Anti-inflammatory drugs can benefit patients after colorectal cancer surgery

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Recent research from Umeå University has highlighted the potential benefits of non-steroidal anti-inflammatory drugs (NSAIDs) for patients recovering from colorectal cancer surgery.

The study, led by Oskar Grahn from the Department of Diagnostics and Intervention, indicates that NSAIDs could reduce cancer recurrence and the incidence of leaks at the surgical connection site, known as anastomotic leakage.

The research began by examining whether NSAIDs, when administered in the first week post-surgery, could enhance recurrence-free survival in patients with rectal cancer.

Initially, no definitive effects were observed, which could be due to various factors such as the small number of patients studied, the use of different types of NSAIDs, or possibly the need for a longer duration of NSAID treatment to see beneficial effects.

However, as the study expanded to include a larger group of patients, clearer benefits began to emerge.

Patients who received NSAIDs showed a significantly lower rate of cancer recurrence, particularly in cases of left-sided colon cancer, and experienced fewer instances of anastomotic leakage.

The study also delved into the biological processes related to anastomotic leakage and its impact on long-term cancer outcomes.

Although patients who suffered from leakage or intra-abdominal abscesses showed normal levels of C-reactive protein (a marker of inflammation) 41 days after surgery, researchers discovered changes in 72 proteins that were upregulated and five that were downregulated.

This finding suggests that even when it appears that recovery is progressing well, there may still be underlying harmful processes occurring.

Additionally, the research investigated the prevalence of a specific mutation in the gene encoding for the enzyme cyclooxygenase (COX-2) among Swedish colorectal cancer patients. COX-2 is an enzyme that NSAIDs typically inhibit.

While earlier studies suggested this mutation might be linked to increased risk of anastomotic leakage, the Umeå University study could not confirm this association.

The findings underscore the potential role of NSAIDs in improving outcomes for patients with colorectal cancer, especially those with tumors on the left side of the colon, where COX-2 is often overexpressed.

These tumors may particularly benefit from NSAID treatment due to their specific biological behavior.

Oskar Grahn emphasized the need for further research to solidify these results and to explore whether extending the duration of NSAID treatment could further enhance its effectiveness.

This study points towards a promising direction for post-operative care in colorectal cancer, suggesting that a common and generally accessible medication could significantly improve patient outcomes.

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