Breast Cancer Surgery Can Awaken Tumor Cells -- But A Simple Pill Might Help

New study suggests NSAIDs may help prevent post-surgical spread of breast cancer cells

Some exciting scientific news today about the spread of breast cancer after surgery — and the surprisingly simple potential solution. A study involving mice and a very cheap and available pill could be key in stopping the spread of tumor cells in the months after a lumpectomy or mastectomy.

Doctors and researchers have long tried to figure out why breast cancer patients are most likely to experience their cancer spreading in the first 18 months after surgery to remove a cancerous tumor or the breasts. A new study published in Science Translational Medicine suggests that the healing of the surgical site might be what triggers the spread of cancerous cells in the body after surgery.

Basically, as the body and immune system fight and work to heal the surgical wound, it stops working toward holding back cancer cells that are nowhere near the site of the original tumor. Without the body’s unrelenting response, those cells are left to grow and sometimes, that means the formation of new tumors. Robert Weinberg, the paper’s senior author and a biologist at the Massachusetts Institute of Technology tells Stat News, “It’s not the actual surgery, but instead, it’s the post-surgical wound response. It is provoking already disseminated cells to begin to grow into clinically detectable metastases.”

Luckily, science seems very close to fixing this problem, and it might be as simple as aspirin.

Yes, an anti-inflammatory drug administered pre-surgery and in the days after could be all it takes to halt the spread of cancerous cells in the body and to stop the growth of post-surgery tumors. Just plain NSAIDs like aspirin can help stop the immune system from abandoning its post in regard to preventing those cancer cells from turning into full-blown tumors. A recent study in lab mice is what’s giving doctors and researchers hope that this could help humans as well.

The mice were injected with aggressive breast cancer. When the cancer cells had a makeup that caused the mice’s immune systems to react, up to 90 percent of the lab animals rejected the cancer cells. “There are tumors that are doomed to be rejected by the immune system,” Weinberg said. “We wanted to ask, what mechanisms awaken previously dormant micrometastases?”

So, some of the mice underwent surgery to see what changes would occur afterward in their ability to fight the cancer cells. The scientists couldn’t mimic tumors since the size of them in each animal wouldn’t be consistent, so they had previously implanted tiny surgical sponges and removed them. In the mice that had surgery, 60 percent of the cells continued to grow and formed new tumors. Only 10 percent of mice who didn’t have surgery experienced new tumors developing. That helped researchers determine that there’s a link between surgical wounding and cancer regrowth.

Now for the exciting part.

Giving the mice an NSAID two hours before surgery and then twice each day for three days after the procedure kept the wound from “awakening” those potentially tumor-creating cells. The results affirm a 2012 study where breast cancer patients taking an NSAID for pain management after a lumpectomy were found to have fivefold lower rates of relapse than patients who took opioids to help reduce their post-surgical pain.

Wow.

Of course, more research will be needed to determine if the effect will be the same across the board with humans as it was with mice, but studies in breast cancers patients have shown metastasis is most likely 6-18 months after the initial surgery. Now we know it’s those inflammatory cells from bone marrow that impair the immune response — which could all be stopped by a simple aspirin regimen.

Weinberg emphasizes that he and his fellow researchers are not saying that cancer patients should forego surgery to remove tumors or mastectomies. Instead, he hopes his convincing research leads to human studies that test adding NSAIDs to post-surgery care.