Understanding Cancer & How Treatment Really Works

When did cancer actually start?

By the time a cancer is visible on a scan, it has usually been growing silently for years.

A tumor becomes detectable when it reaches about 1 billion cells (10⁹). To reach that number, cancer must divide again and again. It takes roughly 30 doublings — because 2³⁰ ≈ 1 billion.

So depending on how fast it grows: a cancer that doubles monthly may take years to appear; a cancer that doubles weekly may appear within months.

This is why two people can develop cancer at the same time, but one is diagnosed much later. Cancer doesn’t start when we detect it. It starts long before.

Why surgery alone is not always enough

Removing a visible tumor is important. But cancer is not just what we can see.

By the time a tumor forms, tiny cancer cells may already have spread — some may be circulating in blood, some may be hiding in distant organs. These microscopic cells cannot be detected on scans.

This is why additional treatment is often needed after surgery: chemotherapy, targeted therapy, hormonal therapy, immunotherapy. The goal is to treat disease we cannot see.

Why treatment happens in phases

Cancer treatment is rarely a single step. It usually happens in layers: diagnosis, local treatment (surgery / radiation), systemic treatment, follow-up monitoring.

Each phase targets a different part of the disease. Stopping early increases the risk that hidden cancer cells survive.

If the cancer responded, why continue treatment?

This is one of the most common questions. When scans improve, it means treatment is working. But response does not always mean cure.

Even when a tumor shrinks, some cancer cells may still remain. These cells can regrow if treatment stops early. Continuing treatment reduces the risk of relapse. This is why doctors often recommend completing full treatment plans even after early improvement.

Why follow-ups are necessary

Cancer care doesn’t end after treatment finishes. Follow-ups help to: detect relapse early, monitor long-term side effects, and ensure recovery is stable.

Many cancers are most likely to return in the first few years. Regular monitoring improves the chance of catching problems early.

Switching doctors during cancer care

Patients sometimes move between hospitals or cities during treatment. While this can happen, continuity is important because: treatment plans are long and structured, dose timing matters, and previous response guides future decisions.

When transitions happen, complete medical records and treatment summaries are essential.

The Indian reality: risk factors around us

Cancer risk is influenced by daily exposures over years. Common contributors include: tobacco use, pollution, processed foods, infections, and lifestyle patterns.

Awareness helps people make informed choices, but it’s important to understand: cancer is rarely caused by one single factor. It is usually the result of multiple exposures over time.

Why treatment decisions are individual

Two patients with the same cancer may receive different treatments. This depends on: stage of disease, age, overall health, response to therapy, and risk of relapse.

Treatment is tailored, not standardized.