Cancer Discussions, Cancer Treatment Options Forum - March 4th, 2010 - 5 Comments
Is radiation or chemotherapy necessary after multiple organ cancer surgery?
A close relative of mine recently had surgery for what was (apparently) secondary liver cancer, and during the surgery they removed his gallbladder, spleen, half of his liver and a third of his pancreas. The doctors said they think they got all of the cancer out of him, but doesn’t he also need radiation or some other kind of treatment to prevent it from coming back, since it had already spread to other organs? How likely is it he’s been cured just by surgery?
It’s really the oncologist’s decision as to whether chemo or radiotherapy is needed after surgery. The basis is that if the cancer has spread in such a way that extensive surgery can’t be done since a lot of vital structures may get damaged, then other treatment options may follow. If the doctor believes that the surgery completely removed all the cancer cells, then no other treatments should be done.
Of course, your friend will be under observation for a period of time just to check periodically if there are cancer cells left undiscovered or new cancer cells have developed.
Honestly? With multiple organs involved, when a dr. says he "got it all" it’s so that the person goes back to his life and doesn’t spend his remaining time worrying about recurrence. It’s a kindness on the part of the doctor. But it sounds very likely that there will be recurrence … he can only get what he can see, and he can’t spend all day with the guy cut open looking for microscopic metastates.
When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy drug is gemcitabine, but other drugs may be used. Gemcitabine can help approximately 25% of patients.
That can only be answered by this person’s oncologist. There is no way for anyone here to answer your question about him being cured. We don’t know all the facts. Only his doctor knows that.
If this person trusts his doctor, then let it be. Its between the two of them.
Radiation and chemo would be a cautionary measure to make sure that cells that escaped get killed, as it cannot be detected if it is only a few cells. The aim of radiation and chemo is to kill sick cells without killing the "host", hoping that the person is strong enough to survive the treatment. Surgery could only remove large enough tumors to be detectable, and as it is secondary already, there is a chance that the bad guys are all around.