Local Anesthetics and Cancer

There is considerable interest in the influence of anesthetic technique and/or perioperative analgesia on outcomes following surgical tumor excision. While the current clinical evidence is mixed, most clinical studies are predicated on the effects of anesthetics in cancer being indirect. In this chapter we summarize the current evidence related to the direct effects of local anesthetics (LAs) on cancer cells mediated by voltage-activated sodium ion channels (VASCs) and muscarinic acetylcholine receptors (mAChRs). The link between VASC activity and cancer is one example of an emerging awareness of oncochannelopathies in which aberrant ion channel expression contributes to cancer hallmarks. The presence of VASCs (and other membrane proteins such as mAChRs) may contribute to the beneficial effects of LAs. Clinical trials testing systemic or tumor application of LAs will help to evaluate the potential benefits of their direct effects on cancer outcomes.