Prevenzjoni Kirurġija indotta metastasi Kanċer
mill Steven Nemeroff ND fuq 09/12/09 fil 04:53
Kirurġija Kanċer: X'għandek tkun taf qabel iż-żmien
Il-pedament ta 'trattament għall-maġġoranza kbira ta' kanċer huwa t-tneħħija kirurġika tat-tumur primarju. Ir-raġuni għal dan l-approċċ huwa sempliċi: jekk inti tista 'jeħles mill-kanċer billi sempliċiment tneħħih mill-ġisem, imbagħad kura tista' x'aktarx jintlaħqu. Sfortunatament, dan l-approċċ ma jieħu in kunsiderazzjoni li wara l-kirurġija l-kanċer spiss metastasize (jinfirxu għal organi differenti). Spiss ir-rikorrenza metastatiku hija ħafna aktar gravi minn tumur oriġinali. Fil-fatt, għall-kanċer ħafna huwa l-rikorrenza-u metastatiku mhux il-primarja tumur li finalment jirriżulta li jkun fatal.1
Fi ironija xokkanti, korp dejjem jikber ta 'evidenza xjentifika wriet li kirurġija ta' kanċer jistgħu jżidu r-riskju ta metastasis.2 Dan jtiru fil-wiċċ ta 'ħsieb medika konvenzjonali, imma l-fatti huma evidenti.
Biex jinkiseb fehim aħjar ta 'kif kirurġija jistgħu jżidu r-riskju ta' metastasi, ejja ewwel jiddiskutu l-proċess attwali ta 'metastasi kanċer. Sekwenza kkumplikata ta 'avvenimenti trid iseħħ biex għall-kanċer li jinfirxu għal parti oħra mill-body.2 ċelluli tal-kanċer iżolati li jaqtgħu mill-tumur primarju għandu 1 jiksru l-tessut konnettiv minnufih iddawwar il-kanċer. Ladarba l-ċellula tal-kanċer neħħiet ħielsa tat-tessut konnettiv madwar, il-pass li jmiss huwa li jidħol demm jew bastiment limfatika. Dan huwa aktar faċli minn qal jsir, bħala dħul ġo vina jew arterja teħtieġ l-ċellula tal-kanċer inixxu l-enzimi li jiddegradaw il-membrana kantina tad-demm vessel.3 Dħul ġo vina jew arterja huwa importanti ħafna għall-ċellula tal-kanċer metastatiku jaspiraw, peress li juża l- demm bħala awtostrada għat-trasport lejn organi vitali oħra tal-ġisem bħal pereżempju s-fwied, moħħ, jew pulmun-fejn jistgħu jiffurmaw tumur fatali ġdid.
Issa li l-ċellula tal-kanċer isolati kinitx daħlet fis-demm, il-problemi tagħha biss kif beda. Jivvjaġġaw fi ħdan l-demm tista 'tkun vjaġġ perikoluż għall ċelluli tal-kanċer. Turbulence mid-demm mgħaġġlin jistgħu jagħmlu ħsara u jeqirdu l-ċellula tal-kanċer. Barra minn hekk, ċelluli tal-kanċer għandhom jevitaw kxif u l-qerda minn ċelluli bojod tad-demm jiċċirkola fid-demm.
Biex itemmu vjaġġ tagħha, il-ċellula tal-kanċer diżonesti għandhom jaderixxu mal-inforra tal-arterja, fejn tiddegrada permezz u ħruġ tal-membrana kantina ta 'l-arterja. Kompitu finali tiegħu huwa li bejta permezz tal-connective tissue madwar biex jaslu fl-organu li huwa d-destinazzjoni finali tagħha. Issa l-ċellula tal-kanċer jistgħu jimmultiplikaw u jiffurmaw kolonja li qed jikber li sservi bħala l-pedament għal kanċer metastatiku ġdid. Ħin qed taħdem kontra dawn iċ-ċelluli tal-kanċer solitarji. Din is-sekwenza sħiħa ta 'avvenimenti għandu jiġri malajr, peress li dawn iċ-ċelluli għandhom ħajja limitata span.1
Aħna issa tara li metastasi kanċer huwa proċess ikkumplikat u diffiċli. Mimli peril, ċelluli ftit kanċer free-standing jgħix din journey.2 diffiċli Il-probabilità ta 'ċelluli tal-kanċer superstiti dan il-vjaġġ u li jiffurmaw metastasi ġodda jistgħu jiġu miżjuda xi ħaġa li sservi biex jagħmlu dan il-proċess aktar faċli.
Fi studju revoluzzjonarju ippubblikata fil-Annals ġurnal mediku tal-Kirurġija fl-2009, riċerkaturi rrapportaw li kirurġija ta 'kanċer innifsu jista jinħoloq ambjent fil-ġisem li jnaqqas bil-kbir l-ostakli għall metastasi li ċ-ċelluli kanċer għandu normalment face.2
Hekk kif huwa dwar l-rivelazzjoni li kirurġija ta 'kanċer jistgħu jipproduċu sostitut rotta ta' metastasi li taqbeż ostakoli naturali. Matul kirurġija ta 'kanċer, it-tneħħija tat-tumur kważi dejjem jfixkel l-integrità strutturali tat-tumur u / jew il-vini tmigħ-tumur. Dan jista 'jwassal għal tixrid mhux mgħottija ta' ċelluli tal-kanċer fid-demm, jew jinżergħu dawn iċ-ċelluli tal-kanċer direttament fis-sider jew abdomen.4-7 Dan kirurġija indotta "rotta alternattiva" tista 'tissimplifika l-passaġġ għall metastasi.
Bħala eżempju, studju ppubblikat fil-Ġurnal British ta 'Kankru fl-2001 meta mqabbel-sopravivenza ta' nisa bil-kanċer tas-sider li kellhom tumuri tagħhom jitneħħa kirurġikament, għas-sopravivenza ta 'nisa bil-kanċer tas-sider li ma kellhomx kirurġija. Kif kien mistenni, is-sejbiet stabbilit li operazzjoni sostanzjalment mtejba sopravivenza fis-snin bikrija.
Madankollu, l-analiżi ulterjuri tad-data stabbilit li n-nisa li kellhom kirurġija kellhom spike fir-riskju tagħhom ta 'mewt għal tmien snin li ma kienx evidenti fil-grupp li ma kellhomx surgery.8 Fl-interpretazzjoni tagħhom tar-riżultati, l-awturi tal-istudju iddikjara: "A ipoteżi raġonevoli biex jispjegaw l-mudelli osservati tal-funzjonijiet ta 'periklu [riskju ta' mewt kanċer] hija li wieħed jassumi li ... tneħħija tumur primarju jista 'jirriżulta fil-aċċelerazzjoni f'daqqa ta' proċess metastatiku ..."
Grupp ieħor ta 'riċerkaturi jikkummenta fuq studju li jeżamina l-kura kirurġika ta' kanċer tal-kolon kienu ferm aktar kuraġġuża fil-konklużjonijiet tagħhom: "Din is-sejba jappoġġja bis-sħiħ li kirurġija jibdel il-kors naturali tal-marda mill elongating għomor fil-parti l-kbira tal-popolazzjoni ta 'pazjenti, iżda wkoll simultanjament billi tqassar sopravivenza fi grupp iżgħar ta 'pazjenti. Għalhekk, kemm l-appoġġ evidenza sperimentali u kliniċi li kirurġija, għalkemm naqqas ħafna massa tumur u potenzjalment kurattivi, paradossalment jistgħu wkoll iżidu l-iżvilupp metastasi. "2
Minħabba dawn is-sejbiet inkwetanti, dak li jista 'individwi soġġetti għal kirurġija għall-kanċer tagħhom jagħmlu biex jipproteġu lilhom infushom kontra riskju miżjud ta' metastasi? Strateġija utli tkun li teżamina kollha tal-mekkaniżmi li permezz tagħhom kirurġija jippromwovi metastasi, u mbagħad toħloq pjan komprensiv li jikkumbatti kull wieħed u waħda ta 'dawn il-mekkaniżmi.
X'GĦANDEK BŻONN LI TAF: KIRURĠIJA KANĊER
• tneħħija kirurġiċi ta 'kanċer tipikament tipprovdi l-aħjar ċans ta' ħieles mill-mard sopravivenza.
• Korp dejjem jikber ta 'evidenza tissuġġerixxi li kirurġija ta' kanċer innifsu jista 'jżid ir-riskju ta' metastasi (jinfirxu għal oqsma oħra) permezz ta 'mekkaniżmi bosta inklużi: żieda kanċer taċ-ċelluli adeżjoni, il-funzjoni immuni soppressjoni, anġjoġenesi jippromwovi u infjammazzjoni stimulanti.
• Peress mard metastatiku spiss deadlier mill-tumur oriġinali, huwa importanti li jutilizza l-istrateġiji preventivi biex jipprevjenu metastasi kanċer.
• Passi li jgħinu jipprevjenu kanċer metastasi jinkludu: il-ġlieda kontra adeżjoni ċellula tal-kanċer, l-appoġġ tas-saħħa immuni, titqajjem sorveljanza immuni, anġjoġenesi jinibixxu, infjammazzjoni jimminimizzaw, u kirurgi jagħżlu u anesthesiologists li tutilizza tekniki avvanzati li jistgħu jnaqqsu riskju metastatiku.
• L-nutrijenti Ċerti, drogi, tipi ta 'anestesija, u tekniki kirurġiċi huma assoċjati ma' riskju mnaqqas ta 'metastasi.
Kirurġija Żidiet Adeżjoni Cell Kanċer
Mekkaniżmu wieħed li permezz tiegħu kirurġija iżid ir-riskju ta 'metastasi huwa billi ċelluli tal-kanċer jtejbu cell Kanċer adhesion.9 li jkunu maqsuma bogħod mill-tumur primarju tutilizza adeżjoni biex tingħata spinta lill-kapaċità tagħhom biex jiffurmaw metastasi fl-organi bogħod. Dawn iċ-ċelloli tal-kanċer għandhom ikunu jistgħu miċ flimkien u jifformaw kolonji li jistgħu jespandu u jikbru. Huwa improbabbli li ċellula tal-kanċer waħda se jiffurmaw tumur metastatiku, hekk kif persuna waħda mhux probabbli li jiffurmaw komunità b'saħħitha. Ċelluli tal-kanċer użu adeżjoni molekuli bħall-galectin-3-li jiffaċilitaw kapaċità tagħhom li miċ flimkien. Preżenti fuq il-wiċċ ta 'ċelluli tal-kanċer, dawn il-molekuli jaġixxu bħal velkro billi ċelluli tal-kanċer free-standing li jaderixxu ma' kull Kanċer taċ-ċelluli other.10 jiċċirkolaw fid-demm wkoll jagħmlu użu ta galectin-3 molekoli ta 'adeżjoni tal-wiċċ li lukkett fuq il-kisja ta' demm vessels.11 Il aderenza ta 'jiċċirkola ċelluli tat-tumur (CTC) mal-ħitan arterja huwa pass essenzjali għall-proċess ta' metastasi.
Eżatt bħal persuna jiżżerżqu isfel 1 għoljiet tħaddan m'għandha l-ebda tama ta 'waqfien jekk dawn ma jistgħux grab fuq xi ħaġa, ċellula tal-kanċer li ma jistgħux jaderixxu mal-ħajt arterja biss se tkompli wander permezz tal-fluss tad-demm inkapaċi li jiffurmaw metastasi. Kapaċi li lukkett fuq il-ħitan tal-bastiment demm, dawn ċelluli tat-tumur jiċċirkolaw jsiru bħal "bastimenti mingħajr port" u ma jkunux jistgħu dock. Eventwalment, ċelluli bojod tad-demm jiċċirkola fid-demm se mira u teqred il-CTC. Jekk il-CTC b'suċċess jorbtu mal-ħajt arterja u bejta mod tagħhom permezz tal-membrana kantina, li huma mbagħad jużaw molekoli ta 'adeżjoni galectin-3 li jaderixxu mal-organu li jiffurmaw metastatiku ġdid cancer.10
Il-ġlieda kontra Adeżjoni Cell Kanċer
Sfortunatament, ir-riċerka wriet li kirurġija ta 'kanċer iżid adeżjoni taċ-ċelluli tat-tumur. Fil-esperiment wieħed li mimicked kondizzjonijiet kirurġiċi, xjentisti rrappurtaw li l-irbit ta 'ċelluli tal-kanċer mal-ħitan arterja żdied 250%, imqabbel ma' ċelluli tal-kanċer ma esposti għal conditions.12 kirurġika Għalhekk, huwa ferm importanti għall-persuna li jgħaddu minn kirurġija kanċer li jieħdu miżuri li jistgħu jgħinu biex jinnewtralizza-żieda kirurġija indotta fi adeżjoni ċellula tal-kanċer.
Pektin Modifikat ċitru
Fortunatament, suppliment naturali imsejħa modifikata ċitru pektin (MCP) tista 'tagħmel dan. Pektin-1 Ċitru tip ta 'dieta fiber mhux assorbit mill-musrana. Madankollu, pektin ċitru modifikati ġie mibdul sabiex ikun jista 'jiġi assorbit fid-demm u jeżerċitaw kontra l-kanċer effetti tiegħu. Il-mekkaniżmu li bih pektin ċitru modifikati jinibixxi adeżjoni ċellula tal-kanċer huwa billi jorbtu lill galectin-3 molekoli ta 'adeżjoni fuq il-wiċċ ta' ċelluli tal-kanċer, b'hekk jipprevjeni ċelluli tal-kanċer milli jeħlu ma 'xulxin u li jiffurmaw cluster.13 pektin ċitru Modifikat tista' wkoll jinibixxu jiċċirkola ċelluli tat-tumur minn latching fuq l-inforra tal-vini. Dan intwera permezz ta 'esperiment illi fih pektin ċitru modifikat mblukkat l-adeżjoni ta' galectin-3 għall-kisja tal-vini minn ċifra inkredibbli 95%. Pektin ċitru Modifikat wkoll sostanzjalment naqas l-adeżjoni ta 'ċelluli tal-kanċer tas-sider mal-arterja walls.13
Riċerka impressjonanti dokumentata-poter ta 'pektin ċitru modifikati biex direttament jinibixxu metastasi kanċer. Fi studju ppubblikat fil-Ġurnal ta 'l-Istitut Nazzjonali tal-Kanċer, pektin ċitru modifikata ingħata lil firien li kienu injettat bi ċelluli tal-kanċer tal-prostata, filwaqt firien ma jirċevux pektin ċitru modifikata servew bħala l-grupp ta' kontroll. Metastasi Pulmun kien innutat fil 93% tal-grupp ta 'kontroll, filwaqt li biss 50% tal-modifikata ċitru pektin grupp metastasi tal-pulmun bl-esperjenza. Saħansitra aktar notevoli kien il-konstatazzjoni li l-modifikata grupp pektin ċitru kellhom tnaqqis 89% fid-daqs tal-kolonji metastatiku, meta mqabbel mal-kontroll group.14 Fi esperiment simili, ġrieden injettat mal ċelluli tal-kanċer melanoma li kienu mitmugħa pektin ċitru modifikati esperjenza tnaqqis akbar minn 90% fl-metastasi tal-pulmun meta mqabbla mal-kontroll group.15
Wara dawn is-sejbiet eċċitanti fir-riċerka l-annimali, pektin ċitru modifikata ġiet imbagħad jitqiegħdu għat-test fl-irġiel b'kanċer tal-prostata. F'din il-prova, 10 irġiel b'kanċer tal-prostata rikorrenti rċeviet modifikati pektin ċitru (14.4 g kuljum). Wara sena, titjib konsiderevoli fil-progressjoni kanċer kien innutat, kif determinat permezz ta 'tnaqqis tar-rata li biha l-speċifiku tal-prostata antiġen (PSA) livell increased.16 Dan kien segwit minn studju li fih 49-irġiel b'kanċer tal-prostata ta' diversi tipi ngħataw modifikati ċitru pektin għal ċiklu 'erba' ġimgħat. Wara żewġ ċikli ta 'trattament pektin ċitru modifikat, 22% tal-irġiel esperjenzaw istabbilizzazzjoni tal-marda tagħhom jew il-kwalità ta' ħajja; 12% kellhom mard stabbli għal aktar minn 24 ġimgħa. L-awturi tal-istudju kkonkluda li "MCP (pektin ċitru modifikata) jidher li jkollhom impatti pożittivi speċjalment fir-rigward benefiċċju kliniku u kwalità tal-ħajja għal pazjenti tumur solidu avvanzati ħafna." 17
Jekk jogħġbok ftakar li dawn is-suġġetti ta 'studju tal-prostata kanċer diġà sofrew minn mard avvanzat. Kieku jidher iktar loġiku jekk dawn il-pazjenti kienet bdiet modifikati supplimentazzjoni pektin ċitru qabel proċeduri kirurġiċi biex jipprevjenu kolonji metastatiku milli tiġi stabbilita, kif sar fl-istudji tal-laboratorju ta 'suċċess.
Tagamet (cimetidine) u teħel Cell
Minbarra l-pektin ċitru modifikata, magħrufa sew over-the-counter medikazzjoni jistgħu wkoll jilagħbu rwol ċentrali fit-tnaqqis adeżjoni ċellula tal-kanċer. Cimetidine-komunement magħrufa bħala Tagamet ®-hija droga storikament użata biex ittaffi istonku. Korp dejjem jikber ta 'evidenza xjentifika wriet li cimetidine jippossjedi wkoll qawwi kontra l-kanċer attività. Cimetidine jinibixxi adeżjoni ċellula tal-kanċer billi jimblokka l-espressjoni ta 'kolla molekula imsejħa E-selectin fuq il-wiċċ ta' ċelluli tad-demm inforra vessels.15 ċelluli kanċer lukkett fuq E-selectin sabiex jaderixxu mal-kisja ta 'demm vessels.18 Billi jipprevjenu l-espressjoni ta 'E-selectin, cimetidine jillimita b'mod sinifikanti l-kapaċità ta' aderenza ċellula tal-kanċer mal-ħitan arterja. Dan l-effett huwa analogu għal tneħħi l-velkro mill-ħitan vini li normalment jippermettu tiċċirkola ċelluli tat-tumur li torbot.
Cimetidine ma potenti kontra l-kanċer effetti kienu murija b'mod ċar f'rapport ippubblikat fil-Ġurnal British ta 'Kankru fl-2002. F'dan l-istudju, 64 pazjent b'kanċer tal-kolon rċevew kimoterapija bi jew mingħajr cimetidine (800 mg kuljum) għal sena. Is-sopravivenza ta '10 snin għall-grupp cimetidine kien kważi 90%. Dan huwa f'kuntrast qawwi mal-grupp ikkontrollat, li kellhom sopravivenza ta '10 snin ta' biss 49.8%. B'mod eċċezzjonali, għal dawk il-pazjenti forma aktar aggressiva ta 'kanċer tal-kolon, is-sopravivenza ta' 10 snin kienet 85% f'dawk ittrattati cimetidine meta mqabbel ma 'diżastruża 23% fil-kontroll group.19-awturi tal-istudju kkonkluda, "Flimkien, dawn ir-riżultati ssuġġerew mekkaniżmu sottostanti l-effett benefiku ta 'cimetidine fuq pazjenti tal-kolorektum, preżumibbilment billi jimblokka l-espressjoni ta' E-selectin fuq [inforra tal-vini] ċelluli endotiljali vaskulari u jinibixxi l-adeżjoni ta 'ċelluli tal-kanċer. "Dawn is-sejbiet ġew appoġġati mill-ieħor istudju ma 'pazjenti tal-kolorektum wherein cimetidine mogħtija biss għal sebat ijiem fil-ħin tal-kirurġija żieda ta' tliet snin sopravivenza minn 59% għal 93%! 20
Din id-data jipprovdi każ konvinċenti għal pazjenti tal-kanċer, mill-inqas ħamest ijiem qabel il-kirurġija, li jixrob mill-inqas 14 gramma ta 'pektin ċitru modifikati u 800 mg ta' cimetidine kuljum. Din is-sistema kombinata tista 'segwita għal sena jew aktar biex jitnaqqas ir-riskju metastatiku.
Prevenzjoni Kirurġija-Indotta Soppressjoni immuni
Ir-rwol essenzjali tas-sistema immunitarja jilgħab fil-ġlieda kontra l-kanċer ma jistgħux jiġu esaġerati. Għalkemm hemm ħafna aspetti tas-sistema immunitarja li jidħlu fis-seħħ fil-ġlieda kontra l-kanċer, ir-rwol taċ-ċellula qattiel naturali jippredomina. Naturali Killer (NK) ċelluli huma tip ta 'ċelloli bojod kompitu li jfittxu u jeqirdu ċelluli tal-kanċer. Ir-riċerka wriet li ċ-ċelluli NK jistgħu spontanjament jirrikonoxxu u joqtlu varjetà ta 'kanċer cells.21
Naturali Killer ċelloli (NK) Attività u l-Kanċer
Sabiex juri l-importanza ta 'attività taċ-ċelluli NK fil-ġlieda kontra l-kanċer, studju ppubblikat fil-ġurnal ta' Riċerka Kanċer tas-Sider u Trattament eżaminati NK phone attività tan-nisa ftit wara kirurġija għall-kanċer tas-sider. Ir-riċerkaturi rrappurtaw li livelli baxxi ta 'attività taċ-ċelluli NK kienu assoċjati ma' riskju akbar ta 'mewt minn sider cancer.22 Fil-fatt, imnaqqsa attività taċ-ċelluli NK kien tbassar aħjar ta' sopravivenza mill-istadju attwali tal-kanċer. Fi studju ieħor allarmanti, l-individwi b'attività inqas ta 'ċelloli NK qabel kirurġija għall-kanċer tal-kolon kellhom riskju 350% akbar ta' metastasi matul it-31 xahar! 23
Il-probabbiltà ta 'kirurġija indotta metastasi teħtieġ is-sistema immuni li jkun ferm attiva u viġilanti u jfittxu qerda ċelluli tal-kanċer renegade matul il-perjodu perioperative (il-ħin eżatt qabel u wara l-kirurġija). Traġikament, diversi studji ddokumentaw li kirurġija riżultati kanċer fi tnaqqis sostanzjali fil NK phone activity.6, 7,24,25 Fl-investigazzjoni li jkollhom implikazzjonijiet ominous, il NK phone attività fin-nisa li jkollhom kirurġija għall-kanċer tas-sider tnaqqset b'iktar minn 50% fuq l-ewwel jum wara surgery.24 Fid-dawl ta 'dan evidenza dejjem tiżdied, grupp ta' riċerkaturi qal: "Aħna għalhekk nemmnu li ftit wara kirurġija, anki disfunzjoni immuni tranżitorju jista 'jippermetti neoplażmi [kanċer] li jidħlu fil-istadju li jmiss ta' żvilupp u eventwalment jiffurmaw mdaqqsa metastasi. "7
Il-proċedura kirurġika nnifisha tnaqqas l-attività NK. Dan NK ċelluli itellef effett li jseħħ immedjatament wara l-kirurġija ma jista 'jiġri fi żmien agħar possibbli. Attività taċ-ċelluli NK falters meta aktar meħtieġa għall-ġlieda kontra metastasi. Ir-riskju kirurġija indotta akbar ta 'metastasi flimkien ma' tnaqqis fl-attività taċ-ċelluli NK jista 'jkollha konsegwenzi diżastrużi għall-persuna li jgħaddu minn kirurġija kanċer. Ma 'dak imsemmi, il-perjodu perioperative jippreżenta opportunità biex b'mod attiv tissaħħaħ il-funzjoni immuni billi jtejbu l-attività taċ-ċelluli NK. Fortunatament, nutraceutical numerużi, farmaċewtiċi, u interventi mediċi magħrufa li ttejjeb l-attività taċ-ċelluli NK huma disponibbli għall-persuna li jgħaddu minn kirurġija kanċer.
PSK Żidiet Attività Cell NK
Wieħed suppliment naturali prominenti li jistgħu jżidu l-attività taċ-ċelluli NK huwa PSK, (K polysaccharide mal-proteini) estratt ippreparati apposta mill-versicolor faqqiegħ Coriolus. PSK ġie muri li isaħħu l-attività taċ-ċelluli NK fil-kapaċità multipli studies.26-29 PSK li isaħħu l-attività taċ-ċelluli NK jgħin biex tispjega għaliex ġie muri li jtejbu b'mod drammatiku s-sopravivenza f'pazjenti bil-kanċer. Per eżempju, 225 pazjent b'kanċer tal-pulmun irċevew terapija ta 'radjazzjoni bi jew mingħajr PSK (3 grammi kuljum). Għal dawk l-aktar avvanzati Stadju 3 kanċer, aktar minn tliet darbiet ħafna individwi jieħdu PSK kienu ħajjin wara ħames snin (26%), meta mqabbla ma 'dawk li ma jieħdu PSK (8%). PSK aktar minn irdoppja ħames snin sopravivenza f'dawk individwi fir-Istadju anqas avvanzati 1 jew 2 mard (39% vs.17%) 0.30
Grupp ta 'pazjenti tal-kanċer tal-kolon kienu randomized biex jirċievu kimoterapija waħedha jew flimkien ma' kimoterapija PSK, li ġiet meħuda għal sentejn. Il-grupp li ħadu PSK kellu eċċezzjonali ta '10 snin sopravivenza ta' 82%. Sfortunatament, il-grupp li ħadu kimoterapija waħedha kellha sopravivenza ta '10 snin ta' biss 51% .31 Fi prova simili rrappurtat fil-Ġurnal British ta 'Kankru fl-2004, il-pazjenti tal-kanċer tal-kolon rċevew kimoterapija waħedha jew flimkien ma' PSK (3 grammi kuljum) għal sentejn. Fil-grupp bil-kanċer Stadju aktar perikolużi kolon 3, is-sopravivenza ta 'ħames snin kienet ta' 75% fil-grupp PSK. Dan meta mqabbel ma 'sopravivenza ta' ħames snin ta 'biss 46% fil-grupp li qed jirċievu kimoterapija ta' Riċerka alone.32 kkonfermat li PSK ttejjeb ukoll is-sopravivenza fil-kanċer tas-sider, l-istonku, esofagu, u uterus.33-36
Nutraceuticals, erbali u Farmaċewtiċi li Żieda Attività Cell NK
Nutraceuticals oħra li ġew dokumentati li tiżdied l-attività taċ-ċelluli NK huma tewm, glutamina, IP6 (hexaphosphate inositol), AHCC (attiva kompost hexose korrelatata), u lactoferrin.37-41 Wieħed esperiment fil-ġrieden b'kanċer tas-sider sabet li supplimentazzjoni glutamina wassal għal 40% tnaqqis fit-tkabbir tat-tumur paired ma 'żieda ta' 2.5 darbiet taċ-ċelluli NK activity.40
Xjentisti fil-Ġermanja esplorati l-effetti ta 'estratt mistletoe fuq l-attività taċ-ċelluli NK fi 62 pazjent għaddejjin minn kirurġija għall-kanċer tal-kolon. Il-parteċipanti kienu randomized biex jirċievu infużjoni fil-vini ta 'estratt mistletoe immedjatament qabel ma ngħataw anestesija ġenerali, jew ingħataw anestesija ġenerali waħdu. Il-kejl ta 'attività taċ-ċelluli NK ttieħdu qabel u 24 siegħa wara l-kirurġija. Kif kien mistenni, il-grupp li ma rċevewx mistletoe esperjenzat tnaqqis ta '44% fl-attività taċ-ċelluli NK 24 siegħa wara l-kirurġija. Interessanti, il-xjenzjati rrappurtat li l-mistletoe grupp li ħadu ma jesperjenzaw tnaqqis sinifikanti fl-attività taċ-ċelluli NK wara l-kirurġija. Huma marru fuq li wieħed jikkonkludi li "infużjoni perioperative ta 'estratti mistletoe jista' jipprevjeni t-trażżin ta 'attività taċ-ċelluli NK f'pazjenti bil-kanċer." 42
Farmaċewtiċi użati biex tiżdied l-attività taċ-ċelluli NK jinkludu interferon alfa u granuloċiti-makrofagi kolonji tal-fattur li jistimula. Dawn il-mediċini kienu murija li jevitaw indotta kirurġija suppressjoni immunitarja meta jingħataw perioperatively.43, 44 Mediċina oħra immuni spinta biex tikkunsidra fl-iffissar perioperative jista 'jkun interleukin-2.45
Mill-inqas ħamest ijiem qabel il-kirurġija, jidher loġiku li jibda qattiel naturali (NK) ċelluli titjib programm li jinvolvi nutrijenti bħal PSK, lactoferrin, glutamina, u oħrajn. Drogi bħal interleukin-2 u granuloċiti-makrofagi kolonji tal-fattur li jistimula huma approvati fl-Istati Uniti, iżda assigurazzjoni tas-saħħa ġeneralment ma jkoprix minnhom għall-finijiet perioperative suġġerit hawn. Biex tirċievi kopja bla ħlas ta 'l-aħħar rakkomandazzjonijiet tad-dożaġġ għal dawn in-nutrijenti u d-drogi, sejħa 1-800-841-5433 jew log dwar Kanċer Kirurġija tagħna Rapport Speċjali.
Titqajjem Sorveljanza immuni ma Vaċċini Kanċer
Approċċ medika infurmata għat-trattament tal-kanċer tinvolvi l-użu ta 'vaċċini tal-kanċer. Il-kunċett huwa l-istess bħal użu ta 'vaċċini għall-mard infettiv, ħlief li ċ-ċelluli tat-tumur vaċċini kanċer fil-mira minflok virus. Karatteristika oħra distintiva ta 'vaċċini tumur hija li filwaqt vaċċini virali huma maħluqa minn virus ġeneriku, vaċċini tat-tumur huma awtologi, jiġifieri, dawn huma prodotti minn ċelluli ta' persuna kanċer stess jitneħħew waqt il-kirurġija. Din hija distinzjoni kruċjali billi jista 'jkun hemm differenzi ġenetiċi konsiderevoli bejn kanċer. Dan il-vaċċin kanċer ferm individwalizzat ħafna isaħħaħ il-kapaċità tas-sistema immunitarja biex identifikati u indirizzati xi ċelluli tal-kanċer residwi preżenti fil-ġisem. Vaċċini Kanċer jipprovdu s-sistema immunitarja mal-markaturi speċifiċi ta 'identifikazzjoni tal-kanċer li jistgħu mbagħad jintużaw biex jintramaw attakk ta' suċċess kontra ċelluli tal-kanċer metastatiku.
Vaċċini kanċer awtologi ġew studjati b'mod estensiv, bir-riżultati l-aktar inkoraġġanti innutat fil, provi kliniċi randomised, ikkontrollati jinkludu aktar minn 1,300 pazjent kanċer kolorettali li vaċċini tat-tumur ġew mogħtija wara l-kirurġija. Dawn il-provi rrappurtat rati rikorrenza mnaqqsa u mtejba survival.46 B'differenza kimoterapija, li jista 'jkollu effetti sekondarji severi u tossiċità, vaċċini kanċer huma terapija ġentili ma ppruvata fit-tul safety.47
Fi studju storiku irrappurtat fl-2003, l-individwi 567 b'kanċer tal-kolon kienu randomized biex jirċievu kirurġija waħdu, jew kirurġija flimkien ma 'vaċċini derivati minn ċelluli tal-kanċer tagħhom stess. Is-sopravivenza medjana għall-grupp tal-vaċċin kanċer kien aktar minn 7 snin, meta mqabbla mal-medjan ta 'sopravivenza ta' 4.5 snin għall-grupp li ħadu kirurġija waħdu. Is-sopravivenza ta 'ħames snin kien 66.5% fil-grupp tal-vaċċin kanċer, li mċekknin l-% 45.6 ta' ħames snin sopravivenza għall-grupp li ħadu kirurġija alone.48 Din id-differenza evidenti fil-ħames snin sopravivenza b'mod ċar juri l-qawwa tal-vaċċini tal-kanċer mfassla individwalment biex ħafna tiffoka immunità stess tal-persuna għall-mira u attakk ċelluli tal-kanċer metastatiku residwi.
Kirurġija Kanċer, anġjoġenesi, u metastażi
Kanċer jimpjegaw strateġija għaqlija fit-tfittxija tagħhom li jikbru u jirnexxu fil-ġisem. Anġjoġenesi huwa l-proċess li bih bastimenti ġodda tad-demm huma ffurmati minn vini pre-eżistenti. Il-formazzjoni ta 'bastimenti ġodda tad-demm huwa proċess normali u meħtieġ għat-tkabbir fit-tfulija u l-iżvilupp, kif ukoll għall-fejqan tal-feriti. Sfortunatament, kanċer hijack dan il-proċess inkella normali sabiex tiżdied il-provvista tad-demm għall-tumur. Il-formazzjoni ta 'bastimenti ġodda tad-demm li jfornu l-tumur hija ħtieġa assoluta għall-metastasi suċċess peress tumuri ma tista' tikber lil hinn mill-daqs ta 'pinhead (jiġifieri, 1-2mm) mingħajr espansjoni tad-demm tagħhom supply.49, 50
Kontra l-anġjoġeniċi Fatturi
Jista 'jkun sorprendenti li jitgħallmu li l-preżenza tat-tumur primarju sservi biex jinibixxu t-tkabbir ta' kanċer metastatiku x'imkien ieħor fil-ġisem. Il-tumur primarju jipproduċi anti-anġjoġeniċi fatturi li jillimitaw it-tkabbir ta metastases.51-54 Dawn il-fatturi anti-anġjoġeniċi jinibixxu l-formazzjoni ta 'bastimenti ġodda tad-demm għal siti potenzjali tal metastasi. Sfortunatament, it-tneħħija kirurġika tat-kanċer primarja wkoll riżultati fil-tneħħija ta 'dawn il-fatturi anti-anġjoġeniċi, u t-tkabbir ta' metastasi m'għadux inibita. B'dawn ir-restrizzjonijiet jitneħħew, issa huwa aktar faċli għal siti żgħar ta 'kanċer metastatiku li jattiraw bastimenti ġodda tad-demm li jippromwovu growth.55 tagħhom Tabilħaqq, dan it-tħassib tfissru minn riċerkaturi li ddikjaraw li "... tneħħija tat-tumur primarju jista jeliminaw salvagwardja kontra anġjoġenesi u b'hekk jgħarraf micrometastasis rieqed [siti żgħar ta 'kanċer metastatiku]. "7
Peress li jekk it-telf ta 'inibizzjoni anġjoġeniċi mill-tumur primarju ma kinux biżżejjed ta' problema, jirriżulta li l-kirurġija tikkawża ieħor predicament anġjoġeniċi. Wara l-kirurġija, il-livelli ta 'fatturi li jżidu anġjoġenesi-magħruf ukoll bħala fattur ta' tkabbir endotiljali vaskulari (VEGF)-huma elevati ferm. Dan jista 'jirriżulta fi żieda fil-formazzjoni ta' bastimenti ġodda tad-demm forniment oqsma ta 'kanċer metastatiku. Grupp ta 'xjentisti fil-qosor din ir-riċerka pjuttost tajjeb meta affermat li "wara l-kirurġija, il-bilanċ ta' fatturi anġjoġeniċi pro-u antiangiogenic tiġi mċaqilqa favur anġjoġenesi biex jiffaċilitaw fejqan tal-feriti. Speċjalment livelli ta 'fattur ta' tkabbir endotiljali vaskulari (VEGF) huma persistentament elevati. Dan mhux biss jibbenefikaw rikorrenza tumur u l-formazzjoni ta 'mard metastatiku, iżda jwasslu wkoll għall-attivazzjoni ta' micrometastases fissi. "2
Nutrijenti li jinibixxu VEGF
Minħabba ħtieġa tal-kanċer metastatiku fuq provvista tad-demm jespandu, inibizzjoni ta 'anġjoġenesi ċertament tkun parti integrali ta' strateġija komprensiva għall-ġlieda kontra kirurġija indotta metastasi. Għal dak il-għan, nutrijenti varji intwera li jinibixxi VEGF. Dawn jinkludu iżoflavoni tas-sojja (genistein), l silibinin (komponent ta 'ħalib thistle), chrysin, epigallocatechin Gallat (EGCG) mill-tè aħdar, u curcumin.56-62
Fil-esperiment wieħed, EGCG il kostitwent attiv ta 'green tea-ingħata lil ġrieden bil-kanċer fl-istonku. Ir-riżultati wrew li EGCG naqqas il-massa tat-tumur minn 60%, filwaqt li wkoll inaqqas il-konċentrazzjoni tal-vini tmigħ-tumur minn 38%. B'mod eċċezzjonali, EGCG naqas l-espressjoni ta 'VEGF fit ċelluli tal-kanċer permezz ta' ċifra inkredibbli 80%! L-awturi tal-istudju kkonkluda "EGCG jinibixxi t-tkabbir ta 'kanċer gastriku minn tnaqqis tal-produzzjoni VEGF u anġjoġenesi, u huwa kandidat promettenti għall-anti-anġjoġeniċi trattament tal-kanċer gastriku." 56
Fl-evalwazzjoni tar-riċerka li jappartjenu għall curcumin kontra d-anġjoġeniċi effetti, riċerkaturi fl Emory Università Iskola tal-Mediċina nnotat li "Kurkumin huwa inibitur dirett tar-anġjoġenesi u wkoll downregulates proteini proangiogenic varji bħall fattur ta 'tkabbir endotiljali vaskulari ..." Barra minn hekk, il-xjenzjati irrimarka, "molekoli ta 'adeżjoni taċ-ċelloli huma supraregolata anġjoġenesi attiva u curcumin jista' jimblokka dan l-effett, u żżid dimensjonijiet oħra sabiex effett antiangiogenic curcumin fuq." Bħala konklużjoni, ikkummentaw li "effett Kurkumin dwar il-proċess globali ta 'komposti anġjoġenesi potenzjali enormi tagħha bħala mediċina antiangiogenic." 44
Ħamest ijiem qabel il-kirurġija, il-pazjent jista 'jikkonsidra jissupplimentaw ma estratt tat-te standardizzat aħdar, curcumin, estratt genistein tas-sojja u nutrijenti oħra li jrażżnu s VEGF u għalhekk jista' jgħin biex jipproteġi kontra anġjoġenesi. Biex tirċievi kopja bla ħlas ta 'l-aħħar rakkomandazzjonijiet tad-dożaġġ għal dawn in-nutrijenti, is-sejħa 1-800-841-5433 jew log dwar il-Fondazzjoni Life Estensjoni tal-Kanċer Kirurġija Rapport Speċjali: http://www.lef.org/featured-articles/Cancer -Kirurġija-speċjali-Report.htm
L-Għażla ta 'anestesija kirurġiċi jistgħu jinfluwenzaw metastasi
L-approċċ konvenzjonali biex medika anestesija kirurġika kien l-użu ta 'anestesija ġenerali waqt l-operazzjoni, segwiti minn morfina fil-vini wara kirurġija għall-kontroll uġigħ. L-approċċ konvenzjonali, madankollu, ma jistgħux ikunu l-aħjar strateġija għall-prevenzjoni kirurġija indotta metastasi. L-użu ta 'morfina direttament wara l-kirurġija joħloq problemi sinifikanti. Fi żmien meta l-funzjoni immuni diġà mrażżna, morfina aktar ddgħajjef is-sistema immunitarja billi jonqos taċ-ċelluli NK activity.63
Anestesija kirurġiċi Intwera wkoll li jdgħajfu NK phone activity.64 Wieħed istudju sab li morfina żdied anġjoġenesi u stimula t-tkabbir ta 'kanċer tas-sider fil-ġrieden. Ir-riċerkaturi ikkonkluda: "Dawn ir-riżultati jindikaw li l-użu kliniku ta 'morfina jistgħu potenzjalment ikunu ta' ħsara f'pazjenti anġjoġenesi-dipendenti kanċer." 65
Anestesija reġjonali u l-Kontroll Uġigħ
Minħabba l-problemi inerenti assoċjati mal-użu ta 'morfina u anestesija, ir-riċerkaturi jkunu esplorati approċċi oħra anestesija kirurġika u l-kontroll uġigħ. Approċċ ġdid Wieħed huwa l-użu ta 'anestesija ġenerali konvenzjonali flimkien ma anestesija reġjonali, li tirreferi għall anestesija li taffettwa biss parti speċifika tal-ġisem. Il-benefiċċji miksuba dan l-approċċ huma tnejn: l-użu ta 'anestesija reġjonali tnaqqas l-ammont ta' anestesija ġenerali meħtieġa waqt il-kirurġija, kif ukoll inaqqsu l-ammont ta 'morfina meħtieġa wara l-kirurġija għall-uġigħ control.55
Dan l-approċċ eleganti għal anestesija kirurġika u l-kontroll uġigħ ġiet ivvalidata fi studji xjentifiċi. Fil-esperiment wieħed, ġrieden kanċeroġeni irċieva kirurġija anestesija ġenerali waħdu jew flimkien ma anestesija reġjonali. Ix-xjentisti rrappurtaw li l-żieda ta 'anestesija reġjonali biex anestesija ġenerali "sew jimmodera l-promozzjoni ta' metastasi mill-kirurġija." Anestesija reġjonali mnaqqas 70% ta 'l-metastasi-promozzjoni effetti ta' kirurġija kkawżati minn anestesija ġenerali alone.66
Tobba fil Pennsylvania State University Kulleġġ tal-Mediċina mqabbla attività taċ-ċelluli NK f'pazjenti li qed jirċievu anestesija ġenerali jew reġjonali għall-kirurġija addominali. Attività taċ-ċelluli NK niżel sostanzjalment fil-grupp anestesija ġenerali, waqt l-attività taċ-ċelluli NK kien preservat qabel it-kooperattivi livelli fil-grupp li rċieva reġjonali anesthesia.67 Jibnu fuq dawn is-sejbiet inkoraġġanti, ir-riċerkaturi mbagħad esplorat jekk anestesija reġjonali jista 'jaffettwa metastasi fin-nisa għaddejjin minn kirurġija għall-kanċer tas-sider. Fi studju pijunier, 50 nisa li kanċer tas-sider kirurġija anestesija ġenerali flimkien ma 'anestesija reġjonali tqabblu mal-79 nisa li rċivew anestesija ġenerali waqt il-kirurġija tagħhom kanċer tas-sider segwit minn morfina għall-kontroll uġigħ. It-tip ta 'anestesija reġjonali użata jissejjaħ blokk paravertebral, li tinvolvi l-injezzjoni ta' anestetiku lokali madwar in-nervituri tas-sinsla bejn l-għadam vertebrali ta 'l-ispina. Wara perjodu ta 'segwitu ta' kważi tliet snin, id-differenzi drammatiċi kienu nnutati bejn iż-żewġ gruppi. Only 6% of patients who received regional anesthesia experienced a recurrence, compared to a 24% risk of metastatic recurrence in the group that did not receive regional anesthesia. Stated differently, women who received regional and general anesthesia had a 75% decreased risk for metastatic cancer. These findings led researchers to proclaim that regional anesthesia for breast cancer surgery “markedly reduces the risk of recurrence or metastasis during the initial years following surgery.”55
Surgeons at Duke University Medical Center compared regional anesthesia alone to general anesthesia in women having surgery for breast cancer. The surgeons reported that while 39% of the general anesthesia group required medication for nausea and vomiting, only 20% of the regional anesthesia group needed this medication. Narcotic medication was needed for pain control after surgery in 98% of the general anesthesia group, compared to only 25% of the regional anesthesia group. And 96% of the women receiving regional anesthesia had returned home within a day after surgery, compared with 76% of the women who received general anesthesia. The surgeons concluded that regional anesthesia “can be used to perform major operations for breast cancer with minimal complications… Most importantly, by reducing nausea, vomiting, and surgical pain, paravertebral block [regional anesthesia] markedly improves the quality of operative recovery for patients who are treated for breast cancer and therefore provides the patient with the choice to return home as early as desired after surgery.”68
The results of these studies have vast implications for those undergoing cancer surgery, as a group of researchers enthusiastically announced: “As regional techniques [anesthesia]… are easy to implement, inexpensive, and do not pose a threat greater than general anesthesia, it would be easy for anesthesiologists to implement them, thus reducing the risk of disease recurrence and metastasis.”55
Finally, those requiring morphine for pain control after surgery can consider asking their doctor for a medication called tramadol instead. Unlike morphine, tramadol does not suppress immune function.69 On the contrary, tramadol has been shown to stimulate NK cell activity. In one experiment, tramadol blocked the formation of lung metastasis induced by surgery in rats. Tramadol also prevented the surgery-induced suppression of NK cell activity.70
Less Invasive Surgery Reduces Risk of Metastasis
Surgery places an enormous physical stress upon the body. There is considerable scientific evidence supporting that surgeries that are less invasive—and therefore less traumatic—pose less risk of metastasis, compared to more invasive and traumatic surgery. Laparoscopic surgery is one type of minimally invasive surgery, in which operations in the abdomen, pelvis, and other regions are performed through small incisions, as compared to the much larger incisions needed in traditional “open” surgeries.
A study published in the prestigious medical journal The Lancet compared laparoscopic to open surgery to remove part of the colon (colectomy) in patients with colon cancer. In contrast to the group receiving traditional open surgery, the laparoscopic surgery group had a 61% decreased risk of cancer recurrence coupled with a 62% decreased risk of death from colon cancer. The surgeons concluded that laparoscopic colectomy is more effective than open colectomy for treatment of colon cancer as assessed by tumor recurrence and cancer-related survival.71 A long-term follow-up of these patients (median time 95 months) reported a 56% decreased risk of death from colon cancer for laparoscopic surgery as compared to traditional open surgery.72 Another comparison of laparoscopic surgery to open surgery for colon cancer reported a five-year survival rate of 64.1% for the laparoscopic group, and a five-year survival rate of 58.5% for the group receiving open surgery.73
Minimally invasive surgery has produced substantial improvements in survival for those with lung cancer. Video-assisted thoracoscopic surgery (VATS), a minimally invasive surgery, was compared to traditional open surgery for removing lung tumors (lobectomy). The five-year survival from lung cancer was 97% in the VATS group. This greatly contrasts the 79% five-year survival in the open surgery group.74
Commenting on the use of minimally invasive surgery for lung cancer, surgeons at Cedars-Sinai Medical Center stated that minimally invasive surgery for lung cancer “… can be performed safely with proven advantages over conventional thoracotomy [chest surgery] for lobectomy: smaller incisions, decreased postoperative pain,…decreased blood loss, better preservation of pulmonary function, and earlier return to normal activities… the evidence in the literature is mounting that VATS may offer reduced rates of complications and better survival.”75
Administering Chemo and Radiation Therapies Prior to Surgery
Doctors at the University of North Carolina School of Medicine studied the use of combined radiation and chemotherapy prior to surgery for individuals with esophageal cancer. Twenty-six patients received surgery alone, while 30 patients received radiation and chemotherapy followed by surgery. The group receiving combined treatment had a five-year survival of 39%, while the group treated with surgery alone experienced a five-year survival of only 16%.99
A study published in the New England Journal of Medicine in 2006 compared treatment with surgery alone to treatment with chemotherapy—given both directly before and after surgery—in patients with stomach or esophageal cancer. The five-year survival for the group receiving surgery and chemotherapy was 36%, compared to a five-year survival of 23% in the group receiving surgery alone.100
Research also supports the use of chemotherapy and radiation therapy during the critical perioperative period. In one study, 544 patients with stomach cancer received combined chemotherapy and radiation therapy shortly after surgery. Survival comparisons were made with a similar group of 446 patients with stomach cancer treated with surgery alone. Postoperative chemotherapy and radiation led to a dramatic improvement in survival. The group treated with surgery alone had a median survival of only 62.6 months, compared to a median survival of 95.3 months in the group receiving postoperative radiation and chemotherapy.101 A similar study also demonstrated improved survival with the use of postoperative radiation and chemotherapy compared to surgery alone.102
Inflammation and Metastasis
Cancer surgery causes an increased production of inflammatory chemicals, such as interleukin-1 and interleukin-6.76-78 These chemicals are known to increase the activity of cyclooxygenase-2 (COX-2). A highly potent inflammatory enzyme, COX-2 plays a pivotal role in promoting cancer growth and metastasis.
This was evident in an article appearing in the journal Cancer Research that found levels of COX-2 in pancreatic cancer cells to be 60 times greater than in normal pancreatic cells.79 Levels of COX-2 were 150 times higher in cancer cells from individuals with head and neck cancers compared to normal tissue from healthy volunteers.80 COX-2 fuels cancer growth by stimulating the formation of new blood vessels feeding the tumor.81,82 COX-2 increases cancer cell adhesion to the blood vessel walls,83 and also enhances the ability of cancer cells to metastasize. Experiments in mice revealed that colon cancer cells expressing high levels of COX-2 metastasized freely to the liver, while colon cancer cells expressing low levels of COX-2 did not metastasize to the liver.83
The adverse influence of COX-2 on the growth and progression of cancer was clearly revealed in a study published in the journal Clinical Cancer Research in 2004. Two hundred eighty-eight individuals undergoing surgery for colon cancer had their tumors examined for the presence of COX-2. The findings were alarming—when other factors were controlled for, the group whose cancers tested positive for the presence of COX-2 had a 311% greater risk of death compared to the group whose cancers did not express COX-2.84 A subsequent study in lung cancer patients found that those with high tumor levels of COX-2 had a median survival of only 15 months, whereas those with low tumor levels of COX-2 had a median survival of 40 months.85
Given these findings, researchers began investigating the anti-cancer effects of COX-2 inhibitor drugs. Although initially used for inflammatory conditions, such as arthritis, COX-2 inhibitor drugs have been shown to possess powerful anti-cancer activity. For example, 134 patients with advanced lung cancer were treated with chemotherapy alone or combined with Celebrex® (a COX-2 inhibitor). For those individuals with cancers expressing higher amounts of COX-2, treatment with Celebrex® dramatically prolonged survival.86 Treatment with Celebrex® also slowed cancer progression in men with recurrent prostate cancer.87
Perhaps the most impressive display of the anti-metastatic effects of COX-2 inhibitor drugs was presented at the annual conference of the American Society of Clinical Oncology in 2008. In this study, the incidence of bone metastases in breast cancer patients who had taken a COX-2 inhibitor for at least six months following the diagnosis of breast cancer was compared to the incidence of bone metastases in breast cancer patients who had not taken a COX-2 inhibitor. Remarkably, those who were treated with a COX-2 inhibitor were almost 80% less likely to develop bone metastases than those who were not treated with a COX-2 inhibitor drug.88
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are COX inhibitors. The widespread use of NSAIDs for pain and arthritis has created an ideal environment in which to examine if these drugs can prevent cancer. Large-scale studies have documented a substantial reduction in cancer risk with the use of NSAIDs. A comprehensive review of the scientific literature (91 published studies) reported that the long-term use of NSAIDs (primarily aspirin) produced risk reductions of 63% for colon cancer, 39% for breast cancer, 36% for lung cancer, 39% for prostate cancer, 73% for esophageal cancer, 62% for stomach cancer, and 47% for ovarian cancer. “This review provides compelling… evidence that regular intake of NSAIDs that… block COX-2 protects against the development of many types of cancer,” the authors concluded.89
A number of nutritional and herbal supplements are known to inhibit COX-2. These include curcumin, resveratrol, vitamin E, soy isoflavones (genistein), green tea (EGCG), quercetin, fish oil, garlic, feverfew, and silymarin (milk thistle).58,90-97
Scientists at Memorial Sloan-Kettering Cancer Center in New York created an experimentally-induced increase in COX-2 activity in human breast cells, which was completely prevented by resveratrol. Resveratol blocked the production of COX-2 within the cell, as well as blocking COX-2 enzyme activity.98
Conclusion
A group of noted experts in the field of surgery-induced metastasis stated that cancer treatment “…necessitates the surgical excision of the primary tumor in order to relieve the patient of the major tumor burden, which is the main source of mutating and metastasizing cells. However, along with its obvious benefits, the surgical procedure has been suggested to involve serious hazards as it releases tumor cells into the circulation or lymphatics, promotes the secretion of angiogenic and growth factors, and induces suppression of CMI [immune function]. These consequences synergistically facilitate the establishment of new metastases and the development of preexisting micrometastases. As cancer-related death is most commonly the result of metastatic disease, it is crucial to minimize this facilitation.”55
Remarking further, they commented that “Taken together, it is evident that the perioperative period harbors many risks; however, it is also the ideal time for battling MRD [small numbers of cancer cells remaining after surgery] to reduce recurrence and future metastases.” Thus, these scientists believe “…it is essential to employ preventative interventions during this critical time.” Additionally, they urge that, “Ideally, each problematic aspect of surgery should be treated when oncological patients undergo resection [surgery] in order to minimize recurrence and metastatic spread.”55
Armed with the knowledge discussed in this article, the person with cancer can reap all the benefits that cancer surgery offers, while simultaneously avoiding the metastatic perils imposed by this procedure.
As this article was going to press, a dedicated team of clinical oncologists and researchers are preparing a meticulous report on the optimal doses of nutrients and drugs that a cancer patient should consider during the pre- and post-operative period. You can obtain a free copy of this report by logging on to our Cancer Surgery Special Report — http://www.lef.org/featured-articles/Cancer-Surgery-Special-Report.htm — or calling 1-800-841-5433.
If you have any question on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
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Jacqui Salazar
Oct 31st, 2010
I was interested in the posting from Peter McLellan, but disappointed that he mentioned that it would be less financially beneficial for the doctor and the hospital if regional anesthesia was used as opposed to general anesthesia (much more common and more accepted). Why not actually inform patients about the differences and allow them to make the decision without having the added pressure of having to think about how much “dosh” they were goiing to make out of any operation. This is obviously how most Dr's think and why we dont have a much better outcome after surgery in general.
Jacqui
Denis
Dec 16th, 2009
This was all very interesting but now I am left trying to establish how the use of low dose naltrexone might factor into some of these curative measures; it certainly seems to have some significant anti-cancer properties! Any comment on this would be much appreciated particularly as my wife is now established on her maintenace dose of ldn as a preventative supplement because she is genetically predisposed to increased risk of cancer.
Peter MacLellan
Dec 15th, 2009
This article is very interesting and exciting. Work on the impact of anesthesia on the immune system has been done, in my direct knowledge, since the 1980′s, and necessarily depended on new details on how the immune system functions. As an anesthesiologist, my role has been one of enabling, but it is now apparent that it can also be therapeutic. There is increasing evidence that the choice of anesthetic can affect long term outcome for the patient receiving the anesthetic, because of the effect of anesthetic agents on the immune system.
It may be reassuring for patients to know that this information is not only in the anesthesia literature, some of which is documented in the article, but also in Continuing Medical Education material from the American Society of Anesthesiologists. However given the long-time perception of anesthesia in the eyes of both the public and the profession as merely a means to enable surgery to take place with no or minimal pain and suffering, and also given the “production pressures” in operating rooms, there may be considerable resistance to increasing the use of regional anesthesia. Regional anesthesia tends to take longer than general anesthesia and will therefore decrease the number of cases that can be done, therefore reducing income for both the anesthesia practitioner and the institution. This is a significant barrier to overcome.
There are also 2 significant references missing from the article which describe the possible beneficial effects on outcome of epidural anesthesia for prostate cancer surgery, and of paravertebral block for major breast cancer surgery:
Biki B, Mascha E, Moriarity DC, et al. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: A retrospective analysis. Anesthesiology. 2008; 109:180-187.
Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI: Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology 2006; 4:660-4
Both of these papers are retrospective, and therefore should be viewed as not definitive, but the information is very dramatic.
Epidural anesthesia is fairly widely accepted as a modality for post-operative pain relief after radical prostatectomy, so request for it is more likely to be entertained. Paravertebral block for mastectomy is less likely to be available since most anesthesiologists do not know this technique (myself included.)
Other factors to consider are the use of propofol infusion instead of a volatile agent (gas), since volatile agents seem to have anti-analgesic properties and lead to more post-operative narcotic use, and narcotics have immune suppression effects, inhibiting both cellular and humoral immune function in humans. There is also a small study from Mount Sinai Hospital in Toronto which showed that eating a ground flax containing muffin for several weeks before breast surgery reduced tumor size (no risk – possible benefit). And of course Vitamin D3 deficiency is widespread, is easily avoided and/or corrected (10,000 units per day clearly safe over a 6 months period, therefore could easily and safely be done pre-operatively) and its correction in the wider community will prevent breast cancer occurence in some patients, which in the final analysis is the best way to avoid recurrence – prevent the disease completely.
Deborah
Dec 13th, 2009
Thank you for this article. I had surgery for breast cancer 1 1/2 years ago. I wish my doctor had given me this kind of information. I did know some of the things you mentioned from the reading that I do and i took Modified Citrus Pectin before and after my surgery.
I also take curcumin, vitamin E, green tea (EGCG), quercetin, fish oil, garlic, Maitake D, and Avemar.
How long do you recommend taking Modified Citrus Pectin after surgery?
Grazzi,
Deborah
Catherine L. Pearson
Dec 12th, 2009
Thank you so much for this new info. Both my mother and sister have had breast cancer. My sister twice. They both were in their mid 40′s. I am 64, so far cancer free. I have used natural progesterone cream since menopause, try to eat healthy foods, plus use the important supplements.
I will bookmark this study, and also share info with my family and friends.
-Cathie