Cutting Edge | Local anaesthesia injection can help in breast cancer treatment

Surgery is a crucial intervention that offers a chance of cure for cancer patients. But it often induces the formation of new metastatic disease — when it spreads from its site of origin to another part of the body. Now this local anaesthesia stops the cancer cells from “In a simple form, the intervention puts the cell communicating to sleep, restricting their movement and chances of metastasis,” said Dr Rajendra Badwe, the principal investigator and director of Tata Memorial Centre.

This is the first study of its kind globally that has shown a sizeable benefit by a single intervention prior to surgery.

WHAT THE RESEARCH SHOWS

Dr Badwe’s previous research has suggested that there is a window of opportunity just prior to, during, and immediately after surgical removal of the primary cancer when anti-cancer interventions could reduce the risk of development of disseminated stage 4 metastatic cancer later in the lifespan of the patient.

Dr Badwe explained how the local anaesthesia is injected minutes before undergoing the surgery. Then the surgeons wait for about six minutes. By then the anaesthesia makes the tumour less sensitive to happenings in its micro-environment. “In our initial study, we witnessed that the movement of cells during a surgical procedure is more compared to before and after the surgery. So, once we eject the anaesthesia, it helps us control the movement and reduces the chance of recurrence and metastasis,” he said.

The study is a randomised controlled trial, which included 1,600 women with operable breast cancer, half of whom received an injection of a commonly used drug around the tumor on the operating table, just prior to surgery. All the women were suffering from an early stage of breast cancer which was presented by Dr Badwe at the European Society of Medical Oncology (ESMO) Congress in Paris last week.

Dr Sudeep Gupta, professor of Medical Oncology at TMC, and one of the co-investigators of the study, said, “This study provides an inexpensive and immediately implementable treatment in breast cancer which can be practised by every surgeon who treats this disease. The results from a large randomised trial, which is the gold standard way of evaluating the worth of new treatments, provide the highest level of evidence to support the use of this technique. This study is proof that Indian centres can design and conduct studies which have a global impact.”

As per the World Health Organisation (WHO), the survival rate of breast cancer patients for at least five years after diagnosis is 66 per cent in India.

India witnesses around 1,50,000 new breast cancer patients annually. Most of them are detected at a late stage. The researchers believe that with the incorporation of the intervention in the treatment of all the breast cancer patients, lakhs of lives can be saved.

The administration of 0.5 per cent lidocaine before the surgery will now be a standard protocol for treatment of all breast cancer patients for surgery at the early stage at their centres. Dr Badwe said, “The intervention has low toxicity and side-effects. It will be made part of the national guidelines for the treatment of breast cancer patients.”

The doctors also have plans to conduct similar studies in cannabis. “It will also be tried for other cancer treatments where surgery is part of the treatment course,” said Dr Badwe.