My surgeon doesn’t recommend removing the primary tumor first. Why?

If you are new to a stage IV cancer diagnosis, it can seem confusing if your care team doesn’t seem to have a sense of urgency to remove your primary tumor. However, studies show that removing the primary tumor is not associated with an improvement in quantity or quality of life.

The focus is almost always on treating the metastases first. If you were to focus on removing the primary tumor, surgery recovery usually requires being off chemotherapy — which would leave the metastases untreated and at risk of growth or spread.

Also, in many cases, the primary tumor will shrink in response to chemotherapy. Plus, if surgery is planned for your mets, the primary tumor may be removed during this surgery too. Doing chemo first keeps disease stable during surgery recovery, until you can restart chemo as needed.