surgery as a double-edged sword a clinically feasible approach to overcome the metastasis-promoting effects of surgery by blunting stress and prostaglandin responses手术作为一把双刃剑临床可行的方法来克服metastasis-promoting影响手术的削弱压力和前列腺素的反应.pdfVIP

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surgery as a double-edged sword a clinically feasible approach to overcome the metastasis-promoting effects of surgery by blunting stress and prostaglandin responses手术作为一把双刃剑临床可行的方法来克服metastasis-promoting影响手术的削弱压力和前列腺素的反应.pdf

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surgery as a double-edged sword a clinically feasible approach to overcome the metastasis-promoting effects of surgery by blunting stress and prostaglandin responses手术作为一把双刃剑临床可行的方法来克服metastasis-promoting影响手术的削弱压力和前列腺素的反应

Cancers 2010, 2, 1929-1951; doi:10.3390/cancers2041929 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review Surgery as a Double-Edged Sword: A Clinically Feasible Approach to Overcome the Metastasis-Promoting Effects of Surgery by Blunting Stress and Prostaglandin Responses Marganit Benish and Shamgar Ben-Eliyahu * Neuroimmunology Research Unit, Department of Psychology, Tel Aviv University, Tel Aviv 69978, Israel; E-Mail: benishd@post.tau.ac.il * Author to whom correspondence should be addressed; E-Mail: shamgar@post.tau.ac.il; Tel.: +972-3-6407266. Received: 13 October 2010; in revised form: 14 November 2010 / Accepted: 23 November 2010 / Published: 24 November 2010 Abstract: Surgery remains an essential therapeutic approach for most solid malignancies, including breast cancer. However, surgery also constitutes a risk factor for promotion of pre-existing micrometastases and the initiation of new metastases through several mechanisms, including the release of prostaglandins and stress hormones (e.g., catecholamines and glucocorticoids). However, the perioperative period also presents an opportunity for cell mediated immunity (CMI) and other mechanisms to eradicate or control minimal residual disease, provided that the deleterious effects of surgery are minimized. Here, we discuss the key role of endogenous stress hormones and prostaglandins in promoting the metastatic proces