Professor Vogelstein explains that the only difference between a benign tumor and a malignant tumor is not the size, it's the ability of the malignant tumor to invade, and get through the tissues.

Bert Vogelstein, M.D. is a Howard Hughes Medical Institute Investigator and the Clayton Professor of Oncology and Pathology at Johns Hopkins University. His research focuses on the identification and characterization of genes that cause colon cancer. This has led to the discovery of the APC gene – the "gatekeeper" in colon cancer development. “The only difference between a benign tumor and a malignant tumor is not the size, it's the ability of the malignant tumor to invade, to get through the tissues. A benign tumor stays put so the surgeon can cut it out easily. But in a malignant tumor the cells will invade underneath the layers that normally keep the epethelium away from the connective tissues underneath, and that invasion is what's bad, because they not only invade through those tissues in the colon, they can invade into a blood vessel or lymphatic and start a new tumor called a metastasis in the liver, or the lung, or elsewhere. And once a patient has disseminated metastases then they no longer can be cured by surgery, in fact, the tumors, the cancers in the place they started, in this case the colon, is never what kills people. What kills patients is always the metastasis that the surgeon can't remove.”

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