Lung Cancer: Squamous Cell with Bilateral Lung Masses
Squamous Cell with Bilateral Lung Masses
Caucasian male, age 52, presented with masses in both pulmonary apices. Right upper lobectomy 2/13/97 removed a 2.8 cm squamous cell carcinoma with hilar adenopathy. The left nodule, right hilum and mediastinum received radiotherapy to 5220. BRM was begun during radiotherapy as with Case 4.
During the five months immediately after surgery, LASA-P rose from 24 to 30. IL-2/melatonin using the Lissoni schedule was added to the BRM regimen. After another five months had elapsed, NK% had climbed from 11 to 45. A further nine months later, LASA-P had climbed to 49 and NK% to 65. BRM’s included IL-2 3.6 mln IU daily, GM-CSF 250 mcg every other day, vitamin E 1000 IU once a day, testosterone patches 5 mg daily, ascorbic acid mixture tbsp (2.5 g ascorbate) twice daily, bromocriptine 1.25 mg twice daily, cimetidine 300 mg four times daily, aspirin 5 grains daily, beta 1,3 D-glucan one daily, omega-3 fatty acids 1000 mg daily, equine conjugated estrogen in two week cycles followed by medroxyprogesterone acetate 10 days then off 6 days in cycles, saw palmetto 160 mg twice daily, oligomeric proanthocyanidins 150 mg three times daily, DHEA 50 mg twice daily, melatonin 50 mg daily.
After discussion of his options, patient deferred chemotherapy, and 27 months after presenting with suspected bilateral disease, and in spite of a tumor marker peak 2.5 times the upper limit of normal, (his LASA-P normalized recently) he remains very active and fully employed in farming related businesses. Morbidity of BRM therapy is attributable to injection site indurations from the IL-2 and IL-2 related fevers / malaise of tolerable degree.
Authors’ comments: Bilateral lung masses and surgically documented hilar adenopathy greatly increased the risk of postoperative systemic failure. The postoperative interval rise to twice normal and the absolute elevation of LASA-P at 53.3 (nl 10-24) suggest progressive systemic disease. Continued good quality survival in the face of elevated non-progressive LASA-P and elevated NK% suggests remission, not cure, and further suggests a causal relationship of the elevated NK% to the remission status.