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Stage 4 Hodgkins Lymphoma – Eric Rondeau’s Holistic Healing Journey

Title

Integrative Oncology treatment program heals patient with Stage IV Hodgkin’s lymphoma with acute kidney injury and respiratory compromise.

Introduction

The treatment of Hodgkin’s lymphoma via conventional Oncology has very high year success rates with 5-year survival rates exceeding 80%. Because of this, any deviation from this treatment regimen, though associated with potentially significant side effects, is discouraged. Significant side effects include but are not limited to infertility, secondary cancers, chemoresistance with recurrent resistant cancer. A treatment approach for all patients with cancer, including Hodgkin’s lymphoma, should maximize effects and minimize side effects. That is the goal of the treatment of cancer through the Integrative Oncology approach. This case study highlights the successful treatment of a 53-year-old man with stage IV Hodgkin’s lymphoma, which was complicated by renal failure and respiratory compromise, by an Integrative Oncology approach.

Case presentation

A 53-year-old male, ER, was seen at local Urgent Care for weakness, night sweats, significant edema, abdominal bloating, long-term weight loss with more recent short-term weight gain of 15 lbs, and fever to 103 on December 12, 2018. The patient was retired and traveled around the country with his wife in their RV. ER was found to be significantly anemic, thrombocytopenic on initial examination, and was sent to the local Emergency Room for blood transfusion/platelets and further evaluation. A CT scan of the abdomen and pelvis was performed, which revealed significant liver and spleen enlargement with widespread lymph node enlargement above and below the diaphragm. ER was admitted to the hospital to continue further evaluation. An excisional biopsy of an enlarged right inguinal lymph node was performed on December 14, 2018, positive for Classic Hodgkin lymphoma. ER was discharged from the hospital on December 16, 2018, with instructions to follow up with the local Oncology department to initiate treatment.

ER subsequently presented to An Oasis of Healing for initial evaluation. ER had an important birthday trip planned in 3 weeks and wanted to wait to initiate treatment until after this trip. ER noted that the hot flashes and night sweats had been severe for at least one year prior and that the hot flashes and night sweats would require him to get to change clothes 5-6 times daily and 3-4 times nightly. This experience was the same during the day. Through the previous year, the intensity of the night sweats had increased to an almost continuous nature causing significant sleep disruption and severe fatigue.

Intake labs included:

  • H/H 8.3/26.7
  • WBC 11.2
  • PLTS 217
  • Creatinine 2.57
  • Urea 40
  • GFR 27
  • Potassium 5.4
  • Total Protein 5.7
  • Albumin 3.7
  • ALKP 251
  • D-Dimer 2220
  • Ferritin 2690
  • LDH 226
  • Fe 108
  • Vitamin D 21.5

An intake PET/CT at an Oasis of Healing performed on January 10th, 2019, found:

HEAD AND NECK: multiple prominent enlarged hyper-metabolically active bilateral lymph nodes in the neck. Moderate FDG uptake as high as 6.3 SUV was seen.

CHEST: multiple prominent enlarged hyper-metabolically active bilateral lymph nodes in the axillary, mediastinal, and right hilar regions. FDG uptake as high as 6.8 was seen in a left axillary lymph node. Small left pleural effusion was also seen.

ABDOMEN/PELVIS: multiple prominent enlarged, bilateral hyper-metabolically active lymph nodes in the periportal, aortocaval, left para-aortic, right pelvic side-wall, bilateral iliac and bilateral inguinal regions with FDG uptake as high as 14 SUV. A 4.5 x 4 cm right inguinal seroma from previous right inguinal excisional biopsy was seen. The Spleen was noted to be markedly enlarged with wide-spread avid FDG uptake with SUV at 8.4. Moderate abdominal and pelvic ascites was noted. Small bilateral non-obstructing renal stones were noted.

MUSCULOSKELETAL: numerous areas of avid hyper-metabolic activity were seen in the axial and the proximal appendicular skeleton with the most intense FDG uptake in the right posterior iliac (12.4 SUV) and left sacral wing (12.5 SUV) consistent with bone metastasis.

Diffuse edema and anasarca were noted as well.

Upon initial examination, it was clear that clinical decline was imminent and immediate treatment was required. After consideration, the patient decided to proceed with treatment initiation. Very shortly in the assessment process, severe edema and worsened kidney function required hospitalization. The patient’s condition worsened in the hospital, requiring ICU admission and a ventilator for respiratory support due to respiratory compromise and dialysis due to acute kidney failure (ARF).

The patient required four weeks of hospitalization, of which the majority was in the ICU. The patient underwent numerous procedures to drain fluid from the abdomen (paracentesis) and lungs (thoracentesis)—the largest paracentesis included an amount of 4 L at 1 time. Dialysis was initiated 3 x weekly while in the ICU secondary to ARF. The patient received two 25% chemo treatments in the hospital before discharge. ER was discharged to a rehabilitation center to continue 3 x weekly dialysis.

Treatment

After discharge from the hospital at the end of February 2018 to the rehabilitation center, ER underwent a 12 week customized, extensive cancer healing program at An Oasis of Healing in Arizona that included:

  • Raw Food Vegan Nutrition and green juicing
  • Oasis School of Life program
  • Oasis Psycho/Spiritual/Emotional program
  • Metabolic therapies to include therapies such as Insulin Potentiated Therapy (IPT) with AVD
  • Mitochondrial Regeneration Therapies (MRT) developed in Germany and practiced in several European countries and now, the US
  • targeted detoxification support
  • targeted immune support therapy
  • Healing enhancement therapies

Through the course of treatment at an Oasis of Healing, all symptoms, including hot flashes, night sweats, body-wide edema, ascites, right inguinal seroma, and the palpable presence of enlarged lymph nodes, wholly disappeared. ER steadily improved week by week with the treatments. The patient was successfully tapered off dialysis through the 12-week treatment program at An Oasis of Healing.

An interval, post-treatment PET/CT on June 21, 2019, found:

“interval, complete resolution of previously described hyper-metabolically active FDG uptake in the spleen, bone, and lymph nodes. In addition, the previously seen enlarged bilateral lymph nodes above and below the diaphragm resolved and the enlarged liver and spleen normalized. Mild, residual hyper-metabolic avid FDG uptake was seen in the right inguinal area that was consistent with the previous excisional biopsy/seroma/infection.”

ER completed his 12-week program on June 21, 2019. The patient returned home to his motor coach and has resumed his travels with his wife. The patient continued a monthly maintenance treatment program at An Oasis of Healing in Arizona x 4 months. An interval PET/CT on September 17, 2019, found no residual, active hyper-metabolic FDG activity.

The patient was discharged to f/u in 4 months for interval evaluation and to initiate monthly maintenance therapy. ER has been traveling the country with his wife in their motor coach and enjoyed his son’s marriage and now a grandchild.

Date Ferritin LDH D-Dimer ALKP CRP
1.7.19 4927 302 1954 250 120
1.14.19 11443 418 2200 236
3.18.19 2690 226 2220 251
4.1.19 1649 191 1896 194
4.8.19 1538 232
4.22.19 1606 174 5062 191
4.29.19 1527 217 5353 224
5.6.19 1246 224 5549 253
5.20.19 1290 213 2105 182
6.3.19 1295 193 911 150
6.10.19 1011 185 638 126
6.17.19 1366 172 509 129
6.24.19 1300 154 419 123
7.22.19 921 177 312 120
8.19.19 719 200 486 149
9.19.19 522 170
11.25.19 598 187 106
1.2.20 724 195
1.9.20 103
2.06.20 1028 169
2.26.20 490
3.11.20 483 191 < 215 87
12.11.20 385 200 90 1.8

Most recent labs include:

  • H/H 13.3/40.6
  • WBC 6.9
  • PLTS 134
  • Creatinine 1.45
  • Urea 20
  • GFR 59
  • Potassium 4.8
  • Total Protein 6.4
  • Albumin 4.7
  • ALKP 103
  • D-Dimer 486
  • Vitamin D 113.6

The patient developed shingles while traveling and was also found to have prostatitis with a PSA of 10 which was treated with antibiotics. The shingles and prostatitis, now resolved, were the cause of the slight uptick in the noted LDH and ferritin above.

Discussion

ER is a case study of an advanced stage IV Hodgkin’s lymphoma complicated by renal failure and respiratory compromise during clinic intake successfully treated with an Integrative Oncology approach. The treatment success in this patient was achieved in a significantly shorter interval of time compared to the current standard of care, and the Integrative Oncology treatments were well tolerated by a patient that was complicated with renal failure and respiratory compromise. In addition, some of the Integrative Oncology treatments helped expedite the recovery of the kidneys, including the quick taper off the dialysis.

Cancer is a process that is born out of an adaptation of cells to an inhospitable environment. Documented contributors to cancer include poor long-term nutrition, toxin exposures, DNA damage, hypoxia, acid/base imbalances, oncogenic metabolism, compromised mitochondria function resulting in energy compromise, hormone imbalances… This survival adaptation though excellent in the short-term, when allowed to progress to a long-term process, cancer is almost sure to be the final result. The complexity that leads to cancer initiation, growth, and spread can only be met with an equally complex process. Integrative Oncology integrates on multiple levels:

  • Integration of cancer elimination and body healing
  • Integration of natural therapies and conventional therapies
  • Integration of therapies that work with the body while limiting therapies that work against the body
  • Integration of therapies guided by current science
  • Integration of independent thinking

 The healing of the body must be the primary role of any cancer treatment program. An oversimplified focus on the removal and elimination of a primary tumor ignores the systemic process that is cancer. Only with a strategy that focus’ on healing can the elimination of cancer in the short-term and long-term be achieved. The target goal of 5 years, though admirable, should not be an acceptable long-term goal. How did five-year survival come to equal long-term? Long-term survival is 15, 25, and 35 years.

At its core, Integrative Oncology is the integration of the best of natural therapies and conventional therapies-Holistic.  In using natural treatments of an Integrative Oncology approach, natural therapies are used in targeted, often higher doses, and targeted delivery techniques to maximize the therapeutic effect of the natural therapies. In contrast, conventional medicine is used via a safer, often smarter dose and delivery technique to maximize therapeutic effect and minimize side effects. In essence, holistic treatments are a reference to individual natural therapies (nutrition, vitamin C, curcumin…) and an overall holistic frame-worked of thinking (low-dose metronomic chemotherapy).

Many side effects found in conventional Oncology are the direct result of blocking whole pathways in the body–a more obstructionist method or work. An Integrative Oncology treatment program that works with the body’s normal functions or restores and optimizes the normal body’s functions will provide better long-term effects of healing while minimizing the potential side effects.

As should be the case in all treatment programs, an Integrative Oncology treatment strategy should be guided by the best current evidence available. As evident and logically as this statement appears on the surface, the evidence points to physicians falling further and further behind in knowledge of current research. An Institute of Medicine article from 2001 found that the average physician was practicing at a level that was 17 years behind the current published evidence, but that was in 2001. With the advent and growth of globalized research, which is fantastic, this almost without a doubt has worsened the gap between published evidence and applicable knowledge, as a result of the growing volume of evidence . The conventional medicine approach to this problem is to standardize the dissemination and summarization of education material and published evidence. In addition to the introduction of bias, this has de-emphasized independent physician thinking. Whether intentional or not, this de-emphasis on independent thinking has propagated groupthink and created vacuums of knowledge of new evidence in the clinical application of new research. The likely unintended result is a limitation of set goals that lead to stagnation of outcomes plus little if any improvement in risks. Unfortunately, the average patient finds themselves in the crosshairs of the very medicine that should seek and provide evidence-based solutions for healing.

 Significant side effects are associated with the current standard of care in the treatment of Hodgkin’s lymphoma. These side effects include but are not limited to the side effect of chemotherapy itself, infertility, secondary cancers, and chemoresistance with recurrent resistant cancer. Though there is a high degree of 5-year success rates with the current standard of care in the treatment of Hodgkin’s lymphoma, the increased risk of side effects and significant decrease in quality of life requires continued advancement in maintaining and even improving upon these high success rates without the treatment side effects. Until the goal of 100% success rates is achieved, this pursuit must be the goal.

The word physician in Hebrew is translated as a healer. A treatment program that compromises healing is a treatment program that must be re-evaluated for improvement potential even if considered standard of care. We must always serve the patient’s best interest in their pursuit of healing from cancer.


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