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Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response
Breast cancer accounts for significant morbidity and mortality worldwide. Currently, treatment options in metastatic breast cancer consist of chemotherapy, along with endocrine, radiation, and/or biological therapies. Although advances in management have improved overall survival times, the treatmen...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072186/ https://www.ncbi.nlm.nih.gov/pubmed/33927959 http://dx.doi.org/10.7759/cureus.14686 |
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author | İyikesici, Mehmet Salih Slocum, Abdul Kadir Winters, Nasha Kalamian, Miriam Seyfried, Thomas N |
author_facet | İyikesici, Mehmet Salih Slocum, Abdul Kadir Winters, Nasha Kalamian, Miriam Seyfried, Thomas N |
author_sort | İyikesici, Mehmet Salih |
collection | PubMed |
description | Breast cancer accounts for significant morbidity and mortality worldwide. Currently, treatment options in metastatic breast cancer consist of chemotherapy, along with endocrine, radiation, and/or biological therapies. Although advances in management have improved overall survival times, the treatment options for women with end-stage disease are mostly limited to supportive care. Herein, we present a case report that highlights the response of a 47-year-old premenopausal woman with end-stage (T4N3M1) breast cancer treated with metabolically supported chemotherapy (MSCT), ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT). The patient first noticed a right breast mass in late 2016, which was initially evaluated and ruled out as a cyst. Skin ulceration was observed in the region of the suspected cyst in May 2017. Subsequent bilateral breast ultrasound identified masses in both breasts and an enlarged right axillary lymph node. The diagnosis following biopsy was grade 3, estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2 negative (HER2-), invasive ductal carcinoma of the breast. Initially, the patient refused to receive conventional chemotherapy because of its potential for side effects and toxicity, but she sought medical treatment in August 2018 following extensive disease progression and deterioration of general health. On reevaluation, the patient was considered ineligible for conventional treatment due to her advanced end-stage disease, poor performance status (Eastern Cooperative Oncology Group score: 3), and advanced respiratory symptoms. Exploring other options, the patient was admitted to the ChemoThermia Oncology Center, Istanbul, Turkey in November 2018. At that time, the patient weighed 38 kg (body mass index: 18.1 kg/m(2)) and had extensive metastatic disease with lesions in the brain, lungs, mediastinum, liver, abdomen, and bones that were detected by magnetic resonance imaging of the brain (with contrast) and whole-body (18F)-fluorodeoxyglucose-positron emission tomography-computed tomography. The patient received a six-month treatment protocol comprised of MSCT, KD, HT, and HBOT, which eliminated all detectable lesions. The therapeutic response was sustained for two years with maintenance treatment comprising KD, dietary supplements, and repurposed medications. This single case report presents evidence of a complete and durable response to a treatment protocol combining MSCT and a novel metabolic therapy in a patient with end-stage breast cancer. |
format | Online Article Text |
id | pubmed-8072186 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-80721862021-04-28 Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response İyikesici, Mehmet Salih Slocum, Abdul Kadir Winters, Nasha Kalamian, Miriam Seyfried, Thomas N Cureus Oncology Breast cancer accounts for significant morbidity and mortality worldwide. Currently, treatment options in metastatic breast cancer consist of chemotherapy, along with endocrine, radiation, and/or biological therapies. Although advances in management have improved overall survival times, the treatment options for women with end-stage disease are mostly limited to supportive care. Herein, we present a case report that highlights the response of a 47-year-old premenopausal woman with end-stage (T4N3M1) breast cancer treated with metabolically supported chemotherapy (MSCT), ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT). The patient first noticed a right breast mass in late 2016, which was initially evaluated and ruled out as a cyst. Skin ulceration was observed in the region of the suspected cyst in May 2017. Subsequent bilateral breast ultrasound identified masses in both breasts and an enlarged right axillary lymph node. The diagnosis following biopsy was grade 3, estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2 negative (HER2-), invasive ductal carcinoma of the breast. Initially, the patient refused to receive conventional chemotherapy because of its potential for side effects and toxicity, but she sought medical treatment in August 2018 following extensive disease progression and deterioration of general health. On reevaluation, the patient was considered ineligible for conventional treatment due to her advanced end-stage disease, poor performance status (Eastern Cooperative Oncology Group score: 3), and advanced respiratory symptoms. Exploring other options, the patient was admitted to the ChemoThermia Oncology Center, Istanbul, Turkey in November 2018. At that time, the patient weighed 38 kg (body mass index: 18.1 kg/m(2)) and had extensive metastatic disease with lesions in the brain, lungs, mediastinum, liver, abdomen, and bones that were detected by magnetic resonance imaging of the brain (with contrast) and whole-body (18F)-fluorodeoxyglucose-positron emission tomography-computed tomography. The patient received a six-month treatment protocol comprised of MSCT, KD, HT, and HBOT, which eliminated all detectable lesions. The therapeutic response was sustained for two years with maintenance treatment comprising KD, dietary supplements, and repurposed medications. This single case report presents evidence of a complete and durable response to a treatment protocol combining MSCT and a novel metabolic therapy in a patient with end-stage breast cancer. Cureus 2021-04-26 /pmc/articles/PMC8072186/ /pubmed/33927959 http://dx.doi.org/10.7759/cureus.14686 Text en Copyright © 2021, İyikesici et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Oncology İyikesici, Mehmet Salih Slocum, Abdul Kadir Winters, Nasha Kalamian, Miriam Seyfried, Thomas N Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title | Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title_full | Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title_fullStr | Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title_full_unstemmed | Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title_short | Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response |
title_sort | metabolically supported chemotherapy for managing end-stage breast cancer: a complete and durable response |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072186/ https://www.ncbi.nlm.nih.gov/pubmed/33927959 http://dx.doi.org/10.7759/cureus.14686 |
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