Indraprastha Apollo Hospitals successfully treats 57-year-old Kenyan woman with stage IV Endometrial Cancer

New Delhi: A 57-year-old lady from Kenya underwent successful treatment of her stage IV endometrial cancer (Cancer of the inner lining of the uterus) with chemotherapy and immunotherapy at Indraprastha Apollo Hospitals.

The patient had been suffering from endometrial cancer for the past 1 year and was operated in her native country Kenya in November, 2021. However after the surgery the disease spread to other organs and the patient developed additional complications involving extensive disease in the abdomen and pelvis, fluid in both lungs, liver metastasis, a non-healing surgical wound in the abdomen, and clots in her legs.

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With her condition deteriorating and disease taking a toll on her overall health she was referred to Indraprastha Apollo Hospitals, New Delhi where she was admitted under the supervision of Dr Shuaib Zaidi, Senior Consultant, Surgical Oncologist at Indraprastha Apollo Hospitals, New Delhi. As a first step, she was given chemotherapy under the able guidance of Dr Ajay Gupta, Senior Consultant, Medical Oncology, Indraprastha Apollo Hospitals, New Delhi.

Speaking on the same Dr Shuaib Zaidi, Senior Consultant, Surgical Oncologist at Indraprastha Apollo Hospitals, New Delhi said, "Endometrial cancer is the cancer of the inner lining of the uterus. Often it is diagnosed at an early stage due to frequent abnormal vaginal bleeding but in a few cases, it can reach Stage IV without being diagnosed. In most cases of stage IV endometrial cancer, cancer can spread too far to be removed with surgery and so need chemotherapy and immunotherapy for treatment.

The same was the case with Margaret, from Kenya who presented with extensive peritoneal deposits in her abdomen and pelvis, chest nodes, fluid in both lungs, extensive disease in liver, a non- surgical wound, and clots in both legs after surgery of Stage IV Endometrial cancer. On admission the patient was very weak and fatigued due to multiple health complications. She was admitted in the hospital on 20th January, 2022 for initial management of disease but with her condition deteriorating due to large volume of disease she was advised chemotherapy with immunotherapy.

So far, in world literature, such an excellent response to low-dose immunotherapy and chemotherapy has not been described in endometrial cancer."

Talking about the care Dr Ajay Gupta, Senior Consultant, Medical Oncology, Indraprastha Apollo Hospitals, New Delhi said, "On admission at Indraprastha Apollo Hospitals Margaret was very weak and was unable to walk. She needed chemotherapy to combat the widespread disease process. Considering her poor general condition, we started her on weekly chemotherapy.

Post two months of therapy, she showed reasonable physical improvement and the disease process had stabilised. The nuclear radioisotope FDG PET scan was also showing stable disease. However, there was a danger that this high-risk disease might progress when the chemotherapy was stopped. To circumvent this problem we utilised a novel approach using low-dose immunotherapy, which was very affordable and this was added to her chemotherapy regimen.

Following three cycles of Immunotherapy and six cycles of chemotherapy a PET scan was done to assess the response to treatment. It was seen that the blood clots, along with the extensive metastatic disease in the lungs, abdomen, pelvis, and liver had disappeared suggesting a complete/ near complete response of this deadly disease to the given therapy. She has recovered well and is now back in her country with recommendation to continue immunotherapy there. She is now without any symptoms and leading a normal, healthy active lifestyle."

Both Dr Ajay Gupta and Dr Shuaib Zaidi are elated with these results and feel that it is indeed heartening that the latest advances in immunotherapy in combination with conventional chemotherapy are having such a significant, positive impact on patient's life at a cost they can afford.

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