Why cancer treatment may be starting in the wrong place

If you’ve been diagnosed with cancer—whether it’s colon cancer, breast cancer, colorectal cancer, or even pancreatic cancer—you’re often guided into a standard path: chemotherapy first, then everything else later - after we can detect a recurrence on CT or MRI. But advances in cancer biology, biomarkers, and targeted therapy suggest that this order may not be serving cancer patients as well as it could. 

The current approach to cancer treatment

In most oncology settings, cancer treatment still follows a familiar sequence. Chemotherapy is typically used early, while targeted therapy, immunotherapy, and more personalized approaches come later. That's the rut we are in.

This model made sense when fewer options existed. But today, cancer research has changed what’s possible—while the system hasn’t fully caught up. Even when better options are available most systems default to "standard treatment" which is usually the oldest treatment type.

The claim: “Wait and watch is the Best option”

After treatment, many cancer patients are told they are in remission or stable and are placed into a “wait and watch” phase. This often involves periodic CT scans every few months.

The assumption is that if something returns, it will be caught in time.

But that approach is likely to be missing a critical window. 

What the science shows about biomarkers and early detection

There are blood-based biomarkers already available for many cancers that can detect changes long before a tumor is large enough to be visible on imaging.

Instead of waiting for a tumor to grow large enough to appear on a scan, biomarker trends can indicate a biochemical recurrence much, much earlier.

This applies across multiple cancers, including prostate cancer, breast cancer, colorectal cancer treatment monitoring, and other solid tumors.

The key insight:
It’s not just the number—it’s the trend over time.

Why this matters (mechanism and timing)

Tumors need to reach a certain size and density to show up on CT scans, MRIs, or even PET scans.

By the time they are visible, the disease has already progressed significantly.

Biomarker testing and genetic (ctDNA) testing allow for earlier detection, giving oncologists the opportunity to intervene sooner—when treatment is more effective and less aggressive.

What actually matters clinically

Early detection isn’t just about diagnosis—it’s about timing your cancer care correctly.

• Earlier detection often leads to better outcomes
• Localized tumors are significantly easier to treat
• Late-stage cancers are far more difficult to control and more likely to have metastasized 

At the same time, genomics and biomarker-driven approaches can guide more precise treatment decisions, including when to use targeted therapy or immunotherapy instead of defaulting to chemotherapy. 

Practical takeaway for cancer patients

If you’ve been diagnosed with cancer or completed treatment, there are a few key questions worth asking your oncologist:

• Are there blood-based biomarkers we can track?
• Can we monitor trends instead of waiting for imaging?
• Can genomics or biomarker testing guide treatment decisions earlier?

Because in modern cancer treatment, waiting for something to show up on a scan may not be the earliest—or best—option.

Disclaimer:  This content is for educational purposes only and is not medical advice. It does not replace guidance from your healthcare provider. Cancer and treatment decisions are highly individual—always consult your physician or qualified healthcare professional regarding your specific situation.
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