Boosting the Immune System of Surgical Cancer Patients

This book highlights that, although surgical removal of primary tumors remains the most effective and potentially curative treatment for solid cancers, surgery itself—through nociceptive stimulation—triggers a stress response that impairs the physiological anticancer immune response. In addition, direct manipulation of the tumor during surgery can release circulating tumor cells, which contribute to secondary malignant lesions and cancer recurrence. Surgical inflammation also promotes the production of cytokines and vascular growth factors that favor oncogenesis. In summary, despite its undeniable benefits, surgery is immunosuppressive, while the immune system of cancer patients is often already compromised by factors such as neoadjuvant treatments, anemia, blood transfusions, or undernutrition. Recent advances have highlighted that restoring and enhancing immune function is a key component of care to improve outcomes after cancer surgery. To date, no book has comprehensively explained the immunosuppressive factors occurring during the perioperative period of cancer surgery, nor proposed practical guidelines to help clinicians select protocols that support the immune system and improve surgical cancer care. This book is divided into five sections: general principles, the preoperative period, the intraoperative period, the postoperative period, and future research directions in onco-anesthesiology. For each section, the book offers comprehensive and detailed explanations of immunosuppressive factors and their management. It discusses both pharmacological and non-pharmacological strategies aimed at enhancing immune effector function to improve the anticancer immune response during surgery and to potentiate the effects of conventional anticancer therapies. The book also proposes guidelines for future research in onco-anesthesiology and onco-immunology by discussing potential anticancer treatment candidates. This volume addresses the pressing need for a comprehensive handbook on immunodepression and stress during cancer surgery and fills gaps in existing onco-anesthesiology texts, which often fail to address the management of perioperative immunosuppressive factors, provide protocols for immune support during cancer surgery, or offer guidance for researchers in this field. The book serves as a comprehensive guide for residents and fellows training in anesthesia, oncology, immunology, and surgery, as well as for practicing anesthesiologists, oncologists, immunologists, and surgeons. It is also intended for certified allied health professionals—including anesthesia, surgical, and oncology nurses, physiotherapists, nutritionists, and psychologists—as well as researchers specializing in onco-anesthesiology or onco-immunology.