title: Anesthesia in patients with cancer disorders.
abstract: OBJECTIVE
  Along with the increasing population of elderly people in developed countries, anesthesiologists have increasing opportunities to anesthetize cancer patients in their routine work. However, no guideline of anesthesia procedures for cancer patients is available even though guidelines of operative procedures have been formulated for different types of cancer. This review provides recent findings related to the optimal choice of anesthetics and adequate anesthesia management for cancer patients.
  
  
  RESULTS
  The intrinsic weapon fighting cancer cells is competent immune cells, particularly CD4+ T helper 1-type cells, CD8+ cytotoxic T cells, and natural killer cells. However, surgical inflammation, some anesthetics, and inadvertent anesthesia management suppress these effector cells and induce suppressive immune cells, which render cancer patients susceptible to tumor recurrence and metastasis after surgery.
  
  
  CONCLUSIONS
  Accumulated basic and clinical data suggest that total intravenous anesthesia with propofol, cyclooxygenase antagonists, and regional anesthesia can decrease negative consequences associated with perioperative immunosuppression. Volatile anesthesia, systemic morphine administration, unnecessary blood transfusions, intraoperative hypoxia, hypotension, hypothermia, and hyperglycemia should be avoided.
authors.affiliation: Department of Anesthesiology and Intensive Care, Tohoku University Hospital, Sendai, Japan. s-kurosawa@umin.ac.jp
authors.forename: Shin
authors.initials: S
authors.lastname: Kurosawa
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000765:Anesthesia, Conduction; D000777:Anesthetics / Q000009:adverse effects; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000502:physiology; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D056747:Immunomodulation; D007165:Immunosuppression Therapy / Q000379:methods; D007694:Killer Cells, Natural / Q000187:drug effects / Q000502:physiology; D009369:Neoplasms / Q000150:complications* / Q000276:immunology; D018529:Nutritional Support; D019990:Perioperative Care
chemical_list: D000777:Anesthetics