Lung Cancer: Non Small-Cell Malignant Pleural Effusion
Non Small-Cell Malignant Pleural Effusion
Immunotherapy seems to respond better to certain types of cancer. Non-small cell lung cancer is one in which we have seen encouraging results using BRM therapy
Cancer patient John Reese had been a chronic smoker when he presented in 1978 at the age of 48 with generalized malaise and a bleeding stomach ulcer. Initial physical exam revealed hepatomegaly, edematous feet, and pulmonary rales.
John’s chest X-ray revealed a left pleural effusion, a widened mediastinum, and a big heart shadow. Ultrasound scan revealed a pericardial effusion. The diagnosis of pericardial tamponade with venous hypertension was made. Below, you can see photomicrographs of John’s large cell cancer colonies floating in a sea of bloody pleural fluid.
At parasternal thoracotomy, a pericardial window was created. Histopathological examination of the pericardium revealed extensive infiltrating large cell cancer. Both the pericardial fluid and the bloody pleural fluid contained numerous colonies of large cell cancer. Mediastinal nodes were positive.
Microscopic examination of the tissue and fluid cytology was carried out initially at Saint Dominic Hospital in Jackson, Mississippi, reviewed later by Dr. Roger Arhelger at Mississippi Baptist Medical Center, and still later by Dr. Raymond Yessner, referee pathologist for the VA Cooperative Lung Cancer Study Group. Each interpretation was large cell lung cancer.
In addition to irradiation to the right hilum and mediastinum, John, at the time radiotherapy was initiated, received biological response modifiers with cimetidine (suppressor T-cell blocker), Premarin (estrogen is a direct macrophage stimulant and a direct growth hormone secretagogue) and vitamin E in a pharmacological dose. Other biological response modifiers were added subsequently. John has taken vitamin E, ascorbic acid mixture, and selenium on a daily basis for almost 20 years.