Impact of perioperative pain management on cancer recurrence: An ASRA/ESRA special article

Andres Missair, Juan Pablo Cata, Gina Votta-Velis, Mark Johnson, Alain Borgeat, Mohammed Tiouririne, Vijay Gottumukkala, Donal Buggy, Ricardo Vallejo, Esther Benedetti De Marrero, Dan Sessler, Marc A. Huntoon, Jose De Andres, Oscar De Leon Casasola

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characterized by the surgical stress response, pharmacologic-induced angiogenesis, and immunomodulation results in a physiologic environment that supports tumor spread and distant reimplantation.In the perioperative period, anesthesiologists may have a brief and uniquewindow of opportunity to modulate the unwanted consequences of the stressresponse on the immune system and minimize residual disease. This reviewdiscusses the current research on analgesic therapies and their impact ondisease progression, followed by an evidence-based evaluation of perioperativepain interventions and medications.

Original languageEnglish (US)
Pages (from-to)13-28
Number of pages16
JournalRegional anesthesia and pain medicine
Issue number1
StatePublished - Jan 1 2019

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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