ST Patient Journey (Adenoid Cystic Carcinoma)

Patient Case Story: ST

Short Excerpt: Diagnosed with stage IV adenoid cystic carcinoma in 2017, ST combined conventional therapy with repurposed medications, time-restricted eating, and a plant-rich, low-carbohydrate diet. Over two years later, his cancer remains stable with no new progression, showcasing how integrative, metabolic, and lifestyle-based strategies can help manage even rare, treatment-resistant cancers.

Patient Profile

• • Age: 56 years

• • Gender: Male

• • Date of Diagnosis: December 2017

• • Primary Diagnosis: Adenoid Cystic Carcinoma (ACC) Stage IV

Case Presentation

ST, a 56-year-old male, was initially diagnosed with a 3 cm adenoid cystic carcinoma (ACC) of the left parotid gland. ACC is a rare and slow-growing malignancy known for its propensity for local invasion and distant metastasis, particularly to the lungs. The standard treatment for localized ACC involves surgical resection followed by postoperative radiation therapy to manage the disease and attempt a cure.

Despite undergoing these treatments, ST experienced a recurrence characterized by the development of six lung metastases, a common occurrence in ACC due to its hematogenous spread and late metastatic potential.

Management of Recurrent and Metastatic Disease

Following the diagnosis of recurrence, ST participated in three clinical trials from early 2019 to 2021, targeting novel therapies and combinations, none of which successfully reduced his lung metastases. In August 2022, ST underwent stereotactic radiosurgery (SRS) targeting the lung metastases, a technique aimed at delivering precise, high doses of radiation to isolated metastatic sites.

In early 2022, ST also commenced a regimen of repurposed drugs including Mebendazole, Metformin, Atorvastatin, and Doxycycline. These medications, though originally developed for other indications, have demonstrated potential anticancer effects through various mechanisms such as inhibiting cancer cell growth, inducing apoptosis, and modulating immune responses.

Lifestyle Modifications

ST has implemented significant lifestyle changes to potentially enhance treatment outcomes. His daily regimen includes meditation, Japanese Sencha green tea and Earl Grey tea, and a diet rich in cancer-fighting ingredients. This diet includes tomatoes, onions, poblano peppers, and various mushrooms known for their anticancer properties.

ST also adheres to a time- restricted eating schedule and tries to follow a low-carbohydrate diet.‬ This dietary approach aims to alter the metabolic environment of cancer cells and potentially increase their sensitivity to both conventional and repurposed therapies. ST credits this intermittent fasting/diet approach as crucial to his success in his treatment journey, and his weight loss from 280 lbs to 185 lbs also helped to resolve his type 2 diabetes.

Outcome

As of 2.5 years following the initiation of repurposed drug therapy and lifestyle modifications, there is no evidence of any new oncological progression, and the remaining nodule in his lung‬ has not demonstrated any signs of growth. This outcome suggests a potential synergistic effect of the combined treatments contributing to a favorable prognosis. ST continues to work full time with normal functionality, although he has developed accelerated atherosclerosis in his left neck carotid system due to prior radiation, requiring additional prophylactic measures.

Discussion

Adenoid Cystic Carcinoma (ACC) is a rare salivary gland malignancy characterized by its indolent growth, propensity for local invasion, and frequent distant metastasis. ACC is known for its late onset of metastasis and resistance to conventional chemotherapy. The survival rates for Stage IV ACC are generally poor, with a 5-year survival rate reported to be approximately 20-30%.

The management of recurrent and metastatic ACC remains challenging. The incorporation of lifestyle modifications targeting metabolic pathways and the use of repurposed drugs represents an innovative approach. Mebendazole, Metformin, Atorvastatin, and Doxycycline, though originally intended for other uses, have demonstrated potential anticancer properties through various mechanisms.

Mebendazole has shown cytotoxic activity by disrupting microtubule function. Metformin, an antidiabetic drug, has been associated with reduced cancer incidence and mortality, potentially due to its effects on cancer cell metabolism. Atorvastatin and Doxycycline have also shown anticancer properties, including inhibition of tumor angiogenesis and cancer stem cells.

The cost of repurposed drugs and telehealth monitoring, approximately $1500 to $2000 annually, is often out-of-pocket but may be reimbursable through HSA or flexible medical spending plans.

Conclusion

This case underscores the potential benefits of an integrative treatment approach combining conventional therapies with repurposed drugs and lifestyle modifications. While further research is necessary to validate the efficacy of these strategies in a broader patient population, ST’s case offers valuable insights into the potential for achieving long-term disease control in advanced ACC.

References

1. 1. [AdenoidCysticCarcinoma](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163974/)
   2. [Hematogenous spread of ACC](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314995/)
   3. [Metformin anticancer effects](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610246/)
   4. [Postoperative radiation therapy for ACC](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251273/)
   5. [Disrupting microtubule function in cancer cells](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936894/)
   6. [Mebendazole as a cancer therapy](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500791/)
   7. [Stereotactic radiosurgery for lung metastases](https://www.sciencedirect.com/science/article/pii/S1930043321007627)
   8. [Repurposing drugs for cancer](https://journals.sagepub.com/doi/pdf/10.1177/014556130908800610)
   9. [Atorvastatin and cancer stem cells](https://cancercenterforhealing.com/repurposed-cancer-drugs/)
   10. [Combining therapies for cancer](https://onlinelibrary.wiley.com/doi/full/10.1002/kjm2.12551)
   11. [Clinical trials for ACC](https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-02781-x
   12. [Doxycycline and tumor angiogenesis](https://www.pharmaceutical-technology.com/features/featurebetter-together-combining-therapies-to-slow-down-cancer-growth-4454747/)
   13. [Time-restricted eating in cancer therapy](https://www.scirp.org/journal/paperinformation?paperid=88514
   14. [Low-carbohydrate ketogenic diet in cancer](https://www.jto.org/article/S1556-0864%2818%2930547-1/fulltext)
   15. [Nutrient-rich foods and cancer](https://www.mdpi.com/2077-0383/13/1/267)
   16. [Apoptosis-promoting foods](https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/509114
   17. [Tomatoes and anti-angiogenesis](https://www.sciencedirect.com/science/article/abs/pii/S0090301997003418
   18. [ACC treatment protocols](https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.10455)
   19. [Dietary approaches in cancer treatment](https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-4-41)
   20. [Nutrient-dense mushrooms](https://www.spandidos-publications.com/10.3892/ol.2018.8976)