Is it possible for cancer to spread during surgery?

A fellow caregiver asked...

Isn't it possible that during cancer surgery, some of the cancerous cells can enter the blood stream and establish themselves in other parts of the body? Also, using a cell saver during surgery can possibly cause the same problem? If so, why aren't patients informed of these risks, so they can weigh them as opposed to the doctor weighing the risks for them?

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

I consulted a surgical oncologist on The Compassionate Caregiver’s Medical Advisory Board about this for my book because it is asked so commonly.

He says “Research has shown that cancer cells may routinely enter the blood stream in the weeks and months up to the discovery of the cancer. In the past, there was a concern about an increased release of circulating cancer cells during surgical manipulations. For that reason, operations were designed specifically to prevent this situation but they did not reduce the metastatic rate or improve survival rates over standard operations.” In other words, surgical manipulation of the tumor does not increase the risk of spread through the blood stream. 

Cell Savers are used to collect blood lost during the operation. Cell savers are not recommended for use during cancer surgery because of the risk to introduce an unacceptably high numbers of cells into the blood stream.

The risks for each surgery should be outlined by your surgical staff, as it is different for each patient and each procedure. Ask “What will happen if I don’t have this surgery?” Doctors weigh risks in regards to overall benefit to the patient’s quality of life and should inform you of what you can expect with or without the surgery.