Mumbai A decade-long study by doctors at the Tata Memorial Centre (TMC) showed that a simple intervention of using a local anaesthesia (0.5% lidocaine) as an anti-cancer agent just before breast cancer surgery significantly lowered the risk of death and recurrence by 29% and 30% respectively.
Every year, India has an estimated 1,50,000 new breast cancer patients, of which 90,000-1,00,000 are eligible for the surgery. TMC doctors said that the intervention will henceforth be a standard protocol for treatment of all breast cancer patients slated for surgery at their centres.
In the study, conducted by investigators at 11 cancer centres across India, a commonly used local anaesthesia called lidocaine was injected around the breast tumour minutes before the surgery.
Dr Rajendra Badwe, the principal investigator and director of Tata Memorial Centre, said that they used the local anaesthesia injection (costs less than ₹100) for its anti-cancer properties before the surgery and not for numbing the pain.
“Minutes before the patient, who is on general anaesthesia, is taken up for the surgery, this local anaesthesia is injected. The surgeon waits for five to six minutes before going ahead with the surgery. The local anaesthesia makes the tumour less sensitive to what is happening in the vicinity of the micro-environment of the tumour. It helps in putting the tumour to sleep to ensure the cancer cells do not communicate with each other or escape, thereby reducing the chance of recurrence and metastasis (process by which cancer cells spread to other parts of the body),” he explained.
The study, which involved 1,600 breast cancer patients, was presented by Dr Badwe at the European Society of Medical Oncology (ESMO) Congress in Paris on Monday. The patients who participated in the study comprised those in stage I, stage II and early stage III patients and in the age groups 30-70.
Explaining the implications of the outcome of the study, Dr Sudeep Gupta, one of the co-investigators of the study, said it will help save more lives. “With this simple intervention at the operation table, we can save more lives and at the same time reduce the chances of recurrence/relapse of cancer too,” he said.
As per the World Health Organisation, the survival rate of breast cancer patients for at least five years after diagnosis ranges from more than 90% in high-income countries, to 66% in India.
Dr Badwe administering 0.5% lidocaine before the surgery will now be a standard protocol for treatment of all breast cancer patients slated for surgery at their centres. “This intervention also has low toxicity, no side-effects. It will also become part of the national guidelines to treat breast cancer in India soon,” he added.
The TMC said in their Mumbai hospital they see 5,000 new cases every year out of which 2400 are operated.
Talking about what led to having the local anaesthesia as a part of intervention during surgery, Dr Badwe said the idea came from their previous research where they studied the tumour and how it reacted to oxygen and nutrition supply.
“We found there was communication between the cells through electrical stimulation and this electrical stimulation happens through the voltage-gated channels in the cells that were pro-metastasis. It is known that the local anaesthesia can block these voltage-gated channels. That’s how we decided to study,” he said.
The doctors plan to have similar studies with other agents including cannabis. The doctors said it will be tried for other cancer treatments where surgery is part of the course of treatment.