Expert: Claes-Gustaf Nordquist, M.D. - 4/26/2007

Question
My best friend has been dealing with breast cancer and the struggles that go with that.  Since about September she has had two operations to remove lumps, first from one breast and then the other, followed by a double mastectomy, and interludes of chemo and radiation therapy.  Now she is advised that yet another surgery is required to remove lymph nodes near her shoulders.  

My frustration is this -- why so many surgeries?  I don't pretend to know the details of oncological care, and I'm not saying that something has been done wrong, but I know my friend has been tested and retested again and again, and I don't understand why this wasn't all detected sooner so it could be handled in a single procedure.  

Answer
Without knowing the full story in all its details of this case it is hard for me to give you a good answer covering all possibilities! However the behaviour of a cancer is not always predictable - or rather very often it is not! Nor is all details of its behaviour always detectable early enough to make a smooth treatment procedure possible. While there is always an intention of providing as complete a treatment from the very beginning as possible in order to hopefully cure the patient as early and fast as possible there is also a need of not overdoing the treatment since many of these treatment methods are rather harsh. Sometimes these 2 principles clash and you have the result as you do see it now! This is certainly not an easy illness to treat! Finally we are all humans with limited abilities and powers not some sort of all seeing and all mighty gods! I do hope this explains it.