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Does Surgery Spread Cancer?
A friend has recently been diagnosed with lung cancer. His doctor recommended surgery, but he refused because he believes that the cancer will spread when exposed to air during the operation. Is this true?
Answer (Published 11/17/2003)

Updated on 7/29/2005

No, it isn't true, but the notion that cancer spreads when exposed to air is an old one. No one seems to know where it originated. In fact, researchers at the Philadelphia Veterans Affairs (VA) Medical Center completed a survey of patients (some with lung cancer, some with other types of pulmonary disease) in five hospitals across the United States to learn more about this erroneous belief. They found that 45 percent of the patients they surveyed had heard that exposure to air during surgery causes cancer to spread; 37 percent of the patients said they believed it to be true. However, those surveyed couldn't say where they first heard it. Results of the study were published in the October 7, 2003 issue of the Annals of Internal Medicine.

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The researchers also found that race was a factor in predicting who subscribes to the belief: 61 percent of African-American respondents to the study said they thought it was true compared to 29 percent of Caucasians. A total of 19 percent of the African-Americans said they would oppose surgery on the grounds that it might spread cancer, and 14 percent said they wouldn't accept a physician's assurance that the belief is false.

Lung cancer is more prevalent and more often fatal among African-Americans than among Caucasians, differences that could be related to disparities in treatment. Though surgery is not always an option for people with lung cancer, when it is, it can greatly extend survival and even be curative.

Andrew Weil, M.D.

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