Surgery and metastasis
The surgical removal of the primary tumor has been the cornerstone of treatment for the great majority of cancers. It presents the opportunity to eliminate cancer or stop its development. An issue that raises concern in recent years among the medical community relates to the relationship between surgery and metastatic spread. This controversial issue is a source for anxiety and concern, and has lead to many discussions that have inspired research among leading scientists. The assumption is that during surgery there is some leakage of cancer cells into the blood stream that leads to the spread the cancer. The metastatic recurrence at times is far more serious than the original tumor and can be a cause of cancer-related deaths. The question that comes into mind is if by preventing those cells from leaking we can prevent further dissemination. Research is in its infancy addressing this issue. But early research has shown some possible actions that a patient can make to reduce this risk.
Stress Reduction and Surgery
During stress certain hormones have been shown to be elevated. These hormones have a negative effect on the immune system. A group of Israeli researchers have shown that be giving beta-blockers that inhibit the production of these hormones, they can significantly reduce the development of metastasis.
Stress and the surgery itself can increase hormones (catecholamines and prostaglandins) that suppress the immune system and increase the spread of cancer. The essential role the immune system plays in combating cancer cannot be overstated. Although there are many aspects of the immune system that come into account when fighting cancer, the role of the natural killer cell dominates. Natural killer (NK) cells are a type of white blood cell in charge of seeking out and destroying cancer cells. When NK cells are suppressed, metastases can develop. Animal studies have shown that by administrating beta-blockers that inhibit or decrease the release of these hormones preoperatively an improvement in
the immune system and reduction of tumor metastasis was seen.
The same effect that is obtained by beta blockers can be obtained by stress reduction
techniques. Utilizing stress reduction techniques before and during surgical procedures can reduce complications of surgery, such as bleeding, reduce the length of the surgical procedure time and enhance quick recovery. Link
The fear of surgery, the waiting, and the surgical procedure itself can put stress on the body and the mind. The stronger you are physically and mentally, the better you’ll handle it. There are a few ways to reduce these stresses. One way is to become as well informed as possible regarding the illness, the prescribed therapies, and the surgical treatment. An understanding of the procedure, why it is needed, and how it is performed can relieve a great deal of worry. Other ways of reducing stress include reading a book or listening to music during the preoperative phase which can alleviate anxiety by taking the patient’s mind off of what is about to happen. Also a familiar stress reduction routine, such as taking a bath or a walk, can help with anxiety before surgery.
Modified Citrus Pectin (MCP)
One mechanism by which surgery increases the risk of metastasis is by enhancing cancer cell adhesion. Cancer cells that have broken away from the primary tumor make use of adhesion to increase their ability to form metastases in far away organs. These cancer cells must be able to cluster together and form satellites that can expand and grow in order to form metastases. A natural supplement called modified citrus pectin (MCP) extracted from citrus fruits found in the lab to prevent cancer cell adhesion. Modified citrus pectin can also inhibit circulating tumor cells from latching onto the lining of blood vessels, thus preventing angiogenisis (the building of new blood vessels that support the tumor). Both of these processes inhibit cancer metastasis.
Responses to stress before surgery can harm the immune system and prolong recovery after the surgery. One way to minimize these effects is to reduce inflammation.
Omega-3 found in fish oil has been shown to have anti-inflammatory effects.
A recent animal study showed that fish oil taken before surgery reduced harm to the immune system caused by surgery, reduced metastatic spread of cancer, and increased long term survival.
Selenium is a micronutrient important to human health, primarily through anti-oxidant, anti-inflammatory, and anti-viral mechanisms. Selenium is also credited with having high anticancer and chemopreventive properties. Selenium can be found in both organic forms (found in foods such as Brazilian nuts, seafood, organ meat as well as other cereal grains and dairy products) and inorganic forms (usually found in soil).
NIH fact sheet - Selenium
It is important to note that in its inorganic form (selenite) can have an adverse effect and can exasperate cancer mastitis. In a study using a mouse model, it is suggested that organic Selenium supplementation may reduce or delay breast cancer metastasis while selenite may exacerbate it.
© 2017 Moshe Frenkel MD
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