Cancer is a leading cause of death worldwide. It is estimated that approximately 55,000
Canadians are surviving with brain tumors. It is projected that around 3000 persons will
be diagnosed with brain and spinal cord tumors, and approximately 75 percent patients
will not survive. Out of all brain cancers, high-grade gliomas [Glioblastoma Multiforme
(GBM)] impose highest morbidity and mortality. Therefore, it is important to explore ways
in which Investigators can improve and prolong the lives of patients suffering from brain
cancers, particularly high-grade glioma, which is the most common and aggressive primary
brain tumor.
So far the Investigators know that the surgery, chemotherapy and radiotherapy are the
three corner stones management options for these patients, and majority of the research
have been conducted on these three major domains. Therefore, it is imperative to explore
the other variables those may impact survival characteristics. One of the integral
variables of the brain cancer surgery is anesthesia. Interestingly, the role of
anesthetics was explored in some other non-brain solid organ tumor surgeries. It is
observed that out of the two main types of anesthesia [one is through intravenous
(propofol) and other one is gaseous (sevoflurane)], intravenous based anesthesia
maintenance regime may delay the cancer progression and prolong the recurrence free
period. In addition, two very large retrospective studies with approximately 11,000 and
18,000 patients respectively, showed that as compared to gaseous (volatile anesthetics)
based, intravenous (propofol) based anesthesia conferred some protection against cancer
progression and was also associated with lesser overall mortality. The exact nature of
these protective mechanisms is not known but in animal and other laboratory-based
experiments, propofol seems to inhibit cancer formation steps, delays inflammation and
provide protection from cancer cell growth. This is a feasibility study for knowing
various aspects of workflow; recruitment characteristics of participants and various
obstacles in implying anesthesia based protocols so that the Investigators can conduct a
well-designed multicenter international randomized study.
