[Lani]

Dr. Max Wicha, of breast cancer stem cell fame, has most discussed at the AACR meeting and others his lab's most recent work which relates IL-6 to the awakening/ activation of breast cancer stem cells in the bone marrow, causing/allowing them to spread to distal organs.

If I would not have answered your inquiry, I would have missed this very important article(note it is the IL6 level in the blood vs the IL5 level in the drainage which is the factor governing what those dormant stem cells "see")

In addition the amount of "angiogenic factors" which can help recruit a blood to supply to any of those newly migratory metastatic cells to help them grow may be related to the amount of surgical stress as reflected below:


J Orthop Sci. 2009 Jul;14(4):437-42. Epub 2009 Aug 7.
Serum concentrations of interleukin-6 in patients following unilateral versus bilateral total knee arthroplasty.
Kugisaki H, Sonohata M, Komine M, Tsunoda K, Someya S, Honke H, Mawatari M, Hotokebuchi T.

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan.
Abstract
BACKGROUND: Surgical stress is known to affect body temperature, white blood cell (WBC) count, C-reactive protein (CRP), and interleukin-6 (IL-6). The aim of the present study was to investigate which parameter is most suitable for quantitative analysis of surgical stress.

METHODS: Unilateral total knee arthroplasty (U-TKA) and bilateral TKA (B-TKA) were selected for the subjects of this study because the B-TKA creates approximately double the surgical stress of the U-TKA. The temperature, WBC count, CRP, and IL-6 in the blood were measured pre- and postoperatively in both groups. The IL-6 in the drainage fluid was also measured after the operation.

RESULTS: The temperature, WBC count, CRP, and IL-6 in the blood significantly increased on the first day after the operation in both groups. There were significant differences between the two groups in the WBC count (P < 0.05) and the IL-6 level in the blood (P < 0.05) on the first day after the surgery. There were no significant differences between the two groups for the CRP and IL-6 levels in the drainage fluid. The relative proportions--(B-TKA/U-TKA) x 100 (%)--were 170.4% for the operating time, 219.4 % for total blood loss, 200.0% for blood transfusion, 100.3% for temperature, 128.9% for WBC count, 127.4% for CRP, and 246.5% for the IL-6 level in the blood.

CONCLUSIONS: The serum IL-6 level may best reflect surgical stress and could therefore be a quantitative marker of surgical stress.

PMID: 19662479