title: The potential benefits of the use of regional anesthesia in cancer patients.
abstract: Cancer is a leading cause of morbidity and mortality worldwide. In light of demographic changes among other factors, it is anticipated this trend will continue. Surgical resection is the primary method of treating solid tumours. Unfortunately, even with the use of adjunct therapies, metastatic disease is a leading cause of death in people with cancer. Recent evidence suggests choice of anesthetic technique may influence cancer outcome. This review considers the latest evidence regarding local and regional anesthesia in the context of cancer biology. There is a focus on the indirect and direct mechanisms involved. An integrated approach is used such that diverse areas of research are explored; ranging from epigenetics to cell death pathways. With a better understanding of how regional anesthesia and/or local anesthetics interact with cancer cells, these techniques can be trialed and evaluated to ascertain potential clinical benefits in cancer patients. Thus far, there is insufficient evidence to warrant a change in clinical practice.
authors.affiliation: Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.|Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Wei
authors.initials: W
authors.lastname: Xuan
authors.affiliation: Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Hankin
authors.affiliation: Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Hailin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Shanglong
authors.initials: S
authors.lastname: Yao
authors.affiliation: Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Daqing
authors.initials: D
authors.lastname: Ma
mesh_terms: D000765:Anesthesia, Conduction; D000779:Anesthetics, Local / Q000494:pharmacology; D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology; D003131:Combined Modality Therapy; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D059408:Pain Management
chemical_list: D000779:Anesthetics, Local; D000970:Antineoplastic Agents
keywords: cancer; local anesthetics; metastasis; molecular mechanisms; regional anesthesia