BrownBagger wrote:Post treatment, I'm certainly hoping we got any and all cancer cells that might have been present in my body. But I'm just wondering, if we didn't, does that necessarily mean a recurrence or mets? Can your body's immune system find and kill cancer cells without any outside intervention?
"...it is now known that micrometastases and circulating cancer cells in blood, bone marrow, and lymph nodes are almost always present in advanced-stage cancers; the majority of the cells derived from the primary tumor are not stopped by the liver and enter the systemic circulation. Moreover, it is well known that cancer cells are usually found in the blood spilled in the surgical field [10,11]. In consideration of this, a radical operation is, in some respects, only a cytoreductive operation (a treatment that does not completely eradicate all tumor cells, even if it entirely resects all visible and detectable disease). However, cure can be achieved with the assistance of the patient’s natural immunological defenses and with the latest generation of combination chemotherapy. Surgical tumor burden reduction may provide an immunological benefit, because tumor cells produce substances that interfere with normal defenses. According to the log-kill hypothesis, each dose of a chemotherapeutic agent kills a constant fraction of cells, rather than a specific number of them. Therefore, by reducing the initial tumor volume, one increases the likelihood of chemotherapy to reduce the number of viable tumor cells toward the desired endpoint of zero
Journal of Surgical Oncology 2009;100:345–347
Management of Colorectal Liver Metastases in Patients
With Peritoneal Carcinomatosis
F. IZZO, MD,1*M. PICCIRILLO, MD,1 R. PALAIA, MD,2 V. ALBINO, MD,3 R. DI GIACOMO, MD,3
AND A.A. MASTRO, M