Preoperative Repurposed Drugs: An Overlooked Step to Reduce Cancer Metastases
Discover Dr. Paul Marik’s latest cancer guide on preoperative drugs, taken before and after surgery to improve long-term outcomes and decrease its chances of coming back.
For most patients with solid tumors, surgery is presented as the definitive step: remove the cancer, begin recovery, and move forward.
What’s rarely explained is that surgery itself can change the biology of cancer. It can release tumor cells into circulation. It can lower immune defenses at the very moment they’re needed most. And it can set the stage for recurrence years later.
Patients are often told recurrence is something that simply “may happen.” But growing evidence shows there is more that patients and providers can do to improve outcomes. The days before and after surgery are a critical window—one where smart, low-risk interventions may help protect against metastasis.
IMA Chief Scientific Officer Dr. Paul Marik identified this as a key opportunity to shift outcomes using safe, repurposed medications already widely available. That insight led to the development of this free guide—an accessible companion to his comprehensive Cancer Care monograph—offering practical tools patients and clinicians can begin using today.
“Almost anyone who is going to have a surgical intervention to remove a cancer should consider this therapy, and the protocol is outlined in our guidance”
– Dr. Paul Marik
Download PDF: Preoperative Repurposed Drugs to Reduce Metastases
🧬 Why Surgery Can Accelerate Metastasis
Most solid tumors are treated with surgical resection. But surgery—even when successful—creates conditions that can promote metastasis:
Spillage of cancer cells into the bloodstream or lymphatic system
Release of inflammatory cytokines (IL-1, IL-6)
Immune suppression at a critical time
A surge in COX-2, which fuels tumor growth and blood vessel formation
This creates the perfect storm for circulating tumor cells to stick, survive, and spread. This storm is often described as a “metastatic cascade”.
⚠️ The Metastatic Cascade
The metastatic cascade is accelerated when inflammation is high and immune defenses are low.
The window around surgery is biologically dangerous—but also medically addressable.
📘 About This Guide
This guide was authored by Dr. Paul Marik, IMA Chief Scientific Officer, to help translate the science behind preoperative interventions into practical action.
It is part of a growing collection of focused, accessible resources designed to accompany his in-depth monograph, Cancer Care: The Role of Repurposed Drugs and Metabolic Interventions in Treating Cancer. Other companion guides include:
While the full monograph offers detailed evidence and mechanisms, this guide delivers immediate insight into a critical, but often overlooked, step in patient treatment.
These resources are entirely donor-supported. If you’ve found them valuable, we invite you to consider making a contribution. Your support helps us grow this library and bring accessible, life-saving knowledge to more patients, families, and clinicians.
Together, we can change what’s possible in cancer care.
💊 Repurposed Drugs for Before/After Cancer Surgery
The guide highlights low-cost, well-studied medications that, when started before surgery, may help reduce the risk of recurrence.
✅ Modified Citrus Pectin (MCP)
Blocks galectin-3, a molecule that helps cancer cells stick to tissues
In lab and animal studies, reduced metastasis by 40–90%
Safe, non-toxic, and easy to take orally
✅ Propranolol (β-blocker)
Reduces stress-related signals that promote cancer spread
Improves immune cell infiltration into tumors
Particularly effective when combined with anti-inflammatory drugs
✅ COX-2 Inhibitors (e.g., ketorolac, etodolac)
Reduce the inflammatory surge after surgery
In some studies, cut recurrence rates dramatically
Best suited for patients without cardiovascular risks
✅ Cimetidine (H2 blocker)
Prevents tumor cells from attaching to blood vessels
In colorectal cancer, improved 10-year survival from 49% to 84%
Unique benefit not seen with other H2 blockers
📋 Suggested Protocol for Preoperative Drugs
MCP
Dose: 14 g/day
Timing: 5 days before → 6–12 months after
Propranolol
Dose: 40–80 mg BID
Timing: Start 5 days pre-op, taper post-op
COX-2 Inhibitor
Dose: Per clinician judgment
Timing: Around day of surgery
Cimetidine
Dose: 800 mg/day
Timing: 5 days before → 1 year after
🌟 Turning Risk Into Opportunity
Surgery doesn’t just remove cancer; it creates a window. That window can leave patients vulnerable, or it can become a point of protection.
With safe, widely available medications, there’s an opportunity to reduce metastatic risk and strengthen long-term outcomes.
This is a message both patients and providers deserve to hear. Please share this guide widely with whoever may benefit! Our team has also created an infographic below to make sharing even easier.
📚 More Cancer Care Resources
IMA is committed to building a trusted library of cancer resources for patients and practitioners. What began with Dr. Paul Marik’s Cancer Care monograph has grown into a shared effort across our network. Explore more of our expanded resources below:
Webinar: Journal of Independent Medicine No. 3: Turbo Cancer Research & More
Webinar: Cancer Care: Research and Insights from the Frontline
Post: Here’s a Thought: Why Aren’t We Talking More About PREVENTING Cancer?
Post: $14 Billion Later, Cancer Is Worse Than Ever. Where Did the Money Go?
💙 Help Keep This Life-Saving Work Free
This guide is free—and so is the entire Cancer Care monograph—but research like this takes time. If this vital information matters to you, please support our work.
God bless Dr. Marik- a hero doing God’s work! 🙌🏻🙌🏻🙌🏻
God bless all of you and Merik. In 1988 the liver surgeon assured us cutting into cancerous livers could not and never does spread it. We believed him.