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Can metastasis take place from tumor cells released in the blood during surgery?

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Posted on Thu, 21 May 2015
Question: Following up from the previous thread
http://www.healthcaremagic.com/AskDoctorInboxServlet?page=YYYYqueryId=184639

Hello Dr Indranil,

My mother had her fourth cycle of chemotherapy (AC) last Saturday(25th April). I am attaching her reports prior to the chemo

1. Blood report done on 24 Apr. Differential T cells are on the lower side, but I think absolute count might be within the range
2. LFT - 25 Apr
3. KFT - 25 Apr

Our oncologist has asked us to get my mother reviewed by the surgeon to check if they can do surgery on her.
What would be the best possible course. Surgery now and then remaining chemo or we should get all chemo done first and then go for the surgery.

Surgery can also lead to metastasis because of tumor cells getting released in the blood during surgery, so will it be better to get chemo after surgery to mop them up? Or it is more favorable to get all chemo and then surgery. Are there any studies which suggest one way or the other?
Also, are there centers where integrative oncology is practiced in XXXX?
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
Reports are all fine

Detailed Answer:
Hi
Thanks for getting back.

The reports are all within normal limits for a patient on chemo.

I would recommend finishing chemo and then surgery. Most international experts recommend the same, especially for locally advanced tumors. Some studies (again, not for pure locally advanced tumors, many had early disease) have shown that completing chemo before surgery improves response but the effect on survival is not any different if the remaining chemo is given after surgery. http://YYYY.org/content/00/0/000.full

If a breast conservation surgery is planned (not recommended if there was significant skin involvement at the beginning), and radiologic marker was not inserted before chemo (which helps in localizing the tumor later), sometimes tumor can vanish and breast conservation becomes impossible. In that scenario surgery is done before tumor vanishes and remaining chemo completed later.

There are centers which advertise about integrative oncology but these are dubious.
This one was launched recently and looks believable, but no first-hand experience. http://www.YYYYhealth.org/specialities/YYYY-oncology

Hope this helps.
regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1622 Questions

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Can metastasis take place from tumor cells released in the blood during surgery?

Brief Answer: Reports are all fine Detailed Answer: Hi Thanks for getting back. The reports are all within normal limits for a patient on chemo. I would recommend finishing chemo and then surgery. Most international experts recommend the same, especially for locally advanced tumors. Some studies (again, not for pure locally advanced tumors, many had early disease) have shown that completing chemo before surgery improves response but the effect on survival is not any different if the remaining chemo is given after surgery. http://YYYY.org/content/00/0/000.full If a breast conservation surgery is planned (not recommended if there was significant skin involvement at the beginning), and radiologic marker was not inserted before chemo (which helps in localizing the tumor later), sometimes tumor can vanish and breast conservation becomes impossible. In that scenario surgery is done before tumor vanishes and remaining chemo completed later. There are centers which advertise about integrative oncology but these are dubious. This one was launched recently and looks believable, but no first-hand experience. http://www.YYYYhealth.org/specialities/YYYY-oncology Hope this helps. regards