{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:06:21Z","timestamp":1760241981113,"version":"build-2065373602"},"reference-count":9,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2018,12,3]],"date-time":"2018-12-03T00:00:00Z","timestamp":1543795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>A simple solution may exist for both the problem of sudden dementia and confusion after surgery in the elderly and the bimodal relapse pattern among breast cancer patients who were treated with a mastectomy. Systemic inflammation by a variety of mechanisms can induce tumor outgrowth from dormant states, such as single dormant cells and avascular micrometastases. This may also explain sudden confusion and dementia for the elderly after surgery. We propose that surgery-induced inflammation may be addressed by \u201cprotective anesthesia\u201d. We suggest ketorolac for 4 days starting at the time of surgery to prevent early relapse in breast and probably other cancers; perhaps that or something similar could be used before surgery in elderly patients to prevent post-operative cognitive dysfunction.<\/jats:p>","DOI":"10.3390\/medicina54060101","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T03:01:37Z","timestamp":1543892497000},"page":"101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breast Cancer Relapse, Post-Surgical Confusion, and Dementia in the Elderly: An Unexpected Connection but with the Same Proposed Solution"],"prefix":"10.3390","volume":"54","author":[{"given":"Michael W.","family":"Retsky","sequence":"first","affiliation":[{"name":"Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA, <email>mretsky@hsph.harvard.edu<\/email>"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-8439","authenticated-orcid":false,"given":"Patrice","family":"Forget","sequence":"additional","affiliation":[{"name":"Anesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4163","DOI":"10.2174\/09298673113209990250","article-title":"Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: New findings and a review","volume":"20","author":"Retsky","year":"2013","journal-title":"Curr. 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Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1016\/S0140-6736(16)30580-3","article-title":"Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: A randomised, double-blind, placebo-controlled trial","volume":"388","author":"Su","year":"2016","journal-title":"Lancet"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/54\/6\/101\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:30:57Z","timestamp":1760196657000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/54\/6\/101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,3]]},"references-count":9,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["medicina54060101"],"URL":"https:\/\/doi.org\/10.3390\/medicina54060101","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2018,12,3]]}}}