Cellular Cancer Therapy, part 7

CANCER OF THE FAUCES [throat]

    Buccopharynx, hypopharynx and larynx. Due to the fact that the epithelium of the fauces is the same as the epithelium of the mouth, there are many similarities between the basic data about cancers of both.

    The most important form of cancer of the fauces is the carcinoma of the vocal chords. A small tumoral growth on one of the chords causes hoarseness, grows slowly and in 1—2 years fixes the chord to the side of the larynx by invading the cartilage, musculature, and anterior commissure. Hoarseness worsens and the tumor spreads to the other chord, producing stridor and finally dyspnea by obstruction, This should be treated immediately with Donatian Therapy; if there are no results within 2 hours, then a tracheotomy should be performed to prevent asphyxiation.

    Tumors of the salivary glands: The malignant and benign tumors of the salivary glands make up 1% of all cancers, appearing equally in men and women.

Pathology. The tumors originate in the parotid gland 10 times more frequently than in the submaxillary glands. The salivary glands can develop 4 different kinds of benign neoplasias: mixed benign tumors, Warthin tumors (generally in men), Codwin’s benign lymphoepithelial lesion, and oxyphilous adenoma.

The most common error is in confusing a simple sebaceous cyst near the ear with a carcinoma.

Treatment. Donatian Therapy.

NECK TUMORS: If the patient is an adult, any tumoral mass in the neck, if it is not of the thyroids or salivary glands, will most probably be a metastasization of a cancer from another part of the body. Lymphomas are almost the only primary tumors of the neck. Treatment can be carried out with Donatian therapy.

CANCER OF THE SINUSES: Epidermoid carcinomas predominate and originate from squamous metaplasia of the columna mucous epithelium of the respiratory system. These tumors are rare and the only factor that could lead to a predisposition for them seems to be chronic purulent sinusitis.

Prognosis. Not very good; once discovered, there is little that can be done.

CANCER OF THE THYROID: A rare tumor, making up less than 1% of all cancers. It is twice as common in women as in men.

Pathology. One can best understand thyroid carcinomas in relation to the difference between differentiated and non-differentiated cancers.

Here is Warren and Meissner’s classification:

1. Thyroid carcinoma: 80% differentiated,
   
   
2. Papillary: the most common, 50-60%, the least malignant.
   
   
3. Thyroid carcinoma of the Hurtle cells
   
   
4. Undifferentiated:

a.  Carcinoma of small cells (simple or solid adenocarcinoma):  develops rapidly and is intensely invasive.

b.  Carcinoma of giant and fusiform cells: rare, very rapid development, invariably mortal.

Diagnosis and Treatment.  Use the Oncodiagnosticator and Donatian Therapy.

CARCINOMA OF THE MAMMARY GLANDS [breast cancer]

    This is the most frequent kind of cancer in women--it makes up 22% and occurs occasionally in men: one case in men for every 100 cases in women.

Cause.  Intra- and extracellular biophysicochemical alterations.

Pathology.  Benign tumors and mammary nodes have the same appearance as the initial mammary carcinoma. Seven diseases deserve attention:

1. Fibrocystic Mastopathy

2. Fibroadenoma

3. Sclerosing adenosis

4. Periductal Mastitis

5. Fat necrosis

6. Eczema of the nipple

    Occasionally a reddish-blue inflammatory carcinoma occurs on the skin of the mammary gland, which is hot to the touch. This kind of rapid development, invariably causes death within 1 or 2 years in spite of any known treatment. We have, however, observed that with the use of Donatian Therapy some improvement can be achieved and even a prolongation of the patient’s life. Because of its prognosis, it should be carefully distinguished from the reddening of’ the skin that accompanies many large carcinomas that are much less aggressive. This cancer invades the skin of the nipple and the areola with such speed that the primary tumor has not yet developed a palpable node.

    Paget’s disease of the nipple: This is an infiltrating cancer of the mammary ducts. It begins in a duct near the nipple and Invades the skin of the nipple and the areola. The intraductal carcinoma is considered in general to be a non—metastasizing carcinoma that reaches a large size and may ulcerate. The racemose malignant cytosarcoma and the malignant giant fibroadenoma rarely metastasize to the lymph nodes.

    The majority of the infiltrating intraductal carcinomas invade the tissue of the mammary gland, fat, skin and aponeurosis, and cause a wide range of fibrous reactions and lymphatic obstruction which explains the classic signs of a mammary carcinoma. Subareolar carcinomas and those of the medial quadrant travel towards the intercostal space more quickly than to the axilla; sometimes they travel directly to the infraclavicular lymph nodes.

Diagnosis.  Antecedents, clinical history and very detailed physical exploration, quadrant by quadrant, are necessary for diagnosis. Occasionally there might be a secretion from the nipple which will be serosanguineous, beige, or purulent. Very often this secretion is produced by a benign intraductal papilloma. The node is the symptom and sign that accompanies this form of cancer. Earlier signs that can be discovered are some reddening of the skin, dilated blood vessels, elevation of the nipple, or formation of cutaneous depressions around the nipple, which will have the appearance of an orange peel. Both breasts should be palpated with the patient sitting and lying down.

    The use of the Oncodiagnosticator is very helpful to: decide about the changes that are not felt as nodes; decide why there are areas that cannot be palpated; find and define the suspicious changes; clarify why when the breasts are very voluminous they are difficult to palpate carefully; avoid the use of mammography, which in recent studies has been shown to cause cancer in women.

Differential Diagnosis.    Confronted with the choice of whether or not to perform a biopsy, the characteristics of the seven classes of benign lesions of the mammary glands will be of some use:

1. Fibrocystic Mastopathy. A common mixed lesion made up of obstruction of the duct, multiple cysts, solid fibrous areas, and possibly epithelial, Intraductal proliferation. There are three types: the diffused type, characterized by multiple palpable nodes; the large cyst type, which appears between 40 and 50 years of age, is often bilateral, multiple and may contain a light yellow or greenish cloudy liquid; and the localized type, which is an asymptomatic thickening of the skin.
   
   
2. Fibroadenoma, Appears between 15 and 30 years of age. Small, sometimes multiple nodes. If it grows quickly, it can be diagnosed as a benign racemous cytosarcoma.
   
   
3. Sclerosing adenosis. Hard, unilateral, ill-defined node which causes minimal symptoms or provokes no signs. This has been confused with cancer in histological examinations.
   
   
4. Periductal mastitis. Originates with the erosion and perforation of a major subareolar duct, which produces the most common type of inflammatory reaction in women who are not breast feeding. The secondary infection, with formation of fistulous and abscessed paths, causes the classical inversion of the nipple.
   
   
5. Fat necrosis. This develops from some lesion and from the contents of some obstructed duct in the interior of the surrounding fat. This often causes adherence of the skin and depressions.
   
   
6. Papillomatosis and intraductal papilloma. These often occur together between 30 and 50 years of age. There is a yellowish or sanguinous secretion from the nipple. Papillomatosis can be considered as a premalignant change.

Treatment.  We have used Donatian Therapy in 50 cases where the patients were at the various stages of the International Mammary Carcinoma classification, wIth a 40% rate of cure.

PULMONARY CARCINOMA [lung cancer]

    This type of carcinoma is frequent and makes up 10% of all malignant neoplasias. The most common of all carcinomas in men, it causes 15-16% of deaths in men and 3% of deaths of women or five times as many men affected as women.

Cause. Smoking is a direct or indirect factor, when there already is cancer-susceptible terrain,

Pathology: The classification of pulmonary cancer has been very chaotic, but we group them into the following four categories:

Squamocellular or epidermoid carcinoma 50-60%

Anaplastic 15-20%

Adenocarcinoma 10—20%

Carcinoma of ducted cells 10—15%

Carcinoma of alveolar cells 3—5%

Diagnosis.  Use the Oncodiagnosticator, detailed case history, x-rays, cytology, bronchoscopy. In x—rays one can observe the classic coin—shaped lesion, in general at the pulmonary vertices, unilaterally and very round.

Differential Diagnosis.  Care should be taken to differentiate pulmonary cancer from an apical pulmonary abscess and sometimes from nummular cavitated tuberculous lesions.

Treatment and Prognosis.   We use Donatian Therapy, with a 33% rate of cure.

CANCER OF THE ESOPHAGUS

    An organ like the esophagus that only conducts food along its length, and is linked with squamous stratified epithelial tissue, should develop cancer in much the same way and of the same kinds as those observable in the mouth and throat, and this is what actually happens.

Frequency. Cancer of the esophagus makes up 2% of all cancer and is four times more frequent in women.

Cause.   Intra and extracellular biophysicochemical imbalance.

Pathology.   Almost all of the carcinomas of the esophagus are of squamous or epidermoid cells. In the inferior third, possibly due to the presence of HCl, tumoral masses ulcerate, infiltrate, and proliferate.

Diagnosis.  Clinically, any dysphagia or painful swallowing that lasts for more than a month should be considered to be a carcinoma of the esophagus until proved to be the opposite (Farber’s rule).

    X-rays and esophagoscopy provide 95% of diagnoses. We use the Oncodiagnosticator, which with experience can yield 95% certainty. Cytological examinations in experienced hands can yield 90% certainty. Cytology coupled with esophagoscopy yields a proportion of 98.5% correct diagnoses.

Differential Diagnosis.   The situation is frightening since nine out of ten esophageal lesions are carcinomatose. The other 10% are due to:

Acalasia. Produces similar symptoms, dysphagia and occasionally painful swallowing.

Cysts. Bronchial or duplications of the esophagus.

Benign tumors. They are rare, and originate in the muscular wall of the esophagus, and are mainly leiomyomas which can be polyploid. Benign fibrovascular polyps can also appear but are very rare.

Diverticuli, These are localized in the hypopharynx or in the middle of the esophagus. They are certainly distinguishable in barium x-rays since they absorb it very readily.

Post-traumatic stenosis. Signs similar to those of the carcinoma may appear, but a previous history of ingestion of acid or alkaline solutions helps to clear up these disturbances.

Common errors that lead to earlier death in patients with carcinoma of the esophagus:

1. Failure to use the Oncodiagnosticator.

2. Lack of experience and care with esophagoscopy can cause perforation of this organ, since the carcinoma has destroyed the esophageal wall. This is why we recommend the Oncodiagnosticator.

Prognosis.   Prognosis is usually poor, since the majority of esophageal carcinomas develop in the middle of the esophagus near the trachea, major bronchi and the aorta. The mortality rate is 100%. 10-20% of those with the carcinoma located in the neck survive 5 years, 20-30% of those with the carcinoma located in the inferior part of the esophagus will be alive 5 years later.

    Donatian therapy can prolong the life expectancies of many patients several months or years without any of the signs or symptoms which make the patient with esophageal carcinoma invalid. We have even achieved cases of cures.

CARCINOMA OF THE STOMACH

Frequency.   4-5% of all cancers are of the stomach, and they appear twice as often in men as in women.

Pathology.   95% of the cancers of the stomach are adenocarcinomas. Some are well differentiated, but the majority are non—differentiated or anaplastic. Borman’s classification is still the best as it corresponds best to the various prognoses:

1. Disseminating superficial carcinoma

2. Ulcerating infiltrating carcinoma

3. polyploid

4. Diffuse (plastic linitis)

The remaining 5% of the malignant tumors of the stomach are: lymphomas (except for Hodgkin’s disease). Leiomyomas and leiomyosarcomas are muscular tumors that develop slowly and silently, reaching large sizes, ulcerating centrally and may bleed profusely, though their prognosis is good.

Treatment:    Donatian therapy.

CANCER OF THE SMALL INTESTINE

The small intestine makes up 85% of the mucous membrane of the digestive system, but curiously only develops 3% of all of the neoplasias of that system.

Pathology.   With the increase in the differentiation of the function of normal cells, the range of tumors to which they are susceptible also increases. The small intestine, an organ of prodigious secretion and absorption, shows 4 types of cancer:

1. Adenocarcinoma. This makes up 50% of the cancers of the small intestine. Some adenocarcinomas can develop in the jejunum and very few develop in the ileum, In general they constrict and obstruct the small intestine and metastasize to the mesentery lymph nodes, penetrating the intestinal wall to affect the neighboring organs. They can metastasize to the liver by embolization through the portal vein.

2. Carcinoid tumors. These make up 15% and consist of a group of malignant, often multiple, neoplasias that originate in Kultschisky’s argentaffine cells in the mucous membrane. These yellow submucous growths can produce seratonin and occur very often in the appendix and occasionally in the ileum. They grow very slowly and metastasize to the lymph nodes, in some cases producing symptoms only years after their development. One out of ten produce a carcinoid syndrome, due to the abundant metastasis of hepatic carcinomatose cells. Histologically, similar tumors originate in the bronchi, pancreas, testicles and ovaries.

3. Leiomyosarcomas. These make up 10% of this group. They appear in all three segments of the small intestine and in general bleed abundantly, rarely metastasize, grow slowly and when they metastasize go to the liver and lungs.

4. Lymphomas. Make up 15% of this group, and as is the case in the stomach, both the lymphocytary lymphoma and the reticular cell sarcoma can appear.

Diagnosis.    Barium x-rays provide more definite information than any other diagnostic procedure. The technique is very efficient in the duodenum, but less so in the jejunum and ileum. The injection of barium through a Cantor or Rehfuss catheter to the point of obstruction will yield a clearer outline of the tumoral mass,  Biopsy. Yields good results only when done with a laparotomy.

Differential Diagnosis.   This is a problem since almost any disturbance of the abdominal organs that causes acute or chronic obstruction of the intestines or bile system, bleeding or pain, should be considered in the differentiation of the tumors of the small intestine. Metastases to the small intestine in general come from melanomas

Common errors.   Many surgeons, when faced with a carcinoid tumor, do not remember its slow and painless growth. They often pass over a careful dissection and the complete extinction of the tumor, which could mean palliation, though it might not mean that a cure has been achieved.

Prognosis.   Approximately 20% survive 5 years, though this occurs in patients whose adenocarcinomas have not yet metastasized.   Prognosis betters considerably with other, less common varieties affecting the small intestine. In carcinoid tumors 50% survive 5 years; cases of lymphomas survive 5 years 40% of the time, with leiomyosarcomas 50% survive 5 years. Using Donatian therapy we have achieved a 37.5% rate of cure.

CANCER OF THE PANCREAS

Frequency.   These make up 1-2% of all cancers.

Pathology.   Pancreatic tumors develop from two main types of cells: those lining the ducts (alpha cells) and the beta cells from the Isles of Langerhans. 90% of these tumors are adenocarcinomas of the duct cells, and become cirrhotic.

    Tumors of the beta cells of the Isles of Langerhans (insulinomas) cause episodes of clinical hypoglycemia. The tumor that produces the Zollinger—Ellison ulcerogenous syndrome only affects cells that are not beta and secretes a substance similar to gastrin. This hormone can produce a sudden peptic ulcer due to a hyperstimulation of the gastric hypersecretion. The obstruction of the choledocus by a carcinoma causes a swollen dark green liver with dilated bile ducts, fibrosis, and a gall bladder with thick dark bile. The same changes occur when the tumors of the periampullar duoendum or that of the Ampulla of Vater obstruct the bile ducts.

    Carcinomas of the body and the tail of the pancreas can grow until reaching a considerable size without characteristic symptoms; there are no visible vital structures near the tumoral invasion. These tumors fuse with the vertebrae, obstruct the splenic ducts and the mesentery veins with repeated thromboses or splenic infarct, and invade the solar plexus causing incurable pain.

Prognosis.   Prognosis is usually grave, except in the case of insulinomas and ulcerogenous tumors.

Differential Diagnosis.   Glucosuria and hyperglycemia can indicate diabetes caused by the destruction of the pancreas by a tumor, while the presence of hypoglycemia and a typical response curve to tolbutamide can indicate an insulinoma.

CANCER OF THE BILE SYSTEM AND LIVER

    Though a certain amount of selective absorption occurs in the gall bladder, the extrahepatic system basically serves to conduct bile to the intestine.

Frequency and Distribution. Cancers of the bile system are 5 times more frequent than those of the liver. Together they constitute 1% of all cancers,

Pathology.   

    Bile system. Cancer of the gall bladder is generally an adenocarcinoma, with calculi present in the neck of the organ. The common cirrhotic type hardens the gall bladder and invades the liver from an initial stage, but the papillar and mucinous types form a large intraluminal mass that develops slowly and later becomes infected. The epidermoid cancers also appear occasionally. Direct development in adjacent areas of the stomach, colon, duodenum and liver frequently occur and half of the patients have affected periportal or peripancreatic lymph nodes.

    Liver.   Hepatomas are often characterized by a lone tumoral mass with small satellite nodes, though a diffused type with multiple smaller nodes can frequently develop with cirrhosis. Gall found liver cancers to be frequently present with postnecrotic cirrhosis (20%), than with posthepatic cirrhosis, but rarely with nutritional cirrhosis. One out of 10 patients with hemochromatosis of the liver show hepatomas.

Diagnosis.   Detailed physical exploration and a very meticulous case history often make the physician think of the possibility of this disease. Obstructive jaundice can occur from the beginning with small tumors of the common bile duct or the area near the Ampulla of Vater.

Use of the Oncodiagnosticator is 95% effective in these cases. The use of centelleografia (???) with Bengala pink and I-131 can lead to almost 80% precision in finding defects in the hepatic parenchyma produced by tumors. Biopsy of the liver done with a Menghini needle shows any kind of tumor, though not always is it possible to identify it precisely with histological methods.

Determining the level of alkaline phosphatase is an accurate method for diagnosing hepatomas or tumors of the biliary system. If the level of alkaline phosphatase (normal: 80-100 IU/ml exceeds 500 IU it is very suggestive of a hepatoma; if it goes beyond 1000 IU it is almost certain that there is a tumor of the liver or the bile system. This determination is done together with the use of the Oncodiagnosticator.

Treatment:   We use Donatian therapy.

CANCER OF THE COLON AND RECTUM

    For an understanding of neoplasias, it is misleading to separate the colon from the rectum. The colorectal mucous membrane is more or less uniform and has relatively simple functions, such as the absorption of liquids and electrolytes, assisting in passing the feces and the secretion of mucus.

Frequency and Distribution.   Colorectal adenocarcinoma is the most common visceral cancer, when both sexes are considered together.

Pathology.   Adenocarcinomas are distributed in the colorectum as follows:

Rectum 50%

Sigmoid flexure 20%

Descending colon 7%

Ascending colon 16%

Transverse colon 7%

    Dissemination occurs by direct extension to the neighboring organs, lymphatic embolization towards the lymph nodes in an orderly progression through the veins, metastasizing in the liver or the lungs.

    Differently from many other cancers, size is not related to the frequency of metastasis in the lymph nodes. Many of the well-differentiated tumors can grow to a large size without metastasizing. The majority of the tumoral emboli transported by the blood flow into the inferior and medial hemorrhoidal veins.

A simple and popular classification based on the degree of invasion and lymphatic dissemination is that of Duke:

Duke A: Only the muscle cover is affected.

Duke B: The adenocarcinoma has reached all of the layers of the intestinal wall.

Duke C: There are metastasizing lymph nodes.

    Ackerman and del Regato, Spratt et al., Castleman and Krickstein, Welsh and Butler and Tuller-Haller have shown that the small common adenomatous polyps that develop in isolation or in groups of 2 or 3 are potentially malignant lesions that may or may not become adenocarcinomas depending on the integrity of the patient’s immunological system.

Diagnosis     The following slight symptoms initiate the clinical phase of colorectal cancer: any change in the pattern of defecation, traces of blood that can be attributed to hemorrhoids or constipation, excessive production of gases, or slight episodes of diarrhea.

    Digital anorectal exploration, with the patient in a squatting position is enough to discover half of the colorectal cancers and almost all of the rectal neoplasias.

    Sigmoidoscopy and Biopsy. These procedures are easily carried out in the doctor’s office. Sigmoidoscopy is used to explore the whole rectum and the sigmoid flexure; it can bring to light another 25% of the colorectal cancers.

    Enemas with silicone foam have also proved to be very useful In diagnosis. Silicone foam is injected in liquid form through an enema; when it solidifies it forms a solid mold of the interior of the rectosigmoid and after being expelled can be studied for tumoral depressions and tumoral cells that have stuck to it. We use the Oncodiagnosticator first, and, if necessary, the other procedures to better localize the tumor.

Differential Diagnosis.   Several abdominal diseases are similar to colorectal cancer and perhaps diverticulitis causes more problems than any other. Ovarian and uterine tumors may appear, upon palpation by bimanual exploration, to be a rectosigmoid cancer. A barium enema will clear up the doubt.

    In the straight colon the signs and symptoms of cancer are vague. Appendicitis in the elderly, cholecystitis, ovarian cysts, intussusception, obstruction of the small intestine, local ileitis, and local ulcerative colitis can simulate cancer and require appropriate x-ray studies to distinguish among them.

Treatment:   We have registered a 25%   [ 75%??? mistaken transcription??? ]   rate of cure. In the best cancer clinics in the world, the rate is only 35-40%.

CANCER OF THE CERVIX

    The vaginal portion of the cervix possesses a squamous epithelium that abruptly changes in the external orifice to the columnar type. This columnar type lines the crypts and irregularities of the endocervix and produces mucous. However, both kinds of epithelium develop a more or less uniform type of tumor; the situation, therefore, is similar to that found in the buco—pharyngeal area.

Frequency and Distribution. Carcinomas of the cervix comprise 7% of cancers found in women. The only kinds that are even more common are breast cancer, colorectal cancer, and carcinomas of the skin.

Pathology.    Epidermoid carcinomas that are moderately differentiated make up the majority of the cancers of the cervix. Squamous metaplasia or epidermization of the columnar epithelium of the cervical conduit explains the occurrence of this type of tumor in the endocervix.

    Adenocarcinomas comprise only 5% of all the cervical cancers; they show an irregular glandular pattern and produce mucin.

    The majority of the cervical carcinomas originate at the juncture of the squamous epithelium with the columnar in the external orifice. Some cancers originate in the orifice of the vagina, and some (10%) in the endocervix.

    The squamocellular carcinoma as well as the epidermoid can appear with three different macroscopic manifestations:

a) exophytic growth that expands in the interior of the vagina and that only infiltrates slightly, in the beginning;

b) a nodular infiltrating variety that. characterizes other carcinomas and that begins in the endocervix and stays hidden for a certain amount of time; as well, as

c) the common ulcerating tumor which destroys the cervix and leaves a cavity.

    Carcinoma in situ: Jeffcoate found that 4 out of every 1000 women have in situ cancers, and that 30-80% evolve into an invasive cancer.

Diagnosis.    Symptoms of vaginal bleeding (intermittent or continuous), profuse purulent secretion with a characteristic fetid odor and pain in the lower back practically affirm the presence of the disease. Dr. Herbert K. Brehm, professor of gynecology, was said to be able to diagnose carcinoma of the cervix by simply smelling the patient's vaginal secretions, and this is true.

    Schiller’s test has been abandoned by most gynecologists and oncologists as yielding doubtful, erratic results.

    Brehm’s technique is as follows:

    Wash, with an iodo—iodorate Lugol solution of 10% in distilled water, the whole area of the cervix. Normally the epithelium of the cervix contains a great deal of glucogen which reacts with the iodine and takes on a carob—magenta color. The malignant epithelium, because of its excessive metabolism, has already transformed all of its glucogen and therefore does not combine with the iodine and does not take on the color described above. Biopsy can be used to corroborate this diagnosis.

Differential Diagnosis.    We only use the Oncodiagnosticator.

Chronic cervicitis. This is also similar to cervical cancer, but has a fibrotic character, with a hypertrophic cervix and chronic inflammation.

Cervical polyps. In general these are present in the external orifice and are penduncular, clearly delineated and are often found ulcerating.

Cervical endometriosis. The implantation of fragments of endometrium in the cervix can provoke a submucal lesion with persistent metrorrhagia.

Cancer of the uterus. If it extends to the cervix, necessitates biopsy and fractional scoring of the membrane.

Treatment.    Cervical carcinomas should never be interfered with surgically. We use cyto-ovular cauterization (?) and Donatian Therapy, with the following results:

part 8