Gastric Cancer Case Studies

Title: The Management Of Double Neoplasms: A Case Of A Patient With Small Cell Lung And Gastric Cancer Successfully Treated With Chemotherapy

Authors

David Rossi Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Paolo Alessandroni Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Stefano Luzi Fedeli Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Anna Fedeli Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Paolo Giordani Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Vincenzo Catalano Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Anna Maria Balzelli Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
V. Casadei Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy
Giuseppina Catalano Medical Oncology Unit, S. Salvatore Hospital Pesaro Italy

Abstract

Case report involving a patient with double synchronous neoplasm, small cell lung and gastric cancer, successfully treated with chemotherapy. The cancers responded well to the treatment of chemotherapy, with partial remission of the gastric cancer and complete remission of the lung cancer.

Patient Characteristics

  • Demographic Information: 68yo Male
  • Medical diagnosis if applicable: Double synchronous neoplasm, small cell lung (limited disease) and gastric cancer (cT1)
  • Co-morbidities: Good physical condition
  • Previous care or treatment: None noted

Examination

  • Subjective: Severe pain and claudication in legs
  • Self Report Outcome Measures: No specific outcome measures reported
  • Physical Performance Measures: Good performance status (ECOG=0)
  • Objective : Stenosis of right superficial femoral artery for about 20 centimeters and another stenosis of left femoral artery for about 3 centimeters.  Also, a gastroscopy showed a suspected gastric cancer, confirmed by biopsy with histological diagnosis of ADENOCARCINOMA (T1). Finally, a CT-scan documented a mediastinal enlargement comparable with primary lung cancer (the mass was 14 x 10 x 8 cm); bronchoscopy with cytological sample confirmed diagnosis of SMALL CELL LUNG CANCER.

Clinical Impression

Summarization of Examination Findings

It was the patient’s first time in the oncology unit, and his physical examination was unremarkable. After he was given a gastroscopy, it was suspected he had gastric cancer (confirmed by biopsy). The patient was also given a CT scan which found lung cancer (confired through bronchoscopy).

Intervention

  • Dosage and Parameters: Three cycles of chemotherapy with CAV-E schedule (ciclophosphamide 750 mg/mq i.v on day 1; Adriamicyn 50 mg/mq i.v on day 1; Vincristine 1,5 mg/mq on day 1; Etoposide 100 mg/mq on day 1, 2, 3 every 4 weeks)
  • Rationale for Progression: Based off pt. response to initial treatment It was decided to go on o with another 2 cycles and consolidation radiotherapy on the chest (unknown dosage) was performed
  • Co-interventions if applicable (e.g. injection therapy, medications): Radiotherapy on brain after cancer metastasized

Outcomes

Treatment led to complete remission of lung cancer and partial remission of gastric cancer, however cancer did metastasize to the brain and the pt. rapidly regressed and died.

Discussion

This case could show the optimal treatment for pt’s with double neoplasms. While the pt’s ultimate outcome was death, the purpose of the case study was to show the effects of this particular chemotherapy treatment cycle, which showed significant improvement in the pt’s original dx. The downfall to this study was it did not recognize any outcome measures, and it failed to measure the pt’s quality of life throughout their treatment regimen.

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