Does Hyperthermia Work As An Anti-Cancer Treatment?

Based on an article titled “The role of hyperthermia in the treatment of locally advanced cervical cancer: a comprehensive review”

Originally written by: IJff et al., 2022

https://ijgc.bmj.com/content/early/2022/01/19/ijgc-2021-002473

By: Murielle Nsiela 

Introduction to hyperthermia treatment

Hyperthermia is when the body’s temperature is abnormally high1. It is now used in combination with chemotherapy and radiotherapy to treat several tumour types, including; recurrent breast cancer, cervical cancer, head and neck cancer, bladder cancer, melanoma and soft tissue cancer2. This technique uses temperatures above normal physiological levels (40-43°C ) for an hour3. This technique was first used by Frans Westermark in 1898 to treat cervical cancer. His son, Nils Westermark,  carried on the work and hypothesised that tumour tissues are sensitive to heat in comparison to healthy tissue4

How does it work?

Hypothermia treatment affects the cells and tissues in various ways such as altering the physical properties of the cell components, as well as its cellular responses. For example, hyperthermia treatment can alter the Deoxyribonucleic acid (DNA) repair process of tumours, hindering them from replicating. The treatment can also target cancer cells in the state where they do not have enough oxygen present (hypoxic state) and targets nutrient-deprived tumours where radiation and chemotherapy are less effective. Furthermore, hyperthermia can also alter the factors that are essential for tumour survival and growth, including the oxygen supply, microenvironment and immune responses 5,3

The effectiveness of hyperthermia depends upon the temperatures used, the duration of the treatment, and the time intervals between the use of radiotherapy and hyperthermia. Evidence has suggested that applying radiotherapy and hyperthermia at the same time provides the best results. In addition, it has been suggested that the time interval between hyperthermia and ionising radiation should be as short as possible, within one hour. This is because longer intervals will prevent the inhibition of DNA repair due to the reduced effectiveness of hyperthermia 6,4. Therefore, hyperthermia in combination with chemotherapy and radiotherapy has a synergistic effect instead of just an additional effect. 

Hyperthermia devices  

Hyperthermia devices used for deep-seated tumours, including cervical cancer, use electromagnetic energy, which can be divided into two systems- radiative and capacitive. Radiative heating devices are positioned around the patient’s pelvis, whilst capacitive heating devices use two electrodes placed in front of and behind the pelvis. It has also been suggested that achieving the targeted temperature for hyperthermia treatment is more challenging with the captive device than with the radiative device4.  

Results

Studies have compared treatment with chemoradiation alone and chemoradiation combined with hyperthermia; it was shown that the combination therapy had slightly better performance in comparison to the former. In other words, there were no significant differences in overall survival rates between the two treatment methods4

Some studies found that there has been no increase in toxicity when hyperthermia is added to the treatment. In contrast, others found some toxicity in palliative cancer patients7. Some studies reported that hyperthermia leads to late and acute toxicities, such as thermal burns, fat necrosis, and patient discomfort, which have all been considered hyperthermia-related toxicities8. However, with good quality assurance control, these toxicities can be limited. Furthermore, the treatment with hyperthermia is only contraindicated for patients with pacemakers and hip prostheses. This, therefore, makes this treatment method suitable for patients with advanced cervical cancer and other cancers4

Summary

In summary, treatment with cisplatin and radiotherapy is the standard treatment for advanced cervical cancer. However, the use of chemoradiation and the combination of hyperthermia and radiotherapy has proven to be a well-tolerated alternative treatment. In general, it should be provided to individuals who are contraindicated to have cisplatin. In addition, a good hyperthermia treatment should involve well-trained and experienced professionals, with the use of adequate hyperthermia devices with a good treatment plan and quality assurance. 

References

  1. Hyperthermia: Symptoms, Causes, Treatment and Recovery [Internet]. Cleveland Clinic. 2022 [cited 28 May 2022]. Available from: https://my.clevelandclinic.org/health/diseases/22111-hyperthermia 
  2. Datta NR, Ordóñez SG, Gaipl US, Paulides MM, Crezee H, Gellermann J, et al. Local hyperthermia combined with radiotherapy and-/or chemotherapy: Recent advances and promises for the future. Cancer Treatment Reviews [Internet]. 2015 [cited 2022 Aug 24]; 41(9):742–53. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0305737215001048.  
  3. Crezee J, Franken NAP, Oei AL. Hyperthermia-Based Anti-Cancer Treatments. Cancers [Internet]. 2021 [cited 2022 Aug 24]; 13(6):1240. Available from: https://www.mdpi.com/2072-6694/13/6/1240.
  4. IJff M, Crezee J, Oei AL, Stalpers LJA, Westerveld H. The role of hyperthermia in the treatment of locally advanced cervical cancer: a comprehensive review. Int J Gynecol Cancer [Internet]. 2022 [cited 2022 Aug 24]; 32(3):288–96. Available from: https://ijgc.bmj.com/lookup/doi/10.1136/ijgc-2021-002473.
  5. Elming P, Sørensen B, Oei A, Franken N, Crezee J, Overgaard J, et al. Hyperthermia: The Optimal Treatment to Overcome Radiation Resistant Hypoxia. Cancers [Internet]. 2019 [cited 2022 Aug 24]; 11(1):60. Available from: https://www.mdpi.com/2072-6694/11/1/60.
  6. Leeuwen CM van, Oei AL, Chin KWTK, Crezee J, Bel A, Westermann AM, et al. A short time interval between radiotherapy and hyperthermia reduces in-field recurrence and mortality in women with advanced cervical cancer. Radiat Oncol [Internet]. 2017 [cited 2022 Aug 24]; 12(1):75. Available from: http://ro-journal.biomedcentral.com/articles/10.1186/s13014-017-0813-0.
  7. Richel O, Zum Vörde Sive Vörding PJ, Rietbroek R, Vander Velden J, Van Dijk JDP, Schilthuis MS, et al. Phase II study of carboplatin and whole body hyperthermia (WBH) in recurrent and metastatic cervical cancer. Gynecologic Oncology [Internet]. 2004 [cited 2022 Aug 28]; 95(3):680–5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0090825804006584.
  8. Zee J van der, González DG. The Dutch Deep Hyperthermia Trial: results in cervical cancer. International Journal of Hyperthermia [Internet]. 2002 [cited 2022 Aug 28]; 18(1):1–12. Available from: http://www.tandfonline.com/doi/full/10.1080/02656730110091919.
  9. What is Chemotherapy? Cancer.Net [Internet]. 2012 [cited 2022 Aug 28]. Available from: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/what-chemotherapy.
  10. Radiotherapy. nhs.uk [Internet]. 2017 [cited 2022 Aug 28]. Available from: https://www.nhs.uk/conditions/radiotherapy/.
  11. Deoxyribonucleic Acid (DNA). Genome.gov [Internet]. [cited 2022 Aug 28]. Available from: https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid.
  12. Ionizing radiation, health effects and protective measures [Internet]. [cited 2022 Aug 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/ionizing-radiation-health-effects-and-protective-measures.
  13. Electromagnetic radiation | Spectrum, Examples, & Types | Britannica [Internet]. [cited 2022 Aug 28]. Available from: https://www.britannica.com/science/electromagnetic-radiation.
  14. Quality Assurance vs Quality Control: Definitions & Differences | ASQ [Internet]. [cited 2022 Aug 28]. Available from: https://asq.org/quality-resources/quality-assurance-vs-control.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

Get our health newsletter

Get daily health and wellness advice from our medical team.
Your privacy is important to us. Any information you provide to this website may be placed by us on our servers. If you do not agree do not provide the information.

Murielle Nsiela

MSc Graduate in Medical Engineering - Bachelor's degree, Pharmaceutical Science, Keele University, Staffordshire UK

MSc in Medical Engineering Design, Keele University Modules included: Advanced engineering applications, Engineering for medical applications report, Bioreactors and Growth environment, Creative engineering design, Experimental research methodology and research projects



BSc (Hons) Pharmaceutical Science, Technology and Business, Keele University Modules included: Core topics in pharmaceutical science, Laboratory studies - tabletting and liposomes report, applied Pharmaceutical Science 2, Pharmaceutical research project

Leave a Reply

Your email address will not be published. Required fields are marked *

my.klarity.health presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
Email:
Klarity / Managed Self Ltd
Alum House
5 Alum Chine Road
Westbourne Bournemouth BH4 8DT
VAT Number: 362 5758 74
Company Number: 10696687

Phone Number:

 +44 20 3239 9818