Ricardo F. (Rio de Janeiro, Brazil)
DSRCT Diagnosed 7/03 at age 22
1. August 2003 1st surgery at Memorial Sloan-Kettering Cancer Center (MSKCC), with partial removal of the tumors in the lower abdominal area and diagnose of DSRCT;
2. September 2003 to March 2004 6 cycles 28-day apart of Doxorubicin HCI 75 mg/m2 IV push (reduced to 67.5 mg/m2 on the fourth cycle) + Cyclophosphamide 2000 mg/m2 IVPB / IV intermittent (reduced to 1800 mg/m2 on the fourth cycle) + Vincristine Sulfate 2 mg flat dose IV push at MSKCC; side-effect of neutropenia in every cycle, one time requiring hospitalization for febrile infection; after last cycle Muga scan showed calculated LVEF of 56% but significantly diminished from the prior value of 65%;
3. March 2004 2nd surgery at MSKCC with total removal of visible tumors in the abdominal and pelvic area;
4. April to September 2004 6 cycles of Etoposide (125 mg/m2 IVPB / IV intermittent) + Ifosfamide (2500 mg/m2 IVPB / IV intermittent) for 4 consecutive days out of 28 days at MSKCC ;
5. April 2005 3rd surgery at Mount Sinai Hospital, NY, with total removal of visible tumors at the pelvis, lower intestines and colon;
6. June 2005 to October 2006 - Continuous treatment with Rapamycin 5.5 mg/day + anti-testosterone (Lupron 7.5 monthly + Casodex 50 mg/day) + Curcumin (6 g/day);
7. November 2005 - Increase in VEGF blood levels resulted in addition of Xeloda (5FU) at 2500 mg/m2/day and dropping of Lupron + Casodex; kept Rapamycin and Curcumin unchanged;
8. December 2005 Intermittent diarrhea caused serious lower intestines infection and hospitalization;
9. February 2006 - small surgery to take out abscess 5 cm from rectum; dropped Xeloda and returned to Lupron + Casodex; kept Rapamycin and Curcumin unchanged; kept cocktail until June 2006.
10. July 2006 - 4th surgery at Mount Sinai Hospital, which removed all visible tumors of the right and left pelvis, diaphragm and liver; 3 weeks later 5th surgery at Hospital Copa d'Or, Rio de Janeiro which removed nodules at the left superior lobe;
11. August 2006 - Started new treatment with Temozolomide (Temodar)150 mg m2/day oral one hour before Irinotecan (Camptosar) 50 mg/m2 IV for 60 min for 5 consecutive days out of 28 days;
12. October 2006 Restarted Rapamycin (Rapamune) at 2 mg/day gradually increased to 4 mg/day + Curcumin + Neuromin (golden algae);
13. February 2007 Intermittent diarrhea caused reduction of Rapamycin to 2 mg/day and temporary stop of Curcumin;
14. April 2007 - Added Sutent to the cocktail, initially at very low dose of 12.5 mg/day to check toxicity.
15. April 2007 PET and MRI scans are still negative. Blood exams, blood pressure and electrocardiogram are unremarkable. Ricardo is feeling well and in excellent mood. The only side effect is diarrhea caused by Irinotecan controlled by Dr. Takeda's alkalization treatment developed in Japan.
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