Spontaneous Resolution of Multiple Bladder Neoplasms

Abstract

This paper is a brief clinical report of the apparently successful treatment by insulin coma of malignant growths in two patients: a woman of 53 with metastasized adenocarcinoma of the cervix, and a woman of 62 with metastasized melanoma of the left leg. Both diagnoses were confirmed by tissue examination; and, in the case of the adenocarcinoma, biopsy confirmed the disappearance, after treatment, of the cervical malignancy and its replacement by normal cells. The author originally treated both patients for depressions, following unsuccessful operation for malignancy in the first case and the diagnosis of malignancy in the second. In both cases, there was remission of the mental, as well as of the cancer, symptoms. The material presented here tends to show: (1) that the enzymes of malignant cells may be considered the key point in the problem of malignancy, and (2) that these enzymes can be inactivated by an increased concentration of oxygen, with the consequent destruction of malignant tissues. The amount of clinical material presented is insignificant, but the results may warrant fullscale research in this field along clinical and biochemical lines.

Case Details

Personal Characteristics

The patient, a retired builders labourer, presented in january 1977 with haematuria of a painful and profuse nature. He had previously enjoyed good health.

Clinical Characteristics

The investigations showed blood urea 6.2 mmoles/ l, haemoglobin 9.0 grams and packed cell volume 29.6 liters. Cytological examination of the urine showed numerous atypical transitional cells. Intravenous urography showed normal functioning, non-obstructed kidneys, but evidence of extensive neoplastic involvement of the bladder, particularly in its lower half.

Remission Characteristics

At cystoscopy the bladder was entirely free of neoplasia and of normal capacity, with no evidence of residual scarring or deformity. There were, however, three small papillary lesions on the bladder neck (the bladder neck was clear at the earlier cystoscopy). These were resected. He made a good postoperative recovery. A review cystoscopy 6 months and 18 months later showed no further tumour.

Treatment & Mechanisms

Proposed Remission Mechanisms

Various histological features of the case suggest an immunological basis for the regression.

Clinical Treatment

Cystectomy was advised. Three days prior to the planned operation the patient suffered what in retrospect must be considered a timely pulmonary infarction.

Additional Notes

The patient declined further treatment after recovery from a pulmonary infarction. He was readmitted at the request of his general practitioner with difficulty with micturition. He was observed to be in surprisingly good condition with no abnormalities on physical examination. Blood urea was 6.2 mmoles/l and haemoglobin 14.9 grams. Since his discharge from hospital earlier he had experienced no further haematuria. The IVU was unexpectedly normal.