How ECCT Helped Control Advanced EGFR+ Lung Cancer

Ms. Estu was first diagnosed with lung cancer three years ago, in August 2022, with a mass in her right lung measuring 5–6 cm. In December, she underwent thoracic surgery. The surgical results showed a malignant adenocarcinoma with good differentiation (low grade) and an EGFR+ mutation. After the surgery, throughout 2023, she took targeted therapy medication.

At the end of 2023, her condition worsened. Tests showed that the residual nodules from the surgery had enlarged. She was advised to switch to a new type of targeted therapy, but she did not proceed because it was not covered by BPJS. By mid-2024, her condition had further declined. PET, CT, and bone scans showed that the recurrent mass in the previous surgery area had grown, along with additional spread in the right lung accompanied by significant pleural effusion and metastases to the sternum, spine, and pelvis.

She was still able to carry out daily activities independently at home and work from home, but she had to keep an oxygen tank ready as she frequently experienced shortness of breath. She also regularly took morphine painkillers due to severe bone pain. She relied solely on the first targeted therapy medication to control the progression of her cancer.

Since there were no other effective alternatives for her cancer, which had spread to the bones, Ms. Estu consulted about the possibility of using the ECCT to Control Advanced EGFR+ Lung Cancer. She was informed that the response to ECCT for low-grade tumors is relatively slow, and bone metastases can be very painful as dying (lysed) cancer cells can trigger nerve pain. She was advised to continue her targeted therapy and might need bone radiation if the pain became unbearable.

X-ray results three months after the brief ECCT treatment showed that the mass remained largely the same as three months prior; at least, the tumor did not grow rapidly showing good control of the tumour.

Because the bone pain persisted, Ms. Estu then underwent palliative radiation to reduce pain in her right chest bone, followed by bone injections to strengthen her fragile bones affected by metastases. The targeted therapy had to be switched to a new type, however couldn't fully control the progression of lung cancer. Typically, EGFR+ lung adenocarcinoma treated with the newest targeted therapy only shows a median progression-free survival of 4–9 months.

After her bone pain subsided, Ms. Estu resumed ECCT treatment together with targeted therapy. Result later show dramatic shrinkage of 70–80% within 1–3 months of the lung tumor mass and controlling further cancer progression. The combination of ECCT with targeted therapy helped prevent rapid progression, improve symptoms, and enhance her quality of life, allowing her to gradually wean off oxygen and pain medications. Continued ECCT after tumor remission also helped prevent recurrence and metastasis, offering her the potential for long-term survival with normal daily activity.

X-ray results two months after resuming ECCT showed that the lung mass was relatively clear. A CT scan one year later still showed a residual mass, which was likely scar tissue.

Ms. Estu’s current condition is relatively normal. Over the past six months, she has been off oxygen and painkillers.