Metastatic colon cancer cured by Traditional Chinese Medicine combined with Chemotherapy: A case report

doi:10.21203/rs.3.rs-1618264/v1

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Case Report

Metastatic colon cancer cured by Traditional Chinese Medicine combined with Chemotherapy: A case report

https://doi.org/10.21203/rs.3.rs-1618264/v1

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Introduction: Colon cancer is a kind of disease very common worldwide and one of the leading causes of cancer morbidity and mortality. Traditional Chinese medicine is widely used in varieties of Chronic diseases treatment. Colon cancer results in a high rate of morbidity and mortality and easily metastasizes.

Patient concerns: We report a 71-year-old male patient with a more than 12-year history of old myocardial infarction (OMI) and a more than a 7-year history of diabetes mellitus type 2.

Diagnoses: The patient was diagnosed with colon cancer and was asked to resect part of right-sided colon cancer one year ago, and biopsy specimens from the tumor suggested a moderately poorly differentiated adenocarcinoma. Anastomosis recurrence and pelvic metastasis occurred in this patient was discovered 2 months later. Meanwhile, the liver damage caused by chemotherapy also slowly developed.

Interventions: The patient received adjuvant chemotherapy with XELOX (oxaliplatin and Capecitabine) for 8 months after the Laparoscopic radical resection of the right colon cancer. Then, we advised the patient to take Chinese medicine for his condition to remove the hidden danger of metastatic colon cancer in pelvic.

Outcomes: The patient was finally cured of metastatic colon cancer after receiving TCM therapy based on long-term chemotherapy.

Conclusion: Traditional Chinese medicine can provide an effective way in the process of metastatic colon cancer.

metastatic colon cancer

traditional Chinese medicine

chemotherapy

case report

Colon cancer (CC) is the third most common cancer worldwide and one of the leading causes of cancer morbidity and mortality. This kind of disease is generally seen among people over 70 years old. The common therapy for colon cancers includes adjuvant chemotherapy, palliative chemotherapy and palliative targeted therapy(Moth, Vardy, & Blinman, 2016). Generally speaking, palliative chemotherapy can only prolong progression-free survival(PFS), relieve symptoms, and improve life qualities of patients in a small degree but cannot cure the disease totally. Surgeries for colon cancer can be challenging if it invades other organs or structures.(Klaver, Kappen, Borstlap, Bemelman, & Tanis, 2017) Meanwhile, traditional Chinese medicine provides specific treatment plans for the delay of disease progression. Therefore, TCM may become a meaningful alternative CC treatment soon.

For colon cancer, right-sided cancers are more common. Herein, we report a case of a 71-year-old male patient with a more than 12-year history of old myocardial infarction (OMI) and a more than 7-year history of diabetes mellitus type 2 who was finally cured of metastatic colon cancer after receiving TCM therapy based on a long-term chemotherapy. We present the following case in accordance with the CARE reporting checklist.

A 71-year-old man with a more than 12-year history of OMI and a more than 7-year history of diabetes mellitus type 2 visited our hospital for further examination and treatment of metastatic colon cancer after surgery.

He was diagnosed with colon cancer and was asked to resect part of right-sided colon cancer one year ago, presented with complaints of numbness and tingling in limbs in the near 3 years, as well as weight loss of 10kg in recent 6 months, but no fever, cough, chest pain, chest tightness, abdominal pain, or abdominal distention. Vital signs showed temperature 36.1℃, blood pressure 117/62mmHg, heart rate 86 beats/minute, respiratory rate 20 breath/minute. Biopsy specimens from the tumor suggested a moderately poorly differentiated adenocarcinoma (Fig. 1). Immunohistochemical results after surgery showed that the tumor tissue invades into the deep muscular layer and the serosal layer was involved already(Figure 2). After the Laparoscopic radical resection of the right colon cancer, the patient received adjuvant chemotherapy with XELOX (oxaliplatin and Capecitabine) for 8 months.

Anastomosis recurrence and pelvic metastasis occurred in this patient was discovered 2 months later (Fig. 3). Meanwhile, the liver damage caused by chemotherapy also slowly developed. When the patient visited our hospital, we found an irregular density shadow of soft tissue beside his anastomotic stoma of transverse colon, which was about 1.4*0.9cm (Fig. 4, A). We advised the patient to take Chinese medicine for his condition and prescribed a formula consisting Huangqi 45g, Chenpi 15g, Daxueteng 30g, Baijiangcao 10g, Shancigu 15g, etc. After two months’ sustained medication, CT showed that the recurrent neoplasm was disappeared, reexamination after 4 months and there was still no recurrence (Fig. 4, B &C) and 7 months later, enteroscope showed that the anastomotic stoma of transverse colon was smooth completely (Fig. 5). The tumor markers of this patient also illustrate similar changes to provide more effective evidence (Table 1).

Table 1

Tumor markers
	Reference range	Sept,2020	Nov,2020	Jan,2021	Mar,2021	May,2021
AFP	0.00–7.00	2.31	10.36*	1.95	1.64	1.35
CEA	0.00-4.30	4.52*	6.89*	4.93*	4.80*	4.21
CA199	0.00–27	18.43	26.4	33.32*	22.85	22.97

We reported a patient with metastatic colon cancer after laparoscopic radical resection of the right colon cancer who received chemotherapy for 8 months long, added with TCM treatment and finally was cured. There was no aggravation at the subsequent follow-up. Because after 7months treatment enteroscope showed that the anastomotic stoma of transverse colon was smooth completely, we believed that TCM can provide a new thought of treating colon cancer after surgery.

To date, the recommended treatment of colon cancer is to resect cancerous areas and to advise patients to accept adjuvant chemotherapy, palliative chemotherapy, or palliative targeted therapy. (Banerjee et al., 2017; Ku et al., 2012) The current management of disseminated metastatic colon cancer involves various active drugs, either in combination or as single agents: 5-FU/leucovorin (LV), capecitabine, irinotecan, oxaliplatin, bevacizumab, cetuximab, panitumumab, ziv-aflibercept, ramucirumab, regorafenib, trifluridine-tipiracil, pembrolizumab, and nivolumab(A. B. Benson, 3rd et al., 2017). Personalizing treatment allows patients to maximize benefits while minimizing harms, thus providing optimal survival and quality of life(A. B. Benson et al., 2018). Most patients have good curative effect and a good long-term survival rate. On one hand, it is reported that although about 10.8% patients undergoing colectomy for colon cancer have metastatic disease, a number of the patients who underwent resection have an increased mortality and morbidity.(Moghadamyeghaneh et al., 2016) On the other hand, it seems that combination chemotherapy provides additional toxicity, which is harmful for patients.(Meyers, Cosby, Quereshy, & Jonker, 2017)

In this case, our treatment aimed to remove the hidden danger of metastatic colon cancer in pelvic, reduce the liver toxicity caused by chemotherapy, and improve the quality of life of patients. This prescription may be exerted through the dispelling cold, removing dampness, reducing phlegm, resolving masses, and detoxifying effects of TCM.

There are several limitations to this report that prevent drawing strong conclusions. Firstly, it is only a case report, so the evidence level of this treatment approach is very limited. We don’t know if the therapy is suitable for other people or other situations. When treating patients similar with the one in this case, we can adjust the prescription slightly according to their different conditions. Secondly, the follow-up period is a little bit short. Therefore, a long-term follow-up should be built up to confirm the clinical validity after the consistently treatment of TCM.

Overall, TMC can provide an effective way in the process of metastatic colon cancer. It is meaningful and imperative to share our successful experience of curing metastatic colon cancer after the Laparoscopic radical resection of colon cancer using TCM. Further investigations are expected to confirm the efficacy and mechanism of TCM treatments for colon cancer.

CC=colon cancer, OMI=old myocardial infarction, TCM=traditional Chinese medicine, XELOX =Oxaliplatin and Capecitabine.

Funding Declaration

This work was supported by the National Traditional Chinese Medicine Inheritance innovation Project (no. ZYYCXTD-C-202006-9).

Written informed consent for publication of medical information was obtained from the patient.

Conflict of Interest Statement

The authors declare that they have no competing interests.

Data Availability Statement

All data included in this study are available upon request by contact with the corresponding author.

Author contributions

Supervision: Zhaoheng Liu.

Writing – original draft: Chengeng Deng.

Writing – review & editing: Mengyuan Tang, Zhaoheng Liu

Zhaoheng Liu ORCID: 0000-0002-4729-8102.

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No competing interests reported.

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Metastatic colon cancer cured by Traditional Chinese Medicine combined with Chemotherapy: A case report

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