Hyperthermia for cancer treatment in Germany: a real chance or a false hope?

- 14 October
- Diagnosis & Treatment
- 5210
Hyperthermia for cancer treatment in Germany is considered an experimental technique that is actively studied by the University Of Munich (LMU) and other reputable scientific institutions.
The term "hyperthermia" means "overheating."
These include various methods of cancer treatment, which involve heating the tumor with simultaneous exposure to chemotherapy or radiation.
Standard protocols for hyperthermia treatment include local body heating to 43 ° C for about one hour or whole body heating to 41.5 ° C under anesthesia.
For this purpose, high-frequency electromagnetic waves are used, which are conducted through special applicators.
Local hyperthermia is most often recommended for large inoperable solid tumors. Also, this experimental treatment is prescribed for metastatic cancer, when other traditional methods are ineffective or do not work at all.
Hyperthermia should in no case be considered a “substitute” for standard evidence-based cancer treatment! It works in combination with scientifically proven methods, complementing them.
Hyperthermia principles and procedure
Hyperthermia affects cancer in two ways. First, it directly destroys cellular components. Secondly, it provides better blood microcirculation, improving intracellular chemotherapy penetration, sensitizing malignant tissues before exposure to other treatments (radiotherapy).The mechanism of action is based on the fact that malignant cells are usually more sensitive to heating than healthy cells of the body. With prolonged and frequent heating, they release the so-called Stresseiweiße, or stress proteins. Stresseiweiße act as a “target designator” for patient's own killer cells (leukocytes), which seek and destroy damaged and mutated cells. At a temperature of 42-43 ° C tumors begin to shrink.
As we mentioned above, hyperthermia for cancer treatment is often used in combination with chemotherapy and / or radiation therapy. Studies conducted in Germany showed that the high temperature of malignant tissues dramatically increases their effect.
The decisive success factors are the temperature in the target area (42-43 ° C), the duration of the application and the time interval between heating and the administration of the chemo (radiation).
The procedure takes about 1 hour; preparation takes another 20-30 minutes. After the session, the temperature of the patient's tissue quickly normalizes without any serious complications.
Centers for hyperthermia for cancer treatment in Germany
Combined protocols have been studied for a long time in the Department of Internal Medicine III of the University Hospital of Munich (LMU) by Professor L. Linder and Professor M. von Bergwelt.
Their scientific interest is in optimizing therapy in patients with locally developed tumor diseases (for example, soft tissue sarcoma, pancreatic cancer). In addition to conducting promising clinical studies, LMU group is working on the development of heat-sensitive liposomes for targeted treatment in combination with local hyperthermia.
This innovative treatment remains inaccessible; in many European countries, hyperthermia is not practiced. Moreover, against the background of increasing scientific interest, we are witnessing the spread of numerous clinics offering an “alternative” treatment, which contradicts science. We warn medical tourists: hyperthermia or different "alternative" methods should not replace or interfere with standard cancer treatment protocols! Talk to other experienced oncologists first.
Scientifically based hyperthermia in Germany is available at:
• University Hospital Düsseldorf
• University Hospital Charite in Berlin
• Private clinic HELIOS Berlin-Buch
• Center for Hematology and Oncology in Munich
• University Hospital Tübingen
• University Hospital Erlangen
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Modern types of hyperthermia treatment
Depending on the tissue and the method of heating, there are several types of treatment.Locoregional hyperthermia
During this procedure, the doctor places a silicone applicator filled with water on the skin in the area of the tumor. Spiral antennas inside the applicator emits electromagnetic waves through the water layer directly into the malignant cells, overheating and destroying tumor.Locoregional hyperthermia is used for metastases to lymph nodes in the neck, recurrent breast tumors, malignant melanoma, etc. This procedure is available in most of the clinics listed above.
Regional deep hyperthermia
A well-known salvage treatment can affect tumors located in the deeper layers of tissue. For example, in the abdominal cavity or in the pelvis. During the procedure, the patient lies in a ring applicator, equipped with pillows containing water. Computer-controlled antennas emit high-frequency electromagnetic waves and heat a specific area.This procedure is considered useful in the treatment of advanced endometrial adenocarcinoma, prostate cancer, cervical cancer, bladder cancer and germ cell tumors in young patients.
Other types and protocols
Body part hyperthermia is a technically difficult and inaccessible procedure. This is a further development of locoregional therapy designed to heat, for example, the entire abdomen.The procedure involves temperature control using magnetic resonance imaging (MRI). Thus, treatment is contraindicated for people with an implanted pacemaker, cochlear implants, metal screws and large tattoos with metal-containing dyes.
For intracavitary (in the body cavities) or interstitial (in soft tissues) hyperthermia, the doctor introduces the emitter under local anesthesia directly into the tumor or through a natural opening. For example, in the vagina, rectum or urethra.
Most of these methods are combined with the neoadjuvant radiation therapy.
In whole body hyperthermia (except for the head), the temperature rises to 41.5 ° C. During the procedure, patient is placed in a heated bed, where computers continuously monitor vital signs. The treatment is completely painless because it is performed under anesthesia. Nevertheless, whole body hyperthermia is not always well tolerated. For safety reasons, doctors do not bring the temperature to the maximum, and the brain must be protected from overheating.
Perfusion hyperthermia for cancer treatment is still studied. During this procedure, the abdominal cavity or well drained organ (liver, lungs) is treated with a warm fluid containing chemo agents. The incidence of local complications increases with increasing fluid temperature, but many systemic side effects can be avoided.
Leading German clinics offer other experimental methods, such as magnetic field hyperthermia (MFH). This involves the introduction of magnetic nanoparticles containing iron oxide.
After the distribution of nanoparticles in the malignant cells, the doctor turns on a powerful magnetic field, which literally “fries” the tumor without affecting the surrounding tissue.
MFH opens up new possibilities in the brain cancer metastases treatment.
Clinical efficacy and side effects of hyperthermia
The approved procedures listed above are usually well tolerated.
Hyperthermia for cancer treatment in Germany is performed responsibly and in strict 100% accordance with the requirements of the IAH interdisciplinary working group. As a rule, patients note a local sensation of heat, sometimes discomfort at the site of application. Only in exceptional cases there are minor skin burns and long-term (up to several weeks) pain. The cause of these transient events is that the heating can damage healthy cells near the tumor.
All university clinics that practice hyperthermia are looking for their own ways to eliminate this side effect. The main solution to the problem is advanced computer control to calculate thermal radiation with the highest accuracy.
In case of unforeseen serious side effects, protocols are prescribed to stop treatment.
Contraindications to hyperthermia treatment include:
• Decompensated heart failure
• Implanted pacemaker or other metal implants in a heated area
• Febrile states with disturbed body temperature regulation
The clinical efficacy is individual and is still studied by leading experts.
It is impossible to predict how useful hyperthermia will be in your particular case.
Some studies have shown that in some patients, heating of the tumors temporarily stops the progression of the disease, and sometimes even reduces the size of the primary tumors and metastases. However, the percentage of response to therapy varies greatly.
German experts recognize the effectiveness of high temperatures in sarcomas of soft tissues, certain types of gynecological cancer (including cervix cancer), prostate and breast cancer. In 2000, the study by Van der Zee and co-authors demonstrated a difference of three-year survival rate when combining radiotherapy and hyperthermia in patients with cervical cancer. In 2018, impressive rates of relapse-free survival rates in patients with advanced ovarian cancer were published (intraperitoneal hyperthermia).
It should be understood that hyperthermia treatment is not a miracle.
A patient with stage IV cancer and multiple metastases cannot be completely cured with high temperature, even in combination with chemotherapy. Although such protocols provide very good results, over time, tumors resume growth and new metastases appear.
Is it worth trying an experimental cancer treatment?
Going for experimental methods of treatment in Germany, you should consult with experienced oncologists and get acquainted with the scientific research on the proposed therapy.• How do leading oncologists assess my chances?
• Are there any recognized scientific publications about my cancer?
• What should I expect from therapy: recovery or additional months of life?
• Is it possible to combine hyperthermia with other methods?
• How painful and safe is the treatment?
• How much will the whole course cost?
If the standard treatment in your case is ineffective, and the proposed alternative is scientifically based, safe and provides good clinical results, it looks like a worthwile option.
© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator