opioids and painkillers
© Reuters
Opioids and painkillers given after prostate surgery can actually help spread cancerous cells.
In treating prostate cancer, surgery, also known as a radical prostatectomy, is the most common treatment for patients looking to stop the spread of the disease. Before, during, and after surgery, patients are given drugs such as opioids and painkillers to help control any pain they may experience. A study out of the Mayo Clinic found that the use of these pain drugs could be doing more harm than good by inhibiting the immune system's ability to fight off cancerous cells.

"We found a significant association between this opioid-sparing technique, reduced progression of the prostate tumor and overall mortality," says senior author Dr. Juraj Sprung, a Mayo Clinic anesthesiologist. "Provided future studies confirm what we've found in this study, maybe down the line this would be a standard of care for pain management in patients undergoing cancer surgery."

Dr. Sprung and his colleagues used information from the Mayo Clinic's prostatectomy registry to complete their study. This database includes the medical records of patients who underwent prostate gland surgery to treat adenocarcinoma, the most common type of prostate cancer, between January 1991 and December 2005. The information included whether the patient received anesthesia in the form of pain killers, if there was a cancer recurrence, if the cancer spread, or if the patient died.

In addition to the use of opioids after surgery, researchers also attributed acute stress levels caused by surgery and general anesthesia to the systematic breakdown of the immune system. The body's immune response is especially important during surgery to treat cancer considering that surgery on a tumor can actually help cancer cells spread faster. Dr. Sprung recommended prostate cancer patients going in for a radical prostatectomy substitute general anesthesia for spinal or epidural painkiller. Spinal or epidural painkillers lower the patient's risk of a cancer recurrence while reducing the need for opioids post-surgery.

According to the American Cancer Society, one out of every six men will be diagnosed with prostate cancer at some point in their lifetime. While 238,580 new prostate cancer cases have been projected for 2013, 29,720 men will die as a result of the second most common form of cancer among men in the U.S. behind skin cancer. Older men are more likely to develop this serious disease seeing as six out of every 10 cases is attributed to men over the age of 65.

Source: Scavonetto F, Yeoh T, Umbreit E, Weingarten T, Frank I, Sprung J. "Association between neuraxial analgesia, cancer progression, and mortality after radical prostatectomy: a large, retrospective matched cohort study." British Journal of Anaesthesia. 2013.