Operation of cancer according to time of menstrual cycle may influence success and failure of metastases. Article updated April 5, 2011

September 15, 2003: Source: Nature and Journal of Cancer.

That the moment of surgery in the first half or second half of the menstrual cycle can determine, as the mouse study described below, seems to prove the chances of recurrence and / or metastases has been a study result - made by 565 women - published on May 1, 2002 in the Journal of the NCI Cancer. Women in the second half of their menstrual cycle underwent surgery were 10% lower risk of recurrence and / or metastases than women in the first half of their menstrual cycle were operated on. You might wonder why surgeons and oncologists since no further keep in mind I think.

Source: Journal of Cancer


Mastectomy and Oophorectomy by Menstrual Cycle Phase in Women With Breast Cancer operable
Richard R. Love, Nguyen Ba Duc, Nguyen Van Dinh, Tian-Zhen Shen, Thomas C. Havighurst, D. Craig Allred, David L. Demets

Affiliations of authors: RR Love, Department of Medicine, Section of Medical Oncology, University of Wisconsin School of Medicine, Madison, NB Duc, NV Dinh, Hospital K, National Cancer Institute, Hanoi, Vietnam; T.-Z. Shen, People's Hospital of Haimen City, Haimen, Jiangsu, China, TC Havighurst, Department of Biostatistics and Medical Informatics, University of Wisconsin, DC Allred, Department of Pathology, Baylor College of Medicine, Houston, TX; DL Demets, Department of Biostatistics and Medical Informatics, University of Wisconsin.

Correspondence to: Richard R. Love, MD, MS, 610 Walnut St., 256 Warf, Madison, WI 53705 (email: rrlove@facstaff.wisc.edu).

Background: It's Unclear whethere the phase of the menstrual cycle in Which Primary Surgical Treatment Influences occure disease-free survival (DFS) and overall survival (OS) in premenopausal women with breast cancer. We Investigated this question in the context of a clinical trial Comparing mastectomy alone with mastectomy plus adjuvant oophorectomy and tamoxifen in premenopausal women with operable breast cancer.

Methods: The date of the first day of the last menstrual period (LMP) was Used To estimate the phase of the menstrual cycle Were When The surgeries done. Follicular phase was defined as day 1-14 from LMP. Luteal phase was defined as day 15-42 from LMP. DFS and OS statistics and Determined Were Analyzed by Cox proportional hazards ratios and Kaplan-Meier methods. All statistical tests Were two-sided.

Results: We Analyzed results for 565 Women Who Reported an LMP within-42 days before surgery. For women in the mastectomy only arm (n = 289), Were there no differences in DFS or OS by menstrual cycle phase. For women in the adjuvant treatment arm (n = 276), Those Whose surgery occurred consistently the luteal phase (n = 158) had better DFS (relative risk = 0.54 -819 478 530; [CI] 95% confidence interval = 0.32 to 0.96, P =. 02) and OS (RR = 0.53, 95% CI = 0.30 to 0.95, P = .03) Than Those Whose surgery occurred consistently the follicular phase (n = 118). More over, women Whose surgery occurred consistently the luteal phase and who Received adjuvant therapy had better 5-year DFS Than did women Whose surgery occurred consistently the follicular phase (84%, 95% CI = 78% to 90% versus 67%, 95% CI = 58% to 78%, P = .02); Also They had better OS (85%, 95% CI = 78% to 92% versus 75%, 95% CI = 66% to 84%, P = .03 ).

Conclusions: The phase of the menstrual cycle at Which surgery was done had no impact on survival for women who Received mastectomy only. However, women who Received a mastectomy and Surgical oophorectomy and tamoxifen consistently the luteal phase had better outcomes Than Women Who Received Surgery consistently the follicular phase.

Source: Nature dated September 15, 2003

Surgery in cancer patients according to time of menstrual cycle can have a significant impact on metastasis and recurrence rates.

Although several studies have previously never really have evidence to provide, although the study in Wisconsin - see above - such proof is delivered, now a study in mice showed that an operation for cancer patients at a particular time of the menstrual cycle is indeed an effect on the future development of metastases and therefore a recurrence. This edition of their report in Nature last week dated September 9, 2003. Nearly one third of the mice that were previously injected with melanoma cells and progesterone, and it then underwent surgery developed ovarian cancer Darna. the mice were injected with estrogen showed no prejudice to any other cancer. This conclusion is considered highly significant and research leader Ann Chambers of the London Regional Cancer Centre in London reports suggests that further research is urgently needed. Retrospective studies have previously attempted a conclusion on this, but only in retrospect because participants were asked about their menstrual cycle, so these studies were really difficult to analyze. Now there are several large studies involving women throughout their menstrual cycle accurately capture and track. Hopefully this will be a quick clarification on this remarkable result.

Source: Nature


Menstrual phase Influences cancer spread in mice Study feeds controversy over timing or tumor surgery. 9 September 2003
HELEN PEARSON


Hormone Levels May Affect tumor spread.
© Corbis

The phase of a mouse's menstrual cycle can-Dramatically alter the risk of cancer spreading, say researchers in Canada. The finding fuels the debate about women's cancer surgery whethere Should Be timed to specific menstrual stages.

Some studies on breast-cancer patients have found tumoren Whose That women are removed in a Particular Phase of Their menstrual cycle are more Likely to get secondary tumoren - called metastasis - and that earlier. But Other studies have found no such link.

Nearly a third of mice injected with skin-cancer cells When Their levels of the hormone progesterone was high Developed ovarian tumor, reports a team led by Ann Chambers of the London Regional Cancer Centre in London, Canada1. Those injected When estrogen was high showed no such cancer. "We were so startled," Chambers says.

The study implies That Other tumoren besides breast cancer Might Be More Likely to spread if They Are Particular operated on at times. This Might Be Crucial Particularly for surgery on young tumoren Which Might migrating cancer cells slough off Potentially Before They Would NaturallySpeaking spread, Chambers suggests.

The study is important, says Richard Love, who studies breast cancer at the University of Wisconsin at Madison, becaus it shows Hormones That Might PromoteLimit metastasis by working on the tissues in Which a drifting cancer cell implants. Until now, most research focused on how HAS Hormones change the tumor Itself.

But it is too early to recitals rescheduling operations, breast-cancer researcher warns Hortobágyi Gabriel of the University of Texas at Houston. The Picture May Be very differential in women from thats in mice. "It adds another reason to do a clean clinical trial," he says.

Clinical clash

The results of clinical studies about menstrual phase and metastasis are conflicts, Mainly Because data are Gathered Often retrospectively, and menstrual phase was not recorded Precisely. What's more, the rolling menstrual cycle, with ITS subtly shifting hormone patterns is Difficult to divide neat writing courses.

Large-scale prospective studies are now under way in the United States in Which women's blood hormone levels are accurately Measured before breast-cancer surgery. "Everything else is just background noise," says Hortobágyi.

It's a stretch to say it directly applies to patiënten
Ann Chambers
London Regional Cancer

Researchers are not sure how shifting levels of estrogen and progesterone Might trigger metastasis. Chambers speculates thats the Hormones alter the structure of the ovary stimulation or the growth of blood vessels, making themself more receptive to implantation or development of cancer cells.

If the protective Hormones - or Other molecules - can be Identified, They Might be Administered just before surgery, Chambers suggests, an Idea That Might Be Tested Using her mouse model.


References
Vantyghem SA Postenka, CO & Chambers, AF Estrous Cycle Influences Organ-specific metastasis of B16F10 cells. Cancer Research, 63, 4763-4765, (2003).