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Case report
peer-reviewed

Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer



Abstract

Triple-negative breast cancer (TNBC) is more aggressive and metastatic than other breast cancer types. Cytotoxic chemotherapy is presently the predominant systemic therapy for TNBC patients. This case report highlights the influence of metabolically supported chemotherapy (MSCT), ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT) in an overweight 29-year-old woman with stage IV (T4N3M1) triple-negative invasive ductal carcinoma of the breast. The patient presented with an observable mass in her left breast detected during a physical examination in December 2015. Magnetic resonance imaging revealed a Breast Imaging Reporting and Data System Category 5 tumor and multiple lymphadenomegaly in the left axilla. A Tru-Cut biopsy led to the diagnosis of a triple-negative nuclear grade 2 invasive ductal carcinoma. The patient was admitted to ChemoThermia Oncology Center, Istanbul, Turkey in October 2016, and a whole body (18F)-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET-CT) scan revealed a 77 mm x 55 mm primary tumor in her left breast, multiple left pectoral and axillary lymph nodes, multiple widespread liver masses, and an upper left nodular abdominal lesion. The patient received a treatment protocol consisting of MSCT, KD, HT, and HBOT. A follow-up whole body 18F-FDG PET-CT scan in February 2017 showed a complete therapeutic response with no evidence of abnormal FDG uptake. The patient continued to receive this treatment protocol and in April 2017 underwent a mastectomy, which revealed a complete pathological response consistent with the response indicated by her PET-CT imaging. This single case study presents evidence of a complete clinical, radiological, and pathological response following a six-month treatment period using a combination of MSCT and a novel metabolic therapy in a patient with stage IV TNBC.



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Case report
peer-reviewed

Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer


Author Information

Mehmet Salih İyikesici

Medical Oncology, Kemerburgaz University Bahcelievler Medical Park Hospital

Abdul Kadir Slocum Corresponding Author

Medical Oncology, Chemothermia Oncology Center

Ayshe Slocum

Medical Oncology, Chemothermia Oncology Center

Ferhan Bulent Berkarda

Medical Oncology, Chemothermia Oncology Center

Miriam Kalamian

Nutrition Consultant, Dietary Therapies Llc

Thomas N. Seyfried

Biology, Boston College


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

We thank the Single Cause, Single Cure Foundation for their support.


Case report
peer-reviewed

Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer


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Case report
peer-reviewed

Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer

  • Author Information
    Mehmet Salih İyikesici

    Medical Oncology, Kemerburgaz University Bahcelievler Medical Park Hospital

    Abdul Kadir Slocum Corresponding Author

    Medical Oncology, Chemothermia Oncology Center

    Ayshe Slocum

    Medical Oncology, Chemothermia Oncology Center

    Ferhan Bulent Berkarda

    Medical Oncology, Chemothermia Oncology Center

    Miriam Kalamian

    Nutrition Consultant, Dietary Therapies Llc

    Thomas N. Seyfried

    Biology, Boston College


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    We thank the Single Cause, Single Cure Foundation for their support.


    Article Information

    Published: July 07, 2017

    DOI

    10.7759/cureus.1445

    Cite this article as:

    İyikesici M, Slocum A, Slocum A, et al. (July 07, 2017) Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer. Cureus 9(7): e1445. doi:10.7759/cureus.1445

    Publication history

    Received by Cureus: May 24, 2017
    Peer review began: June 06, 2017
    Peer review concluded: July 06, 2017
    Published: July 07, 2017

    Copyright

    © Copyright 2017
    İyikesici et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Triple-negative breast cancer (TNBC) is more aggressive and metastatic than other breast cancer types. Cytotoxic chemotherapy is presently the predominant systemic therapy for TNBC patients. This case report highlights the influence of metabolically supported chemotherapy (MSCT), ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT) in an overweight 29-year-old woman with stage IV (T4N3M1) triple-negative invasive ductal carcinoma of the breast. The patient presented with an observable mass in her left breast detected during a physical examination in December 2015. Magnetic resonance imaging revealed a Breast Imaging Reporting and Data System Category 5 tumor and multiple lymphadenomegaly in the left axilla. A Tru-Cut biopsy led to the diagnosis of a triple-negative nuclear grade 2 invasive ductal carcinoma. The patient was admitted to ChemoThermia Oncology Center, Istanbul, Turkey in October 2016, and a whole body (18F)-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET-CT) scan revealed a 77 mm x 55 mm primary tumor in her left breast, multiple left pectoral and axillary lymph nodes, multiple widespread liver masses, and an upper left nodular abdominal lesion. The patient received a treatment protocol consisting of MSCT, KD, HT, and HBOT. A follow-up whole body 18F-FDG PET-CT scan in February 2017 showed a complete therapeutic response with no evidence of abnormal FDG uptake. The patient continued to receive this treatment protocol and in April 2017 underwent a mastectomy, which revealed a complete pathological response consistent with the response indicated by her PET-CT imaging. This single case study presents evidence of a complete clinical, radiological, and pathological response following a six-month treatment period using a combination of MSCT and a novel metabolic therapy in a patient with stage IV TNBC.



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Mehmet Salih İyikesici

Medical Oncology, Kemerburgaz University Bahcelievler Medical Park Hospital

Abdul Kadir Slocum

Medical Oncology, Chemothermia Oncology Center

For correspondence:
abdulkadirsl@gmail.com

Ayshe Slocum

Medical Oncology, Chemothermia Oncology Center

Ferhan Bulent Berkarda

Medical Oncology, Chemothermia Oncology Center

Miriam Kalamian

Nutrition Consultant, Dietary Therapies Llc

Thomas N. Seyfried

Biology, Boston College

Mehmet Salih İyikesici

Medical Oncology, Kemerburgaz University Bahcelievler Medical Park Hospital

Abdul Kadir Slocum

Medical Oncology, Chemothermia Oncology Center

For correspondence:
abdulkadirsl@gmail.com

Ayshe Slocum

Medical Oncology, Chemothermia Oncology Center

Ferhan Bulent Berkarda

Medical Oncology, Chemothermia Oncology Center

Miriam Kalamian

Nutrition Consultant, Dietary Therapies Llc

Thomas N. Seyfried

Biology, Boston College