Perioperative Effects of Surgery, Anesthesia and Analgesics Associated with Cancer Progression: A Review  - Pages 1-20

Keishla M. García, Karla M. Flores, Adriana Falcón, Charlynne De Jesus, Loida Del Rio, Laura C. Rivera, Michelle Marquez, Santos Ortiz, Gretchen Sandoval, Alejandro Ruiz, Fabiola Rodriguez, Frances Gonzalez, Kenneth Cintron, Miguel J. Berdiel, Jorge Duconge, Maricelly Santiago, Ines Alfaro and Michael J. Gonzalez

DOI: http://dx.doi.org/10.6000/1929-2279.2018.07.01.1
Published: 28 February  2018

Abstract: One of the most common treatments available for cancer patients is surgical removal of the malignant tumor; its long-term implications, however, are still little-known. The purpose of this review is to look at the perioperative effects and determine if there is any correlation between surgery, anesthetics and analgesics, and cancer progression, in the form of cancerous tumor growth and progression and patient survival, within the Puerto Rican population. A retrospective literature review was conducted. Current data suggest that surgery is associated with an increase in cancer proliferation and metastasis, for various reasons such as angiogenesis enhancement and bloodstream migration. Also, it was found that some anesthetics and analgesics have been associated with cancer progression, based on the peri- and postoperative immune status of the patient. Thiopental, ketamine, isoflurane, halothane and some opioids were positively correlated with cancer progression given their role in immunosuppression; while propofol, lidocaine, ropivacaine and bupivacaine were negatively correlated with tumor progression given their immune enhancement. Others, like sevoflurane, nitrous oxide, and etomidate showed inconclusive correspondence. Therefore, it was concluded that immune system boosting anesthetics and analgesics can reduce cancer progression in a patient that has undergone surgical resection. For further research and since the available data are not extensive, other variables such as age, sex, stressors and comorbidities could be considered to better understand the mechanism in which the chemicals hereby studied can cause cancer progression.

Keywords: Anesthetics, analgesics, opioids, cancer, metastasis, recurrence, immunosuppression.