Fatal Cesium Chloride Toxicity After Alternative Cancer Treatment

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 lg/L (reference range < 10 lg/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.

Levels of Trace Elements in the Aqueous Humor of Cataract Patients Measured by the Inductively Coupled Plasma Optical Emission Spectrometry

“…However, its effectiveness has not been proven, and the collected evidence indicates a life-threatening toxicity. There is even a case of lethal toxicity after injection of a CsCl solution into a tumor [42]. The patient’s measured cesium level in the blood was 100,000 μg L −1 (reference range <10 μg L −1 ).…”

Anticancer drugs-related QTc prolongation, torsade de pointes and sudden death: current evidence and future research perspectives

“…Cesium chloride, an alternative or second-line treatment for several cancers, also has been reported to induce LQTS [ 41 , 42 , 43 , 44 ]. TdP occurred several weeks to one year after cesium therapy in the presence of multiple risk factors (female gender, hypokalemia, and bradycardia).…”

The in vivo performance of a novel thermal accelerant agent used for augmentation of microwave energy delivery within biologic tissues during image-guided thermal ablation: a porcine study

“…Nevertheless, it was found that at high levels of caesium (i.e. up to 400 mg/mL per injection) administered to a 45 kg pig with a cumulative dose of approximately 4.0, a tachyarrythmia similar in morphology to polymorphic ventricular tachycardia (torsade de pointes) was provoked [21,22]. This was medically managed by the veterinarian by providing the anti-arrhythmic agent amiodarone (10-15 mg/kg).…”