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Case Study

Cancer of Right Breast with Metastasis to Brain: A Palliation 
NATIONAL JOURNAL OF HOMOEOPATHY 2003 Nov / Dec VOL V NO 6.
Dr Ardeshir T Jagose
'Lyco

Introduction
I was called to see a 94 yr old patient at home on 8th October 2002, who was a known case of Cancer of Right Breast with Metastasis to the Brain. The history obtained from the daughter is as follows:-

Chief Complaint 
C/o of vomiting since 8th October 2002
ODP - 
Vomiting of brownish lumpy discharge which was worse from 5 pm to 7 pm. The patient felt better by vomiting. Whenever she used to vomit there was redness of the face. Vomiting is more after eating, after drinking water and in the evening. The patient felt better for some time after taking Tab Domstal.

Past History 
Tumour in the right breast since many years.
Family History 
A strong history of cancer in the family: the youngest son- Cancer of Thyroid Gland and the elder son- Cancer of Pancreas
Personal History
Appetite :
 Normal
Thirst : Decreased
Urine : Decreased output.
Stools : Constipation +3
Craving : Sweets +3, Fish +3, Vegetables +3 and hot food.
Aversion : Nothing particular
Perspiration : Decreased
Sleep : Sleeplessness. Can sleep only from 3:00 am to 7:00 am.
Dreams : Unremembered
Thermal : Chilly patient
Mentals : Very dominating +3, Fastidious +3,
Intelligent +3. Stubborn personality,
Religious. Optimistic. Bold +3. Great
Anxiety +3. Helpful nature.
Perfectionist.

Investigations
2/10/2002 Digital X-ray Chest PA View 
: Normal.
On 3/10/2002: Ltd Post-Contrast MRI Brain
: Large heterogeneously enhancing lesion in the right cerebellar hemisphere with mass effect on the adjacent cerebellar parenchyma, 4th ventricle and brainstem.

Sub ependymal enhancing nodules in lateral ventricles, largest lesion seen in sub-ependymal region of the body of left lateral ventricle and additional enhancing nodular lesion in the suprasellar cistern inseparable from the optic chiasma more so on the right and subtle lepto meningeal enhancement overlying both cerebral hemispheres.
Above imaging features are suggestive of metastasis.

On 3/10/2002 MRA Angiogram
 :
Reveals tourtuosity of the intracranial cerebral arteries without significant stenosis. No other significant vascular abnormality detected.
On Examination:
 Patient was weak, lying in bed. Pulse 60/min and tongue showed severe glossitis.

Remedy Selection 
The non repertorial approach was taken into consideration and Lycopodium was the drug of choice based on the following totality:
Obstinate +3
Dominant +3
Intelligent +3
Anticipatory Anxiety
Optimistic
Craving - Sweets +3, Fish +3 and Hot Food
Vomiting worse 5 to 7 pm
Right sided affections

Follow-Up

Lycopodium
 200 1 dose and placebo for 7 days. There was gradual improvement in the health of the patient-and vomiting reduced. The duration of action of Lycopodium lasted for 15 to 20 days. Hence every fortnight 1 dose of Lycopodium200  was repeated. Much relief.

Later, it was observed that the duration of action of Lycopodium lasted longer - ie when the susceptibility of the patient increased to an appreciable extent then the amelioration lasted for over a month. Hence repetition of Lycopodium reduced to 1/mth.

At present the patient is free from Tab Domstal which she used to take 3-4 times a day for vomiting

Conclusion
In this case, considering the advanced age of 94 years, the family was not very keen on any other treatment. Hence her health was neglected for long, as evident from the past history of tumour in the right breast since many years. It was only when the disease progressed to a level to become distressing; that the family members opted for investigations. But declined chemotherapy. When allopathic treatment failed to give relief for vomiting then only they opted for the homoeopathic line of treatment .

Hence in this case palliation was achieved, which reduced the suffering of the patient and also boosted the immune status of the patient.