Metastatic Bone Cancer of Unknown Primary Resolved by Herbal Therapy: A Case Study

摘要

Angela, 69-year old female, was diagnosed with metastatic bone cancer of unknown primary in September 1999. She declined radiotherapy and took herbs instead. She was on herbal therapy for five years. Medical examination in August 2004 indicated that her suspected bone cancer had resolved. She is currently on medication for osteoporosis. Introduction Metastatic bone cancer originates from other primary site of the body such as breast, prostate, lung, thyroid and kidney. The bone is one of the four favourite sites that cancer cells like to anchor on after moving out of their primary site. Other organs that are targets of secondary cancer are the lung, brain and liver. Metastatic spread represents the final phase in the progression of cancer in the body (1, 2).Bone scintigraphy or commonly referred to as bone scan, is the primary imaging modality for detecting bone metastasis. In this procedure radioactive tracer will accumulate in the skeletal structures where the bone is undergoing destruction or repair, resulting in formation of “hot spots” on the film (2, 3). While bone scan is a valuable procedure that allows for rapid evaluation of the entire skeleton, it unfortunately, lacks specificity. Tracer accumulation is not only confined to cancerous tissue but also areas where there is active bone turnover such as in degenerative joints, healing of fractures or infection (3). However, an experienced radiographer should be able to provide some degree of confidence in interpreting bone scan. Bone metastasis usually involve multiple sites (i.e. three or more lesions) and the tracer uptake do not correspond to any single anatomic structure (4). MRI is another additional tool for evaluating patients with positive bone scan. It is said to be more sensitive than bone scan for detecting bone metastasis at its early stage (4). Patients with bone metastasis often suffer from lytic destruction of the spine. This is the most commonly affected site, followed by the sacrum, pelvis, fermur, skull and humerus (3, 5). The symptoms shown by patients with metastatic bone cancer include: pains, hypercalcemia and increasing disability (4, 6). Bone metastasis can also lead to serious bone fracture (5). At present, there is no cure for metastatic bone diseases (7). Case Presentation Angela (not real name), 69-year-old female, suffered from chronic pains since 1995. She consulted two doctors and both of them prescribed her painkillers. During this initial period the pains just “came and went off”. In 1998, the problem became more serious and Angela went to consult another doctor. Again she was prescribed painkillers. She took the pain tablets as and when necessary. By August 1999, the pain became too unbearable and she consulted another doctor. This time she was referred to an orthopedic surgeon, who suggested that Angela undergo a full blood test and do both a bone scan and MRI. The blood test done on 4 September 1999 indicated mild polyclonal increase in gamma globulins, consistent with chronic inflammation / infection. A bone scan done on 23 September 1999, indicated: multiple foci of increased trace accumulation involving both the sternoclavicular junctions, lower cervical vertebra, T5 or T6 vertebra, L3, right sacro-illiac joint and the right side of the lower aspect of the sternum. In view of the multiplicity of the lesions, metastasis has to be considered.MRI report of 28 September 1999, indicated: abnormal signal seen involving the T6, T7, T8, L3 and possibly L4 vertebral bodies. This signal abnormality suggest metastatic lesion involving these vertebral bodies. The T 6, T7 and T8 vertebral body shows mild loss of vertebral height anteriorly. The L3 vertebral areas show an otherwise normal configuration. Spondylotic changes of the lower lumbar vertebrae with degenerated disc area, also seen at L4 / L5 and L5 / S1 levels. Impression: Appearance suggests metastatic involvement of the T6, T7, T8 and L3 vertebral bodies. No cord compression is seen.An