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Perioperative Morphine and Cancer Recurrence

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Morphine and Metastasis

Abstract

There is growing evidence suggesting that certain interventions during the perioperative period may have an impact on long-term outcomes of patients undergoing cancer surgery. It has been postulated that regional anesthetic techniques and other targeted interventions could decrease the risk of cancer recurrence, therefore increasing the disease-free interval and overall survival, of those patients undergoing cancer surgery. Conversely, however, it has also been theorized that volatile anesthetics, opioids and surgery itself are directly or indirectly linked to cancer recurrence. Among the opioids used during the perioperative period, morphine has raised most of the concerns regarding its putative effects on cancer. Indeed, morphine has been found to affect many cellular and cell signaling pathways involved in cancer genesis and possibly causing tumor growth. This chapter will focus on the role of the perioperative period on cancer progression, the recognized mechanisms of action of morphine on cancer and alternative pain management options for patients undergoing cancer surgery.

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Abbreviations

cAMP:

cyclic adenosine monophosphate

COX-2:

cyclooxygenase 2

HIF:

hypoxia inducible transcription factor

NK:

natural killer

NO:

nitric oxide

NSAIDs:

non-steroidal anti-inflammatory drugs

PMN:

polymorphonuclear leucocyte

PGE2:

prostaglandin E2

STAT-3:

signal transducer of activation and transcription-3

VEGF:

vascular endothelial growth factor

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Authors and Affiliations

  1. Associate Professor of Anesthesiology and Obstetric and Gynecology, University of Virginia, 800710, Charlottesville, VA, 22908, USA

    Ashley M. Shilling M.D.

  2. Department of Anesthesiology and Obstetrics and Gynecology, University of Virginia, 800710, Charlottesville, VA, 22908, USA

    Mohamed Tiouririne M.D.

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  1. Ashley M. Shilling M.D.
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  2. Mohamed Tiouririne M.D.
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Correspondence to Mohamed Tiouririne M.D. .

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  1. , School of Pharmacy, University of Queensland, Cornwall Street 20, Woolloongabba, QLD4102, Australia

    Marie-Odile Parat

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Shilling, A.M., Tiouririne, M. (2013). Perioperative Morphine and Cancer Recurrence. In: Parat, MO. (eds) Morphine and Metastasis. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5678-6_9

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