Malignancy and Inhaled Anesthetics - Abstract
Surgery is the most commonly used treatment for cancer patients, particularly in cases of solid tumors. The perioperative period includes various factors that could adversely affect tumour progression. Tumor growth, progression and recurrence depends on the invasive and metastatic potential of the tumor cells, as well as a normal functioning immune system. It has been demonstrated that surgery and anesthesia exert inhibitory effects on cellular immunity favoring metastasis. Inhalational anesthetics reportedly promote tumorigenesison cancer cells in vitro. However, depending on secondary analyses of randomized controlled trials addressing different outcomes and retrospective cohorts, clinical data supportthe use of regional anesthesia/analgesia as a supplement or alternative to general anesthesia with inhalational anesthetics.
It is well known that regional anesthesia/analgesia reduces stress responses and reduces the requirement for anesthetic agents and opioids, thereby providing beneficial effects for oncologic patients. Currently available data do not definitively suggest any avoidance or preference for any anesthetic agent or technique for these patients. There are, however, ongoing randomized controlled trials promising definitive results on the subject. It is most likely that simple changes will probably not significantly improve patient survival.