Stimulating the immune system prevents postoperative metastasis

In a groundbreaking study recently published in the journal Nature, Tel Aviv University researchers found that the short period of time around tumor removal surgery (the weeks before and after surgery) is critical to preventing cancer. development of metastases, which develop when the body is under stress.

According to the researchers, to prevent the development of metastases after surgery, patients need immunotherapeutic treatment along with treatment to reduce inflammation and physical and psychological stress. The research was conducted by Professor Shamgar Ben-Eliyahu from the Faculty of Psychological Sciences and the Sagol School of Neuroscience at Tel Aviv University and Professor Oded Zmora from the Assaf Harofe Medical Center.

Immunotherapeutic treatment is a medical treatment that activates the immune system. One such treatment, for example, involves injecting substances with receptors similar to those of viruses and bacteria into the patient’s body. The immune system recognizes them as a threat and is activated, so it can prevent metastatic disease.

Professor Ben-Eliyahu explains: Surgery to remove the primary tumor is a mainstay in cancer treatment, yet the risk of developing metastases after surgery is estimated to be 10% among breast cancer patients and between 20% and 40% among patients with colorectal cancer, and 80% among patients with pancreatic cancer.

According to Professor Ben-Eliyahu, when the body is under physiological or psychological stress, such as surgery, large amounts of groups of hormones called prostaglandins and catecholamines are produced. These hormones suppress the activity of the cells of the immune system and thus indirectly increase the development of metastases.

In addition, these hormones help tumor cells that remain after surgery develop into life-threatening metastases. Therefore, exposure to these hormones causes tumor tissues to become more aggressive and metastatic.

“Medical and immunotherapeutic intervention to reduce psychological and physiological stress and activate the immune system in the critical period before and after surgery can prevent the development of metastases, which will be discovered months or years later”, emphasizes Prof. Ben- Eliyahu.

Professor Ben-Eliyahu adds that the current antimetastatic treatment skips the critical period around surgery, thus leaving medical personnel to face the consequences of treating progressive and resistant metastatic processes, which are much more difficult to stop. Prof. Ben-Eliyahu’s research contradicts the widely held assumption in the medical community that, as with chemotherapy and radiotherapy, immunotherapeutic treatment of cancer patients in the month before and after is not recommended to surgery.

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