keep producing metastastasis even though we are removing them at the same time. Eg a water bucket, and some guy pouring a cup of water in (tumour) as another guy pour a cup out (chemotherapy), so there is no net gain and task is futile.

[pwagen]

I'm afraid my knowledge of the topic doesn't allow me to give a much more detailed answer than I have. Indeed, treatment of cancer is a battle between medicine and the spreading cells. While such things as radiation therapy or chemotherapy can help in slowing the spread or even removing cancer entirely, there are never any guarantees.

 

Advanced cancer is so called for a reason, and I think it's too simplistic to think of it as a balanced equation. While you can pour glasses out, sooner or later the water system might break and flood the entire bathroom.

 

For some more reading:

 

http://m.cancer.org/treatment/understandingyourdiagnosis/advancedcancer/advanced-cancer-treatment

[scilearner]

After some thinking I have come to this conclusion. Surgery is risky in metastatic disease as

 

1. Patient is not suitable to endure a major surgery when there is systemic metastasis, as his body would not be able to handle it.
2. Doing the surgery could accidentally create more pathways for metastasis to spread.
3. As you said systemic problems caused by metastasis takes precedence and must be treated first.

 

Thanks for the help