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Israeli study on colorectal cancer patients aiming to halt metastasis yields promising results

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Last month, the Tel Aviv University research team announced that they found metastases can develop when the body is under both physical and psychological stress.

By ILANIT CHERNICK

A team from Tel Aviv University has found that implementing a stress-inflammatory response reducing treatment pre- and post-surgery could lead to a decrease in metastatic risk in colorectal cancer patients.

Last month, the team, led by Prof. Shamgar Ben-Eliyahu from the School of Psychological Sciences and Sagol School of Neuroscience at TAU and Prof. Oded Zmora from Shamir Medical Center, announced that metastases can be found to develop when the body is under both physical and psychological stress.

Recently, they put this theory to the test in patients who were set to go through colorectal tumor removals.

“Using a short medication treatment around the time of the surgery,” the researchers were able to reduce body stress responses and physiological inflammation during this critical period. 

This, they found, prevented the development of metastases in the years following the surgery with only 12.5% of patients who received the treatment developing metastases.

During the study, which lasted three years, the researchers monitored 34 patients, who received the treatment surrounding a colorectal tumor removal surgery. 

During the pre- and post-surgical period, the patients were administered two safe and known drugs: Propranolol, which is an anti-anxiety and blood pressure reducing drug and Etodolac, which is an anti-inflammatory analgesic. 

Prof. Shamgar Ben-Eliyahu from the School of Psychological Sciences and Sagol School of Neuroscience at TAU
(Credit: Tel Aviv University)

“The drugs were only administered to the patients for 20 days,” the team explained, pointing out that it started “from five days prior to surgery, and until two weeks afterwith” and “half of the patients receiving a placebo treatment, as a control group.”

Ben-Eliyahu emphasized the study’s promising results with only 2 out of 16 patients who received the treatment exhibiting metastatic spread in the years following.

Those who received the placebo were found to have a 33% rate of metastases development, working out to 6 of the 18 patients. This, Ben-Eliyahu stressed, is the known rate for colorectal cancer patients. 

Ben-Eliyahu said that although he is highly satisfied with the results, “this treatment must be examined again, in a much larger number of patients, in order to test whether it is, in fact, life-saving.”
He explained that when the body is in a state of stress, whether physiological (from surgery) or psychological, “this causes a release of high amounts of two types of hormones, prostaglandins and catecholamines. 

“These hormones suppress the activity of the immune cells, thus indirectly promoting the development of cancer metastases,” Ben-Eliyahu said. “In addition, these hormones also directly promote the acquisition of metastatic traits in cancer tissue.”

According to Ben-Eliyahu, the study of molecular markers in the cancerous tissue excised from the patients showed that the treatment with the medications led to a reduction in the metastatic potential of the tumor and potentially the residual cancer cells. 

In addition, he said, “the drugs triggered some beneficial alterations in infiltrating tumor leukocytes of patients’ white blood cells, both in number and type, which are also markers indicating a reduced chance of disease recurrence.

“Our study shows that inexpensive, accessible medication treatment could be used in order to reduce body stress responses and inflammation associated with surgery, which affects the tumor, significantly reducing the risk of metastases that might be detected months or years after surgery.”

Following the success of their initial research, Ben-Eliyahu and Zmora are encouraging Israeli colorectal and pancreatic cancer patients, intended for surgery, to apply for participation in a large-scale clinical study “which is now starting across the state in eight different medical centers” in hopes of saving lives.

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