Hyperthermia Flashcards
Hyperthermia
Application of heart in a therapeutic setting Hyperthermia treatment exposes body tissue to high temperatures (up to 113 degrees F) to damage/kill cancer cells
- strive for an average of 42-44 degrees C for 30-60 minutes 2-3x/week
Adjuvant to radiation
Mechanisms of Action
- Effective hyperthermia is related to temperrature achieved during treatment, length of treatment, and cell/tissue characteristics
- Believed that prolonged exposure to heat denatures proteins leading to cell death
- 40 degrees C threshold temperature for protein denaturation
Heat Shock Proteins (HSPs)
HSPs are family of proteins produced by cells in response to exposure to stressful conditions
HSPs render heated cells more resistant to addtional heat stress and are the mediators of thermotolerance
Maximal thermotolerance occurs by 24 hours
Methods of Hyperthermia
Local hyperthermia (heat is applied to a small area)
- external/superficial
- intraluminal
- interstitial
Most often used to treat tumors that are close to the surface
Most common sites: breast/chest wall, melanoma, and squamous cell carninomas of the H&N
Useful for treatment of reoccurent cancer
Methods of Hyperthermia: Superficial
Applicators positioned around or near the region
Temperature probes placed an diagram is made so probe placement can be recreated
Water bolus (bag of water) used to focus energy and minimize scattering
Microwave energy
Adjuvant to radiation or chemo
Methods of Hyperthermia: Regional
Large areas of tissue are heated
- Deep tissue
- Regional perfusion
- Continuous hyperthermic peritoneal perfusion (CHPP)
Deep tissue: position patient in comfortable position in hammock-like structure; they are surrounded by a structure that fills with water and physicists distribute power
- Patients at risk for developing heat stroke
- Physicits must be present
Methods of Hyperthermia: Whole Body
Used for mestastatic cancer
Body temperature increase achieved by:
- hot water blankets
- thermal chamber/incubator
Process can take up to 120 minutes
Anesthesia is typically required
Hyperthermia at NMH
BSD 500 – Interstitial microwave hyperthermia system
915 mHz power
Requires daily QA
Costs up to $400,000
Single hyperthermia treatment costs ~$5,000
Side effects of Hyperthermia
Thermal blister
Pain
Burning
Hyperthermia care path
Pretreatment =education and pre-treatment prep
Procedural Care = set-up, mapping of treatment area(s), probe placement, water bolus, and applicator
Assessment = skin care, pain management, manage anxiety, manage hot spots, documentation
Post-procedural care = observation, evaluation, vital signs, hydration, pain, dressings, skin assessment, education
Barriers
Reimbursement rate is too low
Space and personnel demands are too high
Cannot heat all patients/sites
Cannot deliver a precise thermal dose
Terrible equipment
Difficult to setup in many sites
Difficult to tolerate for some patients
