Hyperthermia

Hyperthermia by definition, is the elevation in temperature and for purposes of this explanation, the term refers to body temperature.

The most common type of hyperthermia the body experiments is fever.

Fever is one of the body's defense mechanisms, this can be activated by external factors such as infections, intoxications, excessive sun exposure, as well as internal factors such as chronic disease, leukemias and lymphomas to name a few.

But, why does the body increase its temperature in these situations?

Like many functions of the body, these have developed through the evolution of the human being and exposure to it’s environment, resulting in this evolutionary development and defense mechanisms, in this case, fever.

Through different biochemical signals the hypothalamus located at the base of the brain, is responsible for the regulation of this function.

The approximate temperature, which maintains some constancy or little variability and considered as "normal" is 36.7 degrees Celsius with only slight variations

The hypothalamus is the thermostat of the body, which through different biochemical signals adapts or generates response to keep the body at an optimal temperature, it is important to mention that by definition, fever is a syndrome, a set of signs and symptoms, where the main or most common one is hyperthermia.

We use the term hyperthermia when the body temperature is above 38 degrees Celsius, temperatures above 44 degrees Celsius are usually fatal for humans.

We can say that fever is mostly a controlled mechanism. From which we can obtain certain benefits, such as the improvement of the immune response, it also hampers bacterial growth and viral replication, and is of influence on vaccine efficacy.

 

Hyperthermia and cancer.

As we have already mentioned, fever is a syndrome where one of the symptoms is the elevation of body temperature AKA Hyperthermia.

Remember that cancer is a multifactorial disease, a result of the possible combination of multiple diseases, where its main manifestation is the formation of a tumor.

Now, lets also remember that this battle is being fought at a cellular level, where the characteristics of these dysfunctional cells exhibit weaknesses from which we can take advantage of; being one of them, the liability of the malignant cell to temperatures between 39 and 42 degrees Celsius. Where we can see multiple events that generate stress to the malignant environment resulting in different beneficial responses within the context of the cancer treatment.

By generating these temperatures and maintaining them in a controlled manner, it has been possible to observe these changes and aggressions that aggravate the environment and, therefore, weakens the malignant cell. On one hand, we observe instability of the cell membrane, making it more permeable; it is here that there is an opportunity to penetrate inside the malignant cell with a killing agent, to generate a better effect and result.

Antigenic release

Hyperthermia induces the malignant cell to release surface antigens important for immune recognition and activation; this is a cardinal point for our therapies. We have observed dysfunctional cell death during sustained and prolonged hyperthermia, this is achieved through deficient circulation of the tumor that is unable to adequately dissipate the temperature, generating thermal entrapment and intra-tumoral changes that can be considered cytotoxic.

It is of utmost importance not to exploit this benefit since hyperthermia alone as an oncological treatment does not have the capacity to cope with the disease.

Hyperthermia as a medical treatment

First introduced in Germany, the hyperthermia may be performed different techniques that allow the medical induction of controlled heat for therapeutic purposes.

There are multiple modalities, all achieving their end through different methods and technologies, where the use of infrared lamps is the most well-known technique. These lamps have medical standards for their use and should not be compared in any way with the infrared light bulbs found for example in dry or commercial saunas.

With the advancement of the technology, we now have the ability to generate hyperthermia in a way not limited to the use of lamps, and in a much more controlled environment.

Hyperthermia can be used as a treatment of many health problems, such as cancer, chronic infections, autoimmune diseases, connective tissue diseases, to name a few.

For the purpose of this explanation, we will focus on the system that the Functional Oncology Center uses against cancer.

Types of hyperthermia

Hyperthermia can be: regional, localized or systemic.

Regional hyperthermia refers to the increase of temperature to hyperthermic levels of a single zone or area.

Systemic hyperthermia, also known as Whole body hyperthermia, refers to the increase in temperature to hyperthermic levels over the entire body.

Localized hyperthermia, refers to the increase in temperature to hyperthermic levels over a pin-point location

As mentioned, hyperthermia as an effective method of treatment must be controlled and sustained.

For this to be effective we should not only focus on keeping the temperature stable once the hyperthermic levels have been reached, it is also of utmost importance to prolong this stability for a prolonged time. Studies show benefits between 2 to 4 hours of constant, sustained hyperthermia and must always be done under close medical monitoring.

Systemic Perfusion Hyperthermia technique.

This method requires a previous evaluation to ensure the patient’s condition is optimal to receive treatment and its correct use, indication and safe execution.

A physician who specializes in the application of this technique performs the treatment; the patient is alert and lying in a hospital room, connected to monitors that provide constant measurement of vital signs.

Before explaining the technique, let us understand that in these cases an "artificial" hyperthermia is being generated, not mediated by the body, where the first answer that we will find as a challenge are the mechanisms in charge of maintaining the temperature in normal limits, in others words, we will face the cooling systems of the body that will try to counteract our efforts; this is where the hyperthermia system of choice and its employment skills are of great importance.

The technique used in our comprehensive oncology program is called systemic perfusion hyperthermia, which combines the principles used in cardiology and nephrology in an advanced hyperthermia equipment built for this purpose.

The system consists of a pump with a heater where the steady flow and temperature is determined by the physician but regulated by a computer, which leaves no room for human error.

The first step is to place a central two-sided catheter, which will allow us to obtain a high output and return flow, this catheter is placed in the left sub-clavian area and the catheter is connected to the hyperthermia system, once the system is connected and programmed, blood is pumped through the hyperthermia system which exits through the catheter to reach the heater and will gradually raise the temperature of the blood and later the whole body.

The goal temperature to reach is a sustained 42 degrees Celsius.

To support the hyperthermia system and counteract several of the cooling mechanisms of the body, a thermal sheet is used along the process, which is in constant function throughout the procedure. This helps the hyperthermia system to work more effectively, and allows us to maintain the desired temperature without so many obstacles.

The perfusion hyperthermia technique has certain benefits over other techniques, such as:

1. Rapid induction of hyperthermic state. Thanks to the perfusion system it takes approximately 20 to 25 minutes maximum to reach the desired temperature.
2. The patient is alert, avoiding the need for sedation due to heat intolerance and the prolonged time that it takes to carry out the therapy.
3. The patient does not report any discomfort, allowing us to maintain therapeutic sessions for a much larger period of time, and hence, achieving in a single session, what would take us up to 8 sessions to achieve with other methods.
4. It helps and improves muscle and bone pain, thanks to the immunomodulatory effect it brings.
5. Physicians are able to control the patient’s core body temperature, something that cannot happen with other techniques.

The perfusion technique may be combined with other synergistic therapies such as, immune therapy, radiation, metabolic therapy, etc.

Despite the enormous amount of medical information available, medical publications, international associations, leading hospitals performing the treatment, hyperthermia is not yet placed as part of traditional cancer treatment.

The future aims positively for this therapy where soon, we will find it as a true synergistic option in any comprehensive treatment center that deals with chronic degenerative diseases.

 

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