Reducing the risk of post-surgical cancer recurrence: a perioperative anti-inflammatory anti-stress approach

What is it about?

Cancer metastases (cancer recurrence) is the leading cause of cancer mortality. Here, we indicate the critical impact of the perioperative period (defined as the days before to weeks after surgery for tumor removal) on long-term cancer outcomes and survival. We focus on the de-stabilization of the pre-operative balance between pro- and anti-metastatic signals, leading to either post-operative metastatic outbreak, or to post-operative disease arrest (dormant or non-progressing residual malignant disease). This critical perioperative period remains mostly un-exploited for therapy, and we suggest that a perioperative β-adrenergic blockade and COX2 inhibition, through the perioperative use of safe and inexpensive drugs (i.e., propranolol and etodolac), which reduces stress and inflammatory responses, will attenuate cancer recurrence.

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