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Radiation after an operation is often recommended when it is either suspected or definitely known that cancer cells have been left behind. You will remember from the chapter on surgery that the chances of not being able to completely remove the cancer can be reduced by careful assessment before the operation. Postoperative radiation is more likely to be recommended after poorly planned than after carefully planned surgery. Radiation in this setting is also very unlikely to improve the cure rate. However, depending on the type and location of the cancer it can certainly reduce the chance of local recurrence. If this approach is recommended to you, ask what the chances of local recurrence are with and without radiation. Of course, if your surgeon knows that cancer cells are still there, local recurrence is certain if no other treatment is given. Find out how much the chance is likely to be improved by radiation and at what ‘cost’ to you. Are there any other ways of reducing the chance of local recurrence? Ask what difference it would make if radiation was reserved until the local recurrence occurred, instead of being given as a preventive. Would cure still be possible if you waited until you got a definite local recurrence? What symptoms could a local recurrence cause and how could they be treated? Don’t agree to the additional treatment unless you feel sure that the likely benefit is greater than the likely cost.
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