CLINICAL CASES
CASE 1. Treatment optimization. Saving someones’ life.
31 years old man living in Greece (Doctor in Economics) diagnosed with a 2 cm glioblastoma multiforme (astrocytoma IV).
Summary: Result prior to our intervention:The patient had been sentenced to die by his own doctors. The family members had no medical criteria and did not know what should be done.
Summary: Final outcome following our intervention: We read the medical literature that had been published in recent years. Given the tumor location in the frontal lobe we suggested to get the best neurosurgeon in his city of residence. Then we suggested to travel to London and have radiotherapy there. Following the radiotherapeutic protocol, both the neurosurgeon and radiotherapist concluded that chemotherapy was not needed and strongly recommended the family to avoid it. The patient had been sentenced to die. At that time the best chemotherapeutic protocol was the one given in Houston. 17 years have gone by, and today the patient is a full professor of Economics, has had 2 children. The patient is cured.
CASE 2: Diagnostic error. Astrocytoma
9 years old kid. He is diagnosed as an astrocytoma type IV (a very malign tumor of the cerebral trunk). He is offered chemo and radiotherapy. 6-9 months to live. The parents are told that due to the location (tumor at the pons – tumor at the protuberance) of the tumor it is impossible to do any surgery. The parents of the kid get in touch with us. We review the case. We have doubts that the tumor is malign and could be in front of a case with a diagnostic mistake. We believe it could be an astrocytoma type I (benign) due to its perfect roundness shape. We block any possible treatment that they have been offered until we can discern between both diagnostic possibilities. In the meantime we calculate the world ranking on pediatric neuro-oncologists (best neurosurgeons / best doctors in the world). We make a Power Point presentation and send it to the top neuro-oncoloist in the world. 48 hours later we received 24 answers. All of them without exception confirmed our suspicion that the tumor is very likely to be a benign one. We calculated a world ranking on the best neurosurgeons (pediatric) that could access the tumor despite the difficulties due to the anatomical location that could offer us some warranties of success. We selected the best neurosurgeon in Paris (France). We were congratulated for having blocked any treatment with chemo and radiotherapy that would had made the surgery a non-viable option due to the fribrosing effects of radiotherapy. Surgery took place a few weeks later and our initial suspicion of a benign tumor was finally confirmed. As a collateral effect the kid became strabic (cross-eyed). 12 months later the kid got a simple strabic surgery.
Summary: Result prior to our intervention: The initial forecast was 6-9 months to live. With the recommended treatment the kid would had died 12-36 months later by the growth of the benign tumor. The treatment would had done nothing against the benign tumor and worst of all it would had banned any type of salvage surgery due to the fibrosing effects of radiotherapy.
Summary: Final outcome following our intervention: We uncovered a diagnostic mistake. The patient will have a normal life and will live a full natural life.
CASE 3: Anticipation of problems to come. Medical prevention. Strategic Plan.
Mother of a 14-year-old daughter with serious school problems. Diagnosed with attention deficit disorder (ADD).
Summary: Result prior to our intervention:The family did not know what was going on.
Summary: Final outcome following our intervention: We studied the documentation given to us. A 14 years old girl diagnosed with ADD that did not improve with a pharmacological approach. We met with the girl and her parents. We discovered a serious case of bullying, insecurity, shyness, obsessive-compulsive thinking and a serious socialization deficit. We suggested addressing some of the ADD problems with lateralization therapy. We suggest a visit with the best team on ADD in their area of residence. Most importantly, we suggested a mental evaluation by the best team of adolescent psychiatry specialized on psychotic disorders / and obsessive compulsive disorders.
CASE 4: Novel therapeutic avenues. Chordoma.
44 years old man diagnosed with a 5 cm chordoma of the coccyx (cancer in the lower part of the vertebral column). Symptoms of numbness, pain and hypercontinence (inability to urinate and evacuate). His doctors inform him that the only existing therapy is a radical surgery that will leave him incontinent, along with pelvic insensitivity. We do a very thorough medical literature search published in the last 5 years. We discover that there are alternatives to this radical surgery, such as chemo and radiation therapy. We take charge of the biopsy and demonstrate that he is positive for the c-kit gene. Therefore he is a candidate to use a new drug already approved for other tumors. He becomes the first Spanish patient to use this drug for this tumor.
The patient responds very well to the drug. At the same time we explore the possibility to do a specific and novel type of radiation therapy in Heidelberg (Germany), where it shows great effectiveness to eradicate this type of tumor. Following the aforementioned chemo and radiotherapy regimen the tumor shrinks dramatically. Then a surgery to remove the very small tumor is undertaken. 5 years go by and the patient is considered cured, is continent, is pain free, and his pelvic sensibility is restored.
Summary: Result prior to our intervention:The patient is only offered a radical surgery to his 5 cm chordoma tumor dooming him at 44 years old to pelvic insensitivity and incontinence for life. Survival rate: 25% at 5 years from the moment of the initial diagnosis.
Summary: Final outcome following our intervention: In contrast to what he is offered, we find therapeutic alternatives. We are able to demonstrate a mutation on his c-kit gene that puts him in a position to use a new design drug to which he responds magnificently together with a novel radiotherapy modality in Germany. His survival is now 95% at 5 years from the moment of the initial diagnosis. Once the tumor has shrunk over 90% of the tumor’s original size he got a spine surgery that removed his small 0.5 cm tumor. 5 years go by since he was diagnosed, and the patient is considered cured.
CASE 5: New information.
56-Year-old man with a diagnosis of tinnitus (a constant sound of a tearing one’s nail against a chalkboard). A biomedical / biotechnology philanthropist and investor.
Summary: Result prior to our intervention: Despite being a great reader on the subject he did not know who were doctors and scientists that knew most, and on what topics there were more growth and therefore more hope for his case.
Summary: Final outcome following our intervention: We studied all the biomedical literature published in the last 5 years on tinnitus. We calculated a world ranking on the physicians and scientists that knew most on the subject in question (best doctors, best surgeons in the world). We identified all the molecules, active principles, and drugs that have shown some efficacy. A study was produced with the trends in this field and a comparison with trends in related diseases. In this way we could point out a coherent research medical plan for the future.
CASE 6. New experimental drug with great response.
47-Year-old man diagnosed with an 8 cm thallamic brain tumor (glioblastoma multiforme – astroctoma IV). At the time of diagnosis he was incontinent, showed an obvious tremor, with cognitive deterioration and was on a wheelchair. He was given 6 months of live. He was offered the standard treatment; radiation therapy and temozolamide. We calculated a ranking on the best neurosurgeons in the world for brain tumors. We contacted the best neurosurgeons and requested their opinion with respect to a possible surgery. None of them could remove more than 80 % of the tumor. Therefore we rejected this kind of treatment. We calculated a ranking on the best neuro-oncologists in the world. In addition, we read and evaluated all the literature on this type of tumor. Following the published biomedical articles we took the patient’s biopsy and discovered in Madrid and in New Jersey (USA) that he was positive for the gene promoter MGMT. At that time one of the best neuro-oncologist in the world (Dr. Roger Stupp in Lausanne, Switzerland) had just demonstrated that patients with this MGMT positivity responded significantly to the experimental drug “Cilengitide”. We contacted the Swiss doctor. We took the patient to Lausanne. Together with the patient’s contacts/friends we got this miracle drug. The patient’s responded magnificently. At the same time, in a rehabilitation center of international fame, he recovered his cognition and took him off his wheelchair. In addition, his incontinences recovered. Thus the patient came back to his routine life prior to his diagnosis. The tumor shrank for 22 months to its minimum expression. Following the withdrawn of the drug the patient enjoyed his life fully. 6 months later the tumor relapsed (came back). A special type of radiotherapy together with chemotherapy was provided in Heidelberg (Germany). The patient died after 36 months from the time of diagnosis.
Summary: Result prior to our intervention: Initial prognosis for an advanced glioblastoma multiforme; 6 months of life.
Summary: Final outcome following our intervention: 36 months of life (most of which was with good quality).
CASE 7: Best possible treatment.
61 years old woman diagnosed with amyotrophic lateral sclerosis (ALS).
Summary: Result prior to our intervention: The patient was unaware on the possible treatments, state of the art on ALS, open clinical trials, and who / where are the physicians that know more on this disease.
Summary: Final outcome following our intervention: We studied the documents that the patient sent us. We searched for the medical advances on ALS, and a ranking on the top doctors in the world and Spain. Now the patient has the information that she wanted as well as who / where are the best specialists in the world in her disease.
CASE 8: Corrected therapeutic error. Diagnostic mistakes.
65 year-old man diagnosed with a pancreatic neuroendocrine tumor (PNET). The best surgeon in the patient’s country of origin on pancreatic tumors removes the patient’s tumor. Both the surgeon and his gastroenterologist decide that no additional treatment is needed. We refute this decision. We calculate the world physician rankings’ on PNETs. Following this search we decide to go a pay a visit to the top doctor in Europe. Given that the clinical evidence, together with the pathologist report and imaging it is proven that the PNET has metastasized (escaped the organ of origin). The best oncologist in the world on PNETs decides to give chemotherapy to the patient. Unlike Steve Jobs (he had the same kind of tumor), the patient will probably live a full life.
Summary: Result prior to our intervention: His doctors discarded the possibility that the PNET had metastasized (has escaped the tumor’s organ of origin). As in the case of Steve Jobs the tumor would had invaded the liver and the patient would had most likely died in a few months/years.
Summary: Final outcome following our intervention: We confirmed that the PNET had mestastatized. The patient is prescribed chemotherapy. The patient will live a normal life until his natural death. Prognosis 93% survival at 5 years.
CASE 9: Prevention
42 years old woman diagnosed when she was a child with a severe scoliosis. At a young age she had surgery to correct it. At the time she contacts us she has 2 sons (14 and 12 years old) with clear scoliosis with a tendency to worsen.
Summary: Result prior to our intervention: She was unaware of the on the latest advances on corsets and surgical techniques to overturn scoliosis.
Summary: Final outcome following our intervention: We screened and studied the medical literature published in the last 10 years on scoliosis. We read all the information on the most innovative corsets and their differences. Proposed a brace that was likely to fit the kids needs. Were got in touch with the medical orthopedic department in Canada that were the inventors of such a corset. We enquired about their corset. We did a brief study on the latest and most innovative surgical techniques and identified who were the top surgeons that new most on scoliosis.
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