Surgery is a stressful proposition for most patients. It is stressful on the mind, and the body. Many retrospective and observational studies have evaluated this stress response and whether is can drive or be linked to spread of cancer. A concept brought up by these investigators is that the stress response may tip the balance in favor of metastatic progression. It is an opportunity for clinicians to potentially treat cancer patients in the perioperative period with B-Blockers and anti-inflammatory medications in the COX2 family. It is an interesting concept but will be hard to design and implement a study to test the principle and eventually change clinical practice. Read more below.