Metabolically supported chemotherapy for managing end-stage breast cancer: A complete and durable response

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dc.contributor.authorİyikesici, Mehmet Salih
dc.contributor.authorSlocum, Abdül Kadir
dc.contributor.authorWinters, Nasha
dc.contributor.authorKalamian, Miriam
dc.contributor.authorSeyfried, Thomas N.
dc.date.accessioned2022-01-17T06:52:07Z
dc.date.available2022-01-17T06:52:07Z
dc.date.issued2021en_US
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalıen_US
dc.description.abstractBreast 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 endstage 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/m2 ) 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 sixmonth 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.en_US
dc.identifier.citationİyikesici, M. S., Slocum, A. K., Winters, N., Kalamian, M., & Seyfried, T. N. (2021). Metabolically Supported Chemotherapy for Managing End-Stage Breast Cancer: A Complete and Durable Response. Cureus, 13(4).en_US
dc.identifier.issue4en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12939/2185
dc.identifier.volume13en_US
dc.identifier.wosWOS:000645295100001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.institutionauthorİyikesici, Mehmet Salih
dc.language.isoen
dc.relation.ispartofCureus
dc.relation.isversionof10.7759/cureus.14686en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMetabolically Supported Chemotherapyen_US
dc.subjectKetogenic Dieten_US
dc.subjectHyperthermiaen_US
dc.subjectHyperbaric Oxygen Therapyen_US
dc.subjectCanceren_US
dc.subjectWarburg Effecten_US
dc.subjectRepurposed Drugsen_US
dc.subjectCancer As a Metabolic Diseaseen_US
dc.subjectKetogenic Metabolic Therapyen_US
dc.subjectEnd-Stage Breast Canceren_US
dc.titleMetabolically supported chemotherapy for managing end-stage breast cancer: A complete and durable response
dc.typeArticle

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