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Short Communication Open Access

World Cancer 2019: Towards a better management of cancer: Further recommendations from surgeons to anesthesia team

Abstract

 Cancer is the second leading cause of death globally. About 1 in 6 deaths is due to cancer and 70% occurs in LMICs. Local tumor recurrence and/or distal metastasis after surgical resection remain among the cause of morbidities and mortalities in solid tumor’s patients, despite advanced therapies available. Trying to figure out the possible role of anesthesia to their recurrence and metastases after surgical resection, this study dogged deep and generates evidences and recommendation. An online published articled search was done. This was a systematic literature on PubMed, research gate, cancer journal, international anesthesia research society and WHO. They are recent from 2015. The main key search were “use of anesthesia and cancer recurrence”, local anesthesia and cancer surgery general anesthesia and cancer surgery outcome. Volatile Anesthetics attenuated NK cell tumor cytotoxicity by inhibiting LFA-1, conjugation of NK cell with tumor cell and they also attenuate granzyme polarization. Volatile anesthesia found associated with metastasis while intravenous anesthetics (Ketamine and halothane) enhanced lung retention of breast Adenocarcinoma but Propofol didn’t. In vivo studies and clinical data show some evidence that regional anesthesia is beneficial for cancer patients as it may decrease the risk of metastasis. Anesthetic choices during cancer surgery positively or negatively affect immune function during the perioperative period. The immune balance needs to be shifted toward positive effects to reduce immunosuppression, which promotes cancer metastasis. We may prefer regional anesthesia or propofol as other trials are carried out. Towards a better management of cancer ,further recommendations from surgeons to anesthesia team

 Niyomugaba Fulgence

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