I received an e-mail request for an update on my almost 82 year old father suffering from advanced stage NSCLS who has been receiving IPT (insulin potentiation therapy). Significant improvement was observed through 1/15/04 after the completion of the first three week cycle of IPT on December 23. Supplemental oxygen was down to 2.5 liters from 5 liters upon release from hospital in early December. January 15 was the zenith of improvement since diagnosis in late November. IPT did not resume until 1/15/04 due to unexpected myelosuppression (probably from the unusual "quad" mix of chemo agents) and time to recover.
When the second three week cycle of IPT began on 1/15/04, breathing difficulties were immediately noticed especially during the day of and the two days after administration of IPT using the same mix as in late December. Paclitaxel was deleted from the mix and appears to have been the prime suspect for the apparent breathlessness side effect. However, the overall trend of health, which peaked at 1/15/04, was gradually but noticeably downward through early March. Breathing continued to worsen to the point that at times home oxygen concentrator and portable unit were both used to supply 8 liters of oxygen until breathlessness eased.
Recognizing that the IPT appeared to be losing its initial effectiveness, in early March the mix of IPT chemo agents was again altered, this time to a doublet of Cisplatin and Hycamtin (apparently more typically used for SCLC), and there was added daily intramuscular injections of the experimental drug Anvirzel. Also, the frequency of IPT was reduced from twice per week to weekly. These changes have reversed the downtrend and father's health improved significantly between March 9 and March 16 and now appears to have stabilized. Supplemental oxygen is at 4-5 liters, not as good as at 1/15/04, but better than during the February decline from which partial recovery has been made. Still very mentally alert and in no pain. Gross right arm swelling present during November hospitalization and through mid-December has not returned, suggesting that the size of the main tumor was successfully attacked to some degree without radiation by the IPT and that the tumor remains smaller than at time of diagnosis. Father has been able to attend monthly Board of Director meetings and participate actively from his wheelchair (muscle atrophy has occurred during the course of the illness such that he has become less ambulatory) accompanied by his portable oxygen unit. We're hoping that the IPT coupled with Anvirzel and Celebrex as a COX-2 inhibitor will continue to keep the cancer from progressing. Two attempts in late December and mid January to objectively remeasure the main tumor mass by CT scan failed first due to fluid build-up in the linings of the lung and then failure of the lung tissue to rebound after thoracentesis was performed. Thoracentesis is performed as necessary to control the fluid build-up. The most recent interval between thoracenteses lengthened somewhat to 3.5 weeks. We have not yet attempted another CT scan. PET scan performed in January shows cancer still active in lungs but no apparent metastasis to other organs (brain not checked by that PET scan).
Overall conclusion: Presently better than during November hospitalization or initial home care during early and mid-December. Family’s unanimous feeling is that without IPT he likely would have died by 12/31/03 based upon very bad and rapidly worsening condition from late November to mid December. Presently not in as good a condition as at January 15 but condition appears stable after partial recovery from the late January-February downturn.