If the patterns of the different tests and clinical manifestations are concordant, concerning the offbalance present, the agents chosen are from the respective group. Special attention is given however to the level which, clinically or analytically, shows the most abnormality, so that for a patient with a limited tumor, but without pain and in good general condition, the factor guiding the therapy will be the analyses related to the cellular level (as revealed by the potassium in blood). If the general condition is poor, indicating rather a predominant systemic condition, the treatment will be directed especially by the abnormalcy at the organism level revealed by the corresponding analytical tests—such as urinary specific gravity, surface tension and body temperature.

This interpretation of the most needed intervention becomes still more important when the data obtained—clinical and analytical are discordant. The treatment will follow the indication furnished by the level which appears the most important. In a case with a limited tumor, and no other clinical manifestations, the pattern of the cellular level, will determine the nature of the treatment, even if the other analyses show different patterns.

For a patient with a tumor and severe pain—it is the pattern of the pain which will indicate the agent to be used—even if this is discordant with that of other analyses. The same is true for a systemic severe condition, the respective analyses determine the agent to be used, even if these are discordant with the analyses concerning the other levels. In general, the decision of what level will represent the guiding factor in the treatment, represents seldom a problem, the condition of the patient directing the attention toward the principal anomaly.

In general, treatment is started with small doses. If the offbalances, and especially the clinical manifestations persist, increased doses are indicated. Larger amounts are used and are administered more often. Once the desired analytical and clinical effect is obtained, dosage is maintained. If analyses corresponding to the offbalance pass far enough on the opposite side, the amount of the medication is first reduced. If this change persists or increases, treatment is discontinued for several days. If the new offbalance still persists, and especially if new clinical symptoms develop, use of the opposite group of agents is to be considered. A slight passage of an offbalance into the opposite is usually salutary and treatment is continued as long as clinical improvement persists.

It appears to be of great importance that treatment be continued for several months after all subjective and objective manifestations have disappeared. In a number of patients, we have been investigating the value of continuing medication for years in very small doses as a prophylactic measure to prevent recurrences. The results have been highly encouraging. No inconveniences have been noted with controlled continued use of any of the substances.

Results Obtained

With this form of treatment most of the results obtained are striking. With naphthalene or tetrahydronaphthalene perselenide, epichlorohydrin and bixine as principal agents for the type A and heptanol glycerol for the type D, the subjective and objective manifestations were seen to be well controlled. Pain, if present, disappeared in a few days, the tumors progressively diminishing until they disappear, even in cases considered as far advanced. The following few recent observations of such cases, give an idea of these results, up to date.

Mrs. M. C, 59 years old, had 3 years ago a mastectomy for adenocarcinoma. She came under our care with metastases in the right 8th rib and in the 11th and 12th dorsal vertebrae, liver metastases, ascites and pleural effusion. With dyspnea, severe pains and almost continuous vomiting, her general condition was judged very poor. Paracentesis was performed, but the fluid accumulated rapidly, needing a second paracentesis 10 days later. In offbalance A, the patient was treated with perselenide. bixine propanal and epichlorohydrin. Shortly after the beginning of the treatment, the pain decreased in intensity and later disappeared completely. The pleural effusion decreased and after the two paracentesis, the ascites no longer reproduced. The general condition changed rapidly for the best, together with the objective changes. Liver reduced in size after three months of treatment was within the normal limits. Radiological examination, two months later showed the bone metastases completely healed. The general condition continued to improve. The patient resumed her normal life and now does not show any clinical abnormality.

Mr. J. S., 71 years old. Two years prior to admission, the patient had persistent hematuria, for which a prostatectomy was performed. Hematuria reappeared. Cystoscopic examination revealed tumors of the bladder, for which he was operated 1 1/2 years ago. Since then, he has had almost constant hematuria, with frequent micturitions during the night and almost every hour during the day. Pain in the lower abdomen became progressively stronger. The patient was admitted and treated, in accordance with the analyses, with perselenide, bixine and epichlorohydrin. In less than a week, the hematuria disappeared, as did the dysuria, the patient being able to pass clear urine every 6 to 8 hours. With the interruption of the treatment for almost a month, the symptoms reappeared, with hematuria and dysuria. With the treatment resumed, the condition responded well again, the hematuria and dysuria being controlled and pain disappeared.

Mrs. R. A., for five years, had symptoms of gastric ulcers, more accentuated in the summer, which improved with treatments. For six months prior to coming under our care, the patient had progressively marked difficulty in swallowing anything other than fluids. Even after taking fluids, she experienced very severe retrosternal pain, almost always followed by vomiting. X ray examination showed slight dilatation of the esophagus with a clearly visible growth in the stomach near the cardia. According to the analyses, the patient was treated with perselenide in injection, and bixin and epichlorohydrine orally. Two weeks after treatment was started, the patient was able to swallow not only fluids but also finely ground food. The improvement continued, the patient being able after 5 weeks of treatment to swallow food of almost normal consistency.

Mr. J. R., 56 years old, came under our care with severe pains in the right side of the neck and hemoptoic sputum. At examination, a submaxillar gland of 6 cm. diameter was seen. Laryngoscopic examination showed a tumor in the right pyriform fossa—Biopsy revealed a squamous cell carcinoma. The very severe and constant pain and the constant bleeding caused the patient to be hospitalized. According to the analyses, perselenide by injection, epichlorohydrin and bixine were administered. In 24 hours the pain was fully controlled. The bleeding stopped after 4 days, and the gland started to decrease—10 days after the beginning of the treatment. The laryngoscopic examination showed the tumor tranformed into a graying mass, which was progressively decreasing.

Mrs. A. D., 60 years old, admitted to the hospital with dyspnea, cough and pain in the right hypochondrium, epigastrium and generalized weakness. For 30 years, the patient had complained of pain in the right hypo chonder, related to the presence of gall bladder stones. In February of 1960, a laparatomy was performed and a tumor of the gall bladder with metastases to liver was found. Only a biopsy was performed which showed a carcinoma. At admission under our care, the patient was in very poor general condition with marked dyspnea, deep jaundice and severe pains in the upper abdomen, emaciated. A right pleural effusion was found and a thoracentesis performed. An irregular mass was found in the right hypo chondrium arriving until the umbilicus. She had clay colored stools, typical for obstructive jaundice. In spite of thoracentesis the dyspnea continued to be severe and the patient was kept under oxygen. The patient was placed under chemotherapeutic treatment with epichlorohydrin, bixine and perselenide in accordance with her urinalyses. The patient's condition improved progressively. The stool returned to normal color; fluid in the right chest did not reproduce and the mass on the right hypochondrium decreased progressively to have the liver in normal dimensions. At present, the patient with all the subjective and objective symptoms improved considerably, is ambulatory.

Mr. S. S., 64 years old, was operated in 1953 for a hypernephroma of the right kidney. Two years later, massive metastases were seen in the left femur and pelvic bones. Pathological fracture of the neck of the left femur was treated surgically. Further X ray examinations revealed extensive metastases of the femura, and pelvic bones, with multiple lung metastases. When the patient came under our care, he was suffering agonizing pain especially in the left hip. An X ray examination showed an almost complete disappearance of the upper part of the left femur, with multiple metastases in the right femur and pelvic bones, and multiple metastases in both lungs. According to the analyses, the patient was treated with perselenide, bixine, and epichlorohydrin. The condition improved rapidly, the patient being able to sit up and even to walk a little. He was discharged from the hospital to follow the treatment at home which was done very irregularly. He was readmitted a month later with very severe pain and the treatment resumed. The pain subsided gradually and the general condition improved markedly. Recent X rays revealed a manifest recalcification of the upper part of the left femur which, in previous X ray examinations, had no longer been visible. At the same time, many of the metastatic lesions of the lung disappeared while in others, a marked decrease in their size was seen. These subjective and objective improvements are continuing constantly, up to date.

F. G., 61 year old female, in July 1960 had partial cecostomy for adenocarcinoma. The mesenteric lymph nodes were found involved. A month later, because of vaginal bleeding and an erosion of the cervix, a biopsy was performed, showing the same malignancy. With constant bleeding and pain in the abdomen, the patient came under our care. On examination the tumor was seen to occupy all the upper part of the vagina, with infiltration of the recto vaginal wall. According to the analyses, a treatment with perselenide in injection, epichlorohydrin and bixine was instituted. The bleeding stopped completely after one week, as did the pain. While the patient is still under treatment, the lesion has been seen to regress constantly, up to date.

W. M., 48 year old male. In 1956 he had a left nephrectomy for hypernephroma. He was well until early in 1960 when a mass was found in the left side of the abdomen which was progressively growing. At the same time, he had hemoptoic sputum. The x ray examination of the chest showed multiple lung metastases. Five weeks before coming under our care, a very marked edema of the left leg with very severe pain in the back and leg appeared. He came under our care especially for the unbearable pain. According to the analyses, a treatment with heptanol, butanol and glycerol was instituted. The pain disappeared in 2-3 days and has not returned in the two months which have elapsed since then. The edema of the leg also disappeared. The tumor which, at the time of administration, was occupying the entire space between the ribs and the ileac crust, was seen to become first much softer, and progressively to reduce its dimension. Actually two months after the treatment was started, the patient is leading a normal life with the tumor decreasing progressively.

We want to emphasize that benefits, often impressive even in terminal cases, have been obtained only by following the above rules. Treatment guided closely by changes observed in the patterns indicated by analyses appears to be the condition sine qua non for the attainment of good results.

The results obtained and especially their high proportion, even in far advanced cases, permits a fair judgement of the place of the present form of application of this method in the fight against cancer. Based on these results, we are fully entitled to consider it, not only a highly beneficial treatment which can be offered now for this disease, but even a major step nearer to the solution of the problem of the therapy of cancer.