Perioperative anti-inflammatory treatment could prevent or reduce the risk of secondary spread of breast cancer after the primary resection surgery according to a paper published April 11 in Journal of Science and Translational Medicine.
The study was conducted in mice but could offer an explanation for the resurgence of the tumor after primary surgery in humans too. It has been a long-known fact that after undergoing lumpectomy or mastectomy, there is metastatic recurrence elsewhere in the body after a year or two.
The cause of this is long been debated, some researchers taking it as the natural progression of disease while others propose that handling of the tumor during surgery release the cancerous cells in the circulation.
The researchers set up an experimental wound healing mice model who had breast cancer. They did not do any surgery or disturbed the primary tumor. The systemic inflammatory response to wound led to new tumor growth at the distant site, which was kept in check by the tumor-specific T cell response. Probably, the wound healing consumed all the T-cells that previously kept a check on tumor cells.
The researchers gave the mice NSAIDs for wound healing and noted that the growth of secondary metastasis was curbed considerably.
Earlier clinical studies have suggested that perioperative anti-inflammatory drugs reduce early metastatic recurrence in breast cancer patients, but no explanation was put forth for the cause.
A 2012 study particularly showed that breast cancer patients given the anti-inflammatory drug ketorolac during surgery were five times less likely to have their cancer spread than people who didn’t get the painkiller
“This represents the first causative evidence of surgery having this kind of systemic response,” Jordan Krall, the first author of the study and a researcher at the Massachusetts Institute of Technology's White Head Institute for Biomedical Research, said in a statement announcing the study's publication.
“Surgery is essential for treating a lot of tumors, especially breast cancer," Krall added. "But there are some side effects of surgery, just as there are side effects to any treatment. We’re starting to understand what appears to be one of those potential side effects, and this could lead to supportive treatment alongside surgery that could mitigate some of those effects.”
It’s not yet clear whether any specific NSAIDs will give more benefit than others, or what’s the best dose or timing to deliver the drug.
Professor Robert Weinberg, the new study’s senior author says, “Mice are not people and therefore this may not translate into clinical practice. Our paper is only intended to alert people to this possibility and to explore whether this mechanism operates as well in humans as we think it might.”
Scientist agrees that more research is needed to investigate an explanation as simple as this, as NSAIDs are routinely used in the peri and postoperative period to ease the pain.
