Morphine may hurt treatment of breast cancer

Breast cancer researchers have appealed for funding to allow them fully probe their discovery that common pain relief and anaesthesia techniques could hamper patients’ treatment.

The research team from University College Dublin found in laboratory tests that inhaled anaesthetic gas with morphine used in surgery could actually help potentially lethal breast cancer cells to survive.

Their studies used blood samples and extracted cells from patients who underwent surgery for breast cancer rather than direct tests on patients themselves, but they say it’s now crucial to move their research out of the lab and into a full-scale, clinical trial.

Thousands of women in Ireland and around the world would need to give their consent for such a trial, but team leader, Professor Donal Buggy, said the findings could lead to simple but critical and cost-effective changes in treatment choices and techniques.

“This is really the first time there has been a suggestion that anaesthesia and pain relief techniques might affect longer-term outcomes, including cancer outcomes,” he said. “We think the findings are significant and it underlines the need to undertake a randomised clinical trial.”

Professor Buggy, associate professor of anaesthesia at UCD and also a consultant anaesthesiologist at the Mater Hospital, has been probing the possible effects of anaesthetics for several years.

His underlying concern has been what happens to the cancerous cells that come loose and are inadvertently dispersed into a patient’s blood and lymphatic system when a tumour is surgically removed.

His questions about whether the death or survival of those cells — and consequently tumour regrowth — could be influenced by the medications administered to the patient, led to the worrying discovery that some of the very treatments meant to help a patient could hinder their recovery.

Cancerous cells exposed to blood taken from patients who had been administered an inhaled, general anaesthetic with morphine pain relief — the most common technique in Irish surgery — had a higher than expected rate of survival.

But cells exposed to blood from patients who had been intravenously administered a general anaesthetic, which reduced the amount of pain relief needed, died in greater numbers.

Separate but related research found that the anaesthetic technique used could also influence the activity of the body’s immune system with ‘natural killer’ cells more active in the blood of patients who received the anaesthetic intravenously than those who inhaled it.

Breast cancer is the most common form of cancer in Irish women with around 2,600 women newly diagnosed with the disease and 660 dying from it every year.

Professor Buggy said small scale clinical trials to further probe his findings were under way but a thorough investigation needed the involvement of thousands of patients and so far, research funding bodies had rejected his grant applications.

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