Doctor, why do I need chemotherapy after surgery?

This is the 5041th article of Da Yi Xiao Hu

The British royal family's Princess Kate recently made a public appearance. She was hospitalized on January 16 this year for a "planned abdominal surgery". At that time, she did not know that she had any cancer, but "postoperative examinations found that cancer already existed." This sentence means that it was originally thought to be a routine operation, but most postoperative pathology had problems. Her medical team recommended that she undergo a preventive chemotherapy course, and she is now in the early stages of treatment.

Some people may also have such confusion in the hospital clinic: the doctor clearly said that the operation was successful and all tumor tissues had been removed, but he still asked me to do chemotherapy. Is this over-medicalization? Judging from these celebrity cases, the doctor's choice is still scientific and wise.

First of all, what are tumor cells? Under the influence of tumorigenic factors, some cells undergo gene changes and lose normal regulation of their growth, leading to abnormal proliferation. Those cells that should normally age, be damaged, die, or degenerate suddenly lose immune monitoring and become out of control.

Secondly, what is the purpose of chemotherapy? To prevent tumor metastasis! It refers to the process in which malignant tumor cells spread from the primary site to the lymphatic system, blood system, and other pathways such as abdominal and thoracic implantation to other parts of the body to continue growing. This process is what ordinary people often call diffusion, which is often the main reason for the failure of tumor treatment.

It is worth noting that this shows that simple surgical resection is not the only way to solve the problem of tumors. In addition to removing the "bad things" visible to the naked eye, there are also invisible micrometastases. Escaped tumor cells lurk in the blood circulation, lymphatic vessels, bone marrow and other organs like the seeds of the devil, without any clinical manifestations. At first, they may not be detected in imaging or clinical pathology. When the time is right, the "devil's flower" will "bear fruit". This is when the important role of preventive systemic chemotherapy and local radiotherapy in treatment is highlighted. It can control the growth and spread of tumors and may play a positive role in the treatment of tumors.

Finally, we would like to remind you that systemic chemotherapy will have certain effects on the body of cancer patients, such as hair loss, fatigue, decreased immunity, etc. Therefore, patients need to pay attention to their physical condition during chemotherapy, avoid fatigue and maintain a good mood.

Author: Putuo District Central Hospital

Department of Respiratory Medicine Shi Zhaowen, deputy chief physician