As we have seen, a patient may already have advanced metastatic cancer at the time of diagnosis. Moreover, within the variety of conditions referred to as “they’ve just found a tumor”, there is one that seems incredible; this is when a patient who seems to be completely healthy suddenly becomes almost terminal within the space of 1-2 months. Fortunately, this is a very rare occurrence.
These are cases in which, at the time of diagnosis, there are already massive metastases in vital organs, such as the brain, liver or kidney, which prevent these organs from functioning properly. And if the liver and kidney are not working, administering anti-tumor therapy may prove fatal.
We are therefore powerless:
- the tumor is growing rapidly;
- as there are widespread metastases, surgery would be useless;
- the only hope is to slow down the growth of the tumor and/or to shrink it with anti-tumor therapy;
- but this therapy cannot be administered: it would prove fatal because the patient’s kidneys and liver are not working.
This is a terminal condition.
How could this situation arise? Let’s do a few calculations (FIGURE 7).
- on average, a tumor takes three months to double in size; sometimes, however, the tumor cells divide (and the tumor doubles in size) much more quickly, even in as little as one month. HOW LONG HAS THIS TUMOR BEEN THERE?
- the tumor may go unnoticed until it reaches at least 1 cm; in the case of breast tumors or superficial tumors (lymph nodes, skin, etc), it does not usually cause trouble until it is at least 2 or 3 cm in size, and, in internal organs such as the lung, colon, pancreas, stomach etc., at least 3-5 cm.
- from the time when symptoms appear to the time when the diagnosis is confirmed by means of CT and other examinations, at least 3-6 weeks (often much more time) will pass;
- then, there is the time needed to decide whether or not to take a biopsy and the time needed to analyze any biopsies taken.
If we add up these times, we can see that a nodule of 4 cm may double in size twice (to 8 and then 16 cm) in only 2 months (FIGURE 7).
A tumor mass of 16 cm is very big and often prevents the proper functioning of the organ in which it develops. If this is the only mass present, we can try to remove it surgically. In general, however, when the cancer is so aggressive, the primary tumor will already have metastasized; this explains the dramatic situation described above. COULDN’T IT HAVE BEEN DISCOVERED EARLIER?