Written by Dr. KC Hill, AP, Dipl OM
A patient diagnosed with multiple pulmonary nodules, Lung-RADS Category 4A, with a background setting of emphysema, was advised to wait three months and return for a follow-up PET Scan to measure the nodule growth. The patient chose to seek treatment from a licensed Acupuncture Physician and Doctor of Acupuncture and Oriental Medicine (DAOM) in lieu of waiting for three months for more testing. The DAOM treated the patient with a combination of nebulizing a homeopathic injectable, acupuncture, and a herbal tincture. The results measured by comparing two PET Scans done three months apart was a 95% reduction in pulmonary nodules.
A 75-year-old female smoker (>60 years) presents with a history of cervical cancer in 1987 resolved by a partial hysterectomy and colon cancer resolved in 2010 with a partial colectomy (3/4 of the colon removed in two separate surgeries). The patient gasps for air and describes her respiration difficulty as though she "forgets to breathe occasionally." Her blood oxygen level reading was 96-97%. Her symptomology includes: always feels exhausted, experiences shortness of breath with slight exertion, occasional palpitations, and feels emotionally stressed often.
The pharmaceuticals the patient is currently taking are as follows: Armour Thyroid 90mg QD, Divigel (estradiol gel) 1mg QD, Azelastine Hydrochloride (azelastine HCI) Nasal Spray 30 ml 137 mcg Nasal Spray QID PRN, Albuterol Sulfate HFA Inhalation Aerosol INH (200 Puffs) 8.5M QID, Restasis vial (0.4ml each) 1 vial QID, Alphagan0.1% 3ml QD/eye (This is new and subject to change), Lumigan Oph Soin 2.5ml QHS/eye, Pataday QAM, Refresh Optive Mega-3 Lusbricant Eye Drops enhanced with Flaxseed Oil 0.01 Floz QID PRN, and Imodium AD 3 capsules TID PRN.
The supplements, herbal tincture, and homeopathic prescribed by the DAOM are as follows: NAC N-Acetyl-Cysteine 600 mg 1 pill, QD, Homeopathic remedy 1, 1.1 ml ampule, nebulize QD, and an herbal tincture, 20 drops TID.
On June 25, 2020, a Lung Cancer Screening performed via a "Contiguous axial CT scan of the chest was performed from the thoracic inlet of the upper abdomen using low radiation dose technique. Sagittal and coronal reconstructed images were provided for review" (Anderson, 2020).
The Results are the right upper lobe has a "3 mm nodule" and a "part solid nodular opacity measuring 2.0 x 1.2 cm", "increased right apical irregular pleural thickening," and "2 mm subpleural nodule." The right middle lobe is clear. The right lower lobe has a "6.5 mm nodule." The Left upper lobe has a "subpleural 3 mm" and a "4 mm solid nodule". The left lower lobe has a "3 mm solid nodule." The patient has "mild to moderate emphysema," and "bilateral fibrosis that is greatest in the upper lobes" (Anderson, 2020).
The impression is that there are "multiple pulmonary nodules in a background setting of emphysema. Most prominent is a part solid 2 cm right upper lobe opacity. There are also multiple small nodules in the left lung which are new since 2009. The recommend follow-up CT in 3 months. Lung-RADS category: 4A: Probably suspicious" (Anderson, 2020).
On July 2, 2020, a Preliminary PET/CT Standard Study – Eyes-Thighs Subsequent Treatment was performed. "Positron Emission Tomography was performed on a Siemens Biography High Definition Scanner after intravenous administration of 12.01 mCi (F-18) FDG via a vein in the left antecubital fossa. Three-dimensional reconstructed images were performed from the skull vertex through the upper thighs, and multiplanar images were generated in sagittal, axial and coronal planes. CT images were obtained for attenuation correction purposes" (Cotton, 2020b).
Results are a "minimally FDG avid nodular density in the lateral right upper lobe. This measures approximately 12.00 mm in diameter and demonstrates maximum SUV values ranging to 1.2. This is thought most likely fibrotic or inflammatory in etiology due to its low level FDG uptake. Follow up recommended in 3-4 months. Minimally FDG avid fibrotic changes also appear to be present in the right lung apex. Follow up is also recommended" (Cotton, 2020b).
The impression is a "visualization of minimally FDG avid nodular density in the lateral right upper lobe. This is thought most likely fibrotic or inflammatory in etiology. Follow up is recommended in 3-4 months. Minimally FDG avid fibrotic changes are seen in the right lung apex. Follow up is also recommended" (Cotton, 2020b).
The pulmonologist advised the patient that, "It is important not to smoke cigarettes," and to return in three months for a follow-up PET Scan. At this moment, the patient decided to seek alternative health care from a DAOM.
The DAOM performed an intake, reviewed the imaging from the CT and PET Scans, read the reports, and verified with the patient that she quit smoking. The Traditional Chinese Medicine (TCM) diagnosis was Lung Nodules due to Toxic Heat Accumulation Obstructing and Lung Yin Deficient Fire. The treatment plan is to dissolve nodules, clear toxic heat, ventilate the lung, nourish yin, and Extinguish Fire.
This case was more complicated due to the partial colectomy from ten years prior that has caused chronic diarrhea controlled through the use of Imodium AD. The traditional herbal formulas that would treat this condition are very cloying in nature and could potentially cause uncontrollable bowel movements for this particular patient.
The prescription included acupuncture, a homeopathic medicine, and a supplement. The acupuncture prescription opened the Ren, Conception, and the Chong, Penetrating, Vessels to strengthen the patient's constitution. The homeopathic remedy, comes in injectable form, is mixed with Watt-Ahh ®, polarized water, and nebulized it TID. This will help to dissolve nodules, clear toxic heat, and moisten the lungs. The supplement N-acetylcysteine's (NAC) role is to reduce oxidative stress damage from long term smoking and ventilate the lung (Dekhuijzen & van Beurden, 2006). The patient was to follow this protocol for three months until the follow-up PET Scan.
The patient was not compliant with the acupuncture and stopped receiving it after four weeks. The patient was also not compliant with the supplement NAC, stating she is already taking many medications.
In the fourth week of treatment, the protocol changed to include the herbal tincture drops TID. The patient was compliant with the tincture. This TCM herb calms the mind and strengthens and ventilates the lung. Dr. Hsu, et al. discuss studies that demonstrate that herb contains the water soluble polysaccharide WSG. This polysaccharide in in-vitro and in-vivo research has a substantial ability to decrease lung tumors' growth and reduce the size of lung nodules (Hsu et al., 2020).
The patient was able to nebulize the homeopathic remedy mixed with Watt-Ahh on average two times per day. She found it challenging to be able to find the time to nebulize three times per day. The patient was compliant with the herbal tincture. She continued to not smoke throughout the three month period.
The goal for treatment was to arrest the nodules' growth and prevent the development of new nodules. The optimistic goal for treatment was to dissolve a measurable amount of nodules, "shrink the nodules in size."
Side Effects due to treatment
The patient complained of diarrhea that became increasingly uncontrollable and frequent urination. The increase in diarrhea also contributed to the patient not wanting to nebulize three times a day.
Follow-up and Outcomes
The patient had a follow-up PET Scan on October 1, 2020. "A Positron Emission Tomography was performed on the Siemens Biography High Definition Scanner. After intravenous administration of 13.04 mCi (F-18) FDG via a vein in the right antecubital fossa. Three-dimensional reconstructed images were performed from the skull vertex through the upper thighs, and multiplanar images were generated in sagittal, axial and coronal planes" (Cotton, 2020a).
Findings: "PET/CT examination was reviewed and compared with the prior study" (Cotton, 2020a). In the chest, the previously seen minimally FDG avid nodular density in the lateral right upper lobe now demonstrates maximum SUB values ranging to 1.0. This is nearly FDG negative at the current time. Previously seen minimally FDG avid fibrotic changes in the right lung apex are unchanged from prior study. No FDG avid fibrotic changes in the right lung apex are unchanged from the prior study. No FDG avid nodule or mass is seen in the left lung. No metabolically active mediastinal or hilar lymph nodes are seen" (Cotton, 2020a).
"The impression is persistent minimally FDG avid nodular density in the lateral right upper lobe improving in uptake since the prior study. This is nearly FDG negative at the current time. Minimally FDG avid fibrotic changes are again seen in the right lung apex unchanged from the prior exam" (Cotton, 2020a).
In comparing the July PET Scan with the October PET Scan, there is a noticeable difference in the left lung as it is clear of fibrosis and nodules. The right lung upper lobe is nearly clear of any nodules; however, the fibrotic tissue in the apex is unchanged. The treating pulmonologist stated to the patient that her lungs are 95% clear of nodules.
There are three known possibilities that could lead to the vast improvement in the three month period: nodules spontaneously resolved, homeopathic remedy dissolved the nodules, and the herbal tincture ventilated the lung and dissolved the nodules.
Lung nodules can resolve themselves spontaneously. Dr. Zhao, et al. did a study and found that 10% of lung nodules will spontaneously resolve, and of those 77% will resolve in the first three months after diagnosis (Zhao et al., 2013). In this patient's case, 95% of the lung nodules resolved, so the likelihood of nodules spontaneously resolving explaining the results is improbable.
This homeopathic remedy made by Heel is used to detoxify and dissolve growths and masses (Heel, 2005). The delivery method of nebulizing the homeopathic is An off label use of the injectable solution. The idea was to deliver the homeopathic directly to the affected tissue in the lung. A solution to nebulize made from Watt-Ahh® and homeopathic remedy in a ration of 5:1. Watt-Ahh ® is polarized water that supports mitochondrial function and amplifies redox signaling for stem cells and T-cells to wound sites (AquaNew, 2020). The homeopathic remedy and Watt-Ahh® nebulized together theoretically work synergistically to dissolve lung nodules and potentially increase lung tissue health. This piece of the treatment has a high probability for being responsible for the unexpected tremendous results.
The herbal tincture is an alcohol based solution containing 50 g of dried herb soaked for a minimum of 30 days in 1 L of alcohol (40 proof Vodka), and prepared by the author of this case study. G. is an individual constituent of the herband demonstrates an ability to increase the immune system and invigorate effector cells. Several studies suggest that this medicinal mushroom has cancer preventative and tumor reducing properties (Gao & Zhou, 2003). There is a high probability that the tincture may be responsible for the incredible results.
It is most likely that the complete treatment protocol created this positive outcome, including acupuncture, homeopathic, herbal tincture, and the supplement. Research needs to be done to further understand the individual and cumulative effects of each treatment modalities. It will also be essential to ensure that the research protocol is designed to increase patient compliance in future research.