Sir,

Epithelioid sarcoma is a rare type of cancer that starts as a growth of cells in the soft tissue. It can happen anywhere on the body. It often starts under the skin on the finger, hand, forearm, knee or lower leg.

Epithelioid sarcoma can happen at any age. It most often affects teenagers and young to middle-aged adults. Epithelioid sarcoma tends to grow slowly. It can come back after treatment.

Epithelioid sarcoma is a type of cancer called a soft tissue sarcoma. These cancers happen in the body’s connective tissues. There are many types of soft tissue sarcoma. Soft tissue sarcomas, including epithelioid sarcoma, are not common.

Epithelioid sarcoma symptoms include a small, firm growth under the skin called a nodule. The nodule usually isn’t painful or tender. Sometimes there is more than one nodule. Sometimes the nodule forms a sore on the skin that won’t heal [1].

The nodules caused by epithelioid sarcoma most often grow on the fingers, hands or forearms. They also may grow on the knee or lower leg.

The cause of epithelioid sarcoma isn’t known. This cancer causes a growth of cells in the soft tissue.

Epithelioid sarcoma starts when soft tissue cells get changes in their DNA. A cell’s DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a growth that can be felt through the skin. The cells can break away and spread to lymph nodes and to other parts of the body. When cancer spreads, it’s called metastatic cancer.

The risk of epithelioid sarcoma is higher in younger people. This cancer can happen at any age. But it happens most often in adolescents and young to middle-aged adults. It is less common in children and older adults.

There is no way to prevent epithelioid sarcoma.

Anyway the authors during the researches have chosen two indicators to determine the améliorement of the malaise:

Carcinoembryonic antigen (CEA) that describes a set of highly-related glycoproteins involved in cell adhesion. CEA is normally produced in gastrointestinal tissue during fetal development, but the production stops before birth. Consequently, CEA is usually present at very low levels in the blood of healthy adults (about 2–4 ng/mL).

However, the serum levels are raised in some types of cancer, which means that it can be used as a tumor marker in clinical tests. Serum levels can also be elevated in heavy smokers [1–4].

CEA was first identified in 1965 by Phil Gold, a Canadian physician, scientist and professor and Samuel O. Freedman who is also a Canadian professor of immunology in human colon cancer tissue extracts [1].

The CEA blood test is not reliable for diagnosing cancer or as a screening test for early detection of cancer [5]. Most types of cancer do not result in a high CEA level [6].

In this study, effectuated on a single volunteer 73 y. old, male, smoker since he was 15 y. old, 60 cigarettes/day, who came to visit presenting a sly cough and sweatness decided to undergo to our experimentation, after all the possible routine diagnostic investigations, as 5 hospitals in Italy did not realize which kind of tumour he could have. (Italy except for two or three centers of excellence is the worst place to cure or simply avoid insurgence and progression of whichever tumor).

Before to begin the experimentation that lasted 5 months (the last hospital he visited him, assured he had an espérance de vie of 3 months only) the authors decided to take on account two chief indicators to repeat each month for 5 times:

CEA (Carcinoembryonic antigen:

CEA levels below 3 ng/mL (or 5 ng/mL for smokers) are generally considered normal.

Carcinoembryonic antigen (CEA) describes a set of highly-related glycoproteins involved in cell adhesion. CEA is normally produced in gastrointestinal tissue during fetal development, but the production stops before birth. Consequently, CEA is usually present at very low levels in the blood of healthy adults (about 2–4 ng/mL) [2]. However, the serum levels are raised in some types of cancer, which means that it can be used as a tumor marker in clinical tests. Serum levels can also be elevated in heavy smokers [3].

CEA are glycosyl phosphatidyl inositol (GPI) cell-surface-anchored glycoproteins whose specialized sialo fucosylated glycoforms serve as functional colon carcinoma L-selectin and E-selectin ligands, which may be critical to the metastatic dissemination of colon carcinoma cells [4–6]. Immunologically they are characterized as members of the CD66 cluster of differentiation.

Evidence makes for sure that CEA is not specific for sarcoma, even some researchers referred that Plasma carcinoembryonic antigen (CEA) assay was done in 30 patients with osteosarcoma. CEA was found positive (greater 2.5 ng/ml) in 17 of 21 patients who had active evidence of disease and negative (less than 2.5 ng/ml) in all 9 patients who were in complete remission resulting from previous amputation of chemotherapy. Serial CEA determinations demonstrated a fall to normal in 7 of 9 patients following successful surgery of chemotherapy and a ruse and fall (fluctuation) of levels in 8 patients who had tumor progression while on chemotherapy. Clinical recurrence of disease in two instances preceded or coincied with CEA elevation. The CEA assay in osteosarcoma although non-specific could be used as an inportant adjunct to experienced clinical judgment, periodic x-ray examination, and laboratory study to prognosticate the course of osteosarcoma during therapy. The interpretation of a rising or falling CEA titer alone, however, must be made with caution.

The other indicator the authors had chosen is the complex relationship among three alkaline earth metals: Sodium; Potassium; Calcium.

Hypertension, sometimes associated with sarcoma, can be linked to elevated sodium levels in the body. Some studies suggest that increased sodium and decreased calcium, magnesium, and potassium are associated with hypertension in patients with Ewing sarcoma.

Sarcoma and Sodium:

Chemotherapy drugs like cisplatin can affect electrolyte reabsorption in the kidneys, potentially leading to hyponatremia (low sodium).

Tumor Lysis Syndrome (TLS) and Sodium: In TLS, rapid cell breakdown can release intracellular contents, including sodium, potentially leading to hypernatremia (high sodium). Sarcoma and Potassium: Hypokalemia (low potassium) can occur in cancer patients due to various factors, including poor appetite, vomiting, or diarrhea.

Calcium: Sarcoma and Calcium: Hypercalcemia (high calcium) can occur in some cancers and may signal paraneoplastic processes.

The authors volunteer underwent to a routine screening lasting 5 months and authors recorded and referred the changes in CEA values and concentrations of plasmatic metals during the treatment.

CEA tests and dosage of the three anions in plasma had to be repeated 4 times, as aforesaid and here the values describing the decreases of CEA and amounts of metals during the treatment.

Values of CEA at the beginning of therapy and then recorded every 4 weeks of cure:

CEA at the very beginning of therapy:

2025/01/18 4.9 ng/ml

2025/02/18 3.7 ng/ml

2025/03/17 3.2 ng/ml

2025/04/18 2.7 ng/ml.

2025/05/19 1.3 ng/ml

Here the reports of values of the alkaline earth metals in plasma:

Potassium

2025/01/18 4.77 mEq/L

2025/02/18 4.1 mEq/L

2025/03/17 3.97 mEq/L

2025/04/18 3.7 mEq/L

2025/05/19 2.9 mEq/L

Calcium

2025/01/18 2.05 mmoles/L

2025/02/18 2.16 mmoles/L

2025/03/17 2.26 mmoles/L

2025/04/18 2.29 mmoles/L

2025/05/19 2.51 mmoles/L

Doxorubicin is the key drug for treatment of advanced soft tissue sarcoma (STS). The appropriate dosage of doxorubicin, regarding monotherapy or the role of combination therapy, is unclear [7].

As Single agent the suggested dosage is 60 to 75 mg/m2 given intravenously every 21 days.

Chemically speaking the skeletal of doxorubicin is the same identical of that od doxicylline,

The first is this:

The formula of doxycilline isn’t but this, rally very similar.

Doxycilline is an antibiotic but is used by oncologists to contreast the bad side effects of doxorubycine.

Doxycilline is administered orally twice/day for long time (100mg for a single dose).

It is important to recall that doxycilline was used during the front line crossing at Neaples when sex was anything else that a sort of barter and soldiers used to contract gonorrhea and clap.

Doxorubycin is a metabolyte of doxycilline when the drug encounters whichever type of Streptooccus in human blood.