Abstract

Method to prevent early relapses in breast and other cancers

My colleagues and I have been studying a bimodal relapse pattern in breast cancer. This project started in 1993 when data from Italy and UK showed an unexpected bimodal relapse pattern in breast cancer. It seemed that 50 to 80% of all relapses in patients treated only with surgery occurred  in an early wave of relapses in the first 3 years post-surgery. We have reported a reasonable explanation over the years. It appears that the surgery to remove a primary tumor causes systemic inflammation for a week. During that time, dormant single malignant cells and avascular deposits escape from dormancy and appear as relapses within 3 years. The authors of these reports include medical oncologists, surgeons, anesthesiologists, physicists and other scientists from several fields.A potential solution seems to exist based on our analysis, data, and retrospective studies. That therapy is the common inexpensive analgesic ketorolac administered as iv at the time of surgery.We edited a book in 2017 that was published by Springer-Nature (1) and a number of papers including one recently published (2). Other reports support this and suggest mechanisms (3,4). We now show data that predicts this is a process that applies to many solid and other cancers. Based on data from lung cancer, inflammation level on the first day post-surgery predicts outcome.We propose that this disruptive innovation will result in a paradigm shift in oncology. However there is no financial profit from this development making our task more difficult. Our initial focus is on the special case of how to treat breast cancer in low and middle income countries (LMIC) starting with Nigeria. There is a special need in LMIC in that they have 70% of the world’s cancer burden but only 5% of the resources. Later we can address other cancers in other countries.


Author(s): Michael Retsky

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