Michael Retsky
My colleagues and I have been studying a bimodal relapse pattern in breast cancer. This project started in 1993 when data from Italy and UK showed an
unexpected bimodal relapse pattern in breast cancer. It seemed that 50 to 80% of all relapses in patients treated only with surgery occurred in an early wave
of relapses in the first three years post-surgery. We have proposed a reasonable explanation over the years. It appears that the surgery to remove a primary
tumor causes systemic inflammation for a week. During that time, dormant single malignant cells and avascular deposits escape from dormancy and appear as
relapses within three years. The multi-national authors of these reports include medical oncologists, surgeons, anesthesiologists, physicists and other scientists
from several fields. A potential solution seems to exist based on our analysis, data, and retrospective studies. That therapy is the common inexpensive analgesic
ketorolac administered as iv at the time of surgery and perhaps as oral drug for a few days after surgery. We edited a book in 2017 that was published by
Springer-Nature (1) and a number of papers including one recently published (2). Other reports support this and suggest mechanisms (3-5). We now show data
that predicts this is a process that applies to many solid and other cancers. Based on data from lung cancer, inflammation level on the first day post-surgery
predicts outcome. We propose that this disruptive innovation will result in a paradigm shift in oncology. In a recent development we are now working on a method
to prevent late relapses as well. This would suggest that persons who are at risk of late relapse and going to have planned surgery for health or cosmetic reasons
should have perioperative ketorolac just as if the surgery was for cancer.
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Journal of Oncology Translational Research received 93 citations as per Google Scholar report
