cancer-2018-posters-abstracts

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Journal of Medical Oncology and Therapeutics | Volume: 3

July 23-25, 2018 | Moscow, Russia

World Cancer Congress

Solution proposed to a 2000 year old problem in Oncology

Michael Retsky

Harvard TH Chan School of Public Health, USA

University College London, UK

bimodal pattern of hazard of relapse among early stage

breast cancer patients has been identified in multiple

databases from US, Europe and Asia. We are studying these

data to determine if this can lead to new ideas on how to

prevent relapse in breast cancer. Using computer simulation

and access to a very high quality database from Milan for

patients treated with mastectomy only, we proposed that

relapses within 3 years of surgery are stimulated somehow

by the surgical procedure. Most relapses in breast cancer

are in this early category. Retrospective data from a Brussels

anesthesiology group suggests a plausible mechanism. Use

of ketorolac, a common NSAID analgesic used in surgery

was associated with far superior disease-free survival in the

first 5 years after surgery. The expected prominent early

relapse events in months 9-18 are reduced 5-fold. Transient

systemic inflammation accompanying surgery (identified

by IL-6 in serum) could facilitate angiogenesis of dormant

micrometastases, proliferation of dormant single cells, and

seeding of circulating cancer stem cells (perhaps in part

released from bone marrow) resulting in early relapse and

could have been effectively blocked by the perioperative

anti-inflammatory agent. If this observation holds up to

further scrutiny, it could mean that the simple use of this

safe, inexpensive and effective anti-inflammatory agent

at surgery might eliminate early relapses. Similar bimodal

patterns have been identified in other cancers suggesting

a general effect. Based on the writings of Galen and

Celsus, such an effect was known to them 2000 years ago.