2.Materials andMethod
After being successfully treated with six treatments of
Rituxan plus CHOP (cyclophosphamide, doxorubicin
hydrochloride, vincristine, and prednisolone) regime over
a period of three months in 2007, a positron emission
tomography (PET) scan showed a complete remission of the
NHL. With no further treatments by August 2008, the PET
showed his tumors returned in the nasopharynx and neck
lymph glands which presented with a low grade fever of 99.8,
sweating and fatigue.
The Non-Hodgkin’s Lymphoma patient refused conventional
therapy, instead personally obtaining dichloroacetate
(DCA) he began self-administering 900 mg daily at 10mg/kg
in August 2008, adding a daily 750 mg of thiamine to
protect his nerves from toxicity [15, 23]. Four months later a
PET scan showed complete remission (see Figure 2). He has
remained tumor-free on the continued regime of DCA and
thiamine since his last PET inMay 2009.Monthly blood tests
are showing that all of his parameters are normal.
3. Results
In August 2008, an NHL patient, who had been in remission
for almost a year after chemotherapy, complained of soreness
and tenderness in his neck area where protrusions were
visible upon examination. A PET was taken to investigate the
nature of the problem and the extent of lymph involvement.
Figure 1 shows that several new hypermetabolic foci
within the head and neck compatible with recurrent
lymphoma; new hypermetabolism in the right postlateral
aspect of the nasopharynx, measuring 3.2 × 2.2 cm; new
hypermetabolic adenopathy within the right neck involving
the right jugulo digastric region, right jugular chain, and
right posterior triangle extending to the base of the neck;
the largest node measuring approximately 1.9 × 1.9 cm;
several smaller hypermetabolic lymph nodes in the posterior
R L
Figure 1: August 2008 PET scan.
Figure 2: December 2008 PET scan.
triangle extending to the base of the neck; a single focal
area of hypermetabolism within the left posterior triangle
corresponding to a small lymph node which measured 1.0
× 0.5 cm.
Four months after the patient’s daily self-medication with
750 mg of DCA, a PET scan showed no visible signs of
lymphoma. Symptoms disappeared after several weeks and
the results of the PET scan 4 months later in Figure 2 show
that the previously seen foci of abnormal activity within
the nasopharynx and neck had resolved; no abnormal foci
of metabolic activity were seen; no evidence of recurrent
disease.
4. Discussion
The medical community is seeing more and more patients
who are seeking forms of therapy on their own with
varying results; some are deleterious and endangering while
others may prolong their lives but should still be done
under medical supervision. Understandably physicians frequently
cannot ethically advise or administer the use of the
patents’ preferences, leaving the patient to their own devices.
Although this case, and others anecdotally, resulted in a
successful outcome that might be explained by the existing
extensive research on the pharmacology and toxicology
of the dicholoroacetate treatment the patient chose, the
compound’s application in cancer patients is still under
investigation. We are presently looking at in vitro tumor
samples for testing sensitivity to DCA.We are also looking at
laboratory parameters for a possible laboratory correlation in
responders to specific enzyme levels as some patients’ cancers
respond positively or are resolved, DCA does not appear to
be not tumor type specific.