Case Reports

Case 9: Treatment of GI tract Cancer

A male patient 59 years old presented with severe abdominal pain, dyspepsia and ascites at the out patient department of gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science (SGPGIMS) on 10.03.02. His investigation done in SGPGIMS indicated that the patient was suffering from abdominal Koch’s. He also had cholelithiasis with choledocholithiasis and sub acute intestinal obstruction. Chest and abdomen CT scan done on 14.03.02 revealed minimal left pleural effusion (fig 9a) with bilateral basal segment collapse consolidation and mediastinal lymphadenopathy. He also had hepatomegaly and left lode enlargement and collection in the pelvis and hepatorenal pouch (fig 9b). Precutaneous drainage (PCD) of his abdominal collection was done and the patient was started with anti Koch’s therapy. However, the sub acute intestinal obstruction of the patient persisted. Laparoscopic exploration was done on 11.05.02, multiple whitish nodules was seen over parietal peritoneum in the right upper quadrant on falciform ligament and in the right iliac fossa. Parietal nodular biopsy was done (fig 9c). The histopathology revealed pseudomyxoma peritonei / metastatic mucinous adenocarcinoma. In view of disseminated disease and poor general condition, the patient could not be given any curative treatment. For malignancy treatment the patient after leaving SGPGIMS tried alternative poly herbal HUMA therapy from 17.05.02. At the time when the alternative therapy started the patient was extremely anemic, cachexic, anorexic, and was unable to walk without support. The patient was virtually bed ridden. After starting the alternative therapy marked improvement in the general health condition of the patient was noted. His appetite and strength improved and improvement in body weight was also recorded. Ultrasonography (USG) of abdomen done on 06.08.02 in SGPGIMS showed 70 ml of organizing fluid in the pelvis; however, other parameters were normal. The clinical improvement of the patient was tremendous and within about 6 months of therapy he could begin his normal routine activities. His anti Koch’s therapy stopped in November 02. The patient continued the alternative therapy and abdominal CT scan done on 13.09.2003 (fig 1d) indicated a normal study except for cholelithiasis with choledocholithiasis. The HUMA therapy was stopped on 31 March 2004. The patient was monitored for the next 10 months with investigations done at regular intervals. USG done on 04.02.2005 revealed a normal study. Thereafter the patient did not suffer any adverse event. At present the patient is absolute stable and normal and completed over 5 years of event and relapse free survival. No acute or long term side effect of the alternative therapy is so far recorded.

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