Vyléčení se, přežití
Rešeršní otázka:
- Regrese IV. stadia (metastatické choroby) histologicky prokázaného adenokarcinomu pankreatu včetně jaterních metastáz ?
- Pokud toho někdo dosáhl, u kolika % pacientů ?
- Jak dlouho přežívají ?
- Další detaily ?
- Kontakty na autora ?
Seznam lidí, kteří přežili Ca slinivky - Mezinárodní společnost založená Richardem Stephensonem
Statistika přežívání jejich pacientů s metastázami Ca slinivky
Léčebné postupy:
- Intra-arterial chemotherapy
- Nutrition therapy
- Mind-body medicine
- Acupuncture
- Chiropractic care
- Herbal and botanical preparations, including herbal extracts and teas.
- Dietary supplements, including vitamins, minerals and amino acids.
- Homeopathic remedies, extremely low doses of plant extracts and minerals
- Physical therapy and exercise therapy
- Massage and other gentle techniques on deep muscles and joints
- Hydrotherapy
- water-based approaches like hot and cold wraps, and other
- Lifestyle counseling: exercise, improved sleep, stress reduction techniques
Jednotlivé kazuistiky jejich pacientů
- 1) Pancreatic cancer - Stage III
- 2012 dg - dobra přežívání ?
- Pouze laické povídání, žádný detailní popis histologického nálezu či terapie aj.
- 2) Pancreatic cancer - Stage IV
- Obdobně nehodnotitelné ifnormace
- 2008 dg - poslendí zpráva o přežívání 2012
- 3) Pancreatic cancer - Stage IV
- 2008 dg - udajně "13 years later" - to by znamenalo 2008 + 13 = rok 2021
- To pánům obchodníkům trochu nevyšlo... Takže věrohodnost těhlech seznamů ???
- žádná histologie, žádný stageing... tedy nepoužitelné
- 4) Pancreatic cancer -- Stage IIB
- Dg 2013 - doba přežití ?
- žádné histologické ani další přesnější údaje
- 5) Pancreatic cancer - Stage IV
- Dg 2004 - remission June 2005 - 2006 PET scan still no cancer - konec r. 2013 stále bez Ca slinivky
- žádný popis hitologie ani další přesné údaje
- 6) Pancreatic cancer - Stage IV
- Dg 2012 - doba přežívání ?
- 7) Pancreatic cancer - Stage IV
- Dg. 2001 - - poslední zpráva r. 2011 - údaj 12-year+ pancreatic cancer survivor
- žádné přesné údaje
- 8) Pancreatic cancer - Stage III inoperable
- Dg 2012 - 2013 OP - další zmínky o době přežití ?
Five-Year Survival of Metastatic Pancreatic Carcinoma: A Study of Courage and Hope, Gastrointest Cancer Res. 2009; 3(6): 258.
- Adenocarcinoma with minimal staining for synaptophysin
- Excluding a predominantly neuroendocrine differentiated neoplasm
- Reconfirming the original diagnosis of pancreatic adenocarcinoma
- KRAS testing demonstrated the presence of the wild-type (or nonmutated) gene
- Časování chemoterapie a souběžná prevence neuropatie
- Weekly paclitaxel/cisplatin/irinotecan plus cetuximab, with good disease control
Podrobný popis
Spontaneous regression of pancreatic cancer: Real or a misdiagnosis?
World J Gastroenterol. 2012 Jun 21; 18(23): 2902–2908. Published online 2012 Jun 21. doi: 10.3748/wjg.v18.i23.2902, PMCID: PMC3380317
- Review the most important cases of spontaneous regression of pancreatic cancer that have been reported in the literature
- Regrese nádoru nastala nejčastěji vlivem překonání silného zánětu
- Details on the duration and intensity of fever or infection over the course of the illness in most of these cases were not provided.
1) In 1934 and published in 1967
- Jaundice, severe pain, nausea, chills, and a high fever
- Laparotomy and biopsy confirmed pancreatic carcinoma
- Recovery spanned two months, after which she could return to work
- Remained in good health
- Dying seven and a half years later of a pulmonary embolism
- An autopsy did not find any tumors
2) In 1973 by Lokich et al
- Progressive diarrhea and weight loss
- Mass in the head of the pancreas
- Underwent total pancreatectomy
- Microscopic examination
- Moderately well differentiated ductal adenocarcinoma
- In the head of the pancreas
- Also found in the body of the pancreas
- Tail had only pancreatitis with fibrosis
- One year later he presented with rectal carcinomatosis consistent with adenocarcinoma of pancreatic cancer
- Postoperatively 5-fluorouracil + carmustine or bis-chloroethylnitrosourea, experiencing a gradual regression
- 26 months following onset of therapy treatment, there was no evidence of tumor recurrence
3) A two-month history of ulcer pain and diarrhea
- Large tumor of the pancreatic head
- Extending into the liver with involved lymph nodes
- The disease was confirmed by biopsy
- Fourth month following surgery, he was asymptomatic
- Examined six years later, the patient remained symptom-free
- Gastrointestinal exam demonstrated healing of the ulcer
4) In 1962, published in 1974
- 21-year-old male with jaundice, anorexia, and fever of three months duration
- Liver biopsy was followed by abdominal pain, fever, tachycardia, and a decrease in blood pressure
- Exploratory surgery to repair bile peritonitis revealed acute cholangitis and pericholangitis
- Re-operated on seven weeks later
- Diagnosed with pancreatic adenocarcinoma
- A T tube placed in the common duct improved symptoms and he made a slow recovery
5) In 2003, Hoption Cann et al
- Three-month history of weight loss, anorexia, and discomfort after meals
- Hypoechoic mass of 6.5 cm × 4 cm × 4 cm in the body of the pancreas
- CT-guided biopsy was positive for
- Pancreatic adenocarcinoma (T2N1M0, stage IIIb)
- Subsequent CT scan revealed a further 50%-60% increase in tumor volume
- Tumor was considered inoperable
- Received chemotherapy based on gemcitabine, mytomycin, and radiotherapy
- CA19-9 levels increased from 38 to 140 U/mL and the patient’s health declined
- The treatment was considered a failure
- Patient developed acute abdominal pain and fever and, after surgery, he had a perforated duodenal ulcer with contamination of the abdomen
- 90 d later, the patient’s recuperation and weight gain were surprisingly rapid,
- CA19-9 level was normal
- PET scan was negative for any focal disease
- Ultrasound, however, confirmed residual tumor, although it had regressed by approximately 70%
- Five months later, an elevated CA19-9 and subsequent PET scan confirmed a relapse.
- Treated with chemotherapy based on oxaliplatin and 5-FU initially, then gemcitabine,
- His health progressively deteriorated
- He died one year later, almost two years following his febrile infection.
Celý článek
- Popis posledně zmíněné kasuistiky jsem nalezla zde:
Spontaneous regression of pancreatic cancer, Stephen A Hoption Cann, Case Rep Clin Pract Rev, 2004; 293-296
- Weight loss, anorexia and discomfort after meals
- Pancreatic adenocarcinoma (T2N1M0, stage IIIb)
- 2 week regimen of radiotherapy + seven weeks of gemcitabine
- Failed to alter the progress of the disease
- Subsequent perforated duodenal ulcer was followed by severe peritonitis, fever
- And tumor regression.
- A review of the literature uncovered only three previous cases of spontaneous pancreatic cancer regression.
- Appeared to coincide with a prolonged febrile infection similar to that often observed in many other cases of spontaneous regression
- citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.505.466&rep=rep1&type=pdf
Odkaz na fulltext
Laický popis alternativní léčby tchýně s Ca slinivky, která odmítla OP a přežila
- V dlouhém popisu se lze dočíst, že diagnoza karcinoumu slimivky asi stanovena byla, ale že asi neproběhla žádná biopsie a chybí přesné údaje
Pouhý laický popis člena rodiny - výpis toho, co vše dělali:
- B-17 to the IV mix
- Strict diet touted by the Gerson Institute
- Including their well-known enema protocol
- Juicing carrots and apples, and taking gobs of supplements was our focus every day
- Product called GenEpic
- A PEMF bed
- A commercial vibration plate for circulation and lymphatic drainage
- A home ozone unit for rectal insufflation
- Specific enzyme therapy
- Turmeric, Essiac, ginger and more
- Enemas three times a week
- Gerson’s diet and supplement protocol
- Daily sun exposure
- Careful mental and emotional conditioning and love
Odkaz na web, kde o tom píše
Curing Terminal Cancer of the Pancreas with the Gerson Therapy
Anecdotal case history: exclusive Gerson diet treatment leading to full recovery from terminal pancreatic cancer
- Date of first discovery: 1968, Date of death: 1978
- Type of therapy used: Gerson diet (exclusively)
- Laický popis bez přesných údajů - nepoužitelné, web na mne nepůsobí věrohodně
Odkaz na web, kde se o tom píše
Case Report Prolonged Complete Response in a Patient with Metastatic Pancreatic Adenocarcinoma after FOLFIRINOX Chemotherapy and Maintenance with FOLFIRI
2015 Christos Nikolaou et al.
- A 51-year-old male
- Worsening epigastric pain, jaundice, and weight loss of approximately 10 kg
- CT scan revealed a mass at the head of the pancreas
- Maximal diameter of 2.4 cm
- CA 19-9 exceeding 12000 U/mL
- MRI - absence of metastases
- Underwent a Whipple procedure
- Pathology
- Primary pancreatic adenocarcinoma
- Maximal diameter of 3.2 cm
- Perivascular and perineural invasion
- 4 of 7 excised peripancreatic lymph nodes were positive
- All surgical margins were negative
- American Joint Committee on Cancer (AJCC) staging system
- PT2N1M0, stage II
- Postsurgery
- CT scans showed no evidence of metastatic or residual disease
- CA 19-9 tumor marker levels were 1203 U/mL
- Adjuvant chemotherapy
- Gemcitabine 1000 mg/m2 on days 1, 8, and 15 on 28-day cycles was started 2.5 months after surgery, with a plan of administering 6 cycles
- After completing 2 cycles
- Gradual increase of CA 19-9 levels was noted
- New multiple bilateral pulmonary nodules as well as para-aortic lymph nodes and one new liver lesion were shown
- Metastatic disease
- A palpable left supraclavicular lymph node cca 1.5 cm in diameter was noted
- CA 19-9 levels were increased to over 12000 U/mL
- First-line chemotherapy as a bolus - the combination of:
- Oxaliplatin 85 mg/m2
- Irinotecan 180 mg/m2
- Leucovorin 400 mg/m2
- Fluorouracil 400 mg/m2
- Followed by:
- 2400 mg/m2 FOLFIRINOX given as a 46-hour continuous infusion, every 2 weeks
- After 4 administrations of chemotherapy
- Gradual decrease of CA 19-9 levels to 550 U/mL was evident
- Left supraclavicular lymph node was no longer palpable
- Imaging revealed a partial response of the pulmonary nodes
- A complete response of the para-aortic lymph nodes and liver lesion
- After 4 more administrations (8 cycles in total)
- Complete response which he maintained after seven months of FOLFIRINOX chemotherapy
- Despite dose reductions due to hematologic toxicity
- Worsening neurotoxicity caused by oxaliplatin which peaked at grade 3
- Sustained complete remission on reimaging studies
- Completed a total of two years of chemotherapy
- Discontinued treatment due to steatohepatitis with grade 1 transaminitis
- Probably caused by irinotecan
- Eight months after treatment discontinuation he remained alive and in complete radiographic and biochemical remission
Odkaz na článek
Lessons Learned From a Complete Remission of Advanced Metastatic Pancreatic Ductal Adenocarcinoma, 2012
- One-year survival of stage IV patients was approximately
- 2% in the pre-gemcitabine (Gemzar, Eli Lilly) era
- 18% with gemcitabine treatment
- 24% with a combination regimen of gemcitabine and erlotinib (Tarceva, Genentech) !!!
- Objective response single-agent gemcitabine or the combination of gemcitabine and erlotinib
- Are less than 10%
Kazuistika r. 2005
- 44-year-old man with stage IV pancreatic cancer with omental metastasis
- Achieved a complete remission after 3 years of gemcitabine-based therapy
- Activating mutation in KRAS
- Rame-shift mutation in exon 16, 7990del3ins2
- Was BRCA2 mutant
- Increased sensitivity of pancreatic cancer cells carrying BRCA2 mutations to treatments, including
- Capecitabine (Xeloda, Genentech)
- Mitomycin-C
- Gemcitabine
- Cisplatin
- Poly ADP-ribose polymerase (PARP) inhibitors
- Allow hypothesis-generating observations, which suggest that targeting DNA repair systems may be an important key to improving the efficacy of current treatment
- Patients with this molecular profile shouldnot approach that fatalistic view
- Aggressive treatment may lead to favorable outcomes
Odkaz na článek
Longest survivor of INOPERABLE stage 4 adenocarcinoma pancreatic cancer with metastisis to the liver
- Kontakty na lidi laiky, kteri na internetu píší o někom, kdo přežívá déle než 1 rok
- Odkaz na fórum
Complete pathological response following neoadjuvant FOLFIRINOX in borderline resectable pancreatic cancer - a case report and review
Mišo Gostimir et al., BMC Cancer201616:786, DOI: 10.1186/s12885-016-2821-0, © The Author(s). 2016, Received: 25 April 2016, Accepted: 29 September 2016, Published: 10 October 2016
- This article describes the 2nd report of a well documented, histologically proven pCR following systemic treatment with FOLFIRINOX.
- CT scan of the abdomen confirmed a hypovascular mass in the uncinate process
- Borderline resectable pancreatic cancer
- Endoscopic ultrasound guided fine-needle aspiration cytology
- Treatment with FOLFIRINOX
- After a total of 13 cycles
- CT revealed that the lesion had decreased in size
- Underwent pancreaticoduodenectomy
- Final pathology report revealed no evidence of residual adenocarcinoma
- YpT0 ypN0 (0/23)
- Patient remains disease-free 15 months following surgery
- Following various neoadjuvant therapy approaches in pancreatic cancer The probability of:
- Pathologic complete response (pCR)
- 3.6 %
- Partial response rate
- 30.6 %
- In borderline resectable or locally advanced pancreatic cancer
- Neoadjuvant therapy has been shown
- PCR in 13.6 % of patients
- These studies considered all forms of neoadjuvant therapy
- Most existing reports of pCR involve chemoradiation rather than chemotherapy alone
- Other reports of complete responses have been only radiologically confirmed
- Presently multiple definitions for locally advanced and borderline resectable pancreatic cancer
- Difficult to extrapolate conclusions on the efficacy of FOLFIRINOX
- Most current studies include heterogeneous patient populations
Odkaz na celý článek
Studium přeživších pacientů
- Zhodnocení důležitých faktorů podmiňujících lékaři neočekávané uzdravení
Dlouhodobé přežívání na fytoterapii Dr. Jiřího Landy
- Někteří pacienti žijí i přes 5 let a déle
- Některým dle dokumentace vymizely i metastázy
- Někdy se nádor vrátí, ale znovu se nasadí chemoterapie a další byliny a je možné zase existovat
- Více MUDr. Jiří Landa - drlanda.eu
Duktální adenokarcinom slinivky - kurativní terapie
- Jediná „kurativní“ léčebná metoda duktálního adenokarcinomu dnes je považována:
- R0 resekce následovaná v některých případech adjuvatní chemoterapií
- Neodjuvance není v t.č. standardem
- Hemipankreatoduodenektomie
- Levostranná pankreatektomie spolu se splenektomií
- Pokud je nádor lokalizován v těle či kaudě pankreatu
- Několikahodinový rozsáhlý výkon
- Perioperační mortalita kolem 2 %
- Morbidita kolem 30 %
- Insuficience pankreato-jejuno respektive pankreato-gastro anastomózy
- V době diagnózy je ve více než 80 % případů inoperabilní
- Metastatický rozsev (játra, peritoneum) a lokální invaze
Zdokumentované případy regrese nádorů slinivky / vyléčení se
- This phenomenon is exceptional, but well reported, in some types of tumors, but not in pancreatic cancer. [1]
- Pancreatic benign tumors, insulinomas, or autoimmune pancreatitis could be responsible for this misdiagnosis as a pancreatic cancer [1]
Spontánní regrese tumoru slinivky "bez účinné" terapie - publikované kazuistiky
- In 1934
- Published in 1967
- Jaundice, severe pain, nausea, chills, and a high fever
- Laparotomy and biopsy confirmed pancreatic carcinoma
- The patient’s recovery spanned two months, after which she could return to work
- She remained in good health
- Dying seven and a half years later of a pulmonary embolism
- An autopsy did not find any tumors. [1]
- 1973 by Lokich et al described a 42-year-old man
- Progressive diarrhea and weight loss
- Upper image suggested a mass in the head of the pancreas
- Total pancreatectomy
- Microscopic examination
- Moderately well differentiated ductal adenocarcinoma
- Arising in the head of the pancreas
- Adenocarcinoma was also found in the body of the pancreas
- Tail had only pancreatitis with fibrosis.
- One year later he presented with rectal carcinomatosis consistent with adenocarcinoma of pancreatic cancer.
- Postoperatively chemotherapeutic program
- 5-fluorouracil (5-FU)
- Carmustine or bis-chloroethylnitrosourea
- Gradual regression. Twenty-six months following onset of therapy treatment, there was no evidence of tumor recurrence [1]
- Male with a two-month history of ulcer pain and diarrhea.
- Large tumor of the pancreatic head, extending into the liver with involved lymph nodes
- Confirmed by biopsy but no further manipulation was performed.
- By the fourth month following surgery, he was asymptomatic.
- Examined six years later, the patient remained symptom-free and a gastrointestinal exam demonstrated healing of the ulcer [1]
- In 1974 reported one case in 1962 of a 21-year-old male
- Jaundice, anorexia, and fever of three months duration
- Pancreatic adenocarcinoma
- T tube placed in the common duct improved symptoms
- Made a slow recovery with no recurrence at the time of reporting
- Details on the duration and intensity of fever or infection over the course of the illness in most of these cases were not provided [1]
- In 2003, Hoption Cann et al reported a case of a 50-year-old man
- Three-month history of weight loss, anorexia, and discomfort after meals
- CT identified a hypoechoic mass of 6.5 cm × 4 cm × 4 cm in the body of the
- The posterior CT-guided biopsy was positive for pancreatic adenocarcinoma (T2N1M0, stage
- Subsequent CT scan revealed a further 50%-60% increase in tumor volume and the tumor was considered inoperable
- Patient received chemotherapy based on gemcitabine, mytomycin, and radiotherapy.
- As CA19-9 levels increased from 38 to 140 U/mL
- And the patient’s health declined, the treatment was considered a failure.
- Days later, the patient developed acute abdominal pain and fever and, after surgery, he had a perforated duodenal ulcer with contamination of the abdomen.
- Recovery was considered doubtful
- 90 d later, the patient’s recuperation and weight gain were surprisingly rapid
- CA19-9 level was normal
- Positron emission tomography (PET) scan was negative for any focal disease
- Ultrasound, however, confirmed residual tumor
- It had regressed by approximately 70%
- Five months later, an elevated CA19-9 and subsequent PET scan confirmed a relapse
- Chemotherapy based on oxaliplatin and 5-FU initially, then gemcitabine
- His health progressively deteriorated and he died one year later, almost two years following his febrile infection.
- Authors suggested factors could be relevant to this tumor regression followed by this patient:
- Vegetarian diet based on Chinese herbs,
- High-dose vitamin C
- Antioxidant vitamins
- Hy-drogen peroxide
- Ginseng
- But appeared mostly to coincide with a prolonged febrile infection
- Similar to that often observed in many other cases [1]
- Citováno i zde: citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.505.466&rep=rep1&type=pdf
Regrese tumoru slinivky díky chemoterapii
- The current standard of care chemotherapeutic regimens for metastatic pancreatic cancer include
- FOLFIRINOX and gemcitabine, plus nab-paclitaxel (gemcitabine/nab-paclitaxel)
- Based upon positive Phase III trials
- Tumor response rate was 33% and 23%
- Progression-free survival was 6.4 and 5.5 months
- Decision dilemma for oncologists
- Currently no effective method for choosing one approach over the other [2]
- Exceptional responses can be achieved in patients presenting with metastatic pancreatic cancer when effective systemic therapy is combined with well-executed local treatment modalities [2]
- Publik. 2015
- 50-year-old woman
- Adenocarcinoma of the pancreas
- 2.7 x 1.8 cm2 mass
- Two liver metastases
- LM1 and LM2 [2]
- CA 19-9 level of 1,659 U/mL
- Received FOLFIRINOX (leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin)
- Six cycles of FOLFIRINOX over three months
- With removal of oxaliplatin the last month
- Dramatic reduction in CA 19-9 level to 23.9 U/mL
- Complete regression of both liver metastases [2]
- Then received capecitabine
- Maintenance of a normal CA19-9 over the next 12 months
- no evidence of distant disease [2]
- Concurrent systemic and local therapy with capecitabine-based chemoradiation (CapeXRT)
- Observation for eight months with normal CA 19-9 readings [2]
- A mild increase in CA 19-9 (143 U/mL)
- Demonstrating an active primary tumor but no distant disease [2]
- Pancreaticoduodenectomy (PD or Whipple) was performed
- Rendering this patient free of detectable cancer [2]
- Tissue collection under IRB approved protocols
- LAB00-396 and PA15-0176 [2]
- Developed an ex-vivo chemosensitivity assay
- Tumor tissue from an individual patient can be rapidly examined for sensitivity to available systemic therapy treatment strategies
- Tested this patient’s tumor for its sensitivity to gemcitabine (Gem) versus a combination of 5-fluorouracil, irinotecan, and oxaliplatin (FIRINOX)
- Assay confirmed a profound sensitivity of this patient’s tumor to the agents she had received [2]
Rešeršní otázka:
- Regrese IV. stadia (metastatické choroby) histologicky prokázaného adenokarcinomu pankreatu včetně jaterních metastáz ?
- Pokud toho někdo dosáhl, u kolika % pacientů ?
- Jak dlouho přežívají ?
- Další detaily ?
- Kontakty na autora ?
Seznam lidí, kteří přežili Ca slinivky - Mezinárodní společnost založená Richardem Stephensonem
Statistika přežívání jejich pacientů s metastázami Ca slinivky
Léčebné postupy:
- Intra-arterial chemotherapy
- Nutrition therapy
- Mind-body medicine
- Acupuncture
- Chiropractic care
- Herbal and botanical preparations, including herbal extracts and teas.
- Dietary supplements, including vitamins, minerals and amino acids.
- Homeopathic remedies, extremely low doses of plant extracts and minerals
- Physical therapy and exercise therapy
- Massage and other gentle techniques on deep muscles and joints
- Hydrotherapy
- water-based approaches like hot and cold wraps, and other
- Lifestyle counseling: exercise, improved sleep, stress reduction techniques
Jednotlivé kazuistiky jejich pacientů
- 1) Pancreatic cancer - Stage III
- 2012 dg - dobra přežívání ?
- Pouze laické povídání, žádný detailní popis histologického nálezu či terapie aj.
- 2) Pancreatic cancer - Stage IV
- Obdobně nehodnotitelné ifnormace
- 2008 dg - poslendí zpráva o přežívání 2012
- 3) Pancreatic cancer - Stage IV
- 2008 dg - udajně "13 years later" - to by znamenalo 2008 + 13 = rok 2021
- To pánům obchodníkům trochu nevyšlo... Takže věrohodnost těhlech seznamů ???
- žádná histologie, žádný stageing... tedy nepoužitelné
- 4) Pancreatic cancer -- Stage IIB
- Dg 2013 - doba přežití ?
- žádné histologické ani další přesnější údaje
- 5) Pancreatic cancer - Stage IV
- Dg 2004 - remission June 2005 - 2006 PET scan still no cancer - konec r. 2013 stále bez Ca slinivky
- žádný popis hitologie ani další přesné údaje
- 6) Pancreatic cancer - Stage IV
- Dg 2012 - doba přežívání ?
- 7) Pancreatic cancer - Stage IV
- Dg. 2001 - - poslední zpráva r. 2011 - údaj 12-year+ pancreatic cancer survivor
- žádné přesné údaje
- 8) Pancreatic cancer - Stage III inoperable
- Dg 2012 - 2013 OP - další zmínky o době přežití ?
Five-Year Survival of Metastatic Pancreatic Carcinoma: A Study of Courage and Hope, Gastrointest Cancer Res. 2009; 3(6): 258.
- Adenocarcinoma with minimal staining for synaptophysin
- Excluding a predominantly neuroendocrine differentiated neoplasm
- Reconfirming the original diagnosis of pancreatic adenocarcinoma
- KRAS testing demonstrated the presence of the wild-type (or nonmutated) gene
- Časování chemoterapie a souběžná prevence neuropatie
- Weekly paclitaxel/cisplatin/irinotecan plus cetuximab, with good disease control
Podrobný popis
Spontaneous regression of pancreatic cancer: Real or a misdiagnosis?
World J Gastroenterol. 2012 Jun 21; 18(23): 2902–2908. Published online 2012 Jun 21. doi: 10.3748/wjg.v18.i23.2902, PMCID: PMC3380317
- Review the most important cases of spontaneous regression of pancreatic cancer that have been reported in the literature
- Regrese nádoru nastala nejčastěji vlivem překonání silného zánětu
- Details on the duration and intensity of fever or infection over the course of the illness in most of these cases were not provided.
1) In 1934 and published in 1967
- Jaundice, severe pain, nausea, chills, and a high fever
- Laparotomy and biopsy confirmed pancreatic carcinoma
- Recovery spanned two months, after which she could return to work
- Remained in good health
- Dying seven and a half years later of a pulmonary embolism
- An autopsy did not find any tumors
2) In 1973 by Lokich et al
- Progressive diarrhea and weight loss
- Mass in the head of the pancreas
- Underwent total pancreatectomy
- Microscopic examination
- Moderately well differentiated ductal adenocarcinoma
- In the head of the pancreas
- Also found in the body of the pancreas
- Tail had only pancreatitis with fibrosis
- One year later he presented with rectal carcinomatosis consistent with adenocarcinoma of pancreatic cancer
- Postoperatively 5-fluorouracil + carmustine or bis-chloroethylnitrosourea, experiencing a gradual regression
- 26 months following onset of therapy treatment, there was no evidence of tumor recurrence
3) A two-month history of ulcer pain and diarrhea
- Large tumor of the pancreatic head
- Extending into the liver with involved lymph nodes
- The disease was confirmed by biopsy
- Fourth month following surgery, he was asymptomatic
- Examined six years later, the patient remained symptom-free
- Gastrointestinal exam demonstrated healing of the ulcer
4) In 1962, published in 1974
- 21-year-old male with jaundice, anorexia, and fever of three months duration
- Liver biopsy was followed by abdominal pain, fever, tachycardia, and a decrease in blood pressure
- Exploratory surgery to repair bile peritonitis revealed acute cholangitis and pericholangitis
- Re-operated on seven weeks later
- Diagnosed with pancreatic adenocarcinoma
- A T tube placed in the common duct improved symptoms and he made a slow recovery
5) In 2003, Hoption Cann et al
- Three-month history of weight loss, anorexia, and discomfort after meals
- Hypoechoic mass of 6.5 cm × 4 cm × 4 cm in the body of the pancreas
- CT-guided biopsy was positive for
- Pancreatic adenocarcinoma (T2N1M0, stage IIIb)
- Subsequent CT scan revealed a further 50%-60% increase in tumor volume
- Tumor was considered inoperable
- Received chemotherapy based on gemcitabine, mytomycin, and radiotherapy
- CA19-9 levels increased from 38 to 140 U/mL and the patient’s health declined
- The treatment was considered a failure
- Patient developed acute abdominal pain and fever and, after surgery, he had a perforated duodenal ulcer with contamination of the abdomen
- 90 d later, the patient’s recuperation and weight gain were surprisingly rapid,
- CA19-9 level was normal
- PET scan was negative for any focal disease
- Ultrasound, however, confirmed residual tumor, although it had regressed by approximately 70%
- Five months later, an elevated CA19-9 and subsequent PET scan confirmed a relapse.
- Treated with chemotherapy based on oxaliplatin and 5-FU initially, then gemcitabine,
- His health progressively deteriorated
- He died one year later, almost two years following his febrile infection.
Celý článek
- Popis posledně zmíněné kasuistiky jsem nalezla zde:
Spontaneous regression of pancreatic cancer, Stephen A Hoption Cann, Case Rep Clin Pract Rev, 2004; 293-296
- Weight loss, anorexia and discomfort after meals
- Pancreatic adenocarcinoma (T2N1M0, stage IIIb)
- 2 week regimen of radiotherapy + seven weeks of gemcitabine
- Failed to alter the progress of the disease
- Subsequent perforated duodenal ulcer was followed by severe peritonitis, fever
- And tumor regression.
- A review of the literature uncovered only three previous cases of spontaneous pancreatic cancer regression.
- Appeared to coincide with a prolonged febrile infection similar to that often observed in many other cases of spontaneous regression
- citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.505.466&rep=rep1&type=pdf
Odkaz na fulltext
Laický popis alternativní léčby tchýně s Ca slinivky, která odmítla OP a přežila
- V dlouhém popisu se lze dočíst, že diagnoza karcinoumu slimivky asi stanovena byla, ale že asi neproběhla žádná biopsie a chybí přesné údaje
Pouhý laický popis člena rodiny - výpis toho, co vše dělali:
- B-17 to the IV mix
- Strict diet touted by the Gerson Institute
- Including their well-known enema protocol
- Juicing carrots and apples, and taking gobs of supplements was our focus every day
- Product called GenEpic
- A PEMF bed
- A commercial vibration plate for circulation and lymphatic drainage
- A home ozone unit for rectal insufflation
- Specific enzyme therapy
- Turmeric, Essiac, ginger and more
- Enemas three times a week
- Gerson’s diet and supplement protocol
- Daily sun exposure
- Careful mental and emotional conditioning and love
Odkaz na web, kde o tom píše
Curing Terminal Cancer of the Pancreas with the Gerson Therapy
Anecdotal case history: exclusive Gerson diet treatment leading to full recovery from terminal pancreatic cancer
- Date of first discovery: 1968, Date of death: 1978
- Type of therapy used: Gerson diet (exclusively)
- Laický popis bez přesných údajů - nepoužitelné, web na mne nepůsobí věrohodně
Odkaz na web, kde se o tom píše
Case Report Prolonged Complete Response in a Patient with Metastatic Pancreatic Adenocarcinoma after FOLFIRINOX Chemotherapy and Maintenance with FOLFIRI
2015 Christos Nikolaou et al.
- A 51-year-old male
- Worsening epigastric pain, jaundice, and weight loss of approximately 10 kg
- CT scan revealed a mass at the head of the pancreas
- Maximal diameter of 2.4 cm
- CA 19-9 exceeding 12000 U/mL
- MRI - absence of metastases
- Underwent a Whipple procedure
- Pathology
- Primary pancreatic adenocarcinoma
- Maximal diameter of 3.2 cm
- Perivascular and perineural invasion
- 4 of 7 excised peripancreatic lymph nodes were positive
- All surgical margins were negative
- American Joint Committee on Cancer (AJCC) staging system
- PT2N1M0, stage II
- Postsurgery
- CT scans showed no evidence of metastatic or residual disease
- CA 19-9 tumor marker levels were 1203 U/mL
- Adjuvant chemotherapy
- Gemcitabine 1000 mg/m2 on days 1, 8, and 15 on 28-day cycles was started 2.5 months after surgery, with a plan of administering 6 cycles
- After completing 2 cycles
- Gradual increase of CA 19-9 levels was noted
- New multiple bilateral pulmonary nodules as well as para-aortic lymph nodes and one new liver lesion were shown
- Metastatic disease
- A palpable left supraclavicular lymph node cca 1.5 cm in diameter was noted
- CA 19-9 levels were increased to over 12000 U/mL
- First-line chemotherapy as a bolus - the combination of:
- Oxaliplatin 85 mg/m2
- Irinotecan 180 mg/m2
- Leucovorin 400 mg/m2
- Fluorouracil 400 mg/m2
- Followed by:
- 2400 mg/m2 FOLFIRINOX given as a 46-hour continuous infusion, every 2 weeks
- After 4 administrations of chemotherapy
- Gradual decrease of CA 19-9 levels to 550 U/mL was evident
- Left supraclavicular lymph node was no longer palpable
- Imaging revealed a partial response of the pulmonary nodes
- A complete response of the para-aortic lymph nodes and liver lesion
- After 4 more administrations (8 cycles in total)
- Complete response which he maintained after seven months of FOLFIRINOX chemotherapy
- Despite dose reductions due to hematologic toxicity
- Worsening neurotoxicity caused by oxaliplatin which peaked at grade 3
- Sustained complete remission on reimaging studies
- Completed a total of two years of chemotherapy
- Discontinued treatment due to steatohepatitis with grade 1 transaminitis
- Probably caused by irinotecan
- Eight months after treatment discontinuation he remained alive and in complete radiographic and biochemical remission
Odkaz na článek
Lessons Learned From a Complete Remission of Advanced Metastatic Pancreatic Ductal Adenocarcinoma, 2012
- One-year survival of stage IV patients was approximately
- 2% in the pre-gemcitabine (Gemzar, Eli Lilly) era
- 18% with gemcitabine treatment
- 24% with a combination regimen of gemcitabine and erlotinib (Tarceva, Genentech) !!!
- Objective response single-agent gemcitabine or the combination of gemcitabine and erlotinib
- Are less than 10%
Kazuistika r. 2005
- 44-year-old man with stage IV pancreatic cancer with omental metastasis
- Achieved a complete remission after 3 years of gemcitabine-based therapy
- Activating mutation in KRAS
- Rame-shift mutation in exon 16, 7990del3ins2
- Was BRCA2 mutant
- Increased sensitivity of pancreatic cancer cells carrying BRCA2 mutations to treatments, including
- Capecitabine (Xeloda, Genentech)
- Mitomycin-C
- Gemcitabine
- Cisplatin
- Poly ADP-ribose polymerase (PARP) inhibitors
- Allow hypothesis-generating observations, which suggest that targeting DNA repair systems may be an important key to improving the efficacy of current treatment
- Patients with this molecular profile shouldnot approach that fatalistic view
- Aggressive treatment may lead to favorable outcomes
Odkaz na článek
Longest survivor of INOPERABLE stage 4 adenocarcinoma pancreatic cancer with metastisis to the liver
- Kontakty na lidi laiky, kteri na internetu píší o někom, kdo přežívá déle než 1 rok
- Odkaz na fórum
Complete pathological response following neoadjuvant FOLFIRINOX in borderline resectable pancreatic cancer - a case report and review
Mišo Gostimir et al., BMC Cancer201616:786, DOI: 10.1186/s12885-016-2821-0, © The Author(s). 2016, Received: 25 April 2016, Accepted: 29 September 2016, Published: 10 October 2016
- This article describes the 2nd report of a well documented, histologically proven pCR following systemic treatment with FOLFIRINOX.
- CT scan of the abdomen confirmed a hypovascular mass in the uncinate process
- Borderline resectable pancreatic cancer
- Endoscopic ultrasound guided fine-needle aspiration cytology
- Treatment with FOLFIRINOX
- After a total of 13 cycles
- CT revealed that the lesion had decreased in size
- Underwent pancreaticoduodenectomy
- Final pathology report revealed no evidence of residual adenocarcinoma
- YpT0 ypN0 (0/23)
- Patient remains disease-free 15 months following surgery
- Following various neoadjuvant therapy approaches in pancreatic cancer The probability of:
- Pathologic complete response (pCR)
- 3.6 %
- Partial response rate
- 30.6 %
- In borderline resectable or locally advanced pancreatic cancer
- Neoadjuvant therapy has been shown
- PCR in 13.6 % of patients
- These studies considered all forms of neoadjuvant therapy
- Most existing reports of pCR involve chemoradiation rather than chemotherapy alone
- Other reports of complete responses have been only radiologically confirmed
- Presently multiple definitions for locally advanced and borderline resectable pancreatic cancer
- Difficult to extrapolate conclusions on the efficacy of FOLFIRINOX
- Most current studies include heterogeneous patient populations
Odkaz na celý článek
Studium přeživších pacientů
- Zhodnocení důležitých faktorů podmiňujících lékaři neočekávané uzdravení
