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Rich66 · 07-04-2010, 10:39 PM

Hmmm...
Has anyone suggested the cervical ca is any sort of factor?

Although surgery and ablations can have great benefits outweighing the downsides, I wonder whether preventative surgeries are worth it.

Although it will be considered "hypothesis generating" by most docs, here are links to what I was referring to:

Opioids/anesthetic

Antimitotic concerns with mention of surgery cell release/response.

And this:

Breast. 2009 Oct;18 Suppl 3:S93-5.
Should the use of contralateral prophylactic mastectomy be increasing as it is?

Wood WC.
Winship Cancer Institute, Emory University, 1365C Clifton Road NE, Atlanta, GA 30322, USA. wwood@emory.edu
Abstract

Recent studies have shown a dramatic increase in the use of contralateral prophylactic mastectomy (CPM). The choice of surgical procedure is primarily influenced by the recommendations of physicians and surgeons. As smaller breast cancers are detected by improved breast screening, and larger breast cancers are reduced in size by neo-adjuvant chemo- and endocrine therapy, breast conservation therapy (BCT) has been applicable to more women. No one would advocate CPM with the breast primary was to be treated by BCT. This makes the more than doubling of the rate of CPM even harder to understand. The ability to better define inherited breast cancer risk by genetic analysis of BRCA1 or 2 mutations does identify a group of patients at greatly increased lifetime risk of contralateral breast cancer (CBC). This segment of the population does not account for the sharp increase in CPM. It appears that many physicians and surgeons believe the risk of contralateral breast cancer to be sufficiently high to justify advising CPM. This risk is often overestimated by both healthcare providers and patients. The case for additional surgery should involve considerations of risk versus benefit, mortality being the principal patient concern and morbidity secondary. Yet there is some morbidity in adding a second mastectomy, and no evidence of mortality benefit. Invasive lobular carcinoma is considered by some physicians to represent an increased risk of contralateral cancer, but that has not proved to be correct. Women with lobular carcinoma in situ or atypical ductal hyperplasia found at the time of their cancer diagnosis are sometimes advised to consider CPM. Treatment with tamoxifen has shown a 50-75% reduction in risk from these tissue findings. Chemotherapy for the primary breast cancer also lowers contralateral risk by about 20%. Symmetry is another reason some have recommended CPM. Reduction can be performed rather than mastectomy, if required. The use of skin-sparing mastectomy has greatly reduced the incidence of any surgery needed for symmetry on the contralateral breast. MRI used to "stage the breast" can raise questions by noting small foci of enhancement in the contralateral breast. Some women elect CPM rather than biopsy or further imaging of the contralateral breast. The case can be made that CPM should be on the decline. Its increase raises questions of the awareness of breast oncologists, medical and surgical, of the true risk data.

PMID: 19914552 [PubMed - indexed for MEDLINE]

This is in mice but....

Clin Cancer Res. 2009 Apr 15;15(8):2695-702. Epub 2009 Apr 7.
Surgical stress promotes tumor growth in ovarian carcinoma.

Lee JW, Shahzad MM, Lin YG, Armaiz-Pena G, Mangala LS, Han HD, Kim HS, Nam EJ, Jennings NB, Halder J, Nick AM, Stone RL, Lu C, Lutgendorf SK, Cole SW, Lokshin AE, Sood AK.
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.

Abstract

PURPOSE: Surgical stress has been suggested to facilitate the growth of preexisting micrometastases as well as small residual tumor postoperatively. The purpose of this study was to examine the effects of surgical stress on ovarian cancer growth and to determine underlying mechanisms responsible for increased growth. EXPERIMENTAL DESIGN: To mimic the effects of surgery, we did a laparotomy or mastectomy under isoflurane inhalation on athymic nude mice 4 days after i.p. tumor cell injection. Propranolol infusion via Alzet pumps was used to block the influence of sympathetic nervous system activation by surgical stress. RESULTS: In both HeyA8 and SKOV3ip1 models, the mice in the laparotomy and mastectomy groups had significantly greater tumor weight (P < 0.05) and nodules (P < 0.05) compared with anesthesia only controls. There was no increase in tumor weight following surgery in the beta-adrenergic receptor-negative RMG-II model. Propranolol completely blocked the effects of surgical stress on tumor growth, indicating a critical role for beta-adrenergic receptor signaling in mediating the effects of surgical stress on tumor growth. In the HeyA8 and SKOV3ip1 models, surgery significantly increased microvessel density (CD31) and vascular endothelial growth factor expression, which were blocked by propranolol treatment. CONCLUSION: These results indicate that surgical stress could enhance tumor growth and angiogenesis, and beta-blockade might be effective in preventing such effects.

PMID: 19351748 [PubMed - indexed for MEDLINE]PMCID: PMC2746852Free PMC Article

07-04-2010, 10:39 PM	#14
Rich66 Senior Member Join Date: Feb 2008 Location: South East Wisconsin Posts: 3,431	Re: Need Info! Hmmm... Has anyone suggested the cervical ca is any sort of factor? Although surgery and ablations can have great benefits outweighing the downsides, I wonder whether preventative surgeries are worth it. Although it will be considered "hypothesis generating" by most docs, here are links to what I was referring to: Opioids/anesthetic Antimitotic concerns with mention of surgery cell release/response. And this: Breast. 2009 Oct;18 Suppl 3:S93-5. Should the use of contralateral prophylactic mastectomy be increasing as it is? Wood WC. Winship Cancer Institute, Emory University, 1365C Clifton Road NE, Atlanta, GA 30322, USA. wwood@emory.edu Abstract Recent studies have shown a dramatic increase in the use of contralateral prophylactic mastectomy (CPM). The choice of surgical procedure is primarily influenced by the recommendations of physicians and surgeons. As smaller breast cancers are detected by improved breast screening, and larger breast cancers are reduced in size by neo-adjuvant chemo- and endocrine therapy, breast conservation therapy (BCT) has been applicable to more women. No one would advocate CPM with the breast primary was to be treated by BCT. This makes the more than doubling of the rate of CPM even harder to understand. The ability to better define inherited breast cancer risk by genetic analysis of BRCA1 or 2 mutations does identify a group of patients at greatly increased lifetime risk of contralateral breast cancer (CBC). This segment of the population does not account for the sharp increase in CPM. It appears that many physicians and surgeons believe the risk of contralateral breast cancer to be sufficiently high to justify advising CPM. This risk is often overestimated by both healthcare providers and patients. The case for additional surgery should involve considerations of risk versus benefit, mortality being the principal patient concern and morbidity secondary. Yet there is some morbidity in adding a second mastectomy, and no evidence of mortality benefit. Invasive lobular carcinoma is considered by some physicians to represent an increased risk of contralateral cancer, but that has not proved to be correct. Women with lobular carcinoma in situ or atypical ductal hyperplasia found at the time of their cancer diagnosis are sometimes advised to consider CPM. Treatment with tamoxifen has shown a 50-75% reduction in risk from these tissue findings. Chemotherapy for the primary breast cancer also lowers contralateral risk by about 20%. Symmetry is another reason some have recommended CPM. Reduction can be performed rather than mastectomy, if required. The use of skin-sparing mastectomy has greatly reduced the incidence of any surgery needed for symmetry on the contralateral breast. MRI used to "stage the breast" can raise questions by noting small foci of enhancement in the contralateral breast. Some women elect CPM rather than biopsy or further imaging of the contralateral breast. The case can be made that CPM should be on the decline. Its increase raises questions of the awareness of breast oncologists, medical and surgical, of the true risk data. PMID: 19914552 [PubMed - indexed for MEDLINE] This is in mice but.... Clin Cancer Res. 2009 Apr 15;15(8):2695-702. Epub 2009 Apr 7. Surgical stress promotes tumor growth in ovarian carcinoma. Lee JW, Shahzad MM, Lin YG, Armaiz-Pena G, Mangala LS, Han HD, Kim HS, Nam EJ, Jennings NB, Halder J, Nick AM, Stone RL, Lu C, Lutgendorf SK, Cole SW, Lokshin AE, Sood AK. Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. Abstract PURPOSE: Surgical stress has been suggested to facilitate the growth of preexisting micrometastases as well as small residual tumor postoperatively. The purpose of this study was to examine the effects of surgical stress on ovarian cancer growth and to determine underlying mechanisms responsible for increased growth. EXPERIMENTAL DESIGN: To mimic the effects of surgery, we did a laparotomy or mastectomy under isoflurane inhalation on athymic nude mice 4 days after i.p. tumor cell injection. Propranolol infusion via Alzet pumps was used to block the influence of sympathetic nervous system activation by surgical stress. RESULTS: In both HeyA8 and SKOV3ip1 models, the mice in the laparotomy and mastectomy groups had significantly greater tumor weight (P < 0.05) and nodules (P < 0.05) compared with anesthesia only controls. There was no increase in tumor weight following surgery in the beta-adrenergic receptor-negative RMG-II model. Propranolol completely blocked the effects of surgical stress on tumor growth, indicating a critical role for beta-adrenergic receptor signaling in mediating the effects of surgical stress on tumor growth. In the HeyA8 and SKOV3ip1 models, surgery significantly increased microvessel density (CD31) and vascular endothelial growth factor expression, which were blocked by propranolol treatment. CONCLUSION: These results indicate that surgical stress could enhance tumor growth and angiogenesis, and beta-blockade might be effective in preventing such effects. PMID: 19351748 [PubMed - indexed for MEDLINE]PMCID: PMC2746852Free PMC Article __________________ Mom's treatment history (link)