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What part can surgery play in the treatment of cancer which has already formed secondary growths? As we have seen, if the cancer has only spread to the lymph nodes which drain the primary cancer site, it may still be cured simply by removal of both the primary growth and the involved group of nodes. With some particular types of cancer, the chance of cure is improved if chemotherapy or radiotherapy is used as well as surgery, but surgery alone can cure some of these people.
What if the cancer has spread further—either through the blood or more extensively through the lymph system? Most of these people cannot be cured by any form of treatment. The exceptions are those who have one of the few types of cancer which are extremely sensitive to either radiotherapy or chemotherapy. The chances of curing these people may be improved by combining surgical removal of the primary growth, and sometimes also of large secondary growths, with chemotherapy or radiotherapy. However, surgery on its own cannot cure any of them. Some of the cancers which can be cured by such combined treatments are cancers of the testis (both seminomas and non-seminomateous germ cell tumours), ovary, kidney (Wilm’s tumour), muscle (rhabdomyosarcoma) and bone (osteogenic sarcoma).
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