Title:Anaesthesia in Cancer Surgery: Can it Affect Cancer Survival?
Volume: 11
Issue: 1
Author(s): Bruce Ben-David
Affiliation:
Keywords:
Anesthesia, immunologic effects, oncologic, surgery.
Abstract: Surgical removal of a tumor may, ironically, unleash prometastatic effects that enhance
cancer recurrence and metastatic disease. The patient’s physiologic response to the surgical trauma
may increase tumor cell growth and invasiveness while diminishing the immune system’s ability to
eliminate residual disease. At the same time anaesthetic drugs used to accomplish the surgery may
also have important effects on cancer cells and the immune system. Those combined effects potentially
lead to sooner recurrence of local or metastatic cancer, and, ultimately, decreased survival. This review
explores current research on the influences of surgery and anaesthesia on tumor cells, the immune
system, and cancer recurrence. Although a substantial body of evidence sheds much light on the nature of these processes
and is at times suggestive of how they might be relevant in clinical practice that literature also reveals a foundation of data
that remain largely preclinical with as yet insufficient human study to support clinical recommendations. The tantalizing
possibility that anaesthetic care of the surgical oncology patient might affect long term oncologic outcome remains
unproven speculation, awaiting prospective human study.
