Scientists at Tel Aviv University (TAU)have found a way to cut the risk of metastasis of colorectal cancer after their tumor is removed in surgery. Giving medication for a short interval around the time of the surgery, the researchers were able to reduce body stress responses and physiological inflammation during this critical period, thus making it much more difficult for the cancer cells to spread to other parts of the body after the operation.
The study, recently published in prestigious journal Cancer, was led by Prof. Shamgar Ben-Eliyahu from TAU’s School of Psychological Sciences and the Sagol School of Neuroscience and Prof. Oded Zmora from Shamir (Assaf Harofeh) Medical Center in Tzrifin (near Rishon Lezion).
Even though the number of patients was small, the results were very promising. Only 12.5% (2 out of 16) of patients receiving the treatment were found to develop metastases; in the control (placebo-treated) group, metastases developed in 33% (six out of 18) of patients, which is in accordance with the known statistics for colorectal cancer patients
In the study, which lasted for three years, the researchers monitored 34 patients who received treatment surrounding a colorectal tumor removal surgery. During the pre- and post-surgical period, the patients were administered two safe and known drugs – propranolol (Deralin), an anti-anxiety and blood-pressure-reducing drug, and etodolac (Etopan), an anti-inflammatory analgesic. The drugs were given to the patients for only 20 days, starting from five days prior to surgery and until two weeks after, with half of the patients receiving a placebo treatment.
Ben-Eliyahu said he was very satisfied with these data, but added that “despite the impressive results, this treatment must be examined again, in a much larger number of patients, so as to test whether it is, in fact, lifesaving.” According to Ben-Eliyahu, the study of molecular markers in the cancerous tissue excised from the patients showed that the treatment with the medications has led to a reduction in the metastatic potential of the tumor and potentially the residual cancer cells.
In addition, the drugs triggered some beneficial alterations in infiltrating tumor leukocytes (white blood cells), which are also markers indicating a reduced chance of disease recurrence. Ben-Eliyahu explained that “when the body is in a state of stress, whether physiological (from surgery) or psychological, this causes a release of high amounts of two types of hormones, prostaglandins and catecholamines. These hormones suppress the activity of the immune cells, thus indirectly promoting the development of cancer metastases.”
In addition, he said, these hormones also directly promote the development of metastatic traits in cancer tissue. “Our study shows that inexpensive, accessible medication treatment could be used to reduce body stress responses and inflammation associated with surgery, which affects the tumor, significantly reducing the risk of metastases that might be detected months or years after surgery.”
After the initial research success, Ben-Eliyahu and Zmora encourage Israeli colorectal and pancreatic cancer patients due to undergo surgery to apply for participation in a large-scale clinical study that is now beginning in eight different Israeli medical centers.
