Donna McDermott's breast cancer case study
Patient's name: - Donna McDermott
[ Read this interview with her ]
|
Donna in 2002 |
D.O.B.: - October 23, 1951
CHIEF COMPLAINT:
Right breast mass of 15 months duration with weakness and weight loss.
HISTORY OF PRESENT ILLNESS:
This 46 year old female was found to have breast cancer in September of 1997. She first noticed changes in the contours of her right breast
in June of 1996 at which time she had a mammogram and breast ultrasound which demonstrated three discrete
lesions in the retroareloar area of the right breast which were consistent with fibrocystic breast disease. No
biopsy was done. During the following months, the patient
states she became very fatigued to the point where
she was unable to walk around in her home or to perform her ADLs without resting. She also noticed cracking
of her nails, and that changes in the hair growth over her temples. The patient then began an program of
nutritional support for herself. She was experienced in this, being a health and nutritional counselor by
vocation. Over the next year, the patient's general condition worsened with increasing fatigue. She began having
night sweats and nightmares, and she developed pain in her left hip and lower back occasionally severe enough
to prevent ambulation. She persisted in her own ways, working with a variety of non-traditional therapies. In
July of 1997, she noticed a thickening and hardness in her right breast extending up to the clavicle. She began
to experience episodic pain in the breast mass with radiation up the right side of her neck to her right ear. At
this point, she made an appointment to see her gynecologist. On August 28 she underwent a mammogram and breast
ultrasound, and on September 4 an excisional biopsy of the right breast mass was done.
The breast mass was not completely excised, the patient insisting that only as much tissue as would be needed for the diagnosis
was to be removed. The pathological diagnosis was infiltrating ductal adenocarcinoma. She was offered a
modified radical mastectomy, however she elected not to have the surgery. She was quite clear within herself
about avoiding the potential physical damage that surgery, radiation, and chemotherapy would involve.
Informing herself of this as best she could of this alternative approach with Insulin Potentiation Therapy (IPT), the
patient made the decision to proceed with this form of treatment.
PAST MEDICAL HISTORY:
Scarlatina at age 9; hepatitis A infection at age 21; tubal ligation at age 35;
Valley fever at age 29; two normal vaginal deliveries.
FAMILY HISTORY:
Parents both alive and well. One 51 year old sister, alive and well Significant family
history of cancer involving paternal grandmother, aunt, cousin, nephew (colon, lung, prostate). No family
history of heart disease, diabetes, or tuberculosis.
PERSONAL HISTORY:
Health care therapist, married, two children 21 & 23, non-smoker, no alcohol, no
medications, takes vitamin & mineral supplements. No known drug or inhalant allergies. Allergic to wheat and
dairy. - G2-P2-A0, LMP 8/3/92, took BCP for 3 years in mid-20's.
SYSTEM REVIEW:
Fatigue to the point of exhaustion; weight loss of 5 lbs; cracking/splitting of finger nails;
hair loss, abnormal hair growth (short) over temples; pain in right breast; constipation; pain in left hip and
lower back. The rest of the system review was negative for all systems inquired.
PHYSICAL EXAMINATION:
Height: 5 ft. 4 in. Weight: 110 lbs BP: 100/64 P: 80/min. T: 97.4oF Patient is a
46 year old female looking older than her stated age, facies pale, complains of weakness, right breast pain, and
a weight loss of 5 lbs since onset of her history of present illness. Head & Neck: HEENT normal. No palpable
nodes or thyroid. Trachea is in the midline. Respiratory: Clear to percussion and auscultation in all fields.
Cardiovascular: Normal PMI. S1 & S2 normal. No murmurs or extra sounds. Peripheral pulses are present and
equal bilaterally Breasts: There is a firm, tender mass, 3 x 2 cm., in the upper outer quadrant of the right
breast. The mass is fixed to the underlying fascia. There is no gross inflammatory response....
There is no nipple discharge. Left breast
is normal. There are no axillary or supra- clavicular nodes palpable bilaterally. Abdomen:
Scaphoid, soft. No
liver, spleen, or kidneys palpable. No masses or tenderness. Bowel sounds
normoactive. Rectal exam negative. Stool negative for occult blood. Pelvic Exam: Normal....
CNS: Grossly normal. Deep tendon reflexes present and equal bilaterally.
DIAGNOSIS: Infiltrating ductal adenocarcinoma, right breast, clinical stage IIa
TREATMENT:
The patient's first IPT treatment was given on September 11, 1997. Treatments began with an
intravenous bolus dose of 16 units of Lispro insulin (0.4 units/kg body weight). The resultant hypoglycemia
was monitored clinically as well as by blood glucose determinations. At the appropriate time - approximately 25
minutes after the insulin administration - doses of chemotherapeutic agents were administered by IV bolus.
These included cyclophosphamide 50 mg, methotrexate 5 mg, 5-fluorouracil 100 mg, and epirubicin 1 mg.
These were followed by a 20 cc quantity of 50% hypertonic glucose which was run in rapidly in an infusion of
500 ml of normal saline. This effectively halted the insulin-induced hypoglycemic reaction. The patient was
monitored and observed for an additional hour following termination of the hypoglycemia. The patient received
23 such treatments between September 11,1997, and May 25, 1998. All treatments were well tolerated without
any adverse effects, either from the insulin-induced hypoglycemia or from the lowered doses of chemotherapy
agents used. Between the days of her IPT treatments, the patient took cyclophosphamide 50 mg
q.d. and
tamoxifen 10 mg b.i.d. orally.
CLINICAL EVOLUTION UNDER TREATMENT:
From the first treatment, the patient's fatigue started to improve. She experienced an increased sense of well being and an
improved energy level. Her breast pain disappeared after the first treatment and did not recur. The mass
gradually decreased in size to the point where there was no longer any palpable lesion as of May, 1998. Follow up
mammograms, breast ultrasound examinations, blood tests, bone scans, CT scans of
the chest and abdomen, documented the disappearance of the primary breast mass
and the absence of any detectable metastatic spread of the cancer. At the
present time (4/00), the patient has resumed her normal activities of daily
living and working, she continues with regular follow-up medical examinations,
and she remains diligent about her own programs of mental, emotional, and
physical support. All subsequent follow-up examinations have reported no
abnormalities in her right breast.
FINAL NOTE:
Donna passed away on March 9, 2004. Her breast
cancer never came back, and she enjoyed several years of incredibly good health.
In 2003 severe ovarian cancer symptoms developed. IPT helped, but did not
save her.
