Evidence that the use of progesterone receptor modulators/antagonists can provide palliative benefits for a moribund patient with cholangiocarcinoma

There is considerable evidence that most (if not all) malignant tumors utilize immunomodulatory proteins that result from activating membrane progesterone receptors (mPRs) in males as well as females. Support for this concept has been provided by the demonstration that treating people with a variety of different cancers that are very advanced with no more standard or even clinical trial options to have a considerable extension of life (in several instances even more than 5 years with death unrelated to their cancer) by treatment with single agent oral mifepristone a PR receptor antagonist. Just as important, most patients, even when the cancer has damaged vital organs, so a marked extension of life is not possible, are able to experience considerable palliative benefits. Presented is a case of an 85-year-old male whose end stage cardiomyopathy was complicated by a 5.5 cm cholangiocarcinoma with lymph node metastasis. Rather than the suggestion of hospice to end life within 2- 3 weeks, or starting chemotherapy, he chose the option of mifepristone therapy. So far, he has experienced 4 months of a decent quality of life. The purpose of presenting his case is not only to introduce another type of cancer that responds to PR antagonists that has never been reported before, but to introduce this type of therapy for advanced cancer that despite many publications and presentations at scientific meetings, probably because there are no commercial interests, this highly effective therapy is relatively unknown, it may be especially of interest to countries, e.g., India and China, where mifepristone is available at a much lower price than in many other countries. The cost of healthcare could be markedly reduced by simply offering oral mifepristone to patients with advanced cancer and no need to monitor subsequent potential adverse effects because it has a very high safety profile when used at a lower dosage of 200mg/day. Thus, besides just a fraction of the cost of chemotherapy agents or immunotherapy, there would be considerable savings for cost of hospital admissions to treat the complication of most standard cancer therapeutic options.