Positive Health Online

Abstract

BEN-ELiYAHU, Biopsychologu Research Unit, Department of Psychology, Tel Aviv University, Israel, shamgar@post.tau.ac.il, has reviewed (100 references) the promotion of tumour metastases by surgery and stress, with a focus on the immunological basis and implications for psychoneuroimmunology. Abstract: This review emphasizes a psychoneuroimmunology perspective of the hypothesis that surgical excision of a primary tumour can promote tumour metastasis. The empirical and theoretical basis for control of metastasis by cell-mediated immunity is established, and the interactive role of non-immunological risk factors is assessed. Various aspects of surgery that suppress cell-mediated immunity are described, together with the neuroendocrine mechanisms mediating suppression by stress and surgery. It is concluded that immunosuppression can be deleterious, especially when surgery is conducted early. The most sensitive period for metastasis is immediately post surgery. Interventions aiming at reducing stress and immunosuppression should be used peri-operatively and in a multimodal therapeutic fashion. The reduction of immunosuppression induced by surgery and perioperative stress should be seen as an important adjunct in the treatment of cancer.

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References

Ben Eliyahu S. The promotion of tumor metastasis by surgery and stress: immunological basis and implications for psychoneuroimmunology. Brain, Behavior, and Immunity 17 Suppl 1: S27-36, Feb 2003.