Immune function is known to affect cancer incidence. Dexamethasone is used to control postoperative nausea and vomiting. Would its use therefore affect cancer incidence?
Dr. Gildasio S. De Oliveira Jr., Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and colleagues from the Department of Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, and the Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, studied 260 patients who had optimal cytoreductive or “tumor debulking” surgery (residual tumor <1 cm) between January 1997 and October 2007, and who were or were not given perioperative systemic dexamethasone 4-5 mg or 8-10 mg. The results of their study are published in the June 2014 issue of Anesthesia & Analgesia in an article titled “Is Dexamethasone Associated with Recurrence of Ovarian Cancer?”
Median follow-up time was 4 years. Three patients received radiation therapy after surgery. Median time to cancer recurrence was 18 months. Time to cancer recurrence was no different according to dexamethasone use.
This study was small, yet the authors performed a similar study where they showed the use of intraoperative regional anesthesia increased the time for tumor recurrence after surgery, and the number of patients studied then was similar to the number in this study.
It is unclear whether more prolonged use of dexamethasone would be associated with increased cancer risk. Nonetheless, given study’s findings, go ahead and include dexamethasone as part of a multi-pronged approach to treat postoperative nausea and vomiting, even for patients with ovarian cancer.