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Saturday, May 17, 2008

Hyperthermia treatment

This information is about the use of hyperthermia treatment in cancer. It is mainly used as part of research trials and is usually given with other cancer treatments such as radiotherapychemotherapy (anti-cancer drugs). (high-energy rays) and

Hyperthermia is used to treat a number of different types of cancer. These include cancer of the gullet (oesophagus), stomach, breast, pancreas, cervix and rectum. It can also be used to treat melanoma, mesothelioma and some types of soft tissue sarcoma.

Hyperthermia treatment

Hyperthermia means an abnormally high body temperature. It is thought that heating areas of the body that contain a cancer, or heating the tumour itself, may help to kill cancer cells. This treatment exposes the body tissue to high temperatures, between 40°–45°C (104º–113ºF), without harming surrounding healthy tissue. The normal body temperature is 37°C (98.6ºF).

Hyperthermia treatment is mostly used to treat cancer that is localised in one part of the body. Giving hyperthermia treatment in combination with chemotherapy drugs or radiotherapy, or with both, may help to improve the effect of these treatments.

At the moment hyperthermia treatment is not available in the UK. It is available in Europe however, and a small number of patients in the UK may be able to have this treatment abroad through the NHS. Hyperthermia is suitable for breast cancer that has come back in the breast area (local recurrence).

How hyperthermia treatment works

Hyperthermia treatment destroys cancer cells by raising the tumour temperature. This is similar to the way the body uses fever to fight infection.

When normal body tissue is heated the blood vessels open up (dilate) to allow the blood to flow more freely. This helps to cool down the area and prevent damage. The blood supply to cancer cells is different. The blood vessels cannot dilate as well and blood flow is generally slower. When heat is applied to a cancer, the cells are less able to cool down and are more likely to be damaged by the high temperature. The effect of the heat damages the cancer cells and can deprive them of the nutrients they need to survive.

Hyperthermia treatment is almost always used in combination with either radiotherapy or chemotherapy.

How the treatment is given

How the treatment is given, and how much treatment is needed, depends on a number of factors. These include the part of the body affected by cancer and the size and shape of the tumour.

There are three ways in which hyperthermia can be given, depending on how much of the body needs treatment. These are known as local, regional and whole body hyperthermia. This information discusses local hyperthermia. If you would like information about regional or whole body hyperthermia, please contact our cancer support service nurses.

Local hyperthermia treatment

In local hyperthermia treatment, heat is applied to a small area only. This is done using applicators that are placed close to, or in, the tumour. There are different ways to deliver local hyperthermia: external; intraluminal (also called endocavitary); and interstitial. The method used depends on the type and position of the tumour.

External This is the technique that is used to treat breast cancer. It is also used for cancers that are on, or just below, the skin. The tumour is heated externally using applicators that are placed on, or near to, the affected area. Heat is then applied using high-frequency energy waves generated from a device outside the body (such as a microwave or ultrasound).

Intraluminal or endocavitary hyperthermia This may be used to treat cancers that are within or near to body cavities, such as the gullet (oesophagus) or rectum. A sterile probe that can be heated (a thin wire or hollow tube filled with water) is placed inside the cavity where the tumour is. This heats the affected area.

Interstitial hyperthermia This is used to treat tumours which are deep within the body, such as brain tumours. Under anaesthetic, probes or wires are placed within the tumour tissue and then heated. This method allows tumours to be heated to a higher temperature than external techniques.

How local hyperthermia treatment is given

You will lie on a bed or treatment couch and have a local anaesthetic to numb the area. Temperature monitors are applied to the area around the tumour. Thin plastic tubes (catheters) are then inserted into the tumour and small thermometers are placed inside the catheters.

To control the skin temperature, a water bag is placed on the area to be treated. The applicator (a small metal box which contains microwave radiators) is placed on the water bag. You will be awake during the procedure and asked to remain fairly still. During the treatment, members of staff are always nearby and will come and make adjustments to the position of the applicator. Each treatment can take up to an hour and a half.

During treatment, the staff will aim to get the temperature in the tumour as high as possible without damaging nearby tissues. The temperature will be measured continually and will be increased as long as you are comfortable. If you feel symptoms such as a burning sensation or a feeling of pressure on the area being treated, it is important you tell a member of staff. It may be that the temperature is too high and needs adjusting.

You might find that your whole body temperature starts to increase during treatment. You will be kept as comfortable as possible with air conditioning, wet towels and extra ventilation.

If you are having treatment for a tumour deep within the body, you will have your blood pressure and heart rate (pulse) monitored regularly and your temperature will also be checked.

You can have a relative or friend with you in the room during the procedure. If your companion has a pacemaker or is pregnant, however, they are not allowed to stay in the treatment room.

Possible side effects

Generally hyperthermia treatment is tolerated well with few side effects or complications.

During treatment you may feel a sensation of heat (like a hot water bottle). Heat applied directly to the skin can cause discomfort. It can also cause blisters, which usually heal within a few weeks.

Increasing the temperature of the treatment may cause the skin to burn or may cause muscle tenderness. The burn might result in a firm, tender spot below the skin. It will heal and usually the tenderness will disappear within a few days. This may cause problems, however, if you need further hyperthermia treatment.

Often people feel very tired after treatment. Usually the tiredness disappears after a few hours or following a night's sleep.

Skin care

If blisters develop during the treatment, it is important to treat the area with care. Try not to get the area too wet and avoid soaps, talcum powder and deodorant. Do not apply creams or dressings unless they have been prescribed or recommended by your specialist. Staff at the hospital will be able to give you advice on how to look after your skin.

References

This section has been compiled using information from a number of reliable sources, including:

  • Vernon C C and Hand J W (2002) Hyperthermia in the treatment of cancer in Treatment Of Cancer (4th Edition) Eds. Price P and Sikora K. London, Arnold, 81 –102.
  • Wust P et al (2002) Hyperthermia in combined treatment of cancer. The Lancet Oncology.3, 487–97.
  • National Cancer Institute of America. www.cancer.gov

For further references, please see the general bibliography.

Via: http://www.cancerbackup.org.uk

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