9/26/2024
Patient Case Story: SM
Short Excerpt: Diagnosed with stage III HER2-positive esophageal cancer in 2018, SM combined surgery, chemotherapy, radiation, and targeted therapies with repurposed medications and holistic lifestyle changes. Now thriving years later, he credits his recovery to research, discipline, and optimism, proving the power of integrative care and a proactive, hopeful mindset in cancer survival.
Patient Profile
- Age: 59 years
- Gender: Male
- Diagnosis: Stage 3 Esophageal Cancer, HER2 Positive
- Date of Diagnosis: March 2018
Clinical History
SM was diagnosed with stage 3 esophageal cancer in March 2018. In April 2018, he received an aggressive treatment with Carboplatin and Paclitaxel, combined with six weeks of daily radiation therapy. After the initial treatment phase, SM underwent a partial gastrectomy, which revealed residual positive lymph node involvement.
Following surgery, he received three months of 5-Fluorouracil (5-FU), which was stopped early due to neuropathy. In August 2021, he experienced a recurrence in the lung, leading to the initiation of Enhertu (a trastuzumab deruxtecan) for his EGFR-positive tumor. He continued this treatment for two years until transitioning to a combination of Keytruda (pembrolizumab) every three weeks, Herceptin (trastuzumab), and Xeloda (capecitabine), reducing the Xeloda dose recently for better tolerance.
In early 2024, SM began a repurposed medication protocol including metformin, doxycycline, atorvastatin, mebendazole, and also Ivermectin. He supplements his regimen with Vitamin D3, Omega-3 fish oils, high-dose melatonin, Perfect Amino, liver and bone marrow supplements, AHCC mushroom extract, curcumin, and sodium butyrate.
Lifestyle Modifications
SM has made significant lifestyle changes since his diagnosis. He emphasizes a clean diet, and uses the Yuka app to check ingredient toxicity. SM also incorporates nutrient-rich smoothies with watercress, matcha, and ginger. He remains physically active, playing in a band that requires considerable aerobic activity, and focuses on stress management techniques.
Patient’s Perspective
SM attributes his ongoing success in managing his cancer to many things including lifestyle changes, dietary modifications, stress reduction, and the incorporation of repurposed medicines with standard therapies. He believes that strengthening his body creates an inhospitable environment for cancer cells. His advice to fellow cancer patients emphasizes the importance of researching treatment options in addition to the standard of care, and mainly prioritizing choices in their care that make sense to them personally. He encourages them to focus on positive narratives that offer hope and try to avoid negative influences and information.
Discussion of Stage 3 Esophageal Cancer
Overview
Stage 3 esophageal cancer is characterized by early extensive local invasion involving
adjacent tissues and lymph nodes. At this stage, the cancer has not yet metastasized to distant sites but presents significant challenges in terms of treatment and prognosis. With MS, the disease ultimately showed up in the lungs, which is a common natural history for this cancer. The EGFR positivity provides a recent therapeutic opportunity (HER2 therapy) and frequently leads to better free survival.
Survival Rates and Statistics
Survival rates for stage 3 esophageal cancer vary significantly based on several factors, including the specific characteristics of the tumor, the patient’s overall health, and the treatment approaches utilized. According to studies published on PubMed, the overall 5-year survival rate for patients with stage 3 esophageal cancer is estimated to be around 20-30%.
Factors influencing these statistics include:
- Response to Treatment: Patients who respond well to initial treatments (chemotherapy, radiation, surgery) have improved prognosis.
- Tumor Characteristics: HER2 positivity, for instance, can affect treatment options and outcomes, as HER2-targeted therapies like trastuzumab can improve survival.
- Patient Factors: Age, comorbidities, and overall health status at diagnosis significantly impact survival.
Repurposed Medications
A study on drug repositioning for esophageal squamous cell carcinoma (ESCC) found that 21 out of 25 repurposed medications showed strong binding affinity to proteins associated with ESCC. This suggests that repurposed medications could potentially play a role in esophageal cancer treatment.
These drugs, Metformin, Atorvastatin, Doxycycline and Mebendazole might be used
alongside standard treatments to:
- Enhance the efficacy of chemotherapy and radiation
- Target cancer stem cells
- Reduce tumor growth and metastasis
- Improve overall treatment outcomes
Recent studies highlight the critical role of multimodal treatment approaches, combining surgery, chemotherapy, and targeted therapies in improving outcomes in stage 3 esophageal cancer patients. The integration of supportive therapies and lifestyle modifications, as practiced by SM, is increasingly recognized for enhancing patient quality of life and potentially impacting survival.
Conclusion
SM’s case exemplifies the complex interplay of aggressive treatment, lifestyle modification, and patient agency in the management of stage 3 esophageal cancer. His proactive approach and the incorporation of innovative therapies illustrate a growing trend in oncology toward personalized medicine and holistic patient care. Continued research into repurposed medications and lifestyle interventions holds promise for improving outcomes in similar patient populations.
References
- Rice TW, et al. Cancer. 2017;123(11):2094-2102.
- Surveillance, Epidemiology, and End Results (SEER) Program. National Cancer Institute.
- Xie C, et al. J Thorac Dis. 2019;11(Suppl 12):S1562-S1572.
- Lordick F, et al. Ann Oncol. 2022;33(5):476-489.
- https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/survival
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798536/
- https://www.healthline.com/health/oral-cancer/esophageal-cancer-staging
- https://shc.amegroups.org/article/view/5234/html
- https://www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/survival-rates.html
- https://www.medicalnewstoday.com/articles/esophageal-cancer-life-expectancy
- https://www.cancercenter.com/cancer-types/esophageal-cancer/stages
- https://www.saintjohnscancer.org/blog/advice-from-a-stage-3-esophageal-cancer-survivor/
