Do All Tumours Need Surgery Understanding Benign vs. Malignant Growths

By Milind Shetti, Senior Consultant Radiation Oncologist, HCG NMR Cancer Centre, Hubli

A single scan report is often enough to unsettle an entire household. Caregivers grapple with questions they were never prepared to ask: Is this tumour dangerous? Does it always mean cancer? Will surgery be the only option? The fear stems not just from the word “tumour” but from the uncertainty it brings.

Yet, not all tumours behave the same way. Some stay quiet and harmless for years. Others grow quickly, affecting organs and demanding timely care. Understanding this difference helps the patient make clearer decisions and reduces the emotional weight of the unknown.

What a Tumour Really Is

A tumour is simply an abnormal cluster of cells. These cells keep on dividing despite the body’s signals to stop, resulting in an abnormal lump or growth. In many cases, these growths are benign, non-cancerous and slow-growing. They usually stay where they do not spread to other parts of the body.

Malignant tumours, on the other hand, are cancerous. They can grow faster, invade nearby tissues, and travel through the bloodstream or lymphatic system to other organs. Indian health surveys have repeatedly highlighted that the lack of early understanding of this distinction often leads to delayed care, especially in smaller towns and rural regions.

Benign Tumours: When Watchful Waiting Is Enough

A benign tumour does not always mean illness. Many remain unnoticed for years and are found incidentally during routine health checks. Common examples include lipomas, fibroids, and certain thyroid nodules. They generally do not spread and rarely threaten life.

Doctors often recommend a “watchful waiting” approach for benign tumours that do not cause pain, pressure on organs, or changes in daily functioning. Monitoring through periodic scans or clinical examinations helps ensure the tumour remains stable.

Surgery for benign tumours is usually considered only when:

• The growth affects organ function
• It causes pain or discomfort
• It interferes with mobility or appearance
• There is uncertainty about whether the tumour is truly benign

This measured approach prevents unnecessary procedures and reassures families that not everything labelled a tumour needs immediate intervention.

Malignant Tumours: Why They Need Timely Treatment

Malignant tumours behave differently. They have the potential to harm vital organs and spread beyond their original site. Indian cancer registries have consistently noted a rise in early-stage diagnoses due to improved screening and awareness. Early detection is crucial as timely treatment, often a combination of surgery, chemotherapy, radiation therapy, or targeted therapies, can dramatically improve outcomes.

Surgery plays a central role in many early-stage cancers. It allows complete removal of the malignant mass before it spreads. But treatment is now far more personalised than it used to be. Advances in genomic testing, precision medicine, and minimally invasive procedures mean that not every cancer requires extensive surgery. Some tumours respond effectively to medicines that shrink or stabilise them, reducing the need for large operations.

How Doctors Decide: The Factors That Matter

Whether a tumour needs surgery depends on a combination of factors, not on the label alone. Doctors consider:

• Type of tumour: benign vs. malignant
• Size and location: whether the tumour is pressing on vital structures
• Growth pattern: stable, slow-growing, or rapidly increasing
• Symptoms: pain, bleeding, difficulty swallowing, breathing issues, or neurological changes
• Impact on organs: whether it disrupts normal function
• Age and overall health of the patient

This decision-making process ensures that patients receive treatment tailored to their medical needs rather than a one-size-fits-all approach.

Caring for Someone with a Tumour: What Families Should Know

For caregivers, uncertainty is often the hardest part. Clear information can make the journey less overwhelming. It helps to remember:

• A tumour is not automatically cancer
• Benign growths often need only monitoring
• Malignant tumours benefit from early evaluation and timely treatment
• Treatment plans are designed to preserve quality of life, not just remove disease
• Second opinions are common and can be helpful

National health programmes in India continue to encourage early reporting of symptoms, unusual lumps, persistent pain, unexplained fatigue, or changes in bodily habits. Such vigilance makes a meaningful difference in outcomes.

A Balanced Perspective: Acting With Clarity, Not Fear

The presence of a tumour is undoubtedly alarming, but it need not lead to panic. Understanding the difference between benign and malignant tumours helps families focus on facts rather than fear.

The core message is simple: not all tumours need surgery, but all tumours need proper evaluation. Early consultation, timely diagnostics, and personalised treatment plans give patients the best chance at recovery and long-term well-being.

With the right guidance, a diagnosis that once caused distress can become the start of informed, confident decision-making, bringing reassurance to caregivers and strength to those undergoing treatment.