Most cancer deaths happen after cancer spreads from its original location to other parts of the body.
This process, called metastasis, is one of the biggest challenges in cancer treatment because even a small number of cancer cells can travel through the blood or lymph system and form new tumors elsewhere.
Surgery can remove a main tumor, but doctors cannot always see or remove every cancer cell. Tiny groups of cells may already have escaped before surgery, which is one reason chemotherapy or other treatments are often given to reduce the risk that cancer will return.
Researchers at Emory University have investigated whether a familiar pain medicine could help the body fight these remaining cancer cells. Their study suggests that ketorolac, an anti-inflammatory drug, may help prevent metastasis when given around the time of surgery.
The research was led by Dr. Vikas P. Sukhatme and colleagues and was published in the Journal of Clinical Investigation. The findings raise the possibility that an existing medicine could eventually be used in a new way as part of cancer treatment.
Ketorolac belongs to a group of medicines known as nonsteroidal anti-inflammatory drugs, or NSAIDs. These drugs reduce pain and inflammation, and ketorolac is already approved in the United States for short-term treatment of moderately severe pain.
Researchers became interested in ketorolac partly because earlier observations in breast cancer patients suggested that people who received the drug around the time of surgery might have a lower risk of cancer spreading. However, scientists did not fully understand why this might happen.
In the new research, the team studied the drug in mice with cancer. They found that ketorolac could help the immune system attack small groups of cancer cells that had spread away from the original tumor.
This is important because surgery itself can produce inflammation as the body responds to tissue damage. Inflammation is a normal part of healing, but under some circumstances it may create conditions that make it easier for surviving cancer cells to grow.
Ketorolac appears to affect this environment in more than one way. By reducing certain inflammatory signals, the drug may allow immune defenses to work more effectively against cancer cells that have begun spreading.
In the mouse experiments, treatment with ketorolac helped eliminate metastatic cancer cells and improved survival. The researchers also tested the drug together with low-dose aspirin and omega-3 fatty acids, two other substances known to influence inflammation.
The combination produced even stronger survival results in the animals. This suggests that targeting several inflammation-related processes at the same time might offer greater protection, although findings in mice cannot be assumed to work the same way in people.
Ketorolac also has important limitations. Like other NSAIDs, it can cause side effects, including stomach bleeding and kidney problems, so it is generally used for only a short period and is not appropriate for everyone.
The researchers are now interested in learning whether ketorolac could safely be combined with other cancer treatments. Future clinical trials would be needed to determine which patients might benefit, when the drug should be given, and what dose would provide the best balance between benefit and risk.
The study also highlights a broader approach in medical research known as drug repurposing. Instead of developing an entirely new medicine, scientists investigate whether an existing drug with a known safety history might also work against a different disease.
For now, ketorolac is not an established treatment for preventing cancer metastasis, and patients should not take it for this purpose without medical guidance. Still, the research offers an intriguing possibility: changing inflammation around the time of cancer surgery may help the immune system destroy dangerous cells before they can establish new tumors.
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