Surgery alone can sometimes cure cancer, but whether it is sufficient depends heavily on the type, stage, and location of the cancer. In many cases, surgery is a critical part of cancer treatment because it physically removes the tumor and some surrounding tissue, potentially eliminating all visible cancer cells. However, cancer is a complex disease that can spread microscopically beyond what is visible or detectable during surgery, so relying solely on surgery is often not enough for a complete cure.
For early-stage cancers that are localized and have not spread to lymph nodes or distant organs, surgery alone can be curative. Examples include some skin cancers like basal cell carcinoma, certain early-stage breast cancers, and localized prostate cancer. In these cases, removing the tumor with clear margins (meaning no cancer cells are found at the edges of the removed tissue) can mean the cancer is fully eradicated. The success of surgery alone in curing cancer depends on achieving these clear margins and the cancer’s biological behavior.
However, many cancers have a tendency to spread microscopically before they are detected. Even if the primary tumor is removed, cancer cells may have already traveled to lymph nodes or other parts of the body. This is why additional treatments such as chemotherapy, radiation therapy, targeted therapy, or immunotherapy are often recommended after surgery to kill any remaining cancer cells and reduce the risk of recurrence.
Recent advances in cancer treatment have shown that for some specific tumor types, especially those with certain genetic markers, non-surgical treatments like immunotherapy can be highly effective, sometimes even eliminating the need for surgery. For example, patients with mismatch repair-deficient (dMMR) rectal cancer have shown remarkable responses to immunotherapy alone, with many avoiding surgery entirely and achieving long-lasting remission. This represents a significant shift in how some cancers might be treated in the future, emphasizing personalized medicine based on tumor biology.
In other cancers, surgery is combined with radiation or chemotherapy to improve outcomes. For instance, in HPV-positive oropharyngeal cancers, minimally invasive surgery followed by a shorter, less intense course of radiation and chemotherapy has been shown to maintain high cure rates while reducing side effects. This combined approach helps ensure that microscopic disease is treated, improving the chances of cure and preserving quality of life.
There are also experimental and emerging therapies that enhance the effectiveness of chemotherapy or immunotherapy, potentially reducing the need for extensive surgery or high doses of toxic treatments. For example, combining certain drugs can make chemotherapy more effective at killing cancer cells, which might allow for lower doses and fewer side effects.
In summary, while surgery can cure some cancers when the disease is localized and completely removed, it is rarely the only treatment needed for most cancers. The complexity of cancer biology means that additional therapies are often necessary to address microscopic disease and prevent recurrence. Advances in immunotherapy and personalized treatment strategies are changing the landscape, sometimes reducing or even eliminating the need for surgery in select cases, but these are exceptions rather than the rule. The decision about whether surgery alone can cure a particular cancer depends on many factors, including cancer type, stage, genetic characteristics, and patient health.
