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Case Report Squamous-cell bronchial carcinoma From terminal care to healing With seven years survival Dr Raymond Sevar MRCGP FFHom Dean of the Faculty of Homeopathy UK. Abstract/Summary.
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Case Report Squamous-cell bronchial carcinoma From terminal care to healing With seven years survival Dr Raymond Sevar MRCGP FFHom Dean of the Faculty of Homeopathy UK www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Abstract/Summary • A 58 year old lady with squamous cell carcinoma of bronchus confirmed by bronchoscopy/biopsy is referred by GP at the request of her terminal care nurse who has an interest in holistic care. The primary cancer is large, fills most of her right chest, appears adherent to her pericardium & is deemed inoperable with metastases in thoracic vertebrae. She is in pain despite morphine & dexamethasone. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Abstract/Summary • Holistic integrative care using homeopathic medicines, nutritional supplements, diet and a regime of daily prayer and exercise elicit a remarkable response: • the primary cancer shrinks to a quarter of its original size & becomes full of hard scar tissue • the secondary cancers in her thoracic spine disappear www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Abstract/Summary • she stops her conventional medication • seven years later she is alive & well with occasional hot flushes & mild osteoarthritis Keywords • Squamous cell bronchial carcinoma, homeopathy, diet, nutritional supplements, exercise, prayer www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Introduction • “J” has had palliative radiotherapy to metastases in her thoracic spine • is taking Morphine MST 40mg twice a day and Dexamethasone which is now reduced to 2 mg daily, but still has considerable pain. • She recently had a deep venous thrombosis in her left thigh and is on Warfarin www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • Observations: • She is very obese • an obesity of the trunk with thin legs and a red Cushing’s face • is scruffy • has thinning of hair on vertex • anxious with trembling hands www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • Six years ago I fell off a high stack of hay & fractured 6 ribs but didn't come out in a bruise. Five years ago I fell off the hay again & had a crush fracture of my first lumbar vertebra - I have had back pain since. In August last year I got a terrible pain like a band right around my lower chest & went for tests & they found the cancer … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • I get a lot of hot flushes with sweats on my head, neck & chest & am tired all the time .... • My face is getting fat & my legs have got thin & I have a horrible chemical taste in my mouth since I started all these pills … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • I grew up on a farm then went to art college. I got married & had 2 children .... • My mother was kind & gentle & would do anything for anyone .... In build & in nature I suppose I am very like my mother .... She died very suddenly 16 years ago of a burst aortic aneurysm. It was such a shock • Observation: she is weeping. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • I am still upset about it … • I have been very warm for the past 2 years which is odd because I was always chilly .... • I get hot flushes & sweats from my head downwards ... • I can't sit too long in the sun, I get headaches ... • my sweat smells more since the pills ... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • I stick my feet out of bed because they are too hot ... the soles are too hot. ..... I absolutely hate eggs ... I just love chips and ice-cream .... • I am very tidy. Everything has to be in its proper place - I can't rest till it’s tidy … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • I am terrified of snakes. I even dream of snakes. The snakes curl up on my bed & are under my bed. I wake up scared & I know that if I put my foot out of bed they will get me, wind round me & bite me..... as a child I saw a film where a huge snake crushed a man to death & I have been scared since .... • I can't breathe if I am shut in a small place. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2000 • .... I want to live till my daughter's wedding in August but they tell me I have only a few months. • Observation: she begins to cry & cries for a while – I sit & give her time www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 1 • She is terminally ill with cancer • She is in severe pain despite morphine • She is intoxicated with dexamethasone (which is distorting her fat distribution & causing weakness of proximal muscles) • She has little or no hope that she will live till her daughter’s wedding www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 1 • The dreams/fear/delusions of snakes are typical of Sulphur as are: her red face, untidy dress but fastidious need for order, burning heat of feet which she must uncover & desire for ice-cream & chips & aversion to eggs. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 1 • The history of recurrent falls and fractures with idiosyncratic lack of bruising except on the face may indicate a need for treatment with Arnica montana later www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 1 RUBRICS & GRAPH www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
TREATMENT • factors which influence survival in cancer discussed: determination to survive, changes in diet, nutritional supplements, prayer & exercise • advised to pray the Rosary daily (she is Roman Catholic) • advised to go out & walk daily for half hour no matter how ill or how bad the weather www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
TREATMENT • Sulphur 30CH one pill daily (see Graph 1) • Advise supplements - B multivitamins 25 mg daily, Vitamin C 1Gram daily till able to eat normally, then to expand diet variety especially fruit, vegetables & tree nuts www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Purpose of Treatments • To enable your body to fight back • Sulphur to fight off the effects of the drugs & wake up your immune defence systems • Supplements to help build up your immune system while you are not eating well • Exercise to build up your strength & will • Rosary for grace www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Treatment goal = survival to daughter’s wedding • Outcome measures at review: energy, mood, sleep, weight, resilience, pain, dying of cancer or living with cancer ... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation January 2001 • My legs are strong again with more muscle - I can walk up & down stairs easily now and walk the dog every day. ......I stopped Dexamethasone 4 weeks ago. I am still on Morphine which makes me nauseous and Warfarin and the vitamins … • I am much better with more energy. I still get tired and I go to bed at 9, but there is no slump in energy from 2-5 p.m. .... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Treatment • This change is real & significant • It means your body has begun to fight back & has more energy to fight back www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation January 2001 • I have been falling - I fell in the bath and banged the right side of my chest • I asked to examine her & she said • “I don't want you to touch it or prod it” - & she pulled away & guarded the area saying “It is all right” www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation January 2001 • I just fall flat on my face for no reason - I have done my whole life. I fell on my left shoulder 1 year ago & needed a steroid injection & I fell off the hay twice - my face bruises but nowhere else … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 2 & TREATMENT • The Arnica layer emerges with a recent fall & typical behaviour of guarding the sore place & denial • Treatment Arnica montana 30CH one pill 3 doses today then continue with Sulphur 30CH daily www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation March 2001 • I have stopped Morphine - it was very bad - I was shaking & sick & had diarrhoea for 3 weeks … • I feel 1000 times better … • I have even more energy ... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation March 2001 • I am in a fair amount of pain .... in my back(shows lower thoracic spine) & around my sides to the front ... better hot bath & a hot water bottle ... • I take Paracetamol 2 twice a day & an occasional Ibuprofen - with the tablets I have no pain but the pain comes back when they wear off … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation March 2001 • I am not so warm now. I feel cold more often than warm recently, but I still put my feet put of the bed … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 3 • The Sulphur state persists with hot feet but she is becoming chilly again • There is more general improvement off Morphine but the pain from her bony metastases is troublesome with only minor analgesics • “specific” medicines for bone metastases are required www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
TREATMENT 3 • Symphytum officinalis 6CH • &Hekla lava 6CH • one pill of each twice a day • continue Sulphur 30CH 30ml 2 drops daily, 10 succussions before each dose (see Graph 2) www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 3 RUBRICS & GRAPH www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation April 2001 • I feel great with the new medicines • I have been walking more & I have bought an exercise bike & I have been gardening • I can do all the housework now: cooking, washing, ironing ... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation April 2001 • my back aches a bit when I have been resting for a long time and when I first move but then it is OK ... I have never had the bad back pain or girdle pain... • my energy is still gradually increasing … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation April 2001 • I still get the hot feet and still stick them out the bed.... • my weight is going up – that’s why I got the exercise bike... • I have developed a craving for sunflower seeds in the last few weeks … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation April 2001 • I am busy organizing my daughter's wedding .... I am still taking Paracetamol & Ibuprofen & Warfarin • Treatment: continue Sulphur & Hekla lava & Symphytum www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation June 2001 • The cancer has shrunk - I had a Chest X ray & they can see it is much smaller … • Observation: a big smile with glistening eyes www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation June 2001 • Some days I feel absolutely great ... • I still have aches and pains in my old joints - lower back, feet and right knee. • my weight is still going up ... • my nails are growing fast & they are the strongest that they have ever been my whole life www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation June 2001 • The hot flushes are getting terrible. They are getting worse & much more frequent • I throw the covers off then I get cold quickly so I need the covers back on..... www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 4 • The shrinkage of the cancer is remarkable, her general improvement continues, the surge in hot flushes indicates the partial emergence of a new layer but the image is not yet clear – I decide to give a sarcode as an organ remedy in low potency. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
TREATMENT 4 • Add Folliculinum 6D one pill twice daily continue • Sulphur • & Hekla lava • & Symphytum www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation August 2001 • Observation: freckly, tanned & happy • I was very busy before my daughter's wedding. I made her wedding dress & the bridesmaid's dresses & the wedding cake & I was fine. It was such a lovely day, thank you … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation August 2001 • The hot flushes are nearly gone - much less frequent & each flush is milder & shorter... • I keep forgetting to take the paracetamol & Ibuprofen. .... my knees don't hurt so much & my back isn't sore till after 6 pm or after gardening • Treatment: Continue Sulphur, Symphytum, Hecla lava & Folliculinum www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation October 2001 • I still feel great. • I am not dying of cancer. • I am living with cancer … www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation October 2001 • The bone pain in my knee got worse & I had a bone scan which showed a hot spot. I did a lot of raking of leaves off the lawn & my left shoulder has been very sore - the pain shots all the way down my arm to the fingers & my fingers are a bit tickly. www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation October 2001 • I am sure that it is just arthritis after too much gardening but they’re arranging an MRI scan ... • I take an occasional paracetamol or ibuprofen www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
ANALYSIS 5 • Even after her daughter’s wedding (her initial survival target) she feels certain that she is still recovering & is not anxious about a new bony secondary, she feels sure that the pain is rheumatic from overuse • Rheumatic pain shooting down the limb indicates Kalmialatifolia www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
TREATMENT 5 • Kalmia latifolia 12CH one pill 3 times a day for shoulder • continue Sulphur, Symphytum, Hecla lava & Folliculinum www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2001 • I am fine - the scans show the cancer is now half the size it was & the cancers in my spine have gone & the shoulder & knee scans are just arthritis • Observation: shining with joy www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com
Consultation December 2001 • My hands have been getting very sore & the joints are all lumpy. My shoulder is fine - It was OK 2 weeks after starting the Kalmia • On examination: marked Heberden's nodes & osteoarthritis of distal inter-phalangeal joints both middle & index fingers www.facultyofhomeopathy.org www.raymondsevarhomeopathy.com