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Hyperthermia and the treatment of cancer

Infra-red body

The Use Of Heat In Cancer Treatment

This article is about Hyperthermia, or the use of heat to treat, and kill, cancer cells. As you will read, hyperthermia used locally can liquify tumours. Used as a whole body treatment, hyperthermia can improve the effectiveness of radiotherapy and chemotherapy. One London Oncologist quoted below, believes that every UK cancer centre should have a hyperthermia unit, such is the significant improval in 5-year survival and the potential to ´cure´ cancer, if you can catch it early enough in a solid, non-metastasised state.

Most of us have experienced the positive effects of a hot bath on aching muscles, or the balm of holiday sun on an English winter body. Heat just feels good.

Heat has history as a treatment 

We use heat for healing in many ways - for instance a hot water bottle on the tummy for period pains or a microwave-heated wheat-pack on stiff and aching neck muscles. From time immemorial we have benefited from sweating - from Turkish baths to the saunas in modern spas.  The Egyptians treated tumours with heat back in 5,000 BC; Parminides, a Greek Physician in 500BC said ´Give me a chance to create a fever, and I will cure any disease´.

Modern medicine also noted that cancer patients who developed a fever sometimes went into remission. Such an observation prompted Memorial Sloan-Kettering Doctor William Coley in 1891 to publish a paper on how inducing a fever in the body of a cancer patient might stimulate the immune response and cause cancer remission. Subsequently, Coley developed the use of certain bacteria to generate a fever, although results were mixed. Coley´s Toxins, or vaccines, were used with varying success up until the Thalidomide problems, when the FDA demanded Clinical Trials. This effectively stopped their use. Similarly German Studies also fell foul of regulators.

What was interesting was that where Coley´s Toxins had an effect, it was thought due to a ´total´ healing experience. Not merely the product of a heightened immune system, the tissues fought to cleanse themselves, while the raised body temperature seemed to actually ´liquify´ the cancer cells.

DIY Treatments?

A whole spectrum of treatments using heat that can be applied to cancer has hit the market: Everything from saunas to increase blood flow and detoxification to treatments involving very hot footbaths and alternating hot and cold pads on the back of the neck, or using an infrared lamp on tumour sites. Infrared saunas supposedly increase blood flow and immune response generally.  Ceramic heaters emit infrared heat in the same range as the human body, making it easier to absorb. Easier absorption also means that the infrared heat penetrates deeper into body tissues than traditional hot air saunas - up to an inch-and-a-half. This allows for greater circulation and detoxification - both good for people with cancer. Items can be bought on the internet from the US for around $500 and used at home.

According to one manufacturer, "One session in a good quality radiant heat sauna will burn as many calories as you would rowing or jogging for 30 minutes - up to 600 or more. Infrared or radiant heat warms your body directly and provides a healthy purifying sweat at much lower temperatures than standard steam saunas. Infrared saunas provide a highly enjoyable sauna environment at temperatures as low as 100F with fresh air continually circulating through its ventilation so you can still breathe normally and without the discomfort which is the case with the hot, steamy saunas found in some homes and at health spas."

Open quotesInfrared light is the lower range of the light spectrum, not visible to the eye, which generates warmth on sunny daysClose quotes

Infrared light is the lower range of the light spectrum, not visible to the eye, which generates warmth on sunny days. The wavelength of infrared waves ranges from 0.76 microns to 1,000 microns, with far infrared rays occupying the higher range. Their key attributes are the ability to radiate out from a localised spot and, unlike visible light, they can penetrate deeply into the skin and underlying tissues. They naturally generate heat by causing the bodys molecules to rapidly vibrate against each other.

While they can assist with improving circulation and immune system response, the real question is do they impact on the cancer?

Medical Hyperthermia

At the other end of the scale is medically-supervised hyperthermia - available in two forms: whole-body and localised hyperthermia.

Where the whole body is heated, this may not kill cancer cells or affect a tumour, but it makes the cancer cells much more sensitive to the effects of radiotherapy or drugs.

Where heat is applied locally directly to a tumour area, it is called ABLATHERM. And here it has been shown to kill cancer cells and even ´liquify´ tumours. Deep tissue tumours (for example, kidney, prostate) are already being treated using hyperthermia.

1) Localised hyperthermia

Elsewhere on this site you can read about Dr John Holts pioneering work on Hyperthermia in Australia (CLICK HERE) which combines using radio waves to heat the tumours with glucose-blocking agents like glutathione and cysteine which the cancer cell absorbs. Glucose is essential to the energy systems of a cancer cell; without it the cancer cell dies. It´s a true double-whammy. The heat produced by the radio waves encourages their uptake and the cancer cell dies. As usual, Holt was dubbed a quack and a TV crew sent to rubbish his work. Unfortunately, they could only really find patients praising his work. Sadly, his work seems to have retired with him.

The good news is that from China via Japan has come a variation of this Hyperthermia treatment, a localised hyperthermia called ablatherm, or ablation. This treatment has survived the vested interests and critics because it has been used to treat prostate cancer, a disease where the traditional treatment, surgery, causes so much harm and results in often dreadful side-effects according to one lead proponent at University College, London. Ablatherm applies High Intensity Focussed Ultrasound (HIFU) to localised and targeted prostate tumours (although it is also already used in some cases of confined kidney cancer).

The treatment involves an endorectal probe which applies HIFU to the affected tissue heating them and liquefying the tumour cells, whilst leaving surrounding healthy cells unscathed. The treatment lasts about an hour and a half and only requires a brief hospital stay. You can read more about this ´breakthrough and the successful results obtained starting with an exclusive interview with Professor Mark Emberton of UCL by CLICKING HERE.

At CANCERactive, we have championed this low side-effect, cheap, non-invasive alternative to prostate surgery for over 8 years. We have commented that prostate cancer was potentially only the start. Right on cue comes a two year study from the Karolinska Institute on the use of Ablatherm with breast cancer. Local anaesthetic, and a ten minute treatment involving probes into the tumour under local anaesthetic. The results of three studies? Excellent. No reoccurance after two years - now imagine the potential. Catch a cancer early, in a solid, confined state. Use hyperthermia. No surgery (so no risk of spreading the cancer), no need for radiotherapy or drugs. And the beauty of Ablatherm is that, in the rare case of the reappearance of another tumour, you can use the treatment again.

Expect a major backlash against Ablatherm, driven by powerful vested interests.

2) Whole Body hyperthermia

The principle of hyperthermia is that cancer cells are much more sensitive to and intolerant of the effects of excessive heat than normal cells. Also, tumours have an impaired ability to adapt their blood circulation to the effects of high temperatures and thus hyperthermia can cause a reduction of blood flow to a tumour. In addition, heat at this level pushes cancer cells toward acidosis (decreased cellular pH) which decreases the cells viability and ability to spread. It also activates the immune system, causing both increased production of interferon alpha, and increased immune surveillance. German expert, Professor Rolf Issels, believes that hyperthermia increases ´heat shock´ proteins on the surface of the cancer cells making them more prone to attack by the immune system. 

3) Combination Therapies

The success of the treatment on its own is not significant, but it has been used most successfully in conjunction with other treatments.

For example, tumour masses tend to have oxygen-deprived (hypoxic) cells within the inner part of the tumour. These cells are resistant to radiation, but they are very sensitive to heat. This makes hyperthermia is an ideal companion treatment to radiation. Radiation kills the oxygenated outer cells, while hyperthermia acts on the inner low oxygen cells making them more susceptible to radiation damage.

Open quotesHyperthermia overcomes tumour resistance to chemo and radiationClose quotes

In March 2000, the respected medical journal, The Lancet published the results of a six year cancer study comparing the effectiveness of hyperthermia and radiation with radiation treatments alone. The trials reported are a randomised, Phase III study performed on 358 patients with cancer. Although the study showed promise for the treatment of advanced cervical, bladder and colorectal cancer, the most remarkable results were obtained with advanced cervical cancer. Complete disappearance of the tumour was obtained in 83% of those who received the combined treatment, compared to 57% who were treated with radiation alone. In addition, the three-year survival rate for those who received the combined treatments nearly doubled (improved 89%), compared with those who just received radiation. The study was well-received in the Netherlands, where it was conducted and the treatment has received government approval. The other advantage noted in the report was the fact that there was none of the nausea often experienced with radiation, and hospitalisation was not required.

In a 2001 article by Issels, a 5-year trial on sarcoma patients using such combination therapies produced remarkable improvements. With 59 patients the 5-year survival doubled from the conventional treatment norm of around 25 per cent to 49 per cent with 36 patients being completely disease-free after 5 years.

In the 2009 Berlin European Society of Medical Oncology a presentation on Sarcoma using chemotherapy alone, or chemotherapy plus hyperthermia showed that in a randomised trial, the group also using hyperthermia doubled their survival times from a mean of 18 months to over 32 months (Journal of the National Cancer Institute 2010: Twombley)

Open quotesHyperthermia allows very high doses of chemotherapy to be administered more successfully and sometimes without significant side-effects Close quotes

There are a number of German clinics, such as those operated by Dr Wolf in Hanover or by Drs Herzog and Douwes, that practice the use of hyperthermia in combination with more ´orthodox´ therapies.

The use of hyperthermia with chemotherapy, according to one report in the Lancet, seems to significantly increase 5-year survival rates and chemotherapy success. Another report in the Lancet reviewed various studies in USA and Europe and reported that response rates for chemo and hyperthermia combined are 70%, whilst hyperthermia alone gives a response rate of 15%, chemotherapy can give results of 5 - 60 per cent depending upon the drug, and radiotherapy alone about 35%. Hyperthermia also appears to allow very high doses of chemotherapy to be administered more successfully and sometimes without significant side-effects.

What seems to be the case is that hyperthermia overcomes tumour resistance to chemo and radiation; that it can help the performance of some chemo agents and that it helps destroy cancer cells in especially resistant phases of cell division.

How can you improve your personal odds of survival using hyperthermia?

Open quotes"Hyperthermia is the only agent to treat cancer that does not itself appear to be oncogenic (cancer-inducing)."Close quotes

Firstly, what does treatment consist of? Generally speaking, whole-body hyperthermia induces a fever. Patients lie naked in a structure that is like a small tent, where they are closely monitored. The idea is that the body is heated to extremely high temperatures - between 107 and 113 degrees F - not exactly a pleasant sensation, so patients are generally sedated so they can tolerate the heat.

But if you want treatment using hyperthermia you may well need to look abroad. Cancer patients in Britain encouraged by the above account may be disappointed to hear that hyperthermia isnt readily available at their local hospital. Sadly, the one private specialist, Dr Fritz Schellander of the Liongate Clinic in Tunbridge Wells, has retired too! One of his patients was featured in the Living Proof section of icon. Hazel Scade abandoned conventional treatment for breast cancer in favour of a less-invasive route. In addition to many nutritional therapies she used some localised hyperthermia, and wrote about her experience in the July 2003 issue. She quoted a Dr TK Hei of the Columbia University College of Physicians who stated, "Hyperthermia is the only agent to treat cancer that does not itself appear to be oncogenic (cancer-inducing)." Sadly, although Hazel beat the 5-year milestone successfully, she passed away in 2008. 

Fortunately, the new Raphael Centre, in Hildenborough, Tonbridge, Kent provides an option. It uses the latest generation Heckl machine that has water cooled lamps allowing the body to move to internal fever temperature levels (around 104 degrees) without the skin being damaged. No sedation is required therefore. Dr Maurice Orange of the centre adds, "Dose is decided according to tolerance. If used in conjunction with chemotherapy, a patient might have a session once a week or fortnightly, whilst having hyperthermia treatment usually around two or three days away from the chemotherapy"

Open quotesHyperthermia can be effective even when other treatments have failedClose quotes

Dr Clare Vernon of the Hammersmith Hospital is another enthusiast, quoted in The Lancet as saying, "I think every major cancer centre should have a hyperthermia unit." Hyperthermia was used at the hospital for around 25 years, but it is not currently available for a variety of reasons, none to do with its efficacy. Dr Vernon says, "Hyperthermia is very effective even when other treatments have failed. Its also relatively cheap and well tolerated." Dr Vernon now refers patients to the Daniel den Hoed Cancer Centre, part of the University Hospital in Rotterdam, who have a large team devoted to the treatment and an increasing number of referrals. They say, "We are convinced that the increased patient referral by radiation and medical oncology reflects their confidence in the value of hyperthermia as a standard treatment for advanced cancer."

Work on Hyperthermia is moving fast - both as a localised direct treatment on tumours and as an aid to current treatments like radiotherapy and chemotherapy. The American Cancer Society describes it as ´A Promising Way to improve cancer treatment´. So let´s please see some NHS action!

Isnt it time the NHS turned up the heat on cancer?


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