Case Reports Huma Cancer Society Ganj Plaza, 2nd Floor, Opposite Leela Cinema, 42, Hazratganj, Lucknow , U.P., INDIA Phone: FAX:

INDEX Case 1: Treatment of Oral Cancer Case 2: Treatment of Oral Cancer Case 3: Treatment of Oral Cancer Case 4: Treatment of Oral Cancer Case 5: Treatment of Oral Cancer Case 6: Treatment of Oral Cancer Case 7: Treatment of Multiple myeloma Case 8: Treatment of ?Pancreatic Cancer Case 9: Treatment of GI tract Cancer Case 10: Treatment of Osteogenic sarcoma

Case 1: Treatment of oral cancer Figure 1: A - At presentation; B - One months after therapy; C - Six months after the therapy; D - One year after therapy A 70 years old male presented with horney irregular growth from the upper lip in Nishat Hospital and Research Centre, Lucknow on Three years earlier he was operated for a similar benign growth in his upper lip. The patient was diabetic since last 10 years and was taking oral hypoglycemic. The biopsy from his growth done on indicated verrucous carcinoma. The patient was having financial problem and hence, could not react immediately to the situation. Two months later when his pain elevated the patient was referred to J K Cancer Institute (JKCI), Kanpur for further management. He was seen by the oncologists in the JKCI, Kanpur and his biopsy slide was reviewed, his disease was then staged as T4N3MX. The option of conventional therapy was discussed with the patient. However, because of his old age, poor health condition and financial problems the patient did not consented for the same. He wanted to try the alternative cancer therapy HUMA primarily for palliation. His alternative therapy started from March At the start of HUMA therapy (Fig 1a) the patients was unable to take solid food because of pain and swelling in his mouth. After the start of HUMA therapy decrease in pain intensity and shrinkage of tumor was noted (Fig 1b). The patient was able to take solid food. Gradually his health condition improved. After 6 months of this alternative therapy the tumor regressed completely (Fig 1c). His therapy continued for 2 years and then stopped. No adverse side effect of the therapy was recorded. The patient so far has completed 7 years of relapse free survival after stoppage of therapy. A AB D C

ABC Figure 2: A – At presentation; B – Pathology; C – Six months after therapy A 60 years old male presented with a lesion on the right cheek (Fig 2 a). He was earlier treated with antibiotics but did not respond. The biopsy done from his lesion indicated squamous cell carcinoma (Fig 2 b). He was advised conventional therapy, but the patient refused because of financial problems. He wanted to try HUMA. After initiating the alternative therapy his lesion gradually started to heal. After 6 months of therapy his lesion healed completely (Fig 2 c). Because of financial problems the patient discontinued the therapy after 9 months. Four months after stoppage of medication the patient had a relapse. The therapy was restarted; however, the patient did not response to the alternative therapy. The patient lost weight as he was unable to take solid food. Because of financial problem the patient also could not go for any conventional therapy or management. The patient expired 2 months after relapse. Case 2: Treatment of oral cancer

A 58 years old male chronic tobacco edict presented with growth in tongue and lower lips (See Fig). Biopsy done in J K Cancer Institute, Kanpur on indicated squamous cell carcinoma. The staging of the tumor was T 3/4 N 1 M X. He was advised radiotherapy / chemotherapy, but the patient did not have much faith on conventional therapy and he was also having financial problem. Hence, he wanted to try an alternative cancer therapy. He started the HUMA therapy from After about a month of therapy the growth of his tongue and lip started showing signs of regression (Fig. 3b). And after 6 months of therapy the growth of his lip dried up and got detached (Fig 3c). The growth of his tongue also regressed, leaving a white scar in his tongue. The patient wanted to discontinue the therapy after 1 year as his tumor regressed completely, though his tongue patch remained. After stoppage of therapy the patient remained incidence free for about 2 years. In June 05 the patient again reported to the clinic with fresh growth in his tongue at the same site. The therapy was restarted, though the patient showed little sign of regression in the beginning, but his growth did not regress after continuing the therapy even over a month. Biopsy from the tongue was done on which indicated squamous cell carcinoma. Figure 3: A - At presentation; B – After 1 month; C – After 6 months; D - After 1 year; E – After relapse ADECB Case 3: Treatment of oral cancer

ABCDE Figure 4: A – At presentation; B – Pathology; C – Three months after therapy;. D – Six months after therapy; E – After relapse A 30 years male a chronic smoker and tobacco edict presented with small growth in the base of tongue at Mehrotra Pathology Centre on Biopsy from the tongue growth was done which indicated squamous cell carcinoma. The patient was referred to G M & Associated Hospital (KGMC), for further management. The patient was advised for radiotherapy (RT). However, because of long waiting list he was given a date for radiotherapy after 2 months. He then went to Kamla Nehru Memorial Hospital, Regional Cancer Centre, Allahabad. There too he could not get an immediate date for radiotherapy. The patients been a farmer have exhausted a lot of money in travel and investigations. To raise funds for his treatment the patient had to sale some portion of his agricultural land. When he could accumulated sufficient funds after about 6 months he visited SGPGIMS on , there his tumor which was now grown bigger in size was staged as T 4 N 1 M 0 and he was advised radiotherapy / chemotherapy. The patient in SGPGIMS interacted with other cancer patients undergoing conventional therapy. He was afraid to see some cancer patients with adverse side effects caused because of conventional therapy. Finally he decided that he is not going for any conventional therapy. The patient wanted to take some alternative therapy and came and met us on Our best efforts to convince the patient for the conventional therapy failed. The patient could not over come his fear of adverse side effect associated with conventional therapy. When he started HUMA therapy (dated ) he was unable to speak or eat any solid food as his tumor, which was rock solid had infiltrated the vocal cord (Fig 4a). He was also having considerable pain. After a month of therapy his performance status improved considerably, his tumor started to become soft and his pain came down considerably. The patient was able to eat solid food and speak properly. After 3 months of therapy the tumor burst open. He was given antibiotic coverage for 10 days. The patient recovered fast and his lesion healed within 15 days. After 5 months of the alternative therapy though his external lesion healed completely but his internal lesion did not regressed completely. As the general condition of the patient improved, he again resorted to tobacco chewing. Because of which his conditions again started deteriorating and after 2 months a fistula was formed at the same place of the external lesion (Fig 3d). There was continuous discharge from the fistula. Thereafter, the patient started to have difficulty in taking even liquid food. Gradually over all health condition of the patient stared to deteriorate and he expired after 2 months after this incidence. Case 4: Treatment of oral cancer

A 45 years old male presented in the clinic of the Huma Cancer Society with a big lesion in his lower lips (Fig 4a) on He was advised for biopsy; however, the patients refused biopsy because of social and financial problems. The patient was too poor to afford any convention therapy or management. The patient want to try HUMA as one of his friend suffering from oral cancer had been benefited with this therapy. His therapy started from There was a marked regression of oral lesion after 3 months of therapy (Fig 3b ). After 6 months of intensive therapy when his lesion had regressed completely the patients was switch to low dose maintenance therapy. However, after 3 months of maintenance therapy, a fresh tumor appeared in the lower lip (Fig 3d). Aggressive therapy was restarted and the patient responded to it. His growth regressed after another 3 months of therapy (Fig 3e). The therapy was continued for another 6 months and stopped on the request of the patient when his lesion had healed completely. The reason behind stoppage of therapy was financial problems. However, after 2 months after this incidence the patient again reported in our clinic with another relapse. On our request the patient went for a FNAC. The findings indicated grade III Dysplasia with early malignant changes ?Epidermoid carcinoma. The therapy was again restarted. However, there was no effect on the lesion this time. Gradually the lesion spread to his chin. The patient started having difficulty in taking food. The patient expired after 3 months of this incidence. Figure 4: A – At presentation; B – After 3 months; C – After 6 months; D – After 9 months; E – After 14 months; F – After 20 months; G – Pathology; H – After 22 months A G E F DCB H Case 5: Treatment of oral cancer

A 60 year old male, chronic tobacco edict presented with a growth in the right cheek extended upto upper lip (Fig 5a ) in our clinic on Biopsy from cheek growth done on (Dr. RML Mehrotra Pathology Centre) indicated verrucous squamous cell carcinoma. He wanted to try HUMA because he had a deep belief about the effectiveness of this therapy in treatment of oral cancer. His therapy started from The patient responded to the therapy. His growth regressed completely after 8 months of intensive therapy (Fig 5d). Fine Needle Aspiration Cytology (FNAC) done on from the tumor site, was found negative for malignant cells. However, after 15 days of this incidence the patient again came to our clinic with a massive swelling in his cheek. The puncture site which was made for doing FNAC got infected (Fig 5e). He was also having pain in his jaws. X-ray was done which indicated dental cares. He was treated with antibiotics but he did not respond. After a month there was fresh growth in his cheek from the same site. FNAC was done, which indicated relapse of the disease. Along with the HUMA therapy now he was also given 5-FU and Vincrestin for about a month. However, the combination therapy did not have much effect. The patient refused for other conventional therapy and continued the HUMA therapy. However, no further response was observed. The patient health condition gradually deteriorated as he was not able to take solid food and the patient expired on May Figure 5: A – At presentation; B – After 3 months; C – After 5 months; D – Complete regression of disease; E – Recurrence of disease after repeat biopsy AEDCB Case 6: Treatment of oral cancer

A 35 years old male patient presented with severe pain in his back and difficulty in walking at G M & Associated Hospital on He was admitted in the department of Neurology, King George Medical College (KGMC) Lucknow for investigation and treatment. X- ray spine showed multiple vertebral collapse. X ray skull showed multiple lytic areas. The bone marrow examination was suggestive of lymphoma / multiple myeloma. The patient was given 1 cycle of chemotherapy. However, his health condition deteriorated further because of the adverse side effects of chemotherapy. The patient did not wanted to continue further therapy and after leaving the hospital he started HUMA therapy from He was completely bed ridden at the start of therapy. Marked improvement in general health condition was noted after start of the alternative therapy. His back pain gradually came under control. X ray D L spine done on indicated partial collapse of multiple vertebrae (T 7, T 9, T 12, and L 4 ) in dorsal and lower lumber region. Bone marrow exam done on were within normal limits except mild lymphocytic increase. X ray done on indicated partial collapse of multiple vertebrae with preserved I.V. space and no paravertebral soft tissue shadows. Bone marrow done on were within normal limits. As the patient became absolutely normal the alternative therapy was stopped from April 97. Bone marrow examination was again repeated on and which indicated a normal study. Bone marrow examination done indicated presence of a few large atypical lymphocytes. So far the patient has completed over 14 years disease free survival. AGFDECB Figure 6: A & B– At presentation; C & D – After 1 year; E – After 3 years; F – After 5 years; G – After 8 years Case 7: Treatment of Multiple myleoma

Figure 7: A – USG ; B – CT scan ; C & D – USG ; E - Patient ADECB A 43 years old male presented in Fatima Hospital, Lucknow with acute epigastric pain radiating to back on He was treated by Dr. B N Kapoor who prescribed some medicine and advised him to undergo a USG of abdomen. The patient also consulted Dr. V K Khanna for his problems he too advised him for USG. His USG of abdomen done on indicated chronic pancreatitis with ?acute exacerbation. He was given allopathic medicines for managing his problem. The patient continued with the allopathic medicines. After about 2 month his problem aggravated, he was again advised to undergo another abdominal USG on The result of USG indicated slightly bulky pancreas with irregularly dilated pancreatic duct, with bulky head of pancreas. The impression was either chronic pancreatitis or carcinoma head of pancreas. He was advised for ERCP. He was then referred to gastroenterologist Dr. D K Agarwal for further management ( ). The patient was given enzyme supplement for the treatment of chronic pancreatitis, however, he did not respond. His upper abdominal pain went on increasing. The patient went to the Balrampur hospital ( ) for further treatment. For his pain management he was given voveron injection and was advised for a CT scan of abdomen. The abdominal CT scan done on indicated pancreatic head neoplasm with multiple cystic components dense calcification dilated pancreatic duct and atrophic body and tail region. There was a possibility of cystadenoma also. So the patient was advised for a CT guided biopsy of the pancreatic tumor. He was also made aware about going for surgical intervention if the tumor is malignant. The doctors attending the patient told the patient that the chance of his tumor to be malignant was more than 90%. A biopsy was needed only to confirm the diagnosis. The patient who was not in a position to undergo surgical intervention did not go for the biopsy and opted for HUMA therapy. When the patient present in the clinic of the Huma Cancer Society he was extremely ill, cachexic, anorexic, and was having intermittent upper abdominal pain. He started the HUMA therapy from There was a gradual improvement in the general health condition of the patient after the start of the alternative therapy. After about 3 months of therapy the abdominal pain of the patient was completely gone and his appetite became normal. After about 4 months of therapy the patient started to do his regular routine work. The therapy was continued for 11 months and stopped. USG abdomen done on indicated a normal study with some fatty changes in the liver. For the last 10 years the patient is leading a normal life. Case 8: Treatment of ?Pancreatic cancer

Figure : A & B – Pleural effusion and Ascetics before start of therapy; C - Histopathology ; D – Abdominal CT scan CT scan dated A male patient 59 years old presented with severe abdominal pain, dyspepsia and ascites at the out patient department of gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science (SGPGIMS) on His investigation done in SGPGIMS indicated that the patient was suffering from abdominal Koch’s. He also had cholelithiasis with choledocholithiasis and sub acute intestinal obstruction. Chest and abdomen CT scan done on revealed minimal left pleural effusion (fig 1a) with bilateral basal segment collapse consolidation and mediastinal lymphadenopathy. He also had hepatomegaly and left lode enlargement and collection in the pelvis and hepatorenal pouch (fig 1b). Precutaneous drainage (PCD) of his abdominal collection was done and the patient was started with anti Koch’s therapy. However, the sub acute intestinal obstruction of the patient persisted. Laparoscopic exploration was done on , multiple whitish nodules was seen over parietal peritoneum in the right upper quadrant on falciform ligament and in the right iliac fossa. Parietal nodular biopsy was done (fig 1c). The histopathology revealed pseudomyxoma peritonei / metastatic mucinous adenocarcinoma. In view of disseminated disease and poor general condition, the patient could not be given any curative treatment. For malignancy treatment the patient after leaving SGPGIMS tried alternative poly herbal HUMA therapy from At the time when the alternative therapy started the patient was extremely anemic, cachexic, anorexic, and was unable to walk without support. The patient was virtually bed ridden. After starting the alternative therapy marked improvement in the general health condition of the patient was noted. His appetite and strength improved and improvement in body weight was also recorded. Ultrasonography (USG) of abdomen done on in SGPGIMS showed 70 ml of organizing fluid in the pelvis; however, other parameters were normal. The clinical improvement of the patient was tremendous and within about 6 months of therapy he could begin his normal routine activities. His anti Koch’s therapy stopped in November 02. The patient continued the alternative therapy and abdominal CT scan done on (fig 1d) indicated a normal study except for cholelithiasis with choledocholithiasis. The HUMA therapy was stopped on 31 March The patient was monitored for the next 10 months with investigations done at regular intervals. USG done on revealed a normal study. Thereafter the patient did not suffer any adverse event. At present the patient is absolute stable and normal and completed over 5 years of event and relapse free survival. No acute or long term side effect of the alternative therapy is so far recorded. Case 9: Treatment of GI tract Cancer

A 22 years old girl presented with swelling on her right thigh with difficulty in walking in the clinic of Dr. Rakesh Kare, Moradabad on There was a history of right thigh injury 3 months earlier. Since injury her thigh swelling did not subside. X- ray of the knee with thigh was done, which indicated cortical destruction on the lateral margin of lower end of femur & soft tissue mass was seen adjacent to the femur, suggestive of either infection or neoplasm. FNAC done from the femur tissue mass were suggestive of sarcomatous lesion. The patient was advised surgery and / or chemotherapy & radiotherapy. However, the patient refused conventional therapy because of social & financial problem. She started HUMA therapy from August Gradually, some improvement was noted after 1 month of therapy. After 3 months of therapy the pain was gone & she was able to walk properly. She was absolute stable and normal after completing 1 year of therapy. X-ray done on revealed the presence of cortical lytic lesion at the lower end of femur. She was examined in Sanjay Gandhi Postgraduate Institute of Medical Sciences and King George Medical College and a fresh FNAC was done and the finds were suggestive of osteogenic sarcoma. She continued the therapy for another 6 months and discontinued it because of financial problems. In August 2004, seven months after stopping the therapy when she again came to the clinic, the swelling which subsided with the therapy had grown to a massive size. The alternative therapy was restarted. However, there was no response of the therapy. ADECB Figure : A & B – At presentation; C – X ray after 3 months; D – X ray after 1 year; E – 6 months after discontinuing of therapy Case 10: Treatment of osteogenic sarcoma