Perioperative Inflammation as Triggering Origin of Metastasis Development

Unexpected bimodal relapse patterns for early stage breast cancer have now been identified in databases from Europe, Asia and the US. Similar patterns have also been identified in other cancers including lung, pancreatic, and prostate as well as osteosarcoma and melanoma. What does that imply and where does that lead us? That compound question will be explored in this book.

The book will explain previously unconnected clinical data such as why mammography works better for women 50-59 than it does for women age 40-49, why adjuvant chemotherapy works best for premenopausal patients with positive lymph nodes, and it may also explain the racial disparity in outcome. In particular it points to the perioperative period as when systemic inflammation persists for a week or so. This can lead to a variety of mechanisms whereby single cancer cells (perhaps from the marrow) begin division and angiogenesis of dormant avascular micrometastases occurs leading to early relapses.

This investigation crosses several medical specialties and creates new therapeutic opportunities. One such therapy is the use of perioperative NSAID ketorolac as analgesic. This drug has been occasionally used in such manner for several decades. The only unfavorable side effect is excessive bleeding that is reported by some investigators but denied by others. Breast cancer is a disease that runs its course in a decade or more but we propose that most events that ultimately result in relapse occur in the week after primary surgery during which time metastatic initiation is amplified 100 fold. This volume can be used as a reference for practicing physicians and as a jumping-off point for researchers to explore this development. Chapters are presented from distinguished scientists and physicians in a variety of specialties that relate to and border the effects we present.

• ISBN: 978-3-319-57942-9
• Editorial: Springer
• Encuadernacion: Cartoné
• Páginas: 180
• Fecha Publicación: 11/09/2017
• Nº Volúmenes: 1
• Idioma: Inglés