Cancer patients face overwhelming stress levels during their fight against the disease. Although the excision of the primary tumor is undoubtedly necessary, surgery causes extensive physiological stress and inflammatory responses, which is argued to facilitate the formation of metastases. Of great concern are brain metastases due to their prevalence in several types of cancers and their notoriously detrimental impact on prognosis and patient life quality. Despite this, little is known about the impact of the surgical stress responses on brain metastasis. In my research I use various types of approaches to study the impact of surgical stress on initiation and colonization of brain metastases and elucidate the mechanisms underlining these processes. To this end, I combine awake two-photon laser scanning microscopy to image changes in the dynamics in the different steps of the metastatic process, together with in-vivo radioactive assays and bioluminescent imaging to study possible therapeutic approaches (e.g. immune-stimulation) to reduce metastatic incidence in the brain, and various in vitro assays to reveal molecular modulators of the process.
I addition, I study the effects of micro-strokes on the brain micro-environment, using in-vivo two photon imaging and histological approaches. Furthermore, while malignancy is correlated with enhanced ischemic attacks in the brain, I study the effects of micro-occlusions on initiation of brain metastasis.