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We advise all cancer patients to read this IMPORTANT book about the reality of cancer. CANCER: THE SURPRISING TRUTH. Its author is the prestigious molecular biologist Travis Christofferson. We recommend it for all cancer patients and of course for all physicians and oncologists.

Many of these treatments will require authorization from the Ministry of Health (Spanish Agency for Medicines and Health Products) in order to be administered under the legal figure of ‘COMPASSIONATE USE’.
For this purpose, a dossier will be sent with all the necessary information about the patient, their pathology and the drug to be used, while awaiting authorization for its use.

CANCER: THE SURPRISING TRUTH

Oncological Hyperthermia

Oncological hyperthermia, the fourth pillar of cancer treatment. The enhancer of radiotherapeutic and chemotherapeutic treatments.

Oncological hyperthermia is a treatment rarely used in the Spanish oncology community. However, in countries such as the United States, Switzerland, Germany or the Netherlands it is included in standard care processes, even as a first-line treatment. Despite the existence of a large scientific evidence that amply accredits its indication in many situations, the complexity of the oncology sector, with multiple focuses of attention and an often-asphyxiating care load, has meant that in our country it has not been routinely included in oncology care processes.

Our centre is the ONLY one in the Valencian Community, both public and private hospitals, to offer a hyperthermia service for oncology patients.

Hyperthermia (HT, thermal therapy, thermotherapy) is a cancer treatment that, combined with surgery and/or radiotherapy and/or chemotherapy and/or immunotherapy, improves the results of these treatments in clinical situations in which the expected results are not optimal in terms of response and survival.

Specifically in the field of oncology, hyperthermia is considered to be an artificial way of increasing body tissue temperature by delivering heat from external sources to destroy cancer cells or prevent their further growth. Non-ablative hyperthermia occurs in the temperature range of 39-43 °C maintained at the treatment site for a period of approximately half an hour or more.

Why is it useful in cancer treatment?

The rise in temperature causes serious disturbances in our body, such as when we suffer from high fever. This is because at temperatures of around 43ºC the cells suffer certain damage derived from the alteration of the structure of the proteins that carry out fundamental functions for cell survival. Therefore, cells do not function well at those temperatures.

From a molecular point of view, hyperthermia inhibits tumour DNA repair after radiotherapy, alters the tumour cell membrane, favouring the entry of chemotherapy, and enhances the immune system's response to immunotherapy.

In which tumours is it effective?

The fundamental usefulness of this treatment is focused on advanced and metastatic cancers, especially in combination treatments with radiotherapy and chemotherapy. Hyperthermia ‘sensitises’ the tumours, making them less resistant to other classic cancer treatments and therefore increasing their chances of success.

In fact, the Consensus Guide of the Spanish Society of Oncology and Radiotherapy certifies that hyperthermia improves the results of radio and/or chemotherapy in breast, colorectal, bladder, oesophagus, advanced non-small cell lung,cancers and in advanced or recurrent skin tumours.

In addition, the combination with hyperthermia has been shown to be superior to conventional treatments in muscle tumours (sarcomas) and in the treatment of painful bone metastases combined with radiotherapy.

How is it administered?

The biological effects of hyperthermia on tumour cells are maintained for 72 hours, which is why two sessions of oncological hyperthermia are usually administered per week. The standard duration of treatment is 60 minutes.

During the treatment, hyperthermia is administered by 2 or 4 metal plates that emit a 13.5 Mhz radiofrequency that heats the different tissues. Healthy organs are capable of cooling themselves, whereas the tumour does not have this capacity. Therefore, the tumour is heated and we manage to break down its aggressive biology quickly and safely. Unlike classic oncological treatments such as chemotherapy or radiotherapy, the treatment can be repeated as many times as necessary, because it does not produce cumulative damage to healthy organs.

This technique is completely painless and has no contraindications or side effects. It is carried out in 45-90 minute sessions at 48-hour intervals for approximately four weeks, although the standard treatment consists of three one-hour sessions per week for one month.

Hyperthermia has an apoptotic effect on tumour cells by reaching temperatures between 41 and 43 degrees Celsius. It increases the penetration of drugs into tumour cells by inducing vasodilation and increasing the permeability of blood vessels and cell membranes in the tumour area. This makes it easier for drugs to reach the tumour site and penetrate the tumour cells, which improves their efficacy in cancer treatment.

Hyperthermia combined with standard radiotherapy, around 30 to 60 minutes beforehand, significantly increases the efficacy of radiotherapy, as well as decreasing possible side effects. The same occurs when combined with chemotherapy or other treatments, both pharmacological and also therapies with natural molecules such as high doses of vitamin C I.V., producing a greater influx of these, thus increasing their therapeutic efficacy.

Not only do we see benefits in the combination of hyperthermia with radiotherapy and chemotherapy, but studies also point to an important role of hyperthermia in the activation of the immune system, acting in synergy with immunotherapy. Some of these benefits are:

  • Stimulates the immune system: Increases the activity of cells such as lymphocytes and natural killer cells, strengthening the body's ability to fight cancer cells and pathogens.

  • Improves antigen presentation: Makes cancer cells more visible to the immune system, increasing the anti-cancer response.

  • Increases the efficacy of immunotherapy: Increasing the expression of tumor antigens and the release of cytokines improves the immune response to immunotherapy.

  • Improves vascular permeability: Facilitates access of immune cells and therapeutic agents to the tumor, enhancing the response to immunotherapy.

  • Reduces immunosuppression: Helps reverse the suppression of the immune system in the tumor environment, facilitating a more effective immune response against cancer.

  • By improving the efficacy of radiotherapy and chemotherapy, it indirectly contributes to immunomodulation by reducing the tumor burden.

In summary, hyperthermia offers a first-rate therapeutic option by promoting apoptosis alone; it will also work in synergy with standard treatments such as radiotherapy, chemotherapy, and immunotherapy.

Table 1. Table 1. Randomised studies examining the effect of shallow or superficial Hyperthermia (HT) combined with Radiotherapy (RT).

hipertermia

Table 2. Randomized studies examining the effect of regional Hyperthermia (HD) combined with Radiotherapy (RD. CR Complete response; DFS disease-free survival.

hipertermia hipertermia hipertermia

NON-ONCOLOGICAL INDICATIONS

In addition to its applications in Oncology, Hyperthermia is also used in the treatment of certain non-oncological diseases, where it has demonstrated its efficacy.

One of the most prominent applications is in the treatment of chronic inflammatory diseases, such as rheumatoid arthritis, in which hyperthermia can alleviate symptoms by applying heat to the affected joints. In addition to reducing pain and stiffness by improving blood circulation and relaxing muscles. All this provides relief without causing tissue damage, providing an alternative or complement to traditional pharmacological treatments.

Another notable application of Hyperthermia in the non-oncological field is in the treatment of chronic infections and difficult-to-heal wounds, where hyperthermia can be effective in their management by improving blood flow and increasing the activity of the immune system in the affected area.

The application of controlled heat helps fight persistent infections and promotes healing, as elevated temperatures can inhibit the growth of certain pathogens and improve the delivery of nutrients and oxygen to damaged tissues.

This technique is used in the therapy of diabetic ulcers, pressure ulcers and other chronic wounds, providing an additional treatment option to enhance healing in patients who do not respond adequately to other methods.

BIBLIOGRAPHY

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