Anaesthesia technique and cancer reversal

Question 1

Why is the impact of anaesthetic techniques on cancer recurrence important?

Answer 1

Surgical stress, anaesthetic agents, and opioids may suppress immune responses, potentially influencing cancer recurrence and metastasis formation postoperatively.

Particularly, NK cells are notably affected.

Question 2

What are the potential effects of volatile anaesthetics like isoflurane and sevoflurane?

Answer 2

They may promote immunosuppression, angiogenesis (via HIF-1α), and tumour growth in experimental models.

Evidence is inconclusive regarding increased recurrence in some retrospective studies.

Question 3

What is the role of Total Intravenous Anaesthesia (TIVA) with Propofol?

Answer 3

Propofol may have

anti-inflammatory
anti-tumour effects,
reduce cancer cell migration,
improve NK cell function.

Some studies suggest lower recurrence rates with TIVA vs volatile anaesthesia, especially in breast and GI cancers.

Question 4

What are the benefits of Regional Anaesthesia (RA)?

Answer 4

RA techniques like epidural/spinal blocks may

reduce surgical stress response,
decrease opioid use,
and preserve immune function.

Mixed evidence exists regarding its benefits for some cancers, with no strong RCT confirmation yet.

Question 5

What are the potential effects of opioids like morphine and fentanyl on cancer?

Answer 5

They may promote tumour growth via immune suppression and angiogenesis.

Clinical relevance remains debated and is more concerning in preclinical studies.

Question 6

What are some emerging options for reducing cancer recurrence?

Answer 6

NSAIDs and COX-2 inhibitors may reduce recurrence by inhibiting inflammation and tumour-related angiogenesis.

Beta-blockers and alpha-2 agonists like clonidine may blunt stress-induced tumour progression.

Question 7

Fill in the blank: Volatile agents may ______ recurrence via immune suppression.

Answer 7

increase

Question 8

Fill in the blank: Propofol (TIVA) may be ______ (↓ inflammation).

Answer 8

protective

Question 9

Fill in the blank: Regional anaesthesia may reduce recurrence by ______ immunity.

Answer 9

preserving

Question 10

Fill in the blank: Opioids have potential ______ effects on tumours.

Answer 10

tumour-promoting

Question 11

What is the summary impact of NSAIDs and beta-blockers on cancer recurrence?

Answer 11

Experimental benefit under study.

Their exact role and effectiveness for cancer recurrence are still being researched.