title: Multidrug-resistant recurrent breast cancer which responded to medroxyprogesterone acetate showing a remarkable improvement in the quality of life: report of a case and the role of team medical care.
abstract: We herein report the case of a patient with recurrent breast cancer who showed a remarkable improvement in her quality of life (QOL) as a result of a good response to medroxyprogesterone acetate (MPA). A 43-year-old Japanese woman developed bone metastases 3 years after surgery. Subsequent radiotherapy and chemoendocrine therapy with CAF (cyclophosphamide, adriamycin, 5-fluorouracil) and tamoxifen all failed, and she could not sit up because of bone metastases. The performance status (PS) on admission was grade 4. After admission, delirium accompanied with sensory and visual hallucination caused by intense anxiety occurred, and a continuous consultation by psychiatrists was necessary. MPA treatment at the dose of 1200 mg/day alleviated the bone pain, thus improving her PS to grade 1. Her appetite also improved, while her mental state stabilized. A bone scintigram revealed an improvement of bone metastases, and the tumor markers also returned to normal values. The patient thus showed a pronounced improvement in her QOL due to both MPA treatment and team medical care. The role of the medical staff as well as the importance of their cooperation in achieving an improvement in the QOL of cancer patients is also discussed.
authors.affiliation: Breast Surgery Clinic, Saitama Cancer Center, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kurihara
authors.forename: Y
authors.initials: Y
authors.lastname: Higashi
authors.forename: K
authors.initials: K
authors.lastname: Suemasu
authors.forename: T
authors.initials: T
authors.lastname: Tabei
authors.forename: S
authors.initials: S
authors.lastname: Ishiguro
authors.forename: Y
authors.initials: Y
authors.lastname: Iino
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
authors.forename: F
authors.initials: F
authors.lastname: Takeda
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D019008:Drug Resistance, Neoplasm; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010166:Palliative Care; D010348:Patient Care Team; D011788:Quality of Life
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004317:Doxorubicin; D003520:Cyclophosphamide; D017258:Medroxyprogesterone Acetate; D005472:Fluorouracil