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Case Report
Squamous-cell bronchial carcinoma
From terminal care to healing
With seven years survival
Dr Raymond Sevar MRCGP FFHom
Dean of the Faculty of Homeopathy UK
Congress 2010
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Abstract/Summary
• A 58 year old lady with squamous cell
carcinoma of bronchus confirmed by
bronchoscopy/biopsy is referred by GP at
the request of her terminal care nurse who
has an interest in holistic care. The primary
cancer is large, fills most of her right chest,
appears adherent to her pericardium & is
deemed inoperable with metastases in
thoracic vertebrae. She is in pain despite
morphine & dexamethasone.
Congress 2010
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Abstract/Summary
• Holistic integrative care using homeopathic
medicines, nutritional supplements, diet and
a regime of daily prayer and exercise elicit
a remarkable response:
• the primary cancer shrinks to a quarter of its
original size & becomes full of hard scar
tissue
• the secondary cancers in her thoracic spine
disappear
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Abstract/Summary
• she stops her conventional medication
• seven years later she is alive & well with
occasional hot flushes & mild osteoarthritis
Keywords
• Squamous cell bronchial carcinoma,
homeopathy, diet, nutritional supplements,
exercise, prayer
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Introduction
• “J” has had palliative radiotherapy to
metastases in her thoracic spine
• is taking Morphine MST 40mg twice a day
and Dexamethasone which is now reduced
to 2 mg daily, but still has considerable
pain.
• She recently had a deep venous thrombosis
in her left thigh and is on Warfarin
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Consultation December 2000
• Observations:
• She is very obese
• an obesity of the trunk with thin
legs and a red Cushing’s face
• is scruffy
• has thinning of hair on vertex
• anxious with trembling hands
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Consultation December 2000
• Six years ago I fell off a high stack of hay
& fractured 6 ribs but didn't come out in a
bruise. Five years ago I fell off the hay
again & had a crush fracture of my first
lumbar vertebra - I have had back pain
since. In August last year I got a terrible
pain like a band right around my lower
chest & went for tests & they found the
cancer …
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Consultation December 2000
• I get a lot of hot flushes with sweats on
my head, neck & chest & am tired all
the time ....
• My face is getting fat & my legs have
got thin & I have a horrible chemical
taste in my mouth since I started all
these pills …
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Consultation December 2000
• I grew up on a farm then went to art
college. I got married & had 2 children ....
• My mother was kind & gentle & would do
anything for anyone .... In build & in nature
I suppose I am very like my mother .... She
died very suddenly 16 years ago of a burst
aortic aneurysm. It was such a shock
• Observation: she is weeping.
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Consultation December 2000
• I am still upset about it …
• I have been very warm for the past 2 years
which is odd because I was always chilly ....
• I get hot flushes & sweats from my head
downwards ...
• I can't sit too long in the sun, I get
headaches ...
• my sweat smells more since the pills ...
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Consultation December 2000
• I stick my feet out of bed because they
are too hot ... the soles are too hot. ..... I
absolutely hate eggs ... I just love chips
and ice-cream ....
• I am very tidy. Everything has to be in
its proper place - I can't rest till it’s tidy
…
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Consultation December 2000
• I am terrified of snakes. I even dream of
snakes. The snakes curl up on my bed & are
under my bed. I wake up scared & I know
that if I put my foot out of bed they will get
me, wind round me & bite me..... as a child
I saw a film where a huge snake crushed a
man to death & I have been scared since ....
• I can't breathe if I am shut in a small place.
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Consultation December 2000
• .... I want to live till my daughter's
wedding in August but they tell me I
have only a few months.
• Observation: she begins to cry & cries
for a while – I sit & give her time
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ANALYSIS 1
• She is terminally ill with cancer
• She is in severe pain despite morphine
• She is intoxicated with dexamethasone
(which is distorting her fat distribution &
causing weakness of proximal muscles)
• She has little or no hope that she will live
till her daughter’s wedding
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ANALYSIS 1
• The dreams/fear/delusions of snakes
are typical of Sulphur as are: her red
face, untidy dress but fastidious need
for order, burning heat of feet which
she must uncover & desire for icecream & chips & aversion to eggs.
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ANALYSIS 1
• The history of recurrent falls and
fractures with idiosyncratic lack of
bruising except on the face may
indicate a need for treatment with
Arnica montana later
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ANALYSIS 1 RUBRICS & GRAPH
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TREATMENT
• factors which influence survival in
cancer discussed: determination to
survive, changes in diet, nutritional
supplements, prayer & exercise
• advised to pray the Rosary daily (she is
Roman Catholic)
• advised to go out & walk daily for half
hour no matter how ill or how bad the
weather
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TREATMENT
• Sulphur 30CH one pill daily
(see Graph 1)
• Advise supplements B multivitamins 25 mg daily,
Vitamin C 1Gram daily till able to
eat normally, then to expand diet
variety especially fruit, vegetables
& tree nuts
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Purpose of Treatments
• To enable your body to fight back
• Sulphur to fight off the effects of the drugs
& wake up your immune defence systems
• Supplements to help build up your immune
system while you are not eating well
• Exercise to build up your strength & will
• Rosary for grace
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• Treatment goal = survival to
daughter’s wedding
• Outcome measures at review:
energy, mood, sleep, weight,
resilience, pain, dying of cancer
or living with cancer ...
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Consultation January 2001
• My legs are strong again with more muscle
- I can walk up & down stairs easily now
and walk the dog every day. ......I stopped
Dexamethasone 4 weeks ago. I am still on
Morphine which makes me nauseous and
Warfarin and the vitamins …
• I am much better with more energy. I still
get tired and I go to bed at 9, but there is no
slump in energy from 2-5 p.m. ....
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Treatment
• This change is real & significant
• It means your body has begun to
fight back & has more energy to
fight back
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Consultation January 2001
• I have been falling - I fell in the bath
and banged the right side of my chest
• I asked to examine her & she said
• “I don't want you to touch it or prod it”
- & she pulled away & guarded the
area saying “It is all right”
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Consultation January 2001
• I just fall flat on my face for no
reason - I have done my whole life.
I fell on my left shoulder 1 year ago
& needed a steroid injection & I fell
off the hay twice - my face bruises
but nowhere else …
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ANALYSIS 2 & TREATMENT
• The Arnica layer emerges with a
recent fall & typical behaviour of
guarding the sore place & denial
• Treatment Arnica montana 30CH
one pill 3 doses today then continue
with Sulphur 30CH daily
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Consultation March 2001
• I have stopped Morphine - it was
very bad - I was shaking & sick &
had diarrhoea for 3 weeks …
• I feel 1000 times better …
• I have even more energy ...
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Consultation March 2001
• I am in a fair amount of pain .... in my
back(shows lower thoracic spine) &
around my sides to the front ... better
hot bath & a hot water bottle ...
• I take Paracetamol 2 twice a day & an
occasional Ibuprofen - with the tablets I
have no pain but the pain comes back
when they wear off …
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Consultation March 2001
• I am not so warm now. I feel
cold more often than warm
recently, but I still put my feet
put of the bed …
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ANALYSIS 3
• The Sulphur state persists with hot feet
but she is becoming chilly again
• There is more general improvement off
Morphine but the pain from her bony
metastases is troublesome with only
minor analgesics
• “specific” medicines for bone
metastases are required
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TREATMENT 3
• Symphytum officinalis 6CH
• & Hekla lava 6CH
• one pill of each twice a day
• continue Sulphur 30CH 30ml
2 drops daily, 10 succussions before
each dose (see Graph 2)
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ANALYSIS 3 RUBRICS & GRAPH
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Consultation April 2001
• I feel great with the new medicines
• I have been walking more & I have
bought an exercise bike & I have
been gardening
• I can do all the housework now:
cooking, washing, ironing ...
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Consultation April 2001
• my back aches a bit when I have
been resting for a long time and
when I first move but then it is OK
... I have never had the bad back
pain or girdle pain...
• my energy is still gradually
increasing …
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Consultation April 2001
• I still get the hot feet and still stick
them out the bed....
• my weight is going up – that’s why
I got the exercise bike...
• I have developed a craving for
sunflower seeds in the last few
weeks …
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Consultation April 2001
• I am busy organizing my daughter's
wedding .... I am still taking
Paracetamol & Ibuprofen &
Warfarin
• Treatment: continue Sulphur &
Hekla lava & Symphytum
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Consultation June 2001
• The cancer has shrunk - I had
a Chest X ray & they can see it
is much smaller …
• Observation: a big smile with
glistening eyes
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Consultation June 2001
• Some days I feel absolutely great ...
• I still have aches and pains in my old
joints - lower back, feet and right knee.
• my weight is still going up ...
• my nails are growing fast & they are
the strongest that they have ever been
my whole life
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Consultation June 2001
• The hot flushes are getting
terrible. They are getting
worse & much more frequent
• I throw the covers off then I
get cold quickly so I need the
covers back on.....
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ANALYSIS 4
• The shrinkage of the cancer is
remarkable, her general improvement
continues, the surge in hot flushes
indicates the partial emergence of a
new layer but the image is not yet clear
– I decide to give a sarcode as an organ
remedy in low potency.
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TREATMENT 4
• Add Folliculinum 6D one pill
twice daily continue
• Sulphur
• & Hekla lava
• & Symphytum
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Consultation August 2001
• Observation: freckly, tanned & happy
• I was very busy before my
daughter's wedding. I made her
wedding dress & the bridesmaid's
dresses & the wedding cake & I
was fine. It was such a lovely day,
thank you …
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Consultation August 2001
• The hot flushes are nearly gone - much less
frequent & each flush is milder & shorter...
• I keep forgetting to take the paracetamol &
Ibuprofen. .... my knees don't hurt so much
& my back isn't sore till after 6 pm or after
gardening
• Treatment: Continue Sulphur, Symphytum,
Hecla lava & Folliculinum
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Consultation October 2001
• I still feel great.
• I am not dying of cancer.
• I am living with cancer …
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Consultation October 2001
• The bone pain in my knee got worse &
I had a bone scan which showed a hot
spot. I did a lot of raking of leaves off
the lawn & my left shoulder has been
very sore - the pain shots all the way
down my arm to the fingers & my
fingers are a bit tickly.
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Consultation October 2001
• I am sure that it is just arthritis
after too much gardening but
they’re arranging an MRI scan ...
• I take an occasional paracetamol or
ibuprofen
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ANALYSIS 5
• Even after her daughter’s wedding (her
initial survival target) she feels certain
that she is still recovering & is not
anxious about a new bony secondary,
she feels sure that the pain is rheumatic
from overuse
• Rheumatic pain shooting down the
limb indicates Kalmia latifolia
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TREATMENT 5
• Kalmia latifolia 12CH one pill 3
times a day for shoulder
• continue Sulphur, Symphytum,
Hecla lava & Folliculinum
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Consultation December 2001
• I am fine - the scans show the
cancer is now half the size it
was & the cancers in my spine
have gone & the shoulder &
knee scans are just arthritis
• Observation: shining with joy
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Consultation December 2001
• My hands have been getting very sore
& the joints are all lumpy. My shoulder
is fine - It was OK 2 weeks after
starting the Kalmia
• On examination: marked Heberden's
nodes & osteoarthritis of distal interphalangeal joints both middle & index
fingers
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ANALYSIS 6
• The disappearance of cancer
metastases in vertebrae has
coincided with the appearance of
Heberden’s nodes in finger joints &
a surge in osteoarthritis
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TREATMENT 6
• stop Hekla lava & Symphytum &
Kalmia
• continue Sulphur 30CH &
Folliculinum 6X
• take Cod Liver Oil/fish oil
• increase oily fish in diet
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OUTCOME DEC 01-AUG 02
• I continue to see her every 3 months. By
March 2002 her osteoarthritis & hot flushes
are her only complaints, her energy is good,
her weight continues to gradually increase
on Sulphur 30CH 2 drops once a week
• Oncologist continues to be surprised & sees
her infrequently
• The hot flushes continue to increase in
frequency & severity
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Consultation August 2002
• I am going on holiday to Jordan in
2 weeks – my 1st holiday in 3 years
• The hot flushes are ridiculous –
absolutely terrible – I have a fan in
every room & 3 air conditioners, &
my husband says the house is like
an igloo …
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Consultation August 2002
• the heat starts low down in my body &
whooshes up to my head & face & I go
bright red & pour out sweat
• The flushes get worse through the day
& keep on waking me at night – I
throw the covers off till I get cool then
I get chilled & pull the covers back up
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ANALYSIS 7 & TREATMENT
• The picture of Sepia is now clear
• Sepia & Sulphur are
complementary
• Treatment: Sepia LM1 30 ml, 10
succussions & 2 drops in water
daily, continue Sulphur 30CH 2
drops once a week
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OUTCOME TO JUNE 2003
• Two months later her flushes are
beginning to ease off (30% better)
• Her flushes gradually continue to
settle with Sepia LM1 then LM3
plus Sulphur 30CH 2 drops once a
month
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ANALYSIS 6 RUBRICS & GRAPH
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Consultation June 2003
• I have been great. The oncologist
is very pleased & surprised
• The scan shows the cancer has
shrunk to a quarter of its original
size & seems to be full of hard
scar tissue …
• Observation: shining with joy
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Consultation June 2003
• The hot flushes are much better – only
about a quarter of what they were – far
less frequent & far less bad …
• My joints seem to be gradually getting
better as well – I have been doing a lot
of gardening …
• I am going to be a grandmother …
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TREATMENT
• continue Sepia LM3
• if flushes increase again start
Sepia LM5 30ml, 2 drops daily
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OUTCOME
• In December 2005 (5 years after
initial presentation) I discharge
her from formal follow up.
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OUTCOME
• May 2007 her daughter reports “J”
is alive & well - a happy healthy
grandmother with a few hot flushes
& some osteoarthritis controlled by
Sepia LM5 drops & cod liver oil &
fish chondroitin & glucosamine
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DISCUSSION - SURVIVAL
• This lady’s survival response is impressive
but not unique
• Surprising survival durations following
homeopathic treatment in cancer care have
been previously reported
• Rajendran ES, Surprising Cancer Survival with
Homeopathic Treatment, Homeopathy, 2004
Apr; 93(2): 99-102
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DISCUSSION - SURVIVAL
• The positive effect of holistic integrative
care coupled with CAM interventions in
cancer survival is being increasingly
reported
• Monti DA, Sufron M, Peterson C., Potential role of mind-body
therapies in cancer survivorship. Cancer, 2008 Jun 1:
112(11Suppl): 2607-16
• Monti DA Yang J, Complementary medicine in chronic cancer
care, Semin Oncol. 2005 Apr; 32(2) 225-31
• Pujol LA Monti DA Managing cancer pain with nonpharmacologic and complementary therapies, J Am Osteopath
Assoc, 2007 Dec; 107 (12Suppl7): ES 15-21
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DISCUSSION - CAM
• Evidence-Based Clinical Practice
Guidelines begin to acknowledge the
important role of holistic integrative care &
CAM in the control of symptoms associated
with cancer & cancer treatment
• ACCP Evidence-Based Clinical practice Guidelines (2nd Edition).
132(3) (Supplement):340S-354S, September 2007 (Multiple
authors)
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DISCUSSION - SPIRITUAL
• Spiritual issues are not often discussed
between doctors & patients yet there is
evidence to suggest that patients wish to
discuss spiritual issues with their doctors in
at least some circumstances - the most
acceptable being life-threatening illnesses,
serious medical conditions & loss of loved
ones
• McCord G, Gilchrist VJ, Grossman SD et al. Discussing
spirituality with patients: a rational and ethical approach. Ann
Fam Med. 2004;2(4):356-61
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DISCUSSION - SPIRITUAL
• this wish reflects a desire for physician-patient
understanding & the belief that such discussion
would inform the physicians' ability to encourage
realistic hope, give relevant medical advice, &
change medical treatment
• Reed P. Spirituality & wellbeing in terminally ill & hospitalised
patients. Res Nurs Health 1987;9:35-41
• As she was a practicing Roman Catholic the
advice to pray the Rosary daily was relevant &
appropriate
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DISCUSSION - DIET
• There is a lack of good quality evidence to support the
role of oral nutritional supplements in cancer treatment
• Vitamin supplements were only continued until she had
stopped synthetic drugs, regained her appetite &
expanded her diet to include a wide variety of fresh
fruits, vegetables & tree nuts
• Subsequent nutritional supplements of fish oils were
advised for osteoarthritis
• The patient elected also to take fish chondroitin and
glucosamine
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DISCUSSION - EXERCISE
• There is some quality research on the role of
exercise for patients with active cancer showing
that exercise-based interventions are associated
with reduced fatigue, greater quality of life,
reduced emotional distress, improved
immunological parameters, improved aerobic
capacity & muscle strength
• Galvao DA, Newton RU. Review of exercise
intervention studies in cancer patients. J Clin Oncol.
2005;23(4):899-909
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DISCUSSION - EXERCISE
• The first large-scale quality trial looking at
cancer survival & exercise found that women
who exercised to the equivalent of 9-15 METhours per week (roughly equivalent to 3-5 hours
walking per week) had half the death rate from
breast cancer over 4-18 year follow-up compared
to those who did little or no exercise
• Holmes MD, Chen WY, Feskanich D, et al. Physical
activity and survival after breast cancer diagnosis.
JAMA. 2005;293(20):2479-86
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DISCUSSION
• It is not possible to differentiate with
certainty the relative impact of each of
the interventions used in this lady’s
management
• The oncologist suggested a final
explanation of spontaneous remission
• The patient replied “How dare you”
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DISCUSSION GRACE & WILL
• I suggest her response flowed from:
• grace & will
• therapeutic effect of holistic
consultations
• to each indicated homeopathic
medicine appeared to be brisk in onset
& sustained effect
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DISCUSSION – GRACE & WILL
• her determination to survive till her
daughter’s wedding – an act of will
• her continued determination to live
& the birth of her granddaughter
• praying the Rosary daily
• diet expansion & daily exercise
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