Breast cancer and the perioperative window: A historical perspective (April 2022)

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Michael Retsky

University College London, UK

: J Womens Health, Issues Care

Abstract

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Much research in cancer is trying to find ways of avoiding patients from dying after metastatic relapse. Focused by data and analysis, this project is an method to solve the problem upstream, i.e., to prevent relapse. This project started with the unanticipated observation of bimodal relapse forms in breast and a number of other cancers. This was not understandable with the current cancer model that has guided cancer therapy and early detection for many years. After much analysis using computer simulation and input from a number of medical specialists, we finally came to the conclusion that the surgery to remove the primary tumor which produced systemic inflammation for a week after surgery. This systemic inflammation seemingly caused exits of cancer cells and avascular micrometastases from dormant states and resulted in relapses in the first 3 years post-surgery. Animal studies agreed with these findings. It was determined in two retrospective studies that the common inexpensive perioperative NSAID ketorolac could curtail the early relapse events after breast cancer surgery. Ketorolac is routinely used instantly after breast cancer surgery in many centers around the world. Based on what we now know, surgeons and anesthesiologists should take extra precautions to reduce systemic inflammation during the perioperative window using ketorolac. This also applies to cosmetic or health related surgeries for persons who are cancer survivors. Refer to the second 2020 paper below. We are currently seeking funds to conduct a clinical trial in Nigeria.

Biography

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Michael Retsky received a PhD in experimental physics from University of Chicago in 1974. His thesis project was to build a scanning transmission electron microscope that could resolve single atoms of silver, mercury and uranium and measure their elastic cross-sections (in Albert Crewe’s laboratory). While doing electron optics research at Hewlett-Packard in 1982, a friend’s wife was diagnosed with cancer. This friend organized an informal research group to study cancer and possibly help his wife. Retsky got more interested in cancer research than physics research and gradually made a career change over a period of 5 years. He read every paper he could find at Penrose Cancer Hospital. His first publication in oncology (Speer et al Cancer Research 1984) predicted that breast cancer growth included occasional periods of dormancy. This paper studied clinical data using computer simulation. Retsky had developed skills in computer simulation at U of C and especially at H-P. He later became Prof of Biology at University of Colorado, Visiting Prof at University of Texas (in Wm. McGuire’s laboratory) and on Judah Folkman’s staff at Harvard Medical School. He is now Honorary Associate Professor at University College London.