Targeted Thermotherapy
High frequency thermotherapy
High frequency thermotherapy (HFTT) heats a tumor from the inside with high-frequency electromagnetic energy delivered through applicators on the skin. It is a form of local hyperthermia for deep-seated tumors and is given alongside the oncologist's treatment, in sessions of 45 to 60 minutes without anesthesia.
What is HFTT?
HFTT is a form of local hyperthermia. High-frequency electromagnetic energy passes through the body between two applicators on the skin, usually one above and one below the region, and the tissue between them warms. Tumor tissue conducts electricity differently from healthy tissue and carries heat away less well because of its poorer blood supply, so it warms more than its surroundings.
It is added to the oncologist's treatment: heat makes tumor cells more sensitive to radiation and to several chemotherapy drugs, and it improves blood flow and oxygen in the tumor for the hours around a session.
What a session feels like
Under an hour on the treatment bed, awake, without a needle.
Before
The nurse positions the applicators over the region, checks that no metal is in the field and that the skin is intact.
During
Warmth builds deep in the tissue rather than on the skin. Say so the moment anything feels hot, and the energy is turned down.
After
You get up, drink, and carry on with the day. Mild redness under an applicator can appear and fades.
HFTT and local-regional hyperthermia compared
HFTT
- What it is
- High-frequency energy between two applicators heats deep tumors
- Used for
- Liver, pancreas, abdomen and pelvis, with the oncologist's treatment
- Session
- 45 to 60 minutes
- Setting
- Applicators on the skin, no anesthesia
- Recovery after a session
- You carry on with your day; mild redness under an applicator fades
Local-regional
- What it is
- A tumor and its surroundings heated to 40–44 °C / 104.0–111.2 °F
- Used for
- Solid tumors, with radiotherapy or chemotherapy
- Session
- About 60 minutes
- Setting
- Treatment room, no anesthesia, nurse nearby
- Recovery after a session
- You go on with your day; skin may stay red for a few hours
The physician chooses the method by where the tumor sits and how deep the heat has to go.
What conditions is it used for?
- Liver, pancreatic and other abdominal cancers that a surface applicator does not reach, with the oncologist's treatment
- Pelvic tumors, where hyperthermia added to radiotherapy has the strongest evidence
- Patients in the integrative oncology program whose standard treatment continues at home or here
Not suitable with a pacemaker, defibrillator or large metal implant in the field, in pregnancy, over tissue that cannot tolerate heat such as a fresh surgical wound, or with an acute infection on the day. The physician decides from your imaging and findings.
Sessions are timed to the oncologist's treatment, at home or in the hospital's oncology department. Tumors nearer the surface are treated with local and regional hyperthermia and the whole body with whole-body hyperthermia, on a different day of the same week. Patients from abroad receive the sessions within the hyperthermia program for international patients.
Evidence and safety
Strong for heat added to radiotherapy or chemotherapy in several tumors; moderate for the high-frequency method itself. The trials test heat added to standard treatment; heat alone has not been tested this way. Side effects are mostly local and mild.
Show the studies and side effects
In locally advanced cervical cancer a randomized multicenter trial showed better results for radiotherapy plus hyperthermia than for radiotherapy alone (van der Zee et al., 2000), and a systematic review with meta-analyses confirmed the benefit across trials (Datta et al., 2016). In high-risk soft tissue sarcoma, regional hyperthermia added to chemotherapy improved long-term outcomes in a randomized trial (Issels et al., 2018). The biology of combining heat with radiation and drugs is reviewed in the Lancet Oncology (Wust et al., 2002).
Radiofrequency capacitive heating of deep-seated tumors has been studied with radiotherapy since the 1980s (Hiraoka et al., 1987; Ohguri et al., 2009), the clinical literature on modulated electro-hyperthermia has been reviewed for oncologists (Szasz, 2019), and a randomized phase III trial in cervical cancer reported early results on local disease control (Minnaar et al., 2019). Without radiotherapy or chemotherapy, HFTT is a treatment attempt, decided with you and checked in the follow-up imaging.
Safety
The side effects of local hyperthermia are mostly local and mild: skin redness or a small burn under an applicator, rarely a fat necrosis. The power is set by the physician, adjusted to what you feel, and turned down at the first sign of discomfort.
Common questions about HFTT
How is HFTT different from local and regional hyperthermia?
HFTT is one member of the local hyperthermia family. It uses high-frequency electromagnetic energy between two applicators, which reaches deep tumors in the abdomen and pelvis. The local and regional hyperthermia page describes the family as a whole; the physician chooses the method by where the tumor sits and how deep the heat has to go.
Does HFTT hurt?
No anesthesia is needed. You feel warmth building deep in the tissue rather than on the skin, and the energy is turned down the moment anything feels hot or uncomfortable. The applicators press lightly; some patients feel a pulling sensation under them. A nurse checks in during the session.
Is HFTT safe?
Local hyperthermia has been used alongside radiotherapy and chemotherapy for decades, and its side effects are mostly local: skin redness, a small burn under an applicator, or a fat necrosis in rare cases. It is not given over metal implants or a pacemaker in the field, in pregnancy, or over tissue that cannot tolerate heat. The physician screens for these first.
Does HFTT replace chemotherapy or radiotherapy?
No. The evidence for hyperthermia is evidence for hyperthermia added to standard treatment, and that is how it is used at St. George Hospital: timed to the oncologist's chemotherapy, radiotherapy or immune therapy. Used on its own it is an individual treatment attempt, decided with the patient after medical consultation.
How much does HFTT cost?
The cost depends on the number of sessions and on what else your program contains. After a physician has reviewed your findings, the International Office sends you a written, itemized cost overview: a package price plus individual add-ons. A deposit is paid before admission. The costs page explains the details.
References
- Hyperthermia and radiotherapy with or without chemotherapy in locally advanced cervical cancer: a systematic review with conventional and network meta-analyses. Int J Hyperthermia 2016. PMID 27411568
- Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial. Lancet 2000. PMID 10791373
- Effect of Neoadjuvant Chemotherapy Plus Regional Hyperthermia on Long-term Outcomes Among Patients With Localized High-Risk Soft Tissue Sarcoma. JAMA Oncol 2018. PMID 29450452
- Hyperthermia in combined treatment of cancer. Lancet Oncol 2002. PMID 12147435
- Radiofrequency capacitive hyperthermia for deep-seated tumors. II. Effects of thermoradiotherapy. Cancer 1987. PMID 3581027
- Radiotherapy with 8-MHz radiofrequency-capacitive regional hyperthermia for stage III non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2009. PMID 18513887
- Review of the Clinical Evidences of Modulated Electro-Hyperthermia (mEHT) Method: An Update for the Practicing Oncologist. Front Oncol 2019. PMID 31737558
- The effect of modulated electro-hyperthermia on local disease control in HIV-positive and -negative cervical cancer women in South Africa: Early results from a phase III randomised controlled trial. PLoS One 2019. PMID 31216321
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