Introduction

Deliberately induced hyperthermia (raised body temperature) as a means for healing has been known since Hippocratic times. Indeed, our bodies will develop a fever as part of a strategy for overcoming infections, providing our immune system is intact. Controlled, induced hyperthermia, though, has not been available for very long, partly because of the technological difficulties encountered in the development of reliable equipment, which have now been overcome.

Hyperthermia for cancer patients:

It has been known for a long time that cancer cells react more sensitively to the effects of excessive heat than normal cells. In addition, tumours have an impaired ability to adapt their blood circulation to the effects of high temperatures and extreme hyperthermia can therefore cause an actual reduction of blood flow within a tumour. This, coupled with the direct effects of heat on individual cells, can result in an accumulation of harmful metabolic by-products and excessive acidity in the tumour tissue all of which can contribute to a degree of self destruction of the abnormal growth. This process can be further enhanced by simultaneously creating hyperglycaemia (high blood sugar) which leads to further increased tissue acidity.

Certain chemotherapy agents are known to be more effective in a hyperthermic environment and can be usefully combined with this treatment. This can lead to beneficial results with lower dosage regimes than usual and with consequently fewer side effects. Many studies also show clearly that the benefits from radiotherapy can be significantly improved if combined with hyperthermia.

At our clinic this method is usually employed as part of a complex treatment regime which is set out in a separate brochure.

Which tumour patients can be treated?

· Patients with inoperable tumours

· After a successful operation to reduce the risk of a relapse

· Patients in an advanced state with multiple metastases

· Patients with a high risk of relapse

· Patients with a minimal tumour burden who refuse an operation

· As a support measure for chemotherapy and or radiation

What other conditions can be treated with hyperthermia?

· Chronic inflammatory conditions such as ulcerative colitis and Crohn's disease

· Rheumatic conditions

· Bronchial asthma

· Chronic and recurrent viral infections

· Conditions requiring detoxification

How is whole body hyperthermia performed?

Each patient is carefully assessed clinically in preparation for the treatment. Lung function tests, blood tests and ECGs should be done on all patients.

The patient lies in a special, insulated chamber (the head can be outside) which is gradually heated up by means of a special infrared radiation reflector system until the desired body temperature has been reached. The highest temperatures which can be aimed at in a day clinic are around 40.5 C. The final temperature is usually maintained for around an hour or more. Depending on the patient and the temperature obtained, the whole procedure takes from three to five hours which includes the recovery phase. Many patients will have an intravenous drip running during the treatment session which allows the addition of whatever medications may be necessary. During the whole period the patient is continuously and intensively monitored (pulse frequency, blood pressure, ECG, respiratory rate, body core temperature, various blood tests). The patient will spend at least 2-3 hours in the recovery phase at the Clinic before going home or spending the night at a local hotel.

Surface hyperthermia:

Here heat is generated with a special infrared radiation source (infrared A) which is able to penetrate to a depth of 1-1.5cm. This is especially suited for superficial tumours such as skin cancers and skin metastases (in conjunction with electro-chemotherapy - see elsewhere).

Regional or local hyperthermia:

This type of hyperthermia treats a defined region only and is particularly suitable for deep-seated tumours. The temperature generated in the tumour region should be around 42 C and must be well distributed throughout the tumour. This treatment is not yet available at the Clinic but we are in contact with experienced clinics in Germany and other countries

Prostatic thermotherapy

This is a special form of local hyperthermia specifically for benign prostatic enlargement, in which the prostate is heated via a transurethral probe to temperatures above 50 C. Current, world-wide results indicate that this treatment may soon supersede the prevailing operative methods because of its simplicity, minimal morbidity and safety (out-patient procedure). We do not have this equipment yet but can refer to specialized centres in Germany.

 Dr Fritz Schellander M.D., Liongate Clinic, 8 Chilston Rd, Tunbridge Wells, Kent TN4 9LT, UK.

Tel 01892 543535.