title: Surgery and cancer promotion: are we trading beauty for cancer?
abstract: It is well-known that cancer surgery can actually promote the growth of some tumors by a variety of mechanisms. There are observational data suggesting that surgery per se can increase the risk of cancer among individuals without a history of clinical cancer. Occult microscopic cancers are exceedingly common in the general population and are held in a dormant state by a balance between cell proliferation and cell death and also an intact host immune surveillance. The catecholamine surge from the stress of surgery and resulting β(2)-adrenergic signaling culminates in a transient and robust increased vascular endothelial growth factor expression locally and systemically that is enough to start tumor angiogenesis and end dormancy. The same catecholamine surge and β(2)-adrenergic signaling impairs cell-mediated immunity at a crucial time. Elegant animal studies have demonstrated that perioperative nonselective β-blockade abrogates surgical stress-induced angiogenesis and tumor growth. Prospective human trials are desperately needed and clinical implications are discussed.
authors.affiliation: markrgoldstein@comcast.net
authors.forename: M R
authors.initials: MR
authors.lastname: Goldstein
authors.forename: L
authors.initials: L
authors.lastname: Mascitelli
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000209:etiology* / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D013312:Stress, Physiological; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
chemical_list: D000319:Adrenergic beta-Antagonists