Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Nancy Hepp, MS, BCCT Project Manager
Last updated December 20, 2020.
Also known by these names
Hyperthermia uses heat, such as from many forms of electromagnetic energy, to treat cancer by heating tumors. Heat may be used either through local or regional application or by heating the whole body.
“The Food and Drug Administration (FDA) has approved hyperthermia for use in the treatment of cancer when combined with radiation therapy for the palliative management of certain solid surface and subsurface malignant tumors that are progressive or recurrent despite conventional therapy.”1
Types of Hyperthermia Treatments
Local or Regional Hyperthermia
Local hyperthermia is used to heat a small area, such as a tumor, using very high temperatures—40.5°C to 42.5°C (105°F to 109°F) for 1 to 1½ hours. Thermal ablation, a form of local hyperthermia, uses even higher temperatures (55°C/131°F). These temperatures can kill cancer cells directly, destroy nearby blood vessels and sensitize tumors to chemo- and radiotherapies.
Various forms of energy can produce the heat:
- High intensity focused ultrasound, referred to as HIFU or focused ultrasound, uses ultrasound waves
- Radiofrequency ablation, or RFA, uses high-energy radio waves
- Capacitive radiofrequency hyperthermia uses low-energy radio waves
In regional hyperthermia, an organ, limb, body cavity or other body part is heated. The temperatures used may not be hot enough to destroy the cancer cells outright, and heat may be combined with chemotherapy or radiation therapy.2
Hyperthermic Intraperitoneal Chemotherapy
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of loco-regional hyperthermia that involves infusing and circulating warmed anticancer drugs in the peritoneal cavity (abdomen) for a specified time. HIPEC is typically done with cytoreductive surgery (CRS) in cancers that have metastasized to the peritoneal cavity. These metastases are called peritoneal carcinomatosis.
The National Cancer Institute considers HIPEC experimental in the treatment of patients with high-grade serous ovarian cancers.
Hyperthermic Intrathoracic Chemotherapy (HITHOC)
Hyperthermic intrathoracic chemotherapy (HITHOC) is the chest counterpart of HIPEC—warmed anticancer drugs are infused and circulated in the chest cavity. HITHOC is used to treat various pleural malignancies.
Whole-body hyperthermia is used to treat metastatic cancer that has spread throughout the body.
Whole-body hyperthermia seems to activate anticancer components of the immune system as well as “raise the levels of cell-killing compounds in the blood.”6 According to the National Cancer Institute, “Whole-body hyperthermia is used to treat metastatic cancer that has spread throughout the body. This can be accomplished by several techniques that raise the body temperature to 107-108°F, including the use of thermal chambers (similar to large incubators) or hot water blankets.”7 Whole-body hyperthermia is also used to amplify immune responses in the body against cancer while decreasing the cancer cells’ ability to suppress or evade immune responses.8
Many centers use this therapy as a complement to other cancer treatments rather than as a stand-alone treatment. For example, whole body hyperthermia is often used alongside chemotherapy to enhance drug delivery, mainly by increasing the transport of chemotherapy drugs into cells and improving the movement of oxygenated blood to poorly oxygenated tumor tissues.9
Whole-body hyperthermia is considered an investigational therapy. No whole-body hyperthermia equipment is approved for use in treating cancer in the US, although centers do offer this treatment internationally.
Clinical Practice Guidelines
The US National Comprehensive Cancer Network cites an indication for intraperitoneal chemotherapy for patients with low-volume residual disease after surgical debulking for stage II or III invasive epithelial ovarian or peritoneal cancer.10
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
The use of hyperthermia alone (across the various types) has resulted in complete overall response rates of 13 percent. “Significant improvement in clinical outcome has been demonstrated for tumours of the head and neck, breast, brain, bladder, cervix, rectum, lung, esophagus, vulva and vagina, and also for melanoma.”11 Benefits have included remarkably higher (complete) response rates, improved local tumour control rates, better palliative effects and/or better overall survival rates. No increase in radiation toxicity has been found when used with radiotherapy.12
Substantial evidence indicates that loco-regional hyperthermia sensitizes tumor cells to chemotherapy and radiation and improves outcomes such as local tumor control and overall survival. Studies and clinical trials in these cancer types have showed improved outcomes:
Head and Neck Cancers
Liver and Bile Duct Cancers
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Hyperthermic Intrathoracic Chemotherapy (HITHOC)
Lab and Animal Evidence
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
A study compared adding near infrared whole-body hyperthermia to standard multimodal rehabilitation for patients with fibromyalgia. Adding the hyperthermia treatment improved both sensory pain and affective pain (feelings of unpleasantness and emotions associated with future prospects). Few side effects were noted, all of which resolved within 30 minutes.87
Finding a Center for CRS/HIPEC Therapy
Some resources and strategies to try (BCCT does not endorse or recommend any of these centers):
All forms of hyperthermia are widely available in German cancer clinics, some Mexican clinics, Austria and also from some individual practitioners. Local and regional hyperthermia is being used in the US, particularly for prostate cancer. Ralph Moss, in his Moss Reports, provides information on its use at Cancer Treatment Centers of America, University of California San Francisco UCSF) and the Orange County Immune Institute. At UCSF, hyperthermia is combined with radiation therapy to treat prostate cancer. Local and regional hyperthermia are also being used in Canada particularly in integrative oncology clinics.
The American Cancer Society notes that “Local hyperthermia can cause pain at the site, infection, bleeding, blood clots, swelling, burns, blistering, and damage to the skin, muscles, and nerves near the treated area.” Bolus pressure has also been reported.93 Oncology Nurse Advisor provides further cautions:94
Most normal tissues are not damaged during hyperthermia if the temperature remains under 111°F. However, due to regional differences in tissue characteristics, higher temperatures may occur in various spots. This can result in burns, blisters, discomfort, or pain. Perfusion techniques can cause tissue swelling, blood clots, bleeding, and other damage to the normal tissues in the perfused area; however, most of these side effects are temporary. Whole-body hyperthermia can cause more serious side effects, including cardiac and vascular disorders, but these effects are uncommon. Diarrhea, nausea and vomiting are commonly observed after whole-body hyperthermia.
The development of "hot spots" is more likely if sensation is lacking in the area and the treatment is not adjusted. Dehydration is also possible with hyperthermia. Sarah Soles, ND, at the Integrated Health Clinic in British Columbia, has told BCCT they don’t see gastrointestinal symptoms nor dehydration very often. More commonly, short-term peripheral edema (swelling) can result from the use of intravenous saline and dextrose during the treatment.
Integrative Programs, Protocols and Medical Systems
|For more information about programs and protocols, see our Integrative Programs and Protocols page.|
Image from Nullfy from mullfy.com! at Creative Commons
BCCT is grateful for the review and input of this page by Gurdev Parmar, ND, FABNO, founder and medical director of Integrated Health Clinic, Fort Langley, BC, Canada; and Sarah Soles, MSc, ND, at the Integrated Health Clinic.
General Hyperthermia Resources
- American Cancer Society: Hyperthermia to Treat Cancer
- ASCO Post: Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties
- Texas Oncology: Hyperthermia Treatment
- University of Rochester Medical Center: Hyperthermia For Cancer Treatment
- Baronzio G, Parmar G et al. A brief overview of hyperthermia in cancer treatment. Journal of Integrative Oncology. 2014;3(1): 115.
- Medline Plus: Hyperthermia for treating cancer
- Integrated Health Clinic:
- Verthermia: Clinical Trial Update: Verthermia is Heating the Whole Body to Treat Disease
- Oncology Nurse Advisor: Hyperthermia in Cancer Treatment (Fact Sheet)
- Food and Drug Administration: BSD-2000 Hyperthermia System
- Glazer ES, Curley SA. The ongoing history of thermal therapy for cancer. Surgical Oncology Clinics of North America. 2011 Apr;20(2):229-35, vii.
- Hatakeyama H, Wu SY et al. Role of CTGF in sensitivity to hyperthermia in ovarian and uterine cancers. Cell Reports. 2016 Nov 1;17(6):1621-1631.
- Datta NR, Ordóñez SG et al. Local hyperthermia combined with radiotherapy and-/or chemotherapy: recent advanced and promises for the future. Cancer Treatment Reviews. 2015.
- Integrated Health Clinic Cancer Care Centre: OUR—Retrospective Study
Hyperthermic Intraperitoneal Chemotherapy
- Morano WF, Khalili M, Chi DS, Bowne WB, Esquivel J. Clinical studies in CRS and HIPEC: Trials, tribulations, and future directions—a systematic review. Journal of Surgical Oncology. 2018 Feb;117(2):245-259.
- Cowan RA, O'Cearbhaill RE, Zivanovic O, Chi DS. Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer. International Journal of Hyperthermia. 2017 Aug;33(5):548-553.
- Cavaliere D, Cirocchi R et al. 1st Evidence-based Italian consensus conference on cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinosis from ovarian cancer. Tumori. 2017 Nov 23;103(6):525-536.
- Oseledchyk A, Zivanovic O. Intraoperative hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer. Oncology (Williston Park). 2015 Sep;29(9):695-701.
- Sugarbaker PH. Management of peritoneal metastases—basic concepts. Journal of BUON. 2015 May;20 Suppl 1:S2-11.
- Halkia E, Spiliotis J. The role of cytoreductive surgery and HIPEC in epithelial ovarian cancer. Journal of BUON. 2015 May;20 Suppl 1:S12-28.
- Lassche G, Crezee J, Van Herpen CML. Whole-body hyperthermia in combination with systemic therapy in advanced solid malignancies. Critical Reviews in Oncology/Hematology. 2019;139:67-74.
- Zivanovic O, Chi DS et al. It's time to warm up to hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer. Gynecologic Oncology. 2018 Dec;151(3):555-561.
Other Types of Hyperthermia
- Deutsche Gesellschaft für Hyperthermie e.V.: Whole-Body Hyperthermia Guideline
- Kok HP, Crezee J. A comparison of the heating characteristics of capacitive and radiative superficial hyperthermia. International Journal of Hyperthermia. 2017 Jun;33(4):378-386.
More from Our Resources Database
- Moss Reports: Immunotherapy: The Battle Within
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- The New School at Commonweal: Keith Block, MD: Life over Cancer—Achieving A Survivor’s Edge
- Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail
- Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- National Cancer Institute: Office of Cancer Complementary and Alternative Medicine