Why does a Steve Jobs die from cancer when he has the wealth and connections to obtain treatments to which most of us have no access? The problem lies in part in an issue on which your doctor doesn’t want you to obsess. Your doctor doesn’t necessarily know where your cancer is.
Sure, you can see a mass on an MRI or a contrast CT. However, that’s a mass — a large cluster of cancer cells. What currently available imaging technology cannot identify are small clusters and individual cells that are on the edges of the mass, or may even have separated from the mass and moved elsewhere.
The medical community no longer practices whole body radiation, because of the potential damage that can result. If you don’t have cancer in some areas of your body, radiation can induce it. However, that means that cancer cells that you do have and that have separated from the main mass will be neither removed nor treated.
That’s why new technologies that can allow imaging of individual cells are so important (example: http://www.cell.com/cell/abstract/S0092-8674%2814%2901361-0). However, these technologies are still years away from being available on a widespread basis.
The alternative is when doing cancer surgery to take more tissue than is absolutely required to remove the known mass. Doing that can improve results. Example: removing more tissue can reduce the need for a second surgery for breast cancer, http://www.sciencedaily.com/releases/2015/05/150530102209.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily+%28Latest+Science+News+–+ScienceDaily%29.
However, in the case of brain or prostate cancer, removal of “excess” tissue can be catastrophic for the patient. Further, there is no guarantee that stray cancer clusters will only be in the vicinity of the target mass. The surgeon can take the extra tissue and still not rid the body of the cancer.
My wife carries a capillary pool from an abdominal cancer she had 30 years ago. Surgeons are afraid to work around the pool, lest they unleash cancer cells sealed inside it. They don’t know if there are cancer cells present or not.
There has been some discussion of Google working on a nanotechnology solution — nano particles that would identify, attach to and destroy cancer cells. Like other new technologies, if that ever comes to fruition, most people probably won’t be able to afford it.
As much as we don’t want to hear this, there is no certainty in life, much less in medicine.
May 31, 2015