Non-oncological & oncological whole-body hyperthermia and a new immunological road to attack cancer? -some treatment procedures
There is an increasing number of publication-based non-oncological indications in which the application of modern whole-body hyperthermia (WBH) can bring about an alleviation for the patients. Some of these indications are arterial hypertension, chronic back pain, fibromyalgia syndrome, psoriatic arthritis, ankylosing spondylitis, systemic scleroderma and major depressive disorder. This presentation wants to inform about the procedure in the mentioned indications. In a first Table 1 “Publication-Based Treatment Procedures for WBH for some Non-Oncological Indications” are the main parameters for the WBH procedure given with some remarks and together with the publications behind the procedure.
Furthermore, the application of WBH adjuvant to the conventional methods for the treatment of cancer patients – surgery, radiotherapy and chemotherapy – could be helpful. By WBH before operation, which increases the microcirculation and activates the immune system, the risk of wound infection after surgery is reduced. WBH increases with its intensified perfusion the oxygen partial pressure in tumors for higher x-ray sensitivity. WBH combined with chemotherapy for the treatment of cancer patients in a therapy resistant, metastatic or advanced stage of solid malignancies can improve the response rate and increases the quality of life.
Last but not least a view onto the immune system. It is still not proved by (published) clinical trials with cancer patients but there is a good probability that WBH with temperatures until fever-range supports the efficacy of checkpoint inhibitors. Also, not proved by clinical trials is the proposal of Hatfield & Sitkovsky to activate the cytotoxic T-cells to kill cancer cells by increasing the Oxygen partial pressure in the tumor, followed by a reduced adenosine concentration in the tumor microenvironment, and in connection with an adoptive immunotherapy. Fever-range WBH could support this process by increasing the killing efficiency of the cytotoxic T-cells. In a second Table 2 “For Discussion: Treatment Procedures regarding Adjuvant Treatment of Cancer Patients with WBH” is given a proposal of the main parameters for the WBH procedure with the rationale of the procedure and remarks together with the associated publications.
For all the mentioned indications and procedures are currently two leading devices used, realizing body-core temperatures from mild until extreme WBH
Table 1 Publication-Based Treatment Procedures of Whole-Body Hyperthermia for some Non-Oncological Indications
| Indication | Target-Temperature
T (rectal) °C |
Heating-Up
Phase min |
Plateau Phase;
(Retention) min |
Resting Phase
min |
Number of
Sessions |
Monitoring |
| Arterial Hypertension | 38,3 | 30 | 0 | 30 | 8 (2 x /week) or
8 (every 2days) |
T(axillary),
Pulse |
| Chronic Back Pain | 38.5 | 45 | 15 | 30 | 7 (1 x /week) | T(rect), T(axill),
Pulse |
| Fibromyalgia Syndrome | 38.1 | 40 | 15 | 30 | 6 (2 x /week), or
6 (every 2 days) or 6 consecutive days |
T(axill), Pulse |
Based Treatment Procedures of Whole-Body Hyperthermia for some Non-Oncological
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Literature • Mischke M. Wirkungen einer einmaligen bzw. seriellen Infrarot-A-Hyperthermie bei Patienten mit arterieller Hypertonie der
WHO-Stadien I und II. Diss. Humboldt-Universität Berlin 18.07.1991
- MeffertH, Scherf HP, Meffert B. Milde Infrarot-A-Hyperthermie: Auswirkungen von Serienbestrahlungen mit
wassergefilterter Infrarotstrahlung auf Gesunde und Kranke mit arterieller Hypertonie bzw. systemischer Sklerodermie. Akt
Dermatol, 1993;19:142-148
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Literature • Weller E, Ullrich D. Infrarot-A-Hyperthermie-Anwendung bei Patienten mit Analgesic-Abusus wegen chronischer
Rückenschmerzen. Vortrag auf dem 95. Kongreß der Gesellschaft für Phys Med und Rehab 5.10.1990
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Literature • Brockow T, Wagner A, Franke A, Offenbächer M, Resch KL. A Randomized Controlled Trial on the Effectiveness of Mild Water-filtered
Near Infrared Whole-body Hyperthermia as an Adjunct to a Standard Multimodal Rehabilitation in the treatment of Fibromyalgia. Clin J
Pain 2007;1:67-75 • Walz J, Hinzmann J, Haase I, Witte T. Ganzkörperhyperthermie in der Schmerztherapie – eine kontrollierte Studie
an Patient. mit Fibromyalgiesyndrom. Schmerz 2013;1:38-45 • Romeyke T, Stummer H. Multi-modal pain therapy of fibromyalgia
syndrome with integration of systemic whole-body hyperthermia – effects on pain intensity and mental state: A non-randomised
controlled study. J Musculoskel Pain 2014;4:341-55
| Psoriatic Arthritis | 38,5 | 45 | 15 | 30 | 6 (in 8 days) or 6
consecutive days |
T(rect), T(axill),
Pulse |
| Axial Spondyloarthritis | 38 | 30 | 15 | 120 in bed | 6 (2 x /week) | T(axill), Pulse |
| Ankylosing Spondylitis | 38,5 | 45 | 15 | 30 | 6 (in 8 days) or 6
consecutive days |
T(rect),
T(axill), Pulse |
| Systemic Scleroderma | 38,3 | 30 | 0 | 30 | 15 (2 x /week) or
15 (every 2 days) |
T(axill), Pulse |
- SchleenbeckerHG, Schmidt KL. Zur Wirkung einer iterativen milden Ganzkörper-hyperthermie auf den Fibromyalgieschmerz.
Phys. Rehab. Kur Med, 1998;8:113-117
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Literature • Lange U, Schwab F, Müller-Ladner U, Dischereit G. Wirkung iterativer Ganzkörperhyperthermie mit wassergefilterter
Infrarot-A-Strahlung bei Arthritis psoriatica – eine kontrollierte, randomisierte, prospektive Studie. Akt Rheumatol
2014;05:310-16
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Literature • Stegemann I, Hinzmann J, Haase I, Witte T. Ganzkörperhyperthermie mit wassergefilterter Infrarot-A-Strahlung bei
Patienten mit axialer Spondyloarthritis. Orthopäd. & Unfallchirurg. Praxis 2013;10:458-463
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Activity Index
Literature • Lange U, Müller-Ladner U, Dischereit G. Effectiveness of whole-body hyperthermia by mild water-filtered infrared-A
radiation in ankylosing spondylitis – a controlled, randomized, prospective study. Akt Rheumatol 2017; 2:122-128
- ZaunerD, Quehenberger F, Hermann J, Dejaco C, Stadner MH, et al. Whole-body hyperthermia treatment increases
interleukin 10 and toll-like receptor 4 expression in patients with ankylosing
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sustained reduced
Literature • Meffert H, Scherf HP, Meffert B. Milde Infrarot-A-Hyperthermie: Auswirkungen von Serienbestrah-lungen mit
wassergefilterter Infrarotstrahlung auf Gesunde und Kranke mit arterieller Hypertonie bzw. systemischer Sklerodermie. Akt
Dermatol, 1993;19:142-148
| Major Depressive Disorder | 38.5 | 110 | 60 | 0 | 1 | T(rect), T(axill), Pulse |
| Procedure | Rationale | Target-
Temperature T(rectal) °C |
Heating-Up
Phase min |
Plateau Phase;
(Retention) min |
Resting
Phase min |
Number
of Sessions |
Monitoring |
| Surgery
+ Whole-Body Hyperthermia |
Whole-body hyperthermia before
surgery activates the immune system and reduces the risk of a postoperative infection. Hypothesis: better wound care on the side of the body-own immune defense |
+ 0.35 | 30 | 0 | 0 | 1 x right before
surgery |
T(axill) |
- FörsterJ, Fleischanderl S, Wittstock S, Storch A, Meffert H. Letter to the Editor: Infrared-Mediated Hyperthermia is Effective in the
Treatment of Scleroderma-Associated Raynaud’s Phenomenon. J Investig Dermatol, 2005;6:1313-16
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that persisted for 6 weeks after treatment.
Literature • Janssen CW, Lowry CA, Mehl MR, Allen JJB, Kelly KL, Gartner DE, Medrano A, Begay TK, Rentscher K, White JJ, Fridman
A, Roberts LJ, Robbins ML, Hanusch KU, Cole SP, Raison CL. Whole-Body Hyperthermia for the Treatment of Major
Depressive Disorder – A Randomized Clinical Trial. JAMA Psychiatry 2016; 8:789-95
- MeestersY, Beersma DGM, Bouhuys AL, vdHoofdakker RH. Prophylactic Treatmet of Seasonal Affective Disorder (SAD)
by Using Light Visors: Bright White or Infrared Light. Soc Biol Psychiatry 1999; 46:239-246Table 2 For Discussion: Treatment Procedures regarding Adjuvant Treatment of Cancer Patients with
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421 patients with clean breast, varicose vein, or hernia surgery randomized in control- and treatment group. Whole-body hyperthermia
device was left in situ until just before surgery.