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Learn how hyperthermia treatments (thermal therapy) can dramatically improve your response to radiation or chemotherapy. There are several mechanisms for action with how this treatment works biologically, and some cancers respond better than others. Contact Cyrus Rafie at (888) 580-5900 or visit http://www.bhthermalmedicine.com
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(888) 580-5900www.BHThermalMedicine.com
Focusing on Life
BHThermalMedicine.com 1
Hyperthermia
Hyperthermia, a generally non-invasive gentle treatment, raises tumor temperature to approximately 108 degrees Fahrenheit, a temperature similar to high fever
10/29/20135/6/2013 2/11/14
Hyperthermia Improves Response Rates When Used As A Combined Therapy
Per
cen
t %
Clinical Trial Results
¹Valdagni et al., 1993
²Overgaard et al., 1995
³Issels et al., 2010
⁴Colombo et al., 2010
⁵Van der Zee., 2000
⁶Vernon et al., 1996
⁷Hurwitz et al., 2011
⁸Kakehi et al., 1990
⁹Jones et al., 2005
¹ Vernon et al., 1996⁰
Long-Term Follow up- Randomized Trial comparing RT and RT & HT to Metastatic
Lymph Nodes in Stage IV Head & Neck Patients
Melanoma15X3 Gy, 6 hyperthermia
Coley’s Toxin
Mixture of dead bacteria
First attempts to utilize the immune system to counteract cancer.
Adjuvant to conventional surgery, chemotherapy and radiation
Effective in lymphomas
William Bradley Coley(1862-1936) surgeon and oncologist
Treatment Sites
Skin
Chest Wall
Lymph Nodes
Breast
Head and Neck
Axilla
Extremities
Bladder
Prostate
Pancreas
Vagina
Lower Pelvic Region
Rectum
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Hyperthermia Treatments
Stand Alone
Chemotherapy
Radiation Therapy
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Hyperthermia Compliments and Enhances Other Therapies
Hyperthermia is useful for pre-surgical down-staging
Heat with radiation reduces tumor volume
Hyperthermia sensitizes tumor cells to ionizing radiation
Same dose of radiation yields a better treatment response
A lower dose in patients previously irradiated yields same response
Hyperthermia is useful as a ‘trigger’ for targeting chemotherapy
Heat increases cell membrane permeability to enhance drug uptake
Hyperthermia stimulates immune response
Heat unmasks antigens on surfaces of cancer cells
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Hyperthermia Treatments
Direct Kill
Activating the Immune System
Heat Shock Proteins
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Heat Shock Proteins
Discovered in 1962
Conserved
Thermotolerance
Chaperone
Protection of cells
Heat upregulates expression of the HSP genes
Hyperthermia increase HSP 70 KD
Hyperthermia and Radiation Therapy
Improve Oxygenation of Tumors
Sub-lethal Radiation Damage
S Phase
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Tumor Vascular System
Defective
Leakey
Sympathetic nerve ending missing
Dilated and compressed regions
Irregular branching
Hammersen, 1985
Tumor Vascular System
Inefficient orientation
Relative sparse arterioles
Large flow variation
Large Diameter Shunts
Increased metabolic demand
Packing density
Dewhirst, 2008
Minchiton, 2006
Hypoxia Correlates with Negative Prognosis
Cervix Cancer
Pancreatic Cancer
Head and Neck
Prostate
Breast
Soft Tissue Sarcoma
Hocekel, 1993, 1996
Ide, 2007
Brizel, 1999
Movsas, 2002
Vaupel, 2001,
Lungren, 2007
Brizel, 1996
Hypoxia and Radiation Therapy
Hyperthermia Improves Chemotherapy Treatments
Improves Drug Delivery to the Tumors
Increases Permeability of the Cell Wall
Interfering of Sub-lethal Chemo Damage repair
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Hyperthermia Research Review
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Response of matched superficial lesions
Complete ResponseTumors Radiation Radiation
Author Treated Alone Plus Hyperthermia %
Kim, et al 99 46% 70%Arcangeli 123 39% 76%Overgaard (summary) 186 31% 74%Scott 62 39% 83%
Hyperthermia Treatment
External Superficial
Deep
Interstitial Intracavitary Whole Body
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Hyperthermia Process
Patient Selection
Insurance
Authorization
Records
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Hyperthermia Process (2)
Scheduling
Cyrus Rafie
Medical Oncologist
Radiation Oncologist
Same Day Scheduling
Labs
CT, PET CT, MRI
Biopsy
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Hyperthermia Process (3)
Review medical records
Review diagnostic images
Review with Radiologist
Review with Radiation or Medical Oncologist
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Hyperthermia Process (4)
Size of the tumor
Depth of tumor
Normal tissue
Blood flow
Nerves
Skin folds
Surgical suture lines
Pace maker
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Hyperthermia Devices
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Hyperthermia Treatment
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SONOTHERM® Hyperthermia… the Procedure
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1. The tumor is first located and examinedby mammography.
2. A biopsy is analyzed to determine the tissue make-up of the tumor.
3. An analysis of the tumor’s exterior shape and depth is made.
4. An energy pattern of ultrasound matching the tumor shape is programmed to the 16 transducer sections for optimal treatment.
SONOTHERM® Hyperthermia… the Process Within the Body
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1. Transducer emits ultrasound.
2. Ultrasound energy is absorbed by the tumor and converted to heat.
3. Heat penetrates tumor for therapeutic effect. Normal blood flow cools organs and other body
tissue.
Underdeveloped blood circulation makes tumors more vulnerable to heat.
Hyperthermia Equipment
Microwave
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Hyperthermia Devices
Regional Microwave
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Hyperthermia Devices
Capacitive
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Intracavitary Hyperthermia
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Whole body Hyperthermia
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Hyperthermia Codes
77600 External, 4 cm
77605 External, more than 5 cm
77610 Interstitial, 4 or less
77615 Interstitial, more than 4 77620 Intracavitary
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Adverse Effects
There are no known complications of hyperthermia.
Skin discomfort, irritation or local pain.
Blisters
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Hyperthermia Research Review
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The effect of adjunctive hyperthermia on the radiation response in human tumors
Frequency of Complete ResponseRadiation Radiation
Study No. of Patients / Tumors
Alone % Plus Hyperthermia %Arcangeli, et al 163 38 74
Overgaard 101 39 62Kim, et al 238 39 72Hiraoka, et al 33 25 71Kochegarov, et al
161 16 63Lindholm, et al 85 25 46Scott, et al 44 64 86Li, et al 124 29 54Val dagni, et al 78 36 73Vernon, et al
315 40 60
1,342 35% 66%
Beverly Hills Thermal Medicine
For more information, please visit our
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BHThermalMedicine.com
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