[Sticky] NSAIDs Before Breast Cancer Surgery Can Dramatically Decrease Recurrence
This is is a talk given by Dr. Vikas Sukhatme at MIT.
Essentially, out of the 40,000 women who die of breast cancer in the US yearly, 30,000 of them are initially diagnosed at a locoregional stage (Stage I or II). He speaks about a pattern of early recurrence amongst women who receive surgery - indicating that the actual surgical operation might initiate or aid metastasis. Some NSAIDs he talks about seem to dramatically decrease the rate of recurrence - I believe he said by up to 70%.
Obviously some care has to be taken since NSAIDs can cause insufficient wound repair and bleeding so it would have to be monitored carefully.
The full talk is worth a watch.
This is a great presentation you found, and may save a lot of lifes simply by sharing this link here. Just think about the impact of you doing this ... I will make sure the awareness is created. I will probably write a short post to highlight this important information.
So here is a summary of what is discussed during this presentation, for those who like to have that prior to watching the video:
Dr. Vikas P. Sukhatme, Professor of Medicine at Harvard Medical School and Chief Academic Officer at Beth Israel Deaconess Medical Center, presenting at December 8, 2015 at MIT in Cambridge, MA and a co-founder of a not-for-profit organization, GlobalCures:
- 200.00 women diagnosed with early breast cancer in US annually
- 40.000 annual deaths from breast cancer, 75% have been initially diagnosed with localized cancer (no macroscopically sign of disease in other places) and still had recurrence and passed away
- that means 15% of early detected breast cancers are passing away every year
- in other cancers the recurrence is even higher
- most recurrences occur one year after the surgical resection, suggesting that there is something related to the surgery moment that is fueling the high number of recurrences at one year
- an experiment: introducing 15 cancer cells into the portal vein of a rat à no tumor growth; at about 3 months they started to perform repeated surgery on the rat à at 5 months many tumors on the liver à tumor cells can survive for long time without multiply à can be take out of dormant cells by repeated wounding even if wounding is done at a totally different location
- surgery wakes up dormant cells following the inflammation triggered by surgery
- using NSAIDs we can block the inflammatory response – what if we give them prior to the surgery? – the key is to give them prior to the surgery to block inflammatory response
- giving a NSAID, Ketorolac IV prior to the surgery leads to a strongly reduced recurrence rate https://www.ncbi.nlm.nih.gov/pubmed/22622810
- this has also been observed in lung cancer and it is expected to be relevant in all the cancers
- the rule: Anti-inflammatory medication administered prior to surgery may cure more early stage cancers
- the Professor from MIT is asking: “Why are cancer patients slated for surgery not receiving ketorolac routinely? If you would go today to the hospital for tumor surgery and you would ask your surgeon for ketorolac he/she will probably say NO. 99% of the time the answer will be NO even at major hospitals.” He argues this should be standard of care! They would not give because there is a risk of bleeding or inability of the body to heal as rapidly. But that risk has to be weight with the risk of recurrence which is something not considered by most surgeons as they are not aware of the benefits.
- the reason why some (lucky) patients received NSAIDs prior to surgery was to reduce the use of morphine, i.e. serendipity
- actually this knowledge can be used not only for the early cancers but also for advanced cancers: i.e. countering the wound healing response might improve outcomes in patients with advanced cancers
- untreated cancer resembles a wound: cancer cells develop so fast beyond the access to nutrients and as a result part of the tumors die – cell death in turn triggers a wound healing response
- every treatment for cancer makes the situation even worse! Those cells that are not killed by the treatment will get a second life. BUT if you treat at the same time with NSAIDs such as Ibuprofen, the outcome can be very much changed to positive
Conclusion: Cancer is a wound and antiinflammatory medication will likely reduce the chance for recurrence, will work great with chemo to inhibit potential regrowth of the tumor, and/or will slow down the evolution of existing tumors.
There is a clinical trial going on in Belgium, supported by the Anticancer Fund, to test this concept.
My mother is now experiencing lot's of pain in more than one place.
This has been going on for a few days now but today it got worse.
In the recent past, getting an aspirin always muted the pain, likely due to slowing down of metabolism.
I am talking about 750mg of aspirin + 500/750mg metformin.
Today it only made pain worse..... 🙁
Coffee enemas always made her feel better in regards to pain, today it only made it worse.
Not knowing what to think this is, i write here. We are hoping it's necrosis. DCA?
Thank you very much,
Together We Can Do it!
I wonder if you had a similar experience in the past where pain was an indicator of good with DCA or even other treatments.
Do you think it's likely to have met with healing at last or am i hoping for too much at this time?
What's your opinion about the pain based on your past experience, despite aspirin, metformin - who in the past have "muted" pain down to nothing on our side.
Thank you very much,
Together We Can Do it!
Cancer pain can be caused by "mass effect", where the tumour starts to compress normal structures that surround it. I'm not sure that an NSAID would settle this type of pain as it isn't inflammatory. Usually cancer patients get treated with opiates for pain, as they don't tend to kill pain in the same way. Personally when I was prescribed opiates, it just made me less aware of the pain I was feeling, and didn't necessarily 'kill' it. Moreso dulled it.
It could be that the tumour has gotten large and is compressing normal tissue.
Daniel is right though, you should make a thread in the lung forum with details, and maybe we can work through trying to help out better there. Otherwise this thread's purpose may get cluttered with unrelated matters, and you probably won't receive the best advice in an off-topic thread.
Hi Guys, question:
So im finishing my rounds of chemo, should be done first week of march, so after that my surgery is planned lets say 3/4 weeks after that. I wanted to start my detox/fast / cleanse approach after chemo but im also wondering how would i incorporate any of the above to that? Should i rather focus on the NSAIDS before surgery rather than my detox?
I think there may be time for both. Regarding the NSAIDS before surgery, it could be a good idea to contact https://www.anticancerfund.org I think this Foundation is supporting clinical trials on this approach and they should be able to point you towards the places where NSAIDS are given before surgery. Or if you wish to do surgery in a specific place, they may be able to connect your surgeon with others who can explain what are the benefits when using NSAIDS. The point is that your surgeon has to agree with that, since giving NSAIDS prior to surgery may also come with some risks that he needs to manage (although not that high compared to the recurrence risks).
May I ask how much diclofenac would you recommend a day during prevention and how much during active disease?
Would you combine it with aspirin?
What about Naproxen? And the dose a day?
I would like to caution two things:
1) NSAIDs inhibit blood clotting, so taking NSAIDs around surgery can lead to bleeding. Talk to your surgeon, who might OK NSAID administration post surgery.
2) The apparent inhibition of metastasis by 30 mg ketorolac seen in several retrospective analyses is specific to ketorolac, and should not be considered to be a benefit of NSAIDs. see http://cancerres.aacrjournals.org/content/78/4_Supplement/P1-10-12
There is a suggestion that ketorolac works due to inhibition of a class of enzymes used by cancer cells to metastasize, called Rho-GTPases:
Again this activity is unique to ketorolac and not shared by other NSAIDs.