Drugs of anaesthesia and cancer

Department of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, Via C.Valeria, Messina, Italy.
Surgical Oncology (Impact Factor: 3.27). 05/2009; 19(2):63-81. DOI: 10.1016/j.suronc.2009.03.007
Source: PubMed


Anaesthesia represents one of the most important medical advances in history, and, nowadays, can widely be considered safe, thanks to the discovery of new drugs and the adoption of modern technologies. Nevertheless, anaesthetic practices still represent cause for concern regarding the consequences they produce. Various anaesthetics are frequently used without knowing their effects on specific diseases: despite having been reported that invasion or metastasis of cancer cells easily occurs during surgical procedures, numerous anaesthetics are used for cancer resection even if their effect on the behaviour of cancer cells is unclear. Guidelines for a proper use of anaesthetics in cancer surgery are not available, therefore, the aim of the present review is to survey available up-to-date information on the effects of the most used drugs in anaesthesia (volatile and intravenous anaesthetics, nitrous oxide, opioids, local anaesthetics and neuromuscular blocking drugs) in correlation to cancer. This kind of knowledge could be a basic valuable support to improve anaesthesia performance and patient safety.

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Available from: Vincenzo Fodale, Dec 06, 2014
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    • "Unlike inhaled anesthetics, propofol does not seem to inhibit growth of cancer cells, but their ability of invasion. Although its effect on NK cells is not well defined yet [37], propofol seems to have protective effects regarding development of metastases, as it stimulates activity of NK cells and inhibits cyclooxygenase type 2 and formation of PGE2 in tumor cells [41]. In rats instead, ketamine and thiopental appear to suppress NK cells and increase the risk of cancer recurrence [5], but these negative effects could be due to the interaction of ketamine with alpha- and beta-adrenoreceptors [42]. "
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    ABSTRACT: Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients.
    Full-text · Article · Feb 2014 · The Scientific World Journal
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    • "Anesthesia represents one of the most important medical advances in history and is widely considered safe. Nevertheless, numerous anesthetics are used for cancer resection even if their effect on the behavior of cancer cells is unclear [20]. Propofol is one of these anesthetics. "
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    ABSTRACT: Background Propofol is one of the most commonly used intravenous anaesthetic agents during cancer resection surgery, but the effect of propofol on gallbladder cancer is not clear. NF-E2-related factor 2 (Nrf2) is abundantly expressed in cancer cells and relates to proliferation, invasion, and chemoresistance. The aims of the current study were to evaluate effects of propofol on the behavior of human GC cells and role of Nrf2 in these effects. Method The effects of propofol on cell proliferation, apoptosis, and invasion were detected by MTT assays, flow cytometry, and transwell assay. Also, activation of Nrf2 was determined by western blot, RT-PCR, and immunofluorescence assays. Nrf2 was knocked-down in GBC-SD cells by shRNA before evaluating the role of Nrf2 in the influence of propofol on biological behaviors. Results Propofol promoted the proliferation of GBC-SD cells in a dose- and time- dependent manner. After exposure to propofol for 48 h, GBC-SD cells showed decreased apoptosis and increased invasion. Also, propofol over-expressed Nrf2 at both the protein and mRNA levels and induced translocation of Nrf2 into the nucleus. Finally, loss of Nrf2 by shRNA reversed the effect of propofol on cell proliferation, apoptosis, and invasion. Conclusion Propofol induces proliferation and promotes invasion of GC cells through activation of Nrf2.
    Full-text · Article · Aug 2012 · Journal of Experimental & Clinical Cancer Research
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    • "Interventions occurring during the perioperative period have an effect on longterm outcome of patients with cancer surgery (Sessler et al., 2009). Anesthesiologists play an important role during cancer surgery period because anesthetics and anesthesia technique can exert influence on the growth of tumor cells (Gottschalk et al., 2010; Santamaria et al., 2010; Snyder et al., 2010). Anesthetics that have the anti-cancer effect should be used for cancer surgery in order to decrease the risk of recurrence and metastasis of patients after cancer surgery. "
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    ABSTRACT: Sevoflurane, an inhalational anesthetic, is used extensively during lung cancer surgery. However, the effect of sevoflurane on growth of lung carcinoma cells remains unclear. The purpose of this study is to investigate effects on proliferation, apoptosis, and cell cycling in the A549 human lung adenocarcinoma cell line. A549 cells were treated with 1.7%, 3.4%, and 5.1 % sevoflurane for 2, 4, and 6 hours. Cell proliferation was evaluated by the MTT assay and colony formation assay. Apoptosis and cell cycle was analyzed by flow cytometry. Expression of X-linked inhibitor of apoptosis protein (XIAP), survivin, Bcl-2, Bax, caspase-3, cyclin A, cyclin B1, and cdc2 was measured by Western blotting. Significant inhibition of cell proliferation and induction of apoptosis were found in A549 cells after sevoflurane treatment. Simultaneously, expression of XIAP and survivin was supressed, while that of caspase-3 increased significantly, but Bcl-2 and Bax were not altered. Sevoflurane caused cell cycle arrest at the G2/M phase. At the same time, data revealed that cyclin A, cyclin B1, and cdc2 expression was down-regulated after sevoflurane treatment. This study demonstrated that sevoflurane inhibited proliferation, and induced apoptosis in human lung adenocarcinoma A549 cells, associated with down-regulated expression of XIAP and suvivin, and activating caspase-3.
    Preview · Article · Jan 2011 · Asian Pacific journal of cancer prevention: APJCP
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