Perioperative NSAIDs may reduce early relapses in breast cancer: Perhaps transient systemic inflammation after surgery leads to these relapses

Abstract

I developed countries, metastatic relapse after diagnosis of early stage breast cancer is the common pathway leading to mortality from the disease. How to prevent relapses remains perhaps the most important unsolved problem in oncology. As my colleagues and I recently reported, analysis of clinical breast cancer relapse data after mastectomy suggests most distant relapses occur within 4 years of surgery and are precipitated or accelerated by something that happens around the time of surgery. Sudden growth from single cells and angiogenesis of avascular micrometastases are indicated. Late relapses are not accelerated by surgery. Many clinical characteristics of breast cancer can be explained with this hypothesis. Recent retrospective analysis of clinical data from one Brussels hospital indicates early relapse events were reduced 5-fold when an NSAID was used as perioperative analgesic. Combining the surgery induced metastatic activity hypothesis with these Brussels data suggests transient systemic inflammation following primary tumor removal (identified by markers in serum) may facilitate most metastatic activity and was effectively blocked by the NSAID. While breast cancer is a disease that runs its course in over a decade, most of the damage seems to occur in the week or two after surgery. This suggests new mechanisms for metastatic initiation and possibly an effective nontoxic, low cost intervention that may significantly reduce mortality from breast cancer. Michael Retsky, Clinic Pharmacol Biopharmaceut 2013, 2:3 http://dx.doi.org/10.4172/2167-065X.S1.004