Fatal Cesium Chloride Toxicity After Alternative Cancer Treatment

Daniel Sessions

Kennon Heard

Michael Kosnett

^{Rocky Mountain Poison and Drug Center, Denver Health, Denver, CO.}

^{Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.}

^{Division of Clinical Pharmacology & Toxicology, Department of Medicine, University of Colorado Denver, Denver, CO.}

^{Corresponding author.}

Address correspondence to:, Daniel Sessions, MD, Rocky Mountain Poison and Drug Center, Denver Health, 990 Bannock Street, Denver, CO 80204, E-mail:Email: moc.liamg@1issesd

Abstract

Background: Cesium chloride (CsCl) is sold as a treatment for several types of cancers. The purported mechanism of action is alkalinization of relatively acidic neoplastic cells. The efficacy of CsCl has not been demonstrated in controlled experiments. Oral and intravenous CsCl use has been associated with seizures, cardiotoxicity, syncope, and death. Although intratumoral treatment with various antineoplastic agents is described, no cases of intratumoral cancer treatment with CsCl have been found in the medical literature. The case described here appears to be of the first reported patient with CsCl toxicity secondary to subcutaneous exposure after attempted intratumoral injection.

Case Details: A 61-year-old woman presented in cardiac arrest 20 hours after injecting 9 mL of an oral CsCl preparation around a mass in her breast. She had been taking the CsCl orally for approximately 1 year to treat her breast mass. The patient had a headache and nausea for several hours after injection and then experienced ventricular tachycardia arrest at home. She received advanced cardiac life support care and multiple antiarrhythmic medications and underwent electrical cardioversion early in the course of the arrest. After stabilization, her electrocardiogram revealed QT interval prolongation to >700 milliseconds. Upon discovery of her CsCl exposure, she was treated with Prussian blue. Her initial whole blood cesium level was 100,000 μg/L (reference range <10 μg/L). Her QT prolongation resolved after several days, but she experienced no meaningful postarrest neurologic recovery and died at home less than a week after exposure.

Discussion: CsCl is sold as an alternative treatment for cancer. There is no demonstrable efficacy, and clear evidence shows life-threatening toxicity. Reported here is a case of fatal CsCl toxicity after attempted intratumoral injection.

Abstract

References

1. Barnes PM, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report; no. 12. Hyattsville, MD: National Center for Health Statistics; 2008 [[PubMed]
2. Sartori HE. Now that you have learned you that have terminal/incurable cancer [homepage on the Internet]. Online document at: Accessed November22, 2011[PubMed]
3. Sartori HE. How to turn cancer into a new lease on life. [homepage on the Internet]. Online document at: Accessed November22, 2011[PubMed]
4. Sartori HE. Cesium therapy in cancer patients. Pharmacol Biochem Behav 1984;21(Suppl 1):11–13 [[PubMed]
5. Brewer AK. The high pH therapy for cancer tests on mice and humans. Pharmacol Biochem Behav 1984;1:1–5 [[PubMed]
6. Sartori HE. Nutrients and cancer: an introduction to cesium therapy. Pharmacol Biochem Behav 1984;21(Suppl 1):7–10 [[PubMed]
7. Himeshkumar V, Johnson K, Houlihan R, et al Acquired long QT syndrome secondary to cesium chloride supplement. J Altern Complement Med 2006;12:1011–1014 [[PubMed][Google Scholar]
8. Chan CK, Chan MHM, Tse ML, et al Life-threatening Torsade de Pointes resulting from “natural” cancer treatment. Clin Toxicol. 2009;47:592–594 [[PubMed][Google Scholar]
9. Lammers T, Peschke P, Kuhnlein R, et al Effect of intratumoral injection on the biodistribution and the therapeutic potential of HPMA copolymer-based drug delivery systems. Neoplasia. 2006;8:788–795 [Google Scholar]
10. Jones DL, Petrie JP, Li HG. Spontaneous, electrically, and cesium chloride induced arrhythmia and afterdepolarizations in the rapidly paced dog heart. Pacing Clin Electrophysiol 2001;24:474–485 [[PubMed]
11. Antzelevitch C, Sicouri S. Clinical relevance of cardiac arrhythmias generated by after depolarizations. Role of M cells in the generation of U waves, triggered activity and torsade de pointes. J Am Coll Cardiol 1994;23:259–277 [[PubMed]