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Heat therapy as
an alternative practice is different from" hyperthermia" as used in
conventional clinical trials for treatment of cancer. Both types of
heat therapy are discussed here.
Other common
name(s): hyperthermia, heat treatment, thermotherapy,
thermal therapy
Scientific/medical
name(s): none
Description
Heat therapy involves exposing part or all of the body to high
temperatures, usually to enhance other forms of therapy, such as
radiation and chemotherapy. Heat may be applied to affected parts of
the body along with other treatments to help relieve certain kinds of
pain or a few types of infections. Heat therapy may also involve
injecting substances to cause a fever, such as DNP (chemical name
2-4-dinitrophenol) (see also Coley Toxins).
Overview
Local and regional heat therapy is being studied as part of
conventional treatment for some cancers. Heat therapy is currently
being investigated, and clinical trials are studying its use alone and
in combination with radiation therapy and chemotherapy. More research
is needed to determine the full benefits of heat therapy in cancer
treatment.
Heat can be used in different forms to help relieve joint or
muscle pain due to arthritis, injury, or inflammation. It is also used
along with antibiotics for certain kinds of infections that are close
to the body's surface, such as skin infections.
The use of heat therapy for cancer treatment outside clinical
trials remains questionable and is considered an alternative treatment.
There are some serious complications associated with whole-body heat
therapy.
The injection of unproven substances such as DNP to cause
"intracellular hyperthermia" (see below) and fever has caused deaths.
Available scientific evidence has not supported claims that this is a
useful treatment for cancer.
How is it promoted for use?
There is some evidence that local and regional heat therapy
may help stop cancer growth. In some cases, increasing temperature by
several degrees may increase the effectiveness of radiation therapy and
chemotherapy. One possible reason for this is that poor supply of blood
and oxygen in some types of tumor cells make them resistant to
chemotherapy and radiation. Heat therapy seems to help by increasing
blood flow and improving the oxygen supply to the tumor, which can make
the cancer cells more responsive to these medical treatments. Local and
regional heat therapy is being studied as a way to improve delivery of
certain drugs to the cancer.
Conventional medicine also uses lasers, radiofrequency
devices, and other methods for raising temperature of tissues high
enough to kill or in some cases, even vaporize diseased tissue.
Although these methods use heat, they are not considered forms of
hyperthermia.
Proponents of the alternative use of heat therapy claim that
it reduces or even eliminates the need for conventional treatment. They
say it decreases the number of invading organisms so the immune system
can handle them, acting much like a fever helping the body fight off
disease.
There is also an unproven treatment called intracellular
hyperthermia, which is based on the theory that injection of DNP into
the body heats cells from the inside out. Available scientific evidence
does not support these claims. The injected substance is known to be
dangerous and has caused deaths.
What does it involve?
Three major types of heat therapy are being investigated by
medical researchers: local, regional, and whole-body.
- Local heat therapy involves applying heat to a very small
area, such as a tumor. The area may be heated externally, with
high-frequency waves, or internally, using sterile probes (thin, heated
wires or hollow tubes filled with warm implanted microwave antennae)
and radiofrequency electrodes. The temperature of the tumor is high
enough to rapidly kill its cells.
- In regional heat therapy, an organ or limb is heated. One
method, called perfusion, involves removing the patient's blood,
heating it, and then pumping it into a region to heat it internally.
- Whole-body heat therapy is used to treat metastatic cancer
(cancer that has spread). It involves the use of warm blankets, hot
wax, inductive coils (similar to those used in electric blankets), or
thermal chambers (similar to large incubators).
In mainstream medicine, heat is sometimes applied to the
outside of the body to help relieve stiffness and pain from arthritis
or other muscle and joint problems. This may involve warm compresses,
warm baths, melted paraffin, or other techniques. Heat is sometimes
used with conventional therapy to help treat certain skin infections or
inflammation. Warm soaks, warm compresses, and other means may be used
to heat the affected area. Some of these methods are used in treatment
centers, while others can be used at home.
Intracellular hyperthermia is an alternative therapy that
involves the injection of a substance called DNP to produce fever. It
may be used along with other types of treatment in nontraditional
treatment settings.
What is the history behind it?
The first documented use of heat treatment dates back to 400
BC with Hippocrates. In 500 BC, the Greek physician Parmenides believed
that if he could create fever, he could cure all illness. The early
Romans used elaborate heat baths and Native Americans have used sweat
lodges in cleansing practices for centuries (see Native American Healing).
The first scientific study of heat therapy began in 1866, when
M. Busch, a German physician, described a patient with a neck sarcoma
which disappeared after he experienced a high fever. Similar reports
were made by others 20 years later. In 1893, F. Westermark, a Swedish
gynecologist, administered bacterial toxins extracted from
Streptococcus and Serratia marcescens to cause fever and used a coil
containing hot water as a localized source of heat to treat uterine
tumors. Reports followed of tumors responding to both localized and
whole-body heat therapy treatments. However, the scientific evidence
was weak and interest soon faded.
In the 1960s, a series of biochemical studies involving the
effects of elevated temperature on normal and malignant cells were
conducted using rodent cells. Based on their observations, researchers
concluded that cancer cells were more sensitive to heat than normal
cells. However, studies have since shown that there is little or no
difference between cancer cells and normal cells in terms of their
response to heat alone.
What is the evidence?
In a technique called radiofrequency ablation, very high
temperatures can be used to kill cancer cells directly, but the heat is
carefully controlled and precisely targeted to avoid damaging normal
tissues. Radiofrequency ablation uses much higher temperatures than
hyperthermia, and uses electrodes to heat and destroy the cancer (see Radiofrequency Ablation).
The temperatures normally used for hyperthermia (up to
113º F) are usually not hot enough to kill cancer cells unless
used along with radiation therapy or chemotherapy. Many laboratory and
clinical studies have shown that heat therapy can enhance the
effectiveness of radiation therapy in local and regional tumor control.
It can also make chemotherapy more effective for some cancers.
Whole-body heat therapy is currently being studied as a method to treat
illnesses that are spread throughout the body.
More research is underway on different types of chemotherapy
that can be used along with local and regional heat therapy as well as
whole body heat therapy. While hyperthermia is a promising way to
improve cancer treatment, it is largely an experimental technique at
this time and is not commonly used. Many clinical trials of
hyperthermia are now being done to try to find the best way to use this
technique. Current studies are looking at its usefulness in treating
many types of cancer (see Hyperthermia).
Local heat is also applied to certain areas of the body in
conventional medicine. It has been shown in clinical studies to help
relieve symptoms such as arthritis pain for a short time. Its use with
other medical conditions, such as small skin infections, may help speed
healing. There is less high-quality evidence available on the effect of
heat on infections.
Available evidence for DNP and other alternative substances
that are injected to induce fever do not support claims that it can
treat cancer or other illness. There is, however, evidence that some of
these treatments have caused harm or death.
Are there any possible problems or
complications?
Heat therapy can cause internal bleeding. The high death rate
and labor-intensive methods associated with whole-body heat therapy
have also caused concerns. Heat therapy should only be given under
careful supervision by qualified physicians. Most normal tissues are
not harmed during physician-administered hyperthermia if the
temperature stays below 111 to 113° F. However, the heat can be
uneven, and some areas of the body can be exposed to greater heat,
resulting in burns, blisters, or pain.
Heat should be used with caution in people who have anemia,
heart disease, diabetes, seizure disorders, or tuberculosis, as well as
women who are pregnant, and people who are sensitive to the effects of
heat.
Hot compresses or soaks used to help treat skin infections can
spread germs to others if the container or compress is not thoroughly
cleaned after use. Talk with your doctor about how to best protect
others if heat is recommended for an infection.
"Intracellular hyperthermia" using DNP has caused a number of
deaths. DNP has long been banned by the FDA because of this. Relying on
this type of treatment alone and avoiding or delaying conventional
medical care for cancer, may have serious health consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Barrett S. Stay away from Nicholas Bachynsky and
intra-cellular hyperthermia (ICHT). Accessed at: www.quackwatch.org on
May 30, 2008.
Dewhirst MW, Jones E, Samulski T, et al. Hyperthermia. In Kufe
DW, Bast RC, Hait WN, et al (Eds). Cancer
Medicine 7. Hamilton, Ontario: BC Decker, Inc.;2006:
549-562.
Katschinski DM, Wiedemann GJ, Mentzel M, Mulkerin DL, Touhidi
R, Robins HI. Optimization of chemotherapy administration for clinical
41.8/C whole body hyperthermia. Cancer
Lett. 1997;115:195-199.
Nakamura Y, Xu X, Saito Y, et al. Deep cutaneous infection by
Fusarium solani in a healthy child: Successful treatment with local
heat therapy. J Am Acad
Dermatol. 2007;56:873-877.
National Cancer Institute. NCI Fact Sheet: Hyperthermia in
cancer treatment: Questions and Answers. Accessed at:
http://www.cancer.gov/cancertopics/factsheet/Therapy/hyperthermia on
February 21, 2007.
Robins HI, Rushing D, Kutz M, et al. Phase I clinical trial of
melphalan and 41.8/C whole-body hyperthermia in cancer patients. J Clin Oncol.
1997;15:158-164.
Robinson V, Brosseau L, Casimiro L, et al. Thermotherapy for
treating rheumatoid arthritis. Cochrane Database Syst Rev.
2002;(2):CD002826.
US Congress, Office of Technology Assessment. Unconventional
Cancer Treatments. Washington, DC: US Government Printing Office; 1990.
Publication OTA-H-405.
van der Zee J. Heating the patient: a promising approach? Ann Oncol.
2002;13:1173-1184.
Wust P, Hildebrandt B, Sreenivasa G, Rau B, Gellermann J,
Riess H, Felix R, Schlag PM. Hyperthermia in combined treatment of
cancer. Lancet Oncology.
2002;3:487-497.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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