Hyperthermia: Mode of Employment
It has been known for a long time that tumor cells are particularly sensitive to heat. Cancer cell membranes are damaged by temperatures of 40-42°C. Changes in the cell membranes take place because of heat shock proteins, making it easier for the immune system to recognize and fight the cancer cells. Cancer cells are also much more sensitive to cystostatics or radiation when under HT. HT increases the effectiveness of other treatments. Healthy cells are not damaged at these temperatures.
Microwaves, radio waves, or ultrasound are used for heating. Different technically involved procedures have been developed in order to reach the necessary temperature. An optimal effect on cancer cells can be reached at temperatures from 41.5°C to just over 42°C - extreme hyperthermia.
Whole body hyperthermia: This treatment is used when cancer has become systemic, that is when metastases are, or are suspected, in more than one part of the body. It can also be used in cases where cancer is contained within a certain area. The whole body is then warmed. Core temperatures of 41.5-42°C can be reached.
Whole body hyperthermia can be performed by different means. Some clinics use warming pipes with high humidity. In a method developed by Prof. von Ardenne, patients lie on a netted couch and are warmed by water-filtered infrared radiators. Medical practices often use a warming bed heated by infrared radiation.
The curative period of an extreme hyperthermia should last between 45 - 60 minutes. During the treatment the patient is sedated with mild narcotics. The warming-up and cooling-down phases each last one to two hours.
A less time-consuming practice is to use a warming bed that is entirely insulated with aluminum foil, as is used in some practices. The whole body hyperthermia in warming beds is often used in place of or to support a fever therapy. Temperatures of 39-40°C are reached, and are considered a moderate hyperthemia. The curative period should last 4-6 hours then. One is striving to stimulate the immune system. It can increase the effectiveness of chemotherapy.
Regional Deep Hyperthermia: This form of hyperthermia has definite advantages if the cancer hasn´t spread. The patient is less affected and the tumor can reach effective temperatures more easily. Only limited areas are warmed in this method. The patient is either placed in a ring of radiators, or plate electrodes are laid on the body. Temperatures of 42°C at the tumor can be reached.
Intracavitary Perfusion Hyperthermia: The intraperitoneal perfusion hyperthermia was developed to treat metastases in cavities, such as the abdomen or bladder. The abdomen is washed (internally) with a 45°C fluid that contains cystostatics. Metastases that are strewn in the area between the diaphragm and the hips can be reached. The treatment can be helpful if the lymph nodes have been affected following the intestines, stomach or lower abdominal organs, for ascites (cancerous gathering of fluid), or for tumors of the bladder.
Prostate Hyperthermia: Hyperthermia is being increasingly used for both benign and malignant prostate growths. Its advantage is that possible results of an operation, such as incontinence or impotency, can be avoided. A catheter is pushed into the ureter in such a way that a microwave radiator lies directly on the prostate. The tumor tissue can be heated to 43°C and above (thermotherapy).
Superficial Hyperthermia. This method, which uses infrared radiators, can be used when growths in or just under the skin occur, for example in lymph nodes, skin metastases, melanomas, or reoccurances in areas that have been operated (e.g. breast cancer). Using chemotherapy in addition improves the effectiveness.
Hperthermia alone will not damage all tumors cells such that they die. Other therapies are used in addition to reach that. Hyperthermia is then combined with chemotherapy, radiation, and/or an immune therapy. Chemotherapy or radiation can usually then be done in smaller amounts and less often.
In the method of whole body hyperthermia developed by Prof. v. Ardenne, sugar solutions are given, timed with the curative period, to increase the heat sensitivity of the tumor cells. Certain cystostatics are also usually given to increase effectiveness. Additional oxygen is given to protect healthy tissue. An imune therapy can also be used, depending on the case.
Studies done until now have mostly been done of extreme hyperthermia (over 41.5°C) in combination with chemotherapy or radiation. Good results have also been obtained using whole body hyperthermia in a moderate temperature range (39-41°C) with a fever therapy.
Depending upon the type and stage of the cancer, the treatment is repeated, mostly 3-6 times. The number of patients who react positively is high. Sixty per cent of the patients - depending on the type and stage of the cancer - who undergo an extreme hyperthemia in combination with other treatments experience a partial or complete remission.. The results with regional hyperthermia are often higher.
Serious side effects are hardly to be expected when the treatment is properly carried out. Raising the temperature of the entire body in whole body hyperthermia can affect the circulatory system, and lead to complications. The heart and circulatory functions must be carefully observed, therefore.
The whole body hyperthermia holds a lot of promise when used for systemic cancer where metastases are strewn throughout the body, as well as for reoccurances confined within an area.
Regional hyperthermia can be very successful when used for cancer contained within an area - metastases that are confined to an organ or small part of the body, for the most part. Good results have also been reached when it has been used for sarcoma, tumors of the lower colon, regionally metastasized cancer of the ovaries or uterus, melanoma, prostate cancer, and liver cancer and metastases. In some cases full tumor remission can be attained.
Regional hyperthermia is also used for breast cancer metastases, cancers of the throat and pharynx, pancreatic cancer, lung cancer, brain tumors or metastases in the bones.
Hyperthermia can in general be used for all tumors that arise in organs. Some therapists are trying it on low malignancy non-Hodgkins lymphoma, as an intensified fever therapy. Hyperthermia cannot replace surgery unless an operation cannot be carried out or the the size of the growth must be reduced in order to make an operation possible.
Hyperthermia is not part of the regulated coverage of the health insurances. Private insurances often cover the costs, but that differs among the public health insurances. Stationary treatments in clinics are usually included in the daily charges.
If a health insurance company refuses to cover the costs one should refer them to the most recent decision of the Federal Social Court (AZ: 1 RK 28/95. Following it, the cost of treatment for illnesses of unknown origin can be covered if the treatment has found its way into medical use and is being used by a number of doctors. This applies to hyperthermia. Treatments by private doctors will be covered by public health insurances, as an exception, if there is no other possibility of treatment in the area. One should clarify payment of costs before beginning treatment.
Source: Gesellschaft für Biologische Krebsabwehr e.V. (GfBK), Heidelberg 1996 (society for the biological treatment of cancer e.v.)