What Does It Mean to Have Inoperable Cancer?

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A cancer can be inoperable for a variety of reasons. “Liquid cancers,” such as leukemia, lymphoma, and multiple myeloma, are considered inoperable by nature, because they involve cells or tissues that are dispersed throughout the body. Leukemia and multiple myeloma, for example, originate in abnormal cells of the bone marrow, the spongy material within the body’s bones. In such diseases, there generally isn’t a lump, or mass, of cancerous tissue that can safely be removed to treat the disorder.

Leukemia cells.

Leukemia cells.

Although many tumors, such as lung, kidney, or breast cancer, do form masses that can be treated surgically, some cannot. This may be because the tumor is in a sensitive location such as the spinal cord, where surgical removal could critically damage surrounding tissue. Some tumors, such as those found in certain brain cancers, form thin tendrils that wind through surrounding tissue and are impossible to surgically extract without harming the patient. Other tumors arise in locations that are inaccessible to surgery and would require cutting through vital tissue. However, advances in surgical techniques have made it possible to surgically remove some tumors that would previously have been considered inoperable.

The other major type of inoperable cancer involves metastatic tumors. A single, isolated tumor may, over time, seed the growth of multiple secondary tumors elsewhere in the body. In some cases, the original tumor as well as secondary tumors can be removed. But in many instances, the secondary tumors are too numerous to remove safely.

When surgery is impossible – either because the tumor is not accessible or the patient has other medical conditions that limit the ability to withstand surgery – doctors often have a variety of other options for treatment. These include radiation therapy, in which an electromagnetic beam is used to destroy cancer cells. Newly developed “radiosurgical” techniques use a robotic arm to deliver high, precisely aimed doses of radiation to tumors, sparing healthy tissues and critical structures surrounding them that may have been damaged through surgery.

Chemotherapy – the use of cancer-killing drugs – is another weapon in doctors’ arsenal against inoperable tumors. Chemotherapy is considered a “systemic” approach to treatment because the bloodstream carries the drugs to tumor cells throughout the body. Immunotherapy, too, is a form of systemic therapy against cancer. Immune-stimulating drugs, specially engineered white blood cells, and cancer vaccines all ride the bloodstream to spur an attack on cancer at many locations in the body.

Learn more about cancer treatment from Dana-Farber.

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