INDIBA Hyperthermia Therapy

How can Hyperthermia Therapy Help with Cancer?

Hyperthermia is a type of treatment in which body tissue is exposed to high temperatures (up to 113ºF), to damage and kill cancer cells, or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. Local hyperthermia treatment (heat applied to a very small area, such as a tumor) is a well-established cancer treatment method with a simple basic principle: If a rise in temperature to 106ºF can be obtained for one hour within a cancer tumor, the cancer cells will be destroyed. Primary malignant tumors have a bad blood circulation, which make them more sensitive to changes in temperature. In local hyperthermia, heat is applied to a small area, such as a tumor, using various techniques that deliver energy to heat the tumor. Different types of energy may be used to apply heat, including microwave, radiofrequency, and ultrasound. Depending on the tumor location, there are several approaches to local hyperthermia.

Hyperthermia & Cancer Facts

National Cancer Institute, National Institutes of Health
Hyperthermia, a procedure in which body tissue is exposed to high temperatures (up to 113 F), is under investigation to assess its effectiveness in the treatment of cancer. Scientists think that heat may help shrink tumors by damaging cells or depriving them of substances they need to live. They are studying local, regional, and whole-body hyperthermia, using external and internal heating devices. Hyperthermia is almost always used with other forms of therapy (radiation therapy, chemotherapy, and biological therapy) to try to increase their effectiveness.

It is known that heating areas of the body that contain a cancer, or heating the tumor 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 (98.6 ºF).

Local Hyperthermia treatment is primarily used to treat cancer that is localized in one part of the body. Giving hyperthermia treatment in combination with non-toxic cancer therapies, chemotherapy drugs or radiotherapy, or with any combination of these modalities, may help to improve the effect of the treatments.

Hyperthermia is suitable for breast cancer that has come back in the breast area (local recurrence).

How does hyperthermia treatment work?

Hyperthermia treatment destroys cancer cells by raising the tumor 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 to the cancer cells and can deprive them of the nutrients they need to survive.

Local Hyperthermia (Indiba)

A heat therapy using current technology with deep heating of the local tissue area. A very high local heat is produced, particularly in firm tissue. Tumor cells do not support this level of heat, and die while healthy tissue is strengthened in the heat. Metabolism is also increased by this treatment. Hyperthermia is applied locally and is totally painless. Application is ideally done 5 times per week; for some individuals, this treatment works well with fewer applications. This therapy is a specialty of the Integrative Cancer Therapy Centers. Within about twenty treatments, the tumor tissue can be regenerated bringing about a scarring over and connective tissue change in the tumor.

Why is the INDIBA method different?

Through the INDIBA method energy from a radio frequency current is directly dissipated in depth inside the tissues between the electrodes. This, in a comparison with heating obtained via external heat sources, avoids the need to go through the skin barrier, thus wasting a large proportion of the generated energy. In comparison with other techniques using radio frequencies, the low frequency used by the INDIBA equipment avoids contraindications like the presence of metal prostheses, use on eyes, varicose veins, scalp, and other sensitive areas which can be successfully treated. Particular advantages have been reported in ophtalmological uses (hypertext to references) INDIBA treatment units employ either a capacitive or resistive currents to induce deep regional hyperthermia. The concentration of power and the increase in temperature is obtained internally in the areas where the movable electrode is placed. Vasodilation is induced with the result that blood circulation is improved. The patient therefore does not experience the unpleasant sensation of being treated with an electric current and consequently there is normally a high patient tolerance of the treatment. Moreover, there are no known side effects or contraindications with this method, which is absolutely harmless.

The INDIBA system can be defined as:

"The application of an RF current (0.45-0.6MHz) that, by traversing the different living tissues (which behave like electrical resistances inversely depending on their water content), produces an electrical power in them that creates an internal thermal increase."

What are commonly used methods to induce hyperthermia?

Temperature is generally raised in tissues by dissipating energy (often electrical) generated by special appliances. Methods commonly used would include:

  1. Induction through an inductive coil system
  2. Ultrasound Short wave radio frequencies (20-30 Mhz)
  3. Infrared radiation (0.79 microns)
  4. Red light therapy Systems with frequencies above 27 Mhz
  5. Ferromagnetic absorbers working by induction of large magneticx systems
  6. Electrode implant systems absorbing high frequency currents.

Different methods have been used to create Hyperthermia. For example: The "natural" method of increasing fever using drugs. Methods of "global corporal hyperthermia" using immersion were developed. Ultrasounds producing deep heat but with the risk of creating "hot spots" on bone structures and of therefore producing energy dispersion upon reflection.

Microwaves (300 - 2450 MHz) and RF (>2MHz) produce an internal thermal increase by molecular friction but with the resulting destructive effect on the tissue. They can be useful on surface lesions but in deep lesions invasive methods are required - interstitial treatment with coaxial antennae or electrodes -, with complex guiding methods, strict temperature controls and in some cases with associated refrigeration systems.

The non-invasive INDIBA method gives rise to an internal thermal increase with none of the disadvantages of other hyperthermia systems, meaning that it can even be applied to the eyes, brain and spinal column, areas that are completely out of bounds to the other methods.

What are the contraindications of Indiba Hyperthermia?

In principle, apart from the proper temperature range and general tissue behavior at higher temperatures, no particular contraindications are to be noted. Prostheses and IUDs can remain in place and even pacemakers could generally be tolerated.

Although, the contraindications for the application of the hyperthermia equipment should be explained by the corresponding practitioner, there are a series of circumstances where precautions must be fully respected.

Electric and electronic implants, internal or externally connected to batteries or radio control, such as: pacemakers, neuro-stimulators, drug dosifiers, cochlear implants and external monitors.

  • Internal hemorrhage processes in acute phase.
  • During pregnancy on the torso.
  • Patients undergoing de-clotting treatment.
  • In the first post-operative 48 hours in some pathologies

Capacitive Electric Transfer (CET)

INDIBA has made a momentous contribution to medicine with its mechanism for local application of high frequency current. It is based on the electric capacitor and its "capacitive" effect, from where the name of this technique derives.

The active or application electrode (1) (see fig. 1) is equivalent to a capacitor plate and is covered by an insulating film (2) that acts in dielectric mode. The second plate of the capacitor (3) is the patient himself, connected to a return electrode that has a larger surface than the active electrode. When high frequency is applied to the electrode the current circulates through the dielectric, passing through the different tissues until it reaches the return electrode, which closes the electrical circuit. (Figure 2)

The specialist initiates the application by spreading a fine layer of conductive moisturising cream over the area to be treated and then sliding the electrode over the area (applying suitable pressure). Partially superimposed circles are drawn, covering the whole surface to be treated. After a few minutes a thermal increase will be felt on the skin - exteriorisation of the temperature created inside. The power knob of the generator can be regulated in order to obtain the maximum heat level that can be tolerated on the skin. It is worth highlighting that due to the device's technical characteristics it can be applied through bone structures, such as the cranium and create non-invasive hyperthermia on the brain

In 1994 INDIBA included the RET in its generator. This creates an internal thermal increase based on the same electrical principles as the CET. However, the capacitive interface is replaced with the use of the resistive characteristic of tissues for the direct application of high frequency (as the application electrode is not insulated), thus obtaining less dispersion of energy and a deeper temperature increase. (Fig. 3)

The method of application is similar to the CET but without requiring the continual moving of the electrode. It is therefore easier to use and can be applied to skin lesions. With this technique a deeper internal thermal increase is produced.

A greater therapeutic efficacy has been demonstrated in many pathologies. Using both techniques, firstly the capacitive and afterwards the resistive, improves results

Thermal Effects

  • Tissue subjected to the passing of high frequency current raises its temperature as a result of the Joule effect.

  • The electric field route is conditioned by the resistivity of the area's tissues. A highly vascularized tissue is much more conductive than a bony tissue with a high resistance, and therefore the vascularized area will receive more current and generate more heat there.
  • The circulating blood flow conveys the heat by conduction to nearby areas such as joints that do not generate it due to their bony structure.
  • The refrigeration produced by the blood flow of the area treated allows the temperature to be maintained at bearable limits.
  • The high frequency applied (fig. 4) is a cold energy (1) that generates a temperature increase in the inside of the tissue that reaches the surface (2). This also heats the electrode (3) (not the other way around, as was previously thought).

Effects of the procedure:

  • Increase in blood and lymph circulation
  • Increase of oxygen pressure
  • Decrease in carbonic acid production and decrease in tissue acidity
  • Increase in internal temperature
  • Revitalization on a cellular level
  • Increased activity of the immune system locally

Oncology action of hyperthermia

  • Greater heat sensitivity of neoplastic tissues to hyperthermia due to its chronic ischemia and hypoxia and acid pH.
  • Lethal effect on tumoral cells at a temperature of 43Deg C., depending on the application time. The application of repeated moderate hyperthermia at between 39 – 41 degrees C can also produce a temporary growth stabilization.
  • Prolonged action of the temperature inside the tumor - due to lower thermal dissipation caused by a chronic ischemia, as a result of its reduced vaso-regulation mechanisms, that increases to an even greater degree of its ischemia, hypoxia and acidity typical of tumor tissue.
  • Alterations in the cycle of the neoplastic cells, which lead to the blocking of the mitosis in part of the cell population. The blocking seems to be due to a disruption in the synthesis phase of DNA (S-phase of the cell cycle).
  • Hyperthermia has a more marked action on the central core of tumor -necrotic, ischemic, hypoxic and with low pH-, which is less sensitive to radiation. In the tumor periphery -vascularized and with greater cell growth-, radiotherapy is more effective. The benefits of a combined action of Hyperthermia and RT and/or ChT were demonstrated many years ago.
  • It can facilitate apoptosis mechanisms, self -destruction of cells, which are normally absent in tumoral cells.
  • The "athermic" effect of the INDIBA RF generator on cell cultures has shown a significant decrease of the neoplastic cell population and no undesirable effects on normal cells. This could be related to changes of the electrical potential of the neoplastic tissues.

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