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5 months ago


Sorry for the long absence of posting, I just needed a media break.

Below is a review of a very interesting study showing that in mice who had aggressive breast cancer ANY surgery caused an increase in tumor activity. Use of NSAIDs-drugs such as Ibuprofen, lowered this effect, though did not eliminate the risk. This is important in decision making for all non essential surgery after a cancer diagnosis. It also informs the possible use of NSAIDs in the setting of any post cancer diagnosis surgery.

Surgery Might Promote Growth of Metastases

Anthony L. Komaroff, MD reviewing Krall JA et al. Sci Transl Med 2018 Apr 11.

In a mouse model, surgery of any type promoted growth of tumor cells at secondary locations.

Clinical lore says that resection of a primary tumor can cause previously inapparent metastatic deposits to flare. In a mouse model of breast cancer, researchers tested whether and how this phenomenon might occur.

In a series of experiments in 273 mice that had not developed breast cancer naturally, aggressive mouse breast cancer cells were implanted in various locations (i.e., “pseudo-metastases”). Initially, the tumor cells grew, but then they entered a period of dormancy. This dormancy occurred only in mice with intact immunity, not in immunodeficient mice, which suggests that the immune system contains (but doesn't eliminate) pseudo-metastases. Surgery of any type (not just resection of a primary tumor) led to the aggressive growth of pseudo-metastases in 60% of animals, compared with 10% of control animals that did not undergo surgery. Surgical procedures caused systemic inflammatory responses: Activated monocytes from the marrow traveled to the sites of the pseudo-metastases and became tumor-associated macrophages. These macrophages suppressed the immune system near the tumor, thereby awakening the pseudo-metastases from their dormancy. Treating the animals with nonsteroidal anti-inflammatory drugs before and immediately following surgery greatly attenuated growth of pseudo-metastases.
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