There are some cancers which are so likely to spread through the bloodstream that it is best to take it for granted that they already have when planning treatment. Combinations of chemotherapy with surgery and/or radiation have a higher chance of curing these types of cancer than any one treatment on its own. These cancers include acute leukaemias, rhabdomyosarcoma (cancer of muscle), Ewing’s sarcoma (a cancer of bone), Wilm’s tumour (a kidney cancer), and small cell anaplastic cancer of the lung. Chemotherapy is the mainstay of treatment for these types of cancer, because it travels through the blood and gets to nearly every part of the body. However, if local forms of treatment-surgery and radiation—are directed to the areas where cancer cells are most likely to escape being killed by the chemotherapy drugs, the cure rate is higher than if chemotherapy is used on its own.

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Cancer