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June 24, 2006

BehindTheMedspeak: Does cancer surgery cause relapse?

Epidemiologyintroduction

On May 27 I received an email from Gershom Zajicek, M.D., about my September 13, 2005 BehindTheMedspeak post entitled, "Over half of all relapses in breast cancer are accelerated by surgery."

Dr. Zajicek, who is Professor of Experimental Medicine and Cancer Research at The Faculty of Medicine of the Hebrew University of Jerusalem, wrote, "My studies of this phenomenon revealed that it appears in all cancers. Please check my site for a detailed explanation."

I did so and found his hypothesis provocative and most interesting.

There are numerous links to related studies.

Much of his discussion is above my anesthesiologist peabrain medical pay grade but I think I got the gist.

You'll probably fare better.

June 24, 2006 at 02:01 PM | Permalink


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Comments

Well, I was a lot more intrigued until I came across this: "Cancer is caused by a deficiency of a yet unknown metabolite A. In order to replenish the missing metabolite the organism grows a tumor which produces a substitute B. " Hmm.

Trying to maintain an open mind, I will recognize that it can be useful to see things from a different perspective, even a seemingly far-fetched one, because it may suggest a novel approach (bring out stock Kekule and the benzene ring/Oroborus example). Intellectual shivers aside, the bi-modal hazard rate he mentions is an interesting phenomenon. I seem to recall some professor or other mentioning that surgery might spread tumor cells. He cited the use of trans-abdominal orchiectomy in the case of testicular cancer as proof of that. I'm not sure if that's entirely convincing (or even correct, to be honest), but I think Skipweasel is on to something.

As for Skipweasel's idea that the cancer that killed the hypothetical woman was new and unrelated (in the sense of not existing at the time of) her original cancer, that would be pretty difficult to prove. By their nature, micro- (nano-?) metastases would be pretty hard to detect. It would be illuminating to know which it was, though.

Interesting article, as usual, Joe. This one will keep me thinking for a while.

Thanks!

Posted by: Dulcinea | Jun 26, 2006 10:53:35 PM

"The declining curve illustrates that from the time of diagnosis and onward women continue dying from cancer. However we ought to turn our attention to the 60% which live with their cancer for about 25 years. Consider a hypothetical woman who died 25 years after the diagnosis. Since dying from cancer she obviously carried the disease for 25 years. What was her secret?"

That penultimate sentence looks like a massive non-sequitur to me. I don't think you can say "She obviously carried the disease for 25 years". My first thought would be that she may have a suceptibility to cancer, which caught up with her again after 25 years, not that she actively /had/ cancer for the intervening years.

As for the occurance of post operative metastasis, what's wrong with the simple idea that disturbing the tumour causes cells to break away and cause later tumours elsewhere? It's a far simpler idea, and though Occam's Razor isn't always the best tool in the box, it seems to apply here.

Posted by: Skipweasel | Jun 25, 2006 3:08:44 PM

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