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Why has chemo go through the whole body. Why not ecmo chemo only the combat zone?

Usually the cancer cells are throughout the body, even if the tumors themselves have not spread. This is why you might cut out a solid tumor, and then give chemo

For me, they cut out most of a giant tumor, but couldn't get all of it without risking some vital organs. Then I got chemo for the rest. Interesting process.

Usually the cancer cells are concentrated where the tumor is. One of the first things they may do upon diagnosis of cancer is a PET scan (which shows you where cancerous stuff is throughout your body).

Life advice for all the young folks: don't get cancer.

my understanding is that the word "concentrated" does a lot of heavy lifting, and modern thought is that most cancers started spreading cells all over the body, even at very early stages.

metastatic cancer is a numbers game. for example. at stage 0-1, you might still have millions of cancer cells throughout your body, and there is a good chance your immune system can clean them up. At stages 2 or 3 there might be trillions of non-local cancer cells, with a proportionally greater chance of propagation.

Antibody drug conjugates are one attempt at doing this. Basically attach chemotherapy drugs to molecules (antibodies) that bind only to proteins on cancer cells

In particular, this is a treatment for leukemia; a blood cancer.

When my dog had a subcutaneous form of cancer, one treatment discussed was local injection of a chemotherapy agent in the tumor area along with electrochemotherapy to help make the tumor more susceptible to the chemo treatment.

We opted for surgical removal instead.

https://en.wikipedia.org/wiki/Electrochemotherapy

Things like that are done where we can figure out how to get the drugs there. Not an easy problem though.

There's "topical" chemo for some stuff, but it's uncommon. Most chemo is either in pill form, or (as was for me) delivered intravenously. So it goes through the whole body.

Radiation therapy can target specific areas. It's still used instead of chemo in some cases.

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