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Hyperthermia - Therapeutic Fever

“I would cure all diseases if I only could produce fever.” Parmenides, Greek physician and philosopher, 510 BC

Fever and heat therapy have been recognized for their beneficial effects on health since antiquity. Traditionally there have been two forms of hyperthermia—whole body and localized applications. We are now discussing the modern innovations to both approaches of hyperthermia, as applied in the treatment of cancer. Fever turns out to be one of the missing links in understanding cancer. Most cancer patients have a lower core temperature and cannot mount a fever. Thus they are unable to activate their immune system.

• Hyperthermia in the Treatment of Cancer

  Hyperthermia in the Gorter Model – A Significant Part of the Cancer Treatment

  We know scientifically that fever is a protective mechanism. When body temperature reaches 101.3° F (38.5° C) the immune system shifts into a state of alarm. At this temperature, the level of immune chemicals in the bloodstream doubles and immune defenses throughout the body increase. Within six hours, almost every major defense within the immune system doubles its efforts. This process appears to be dormant in many cancer patients, who typically report never having experienced a fever. To reactivate the immune system in these patients, the Gorter Model uses a process of controlled fever referred to in the scientific literature as “fever-range, total-body hyperthermia”—a form of treatment in which the entire body is heated to a moderate fever temperature of approximately 101.3 F (38.5 C). As a result, the immune system is activated in the same way as a natural fever would activate immune response, for example to an infection. This approach is necessary to raise the body to a therapeutic fever range, unlike traditional methods such as sauna methods and hot tub, which do not affect core temperature or achieve temperatures that are as high as the temperature range that occurs during a fever. In the Gorter Model, total-body hyperthermia is provided to about 70% of all patients.   Local hyperthermia is another approach used in the Gorter Model. Localized heat is applied to the tumor tissue; a “region” or area of the body is selectively heated, again so that only the cancer cells increase in temperature. The local heating increases the temperature within the the malignant cells to 42 C (107.6 F) so that they die, due to the increased intra-cellular lactic acid production.Only the cancer cells are increased in temperature which leads directly to cell death (necrosis). The localized high temperature and the resulting cancer cell death also activates the immune system. The surrounding healthy cells are not affected. Local hyperthermia is used with approximately 99% of patients.

• Fever: Friend or Foe?

  In our culture, there is a pervasive fear of fever.

  Many people see fever as the cause of illness, rather than the body’s natural attempt at healing. While fever racks the patient, the mother, father, lover, friend, or caretaker stands by, feeling powerless. It is no wonder that at the first sign of a fever, we quickly reach for medications such as aspirin or Tylenol (NSAIDS—non-steroidal, anti-inflammatory drugs). The medicine represents hope and recovery. Giving medication implies a cure. (And so does the advertising.)

  Many people see fever as the cause of illness, rather than the body’s natural attempt at healing. While fever racks the patient, the mother, father, lover, friend, or caretaker stands by, feeling powerless. It is no wonder that at the first sign of a fever, we quickly reach for medications such as aspirin or Tylenol

  (NSAIDS—non-steroidal, anti-inflammatory drugs). The medicine represents hope and recovery. Giving medication implies a cure. (And so does the advertising.)   The message is: If you can just reduce the fever, the disease will go away.     So the caretaker feels empowered by giving fever-suppressing medication. There is the belief that reducing the fever is a way of fighting the illness.   Ironically, the fear of fever is misplaced. Unless the fever is too high (104 °F (40.0 °C) or above over weeks at a time, no harm occurs. Fever signals the immune system to mount an increased defense and sets the process of healing in motion. In fact, fever is the natural response of all mammals to infection or illness. This is true for cats and dogs, elephants and tigers, horses and humans. Research has made it clear that fever is not the enemy; it is the friend of healing. This scientific rationale, supported by thousands of research studies, provides the basis for hyperthermia treatment at the Medical Center Cologne and other medical centers in Europe, Japan, and world-wide.

• The Role of Fever in Immunity

  Fever is the necessary signal that ramps up the immune response.

  The research makes it clear that fever is a protective mechanism which plays an important role in fighting infection, healing wounds, and destroying malignancies.

  Fever is a basic, protective response to infection, in almost all animals. The U.S. National Library of Medicine affirms this, defining as :

  “An abnormal elevation of body temperature, usually as a result of a pathologic process [ie infection].  However, lay people have assumed that fever was the cause of illness—not realizing that fever is the body’s primary response in fighting infection.”

• A Century of Research on Fever

  • Research on fever
  • NIH Report on Fever

  A number of researchers have tracked this issue in large clinical trials over the past 100 years, starting with published reports in 1854 that many cancer patients have a “remarkable disease-free history.” Several later studies confirmed this, reporting that people who developed cancer were rarely ill before their disease. If it seems surprising that this premise would have gone unrecognized for 150 years, consider the fact that scurvy among seaman caused by lack of vitamin C was not acknowledged for more than 100 after it was first confirmed by a ship’s physician.   The doctor’s recommendations were adopted 105 years later when another naval physician reported a similar finding. In a similar pattern, studies on the importance of fever in a strong immune defense against cancer were published in the medical literature in 1854, 1910, 1934, and 1936, each study involved hundreds of patients. Researchers consistently found increased cancer risk for patients who had no history of infectious illness or fever. The majority of more recent studies have corroborated these findings:

  • German research published in 1983 found that cancer risk more than doubled in patients who had not experienced major infectious diseases (2.6 times greater risk). Cancer risk was more than five times higher in patients who had never experience the common cold (5.7 odds ratio), and there was a 15-fold increase for those who had never experienced fever (15.1 odds ratio).
  • A study of skin cancer patients, published in Melanoma Research in 1992 reviewed the medical histories of 500 comparable patients, with and without cancer. Researchers found that the patients who had experienced infections accompanied by fever had a much lower incidence of malignant melanoma.
  • Research published in the journal Cancer in 1992 evaluated the medical histories of more than 200 patients with brain tumors, who were compared with over 400 similar but non-cancerous patients. Those who had experienced infections and colds had a 70% lower risk of cancer.

  One of the most insightful looks at the role of fever has come from a research team from the National Institutes of Health.    The researchers performed an in-depth review of the medical literature on cancer risk. They reported that risk appears to be increased in individuals who have experienced fewer infections. They noted “an inverse correlation between the incidence of infectious diseases and cancer risk.

  ” In other words, people who have not experience common childhood illness and fever seem to have a greater risk of cancer. Averting fever by the frequent use of aspirin or antibiotics may actually impair immune function. The NIH team concluded that, “the occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease.”

  They also pointed out that “spontaneous remissions are often preceded by feverish infections.”[vi,vii] Their final report includes hundreds of references from the medical and research literature.[vi]

• How Fever Activates Immune Function

  As described in detail earlier in this chapter, fever is actually the signal that mounts immune activity in response to infection, illness, injury, or malignancy. At 101.3° F (38.5° C) the immune system doubles its functions, in response to impulses from deep within the brain stem.   This increase in body temperature has been shown to call up various aspects of the immune function, including chemical messengers such as interleukin that call the immune system into action,  dendritic cells that identify the infection or malignancy, heat shock proteins which activate white cells, , and T-cells to destroy viruses and cancer cells.[iii,iv]

• The Role of Fever in Immune Development

  • Immune Development
  • The Immune System

  In a newborn the immune system is immature and underdeveloped. For example, protective antibodies are not made by the infant’s body, and the baby relies on those transmitted before birth by the mother to her infant through the placenta. These maternal antibodies become depleted by the time the baby is about 6 months old. At this point, the immune system of the child must learn how to respond to invasive infections such as bacteria, viruses, and parasites and to threats from within the body such as abnormal and cancerous cells. Like any other organ system, the immune system must develop and mature if the child is to remain healthy.   On average, each newborn develops about seven viral infections in its first year of life. Researchers now view fever as a “necessary attempt by nature” to support immune system development and have confirmed that it is the process that activates the immune response.ii,iii,iv Cohort studies have also shown that a child needs at least 4 to 5 episodes of high fever before age 6 to develop an adept immune system.   The development of immunity can be compared with the maturation of the muscles and skeleton, which only develop correctly if they are used all the time, and experience periodic exertion from activity and play. That is why we encourage children to participate in sports. A child who is bed-bound or wheel-chair bound does not have the opportunity to develop a proper skeleton and musculature as a result of disuse.

  The immune system can only develop fully if it is put under “stress” by defending the child against invading microbes such as viruses and bacteria. When a child experiences any type of infection, the immune system must augment its defense mechanisms and step up its activities and metabolism. In childhood, fever is important because it plays a role in immune development and maturation so the system can function properly life-long.   A number of researchers have suggested that averting childhood infections and fever through inoculations for benign illnesses such as chicken pox and rubella may be a factor in increased vulnerability to cancer in adulthood.

  • A British study published in 1977 of 300 women with ovarian cancer found lower incidence of measles, mumps and rubella compared to non-cancerous patients.
  • Another study published in The Lancet in 1985 of 500 patients reported that approximately 6% of cancer patients had not develop measles in childhood compared with less than 1% of noncancerous participants in the study.
  • A third study in the American Journal of Epidemiology (1986) reported that children with leukemia had experienced fewer infections in their first year of infancy, suggesting the importance of stimulating the immune system early in life.

• Effects of Fever Suppression

  • Absence of fever
  • Loss of defenses against cancer

  Absence of fever in cancer patients —In clinical cases evaluated at the Medical Center Cologne, the vast majority of cancer patients report that they are never sick and they never missed a day at work. Typically, they may have had a few days when they experienced a sore throat, a cold, or a cough, but it was never accompanied by fever. When fever did develop, it was suppressed with aspirin, Tylenol, or antibiotics. Most cancer patients also have a reduced core body temperature and lack of circadian temperature rhythm.[xxi ] These are indications of the inability to raise temperature to a level necessary to activate the immune system.[xxi] It is possible that we have unknowingly conditioned the immune system not to respond, through our use of fever suppressants with our children.   Interrupting the fever mechanism —Surprisingly, the immune system can be trained to turn on or off in response to repeated cues, for example in response to certain medications. This trained or “conditioned” response was demonstrated in the work of Dr. Robert Ader and colleagues, published over a period of 25 years. Researchers found that the immune system could actually be deactivated through “classical conditioning.”   Applying this finding to the use of fever suppressing medications with children, the implication is that over time the fever response can be permanently inactivated by the frequent use of medication. Childhood fevers are also prevented when vaccines are used to avoid common childhood infections. From that point on, whenever the child develops a fever, the fever process is aborted.   Suppressing the immune response —In time, the body becomes conditioned to suppress fever at the slightest hint of a fever. Since fever is the cue that activates many of the key defenses of the immune system, this also means that immune response is cut short and never activated.

  Loss of defenses against cancer —We now know that our bodies develop cancer cells every day of our lives. When we have periodic bouts of cold or flu, if we allow our bodies to experience a fever, that provides an additional opportunity for clearing malignancies and l ingering infections. If the immune system is never activated, we have lost these opportunities to destroy cancer cells while their number is still small.   Increased risk of chronic infection —Suppressing fever may also enable bacterial and viral infections to become chronic. Without fever, some of the infectious cells escape destruction, linger, and start increasing in number. Note that although we think of antibiotics as our primary protection, it is actually the immune system which protects us. The antibiotics simply lower the infectious load so the immune system can handle it more easily.   Infections linked to cancer —Specific types of chronic infection have been linked to the localized development of cancer, including human papilloma virus, viral hepatitis, and H. pylori bacteria. In the peer-reviewed literature, more than 20,000 articles address the link between cancer and these three infectious agents.

  • Chronic human papilloma virus infection is implicated in about 40% to 80% ofall cervical cancers.
  • Various forms of hepatitis viral infections are associated with the development of liver cancer.
  • H. pylori bacterial infections have been identified as a causal factor in an estimated 40% to 80% of gastric cancers.

  Allergies, asthma, and cancer —Among children who never developed a high fever, about 30% develop food allergies, hay fever, and contact dermatitis (atopic dermatitis). In children who experienced episodes of childhood fever, only 5% develop these allergic reactions. Overuse of fever-suppressing medications has been found to increase the risk of allergies and autoimmune conditions.[xx]   Increased incidence of asthma —A recent study on the effects of Tylenol exposure in childhood published in the British journal Lancet in 2008 reported on the health of 205,487 children ages 6 to 7 years old, from 31 countries.    The study found that exposure to Tylenol (acetaminophen) during intrauterine fetal development or during the first year of infancy was associated with an increased risk of asthma symptoms. The risk was “dose-dependant”—the more frequent the Tylenol use, the greater the likelihood of asthma. Tylenol use, both in the first year of life and in children aged 6 to 7 years is also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema. This data suggests that by suppressing fever, the immune system becomes compromised and less functional.

Patient's Experience with Hyperthermia

• Nothing led me to suspect that I had breast cancer. I’m a strong woman. I’ve always been strong and active… I’ve always done my work with energy and commitment. (I’ve always been very health—one of those people who never misses a day of work.) I was initially diagnosed with breast cancer in the summer of 2005 and had breast surgery, 8 sessions of chemo, 25 sessions of radiation, and medication. Although I went into remission and felt better, in 2007 I learned that the cancer had metastasized to my bones and my oncologist told me that it was incurable. I see cancer as a disease I have to deal with. But I want to live. If other people can survive cancer, so can I. My attitude is that I will do whatever it takes. In August 2008 I began treatment at MCC, despite severe bone pain. At that point I had nothing to lose and everything to gain, so I decided to do the hyperthermia and dendritic cell treatments. The treatments at MCC had no significant side effects, although the two hours of hyperthermia were tough for me. The localized was no problem at all. I experienced the dendritic cell vaccinations as a severe flu with headaches and nausea that lasted for about 6 hours. It was unpleasant but I knew it will be over after just a few hours After three treatments the pain went away. It was totally gone and I stopped taking pain killers. I have felt good ever since. Four months after my first treatment at MCC, I went for a checkup with my original oncologist and they did a PET scan. The bone cancer was gone. There was no trace of the cancer visible on the scans—they had disappeared and in September 2010 another PET-CT Scan still showed no recurrences and I am still in complete remission. Now I am hopeful about the future. God will decide when my time has come. But I know that I will live for many years to come.

  — Fatima Galamba, a patient with metastatic breast cancer and now in complete remission for more than two years and who was treated with the Gorter Model.

• When I arrived at the clinic for my hyperthermia treatment, the nurse checked me in and then helped me settle into the hyperthermia chamber, which is essentially a light box heated by infra-red lighting as shown in Fig. 6.2a and 6.2b. My head was outside the box, comfortably supported by a pillow, which avoids any sense of claustrophobia. The doctor then began an IV infusion of electrolyte minerals to assure that I would not get dehydrated. The infusion included antioxidants, particularly vitamin C and selenium. An electronic thermometer was provided rectally so that my core temperature could be monitored continuously. To monitor my heart rate during the treatment, the nurse also placed a few electrodes on my skin, attached with gel. (This is another step provided to assure the safety of all patients.) The lights inside the light chamber gradually increased my temperature. However, because the container is relatively air-tight, perspiration did not cool my body, which was also covered with heavy towels to retain the heat. My temperature gradually increased. After about three hours, the lights were turned off, but my temperature continued to increase for a while because the blood just under the surface of my skin was still warmer than the rest of my body. Once my skin began to cool, the returning blood began to cool and my core temperature very slowly began dropping naturally. For me, the worst side effect of hyperthermia treatment was boredom and the inability to turn over while lying on my back for four and a half hours. My major concern occurred about 2 hours into the treatment, I had to urinate. This was solved by urinating into a special container. When the treatment session was finished, I took a shower, shampooed my hair, and felt comfortably warm, very relaxed, and ready for a meal. I went downstairs to the hospital cafeteria and ate a large salad and a delicious dessert. This is a very different experience than I imagine I would have had with chemotherapy or radiation.

  — Erik Peper, PhD

• I was diagnosed with colon cancer and that spread to my liver. Although I did well on the chemotherapy, the oncologist made it clear that treatment was palliative and not a cure. So we made an appointment for a consultation in Cologne. When we learned that Dr. Gorter’s treatment could be used together with chemotherapy, we decided to do that as well. I began the total body hyperthermia and dendritic cell therapy in Cologne. Once you’ve received the treatment, you know what to expect. It’s not painful and I was hardly sick at all. I usually feel worse after the dendritic cell vaccination, but only for one day. Every nine weeks a scan is made and they show that there are no new tumors and the liver tumors are getting smaller. The fact that my cancer has stabilized is remarkable.

  — Truus Kleij-Swan, more than five year long-term survivor of intestinal cancer, metastasized to the liver, lymph nodes and peritoneum.

• Twenty years ago, Teun van Vliet was twice an indoor world champion cyclist and in 1988 wore the yellow jersey in the Tour de France. In 2001 he was diagnosed with a brain tumor and in 2006 an inoperable recurrence of the tumor was detected. Teun had another round of brain surgery (“debulking”) and also received radiation treatment. This caused him to lose his power of speech, and to some degree he also lost memory and coordination. Within conventional oncology, nothing could be done for him. He was told that he had a year left to live at the most. Teun and his girlfriend decided to seek a second opinion and they went to Cologne to consult with Dr. Gorter, who advised him to do localized hyperthermia in combination with immune therapy. Teun’s partner soon noticed beneficial changes in his health: “The first thing we noticed about these treatments was that they really improved his speech. He is much more lively; more active. I have my old buddy back, really. When he comes home from Cologne, his speech has improved, his motor skills have improved, he feels more energetic. Nothing but improvements. The quality of his life is definitely better. In April 2010, a new MRI scan confirmed that there is still no recurrence of the cancer and Teun has been clinically cancer-free for more than four-and-a-half years.”

  — Partner of Teun van Vliet, Tour de France Champion Cyclist, survivor of brain cancer.

• References

  Kluger MJ. Fever: Role of pyrogens and cryogens. Physiol Rev. 1991; 71(1): 93–127.   Roberts Jr NJ. The immunological consequences of fever. In: Mackowiak PA, ed. In Fever: Basic mechanisms and management. New York: Raven. 1991:125.   Roberts Jr NJ. Impact of temperature elevation on immunologic defenses. Rev Infect Dis. 1991; 13(3): 462–72.   National Library of Medicine, MeSH Database, available at  http://www.ncbi.nlm.nih.gov/sites/mesh. Accessed 07-20-1   Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation. 2001;9(2):55-64.   Kleef, R. & Hager, D. Incidence of Malignancies and Missing History of Fever in Baronzio, G.F. & Hager, E. (2006). Hyperthermia in Cancer Treatment: A Primer. New York: Springer US.   Laurence JZ. The diagnosis of surgical cancer (Lister Prize say for 1854). London: Churchill. 1854; 56.

  ---

  Ralf Kleef and E. Dieter Hager. Fever, Pyrogens and Cancer. NCBI. Bookshelf » Madame Curie Bioscience Database, Oncology. Epublished 20__. Available at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=eurekah&part=A59581. Accessed 07-14-10.   Remy W, Hammerschmidt K, Zänker KS. et al. Tumorträger haben selten Infekte in der Anamnese [in ….]. Med Klinik. 1983; 78: 95–98.   Kölmel K, Gefeller O, Haverkamp B. Febrile infections and malignant melanoma: Results of a case-control study. Melanoma Res. 1992; 2: 207–211.   Schlehofer B, Blettner M, Becker N. et al. Medical risk factors and development of brain tumors. Cancer. 1992; 69: 2541–2547.   Dinarello CA. Endogenous pyrogens. In: Mackowiak PA, ed. Fever: Basic mechanisms and management. New York: Raven. 1991: 23.   Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am. 1996; 10(2): 433–49.   Burdon RH. The heat shock proteins. Endeavour. 1988; 12(3): 133–8. .   Dressel R, Heine L, Elsner L. et al. Induction of heat shock protein 70 genes in human lymphocytes during fever therapy. Eur J Clin Invest. 1996; 26(6): 499–505..   Newhouse ML, Pearson RM, Fullerton JM. et al. A case control study of carcinoma of the ovary. Brit J Preventive Social Med. 1977; 31: 148–153. [PubMed]   ROnne T. Measles virus infection without rash in children is related to disease in adult life. The Lancet. 1985; 8419i: 1–5.   van Steensel-Moll HA, Valkenburg HA, van Zanen GE. Childhood leukemia and infectious diseases in the first year of life: A register based case-control study. Am J Epidemiol. 1986; 124: 590–594.   Flöistrup, H., Swartz ,J., Bergström, A, ,Alm, J.S,, Scheynius, A., van Hage, M., Waser, M., Braun-Fahrländer, C., Schram-Bijkerk, D., Huber, M., Zutavern ,A., von Mutius, E., Ublagger, E., Riedler, J., Michaels, K.B., Pershagen, G., & The Parsifal Study Group. (2006). Allergic disease and sensitization in Steiner school children.  J Allergy Clin Immunol. 117(1),59-66.   Gorter R. Unpublished clinical data. Medical Center Cologne, Cologne, Germany. 2010.   Ader, R., & Cohen, N. (1975). Behaviorally conditioned immunosuppression. Psychosomatic medicine.37(4), 333-340.   Ader, R. (2003). Conditioned immunomodulation: research needs and directions. Brain Behav Immun. 17, Suppl 1,S51-7.   Goebel, M.U., Trebst, A.E., Steiner, J., Xie, Y.F., Exton, M.S., Frede, S., Canbay, A., Michel, M.C., Heeman, U., & Schedlowski, M. (2002). Behavioral conditioning of immunosuppression is possible in humans. The FASEB Journal,16, 1869-1873.   Hiramoto, R., Rogers, C., Demissie, S., Hsueh, C,M., Hiramoto, N., Lorden, J. & Ghanta, V. (1996). The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity. Int J Neurosci. 84(1-4):229-45.   Sevan-Schreiber D. Anticancer: A New Way of Life. New York: Viking. 2008: 1.   Hildesheim A, Han CL, Brinton LA, Kurman RJ, Schiller JT. Human papillomavirus type 16 and risk of preinvasive and invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol. 1997 Nov;90(5):748-54.   Zhu Y, Jin Y, Guo X, Bai X, Chen T, Wang J, Qian G, Groopman JD, Gu J, Li J, Tu H. Comparison study of complete sequences of hepatitis B virus identifies new mutations in core gene associated with hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010 Aug 10. [Epub ahead of print].    Webb PM, Hengels KJ, Moller H, Newell DG, Palli D, Elder JB, Coleman MP, De Backer G, Forman D. The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology. 1994 Nov;107(5):1335-44.   Beasley, R. K., Clayton, T., Crane, J., von Mutius, J., Lai, C.K., Montefort, S., Stewart, A., & Phasae Three Study Group. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet, 20 (372), 1039-1048.

THERAPEUTISCHES FIEBER

“Ich könnte alle Krankheiten heilen, wenn ich nur wüsste, wie man Fieber erzeugt.” PARAMENIDES, GRIECHISCHER ARZT UND PHILOSOPH, 510 V. CHR.

Die positiven Auswirkungen von Fieber und Hitzetherapie auf die Ge-sundheit sind seit der Antike bekannt. Die antike griechische Medizin, heiße Schwefelbäder im alten Rom, finnische Saunen, europäische und amerikanische Spa-Behandlungen, japanische Whirlpools, indianische Schwitzhütten und therapeutische heiße Quellen auf der ganzen Welt sind Beispiele dafür, wie diverse Kulturen einfache Formen der Hitze als reinigendes und auch als heilendes Mittel einsetzten und noch ein- setzen.

• Fieber: Freund oder Feind?

  In unseren Kulturkreisen herrscht eine weitverbreitete Angst vor Fieber. Für viele Menschen ist Fieber die Ursache einer Krankheit und nicht der natürliche Versuch des Körpers, sich selbst zu heilen. Während der Patient unter dem Fieber leidet, stehen die Mutter, der Vater, der Partner, der Freund oder der Betreuer machtlos daneben. Daher ist es kein Wunder, dass wir beim ersten Anzeichen eines Fiebers meist schnell nach Medikamenten wie Aspirin oder Paracetamol (NSAID – sogenannte nichtsteroidale Entzündungshemmer) greifen. Die Medikamente stehen für Hoffnung und Genesung. Das Verabreichen von Medizin impliziert Heilung (so vermittelt es zumindest die Werbung). Der allgemeine Glaube ist, dass mit der Senkung des Fiebers auto- matisch auch die Krankheit automatisch verschwinden wird. So fühlt sich die betreuende Person darin bestärkt, dem Patienten fiebersenkende Medizin zu verabreichen. Die Senkung des Fiebers wird als ein Weg zur Bekämpfung der Krankheit angesehen.   Paradoxerweise ist die Angst vor dem Fieber völlig deplatziert. Es gibt keinen Grund zur Beunruhigung, es sei denn, das Fieber ist zu hoch (40,0°C oder höher) und hält sich konstant über Wochen. Fieber signalisiert dem Immunsystem, dass es seine Abwehr verstärken muss und setzt so den Heilungsprozess in Gang.   Genau genommen ist Fieber die natürliche Antwort aller Säugetiere auf Infektionen und Krankheiten. Das gilt gleichermaßen für Katzen, Hunde, Elefanten, Tiger, Pferde und Menschen. Die Wissenschaft hat deutlich belegt, dass Fieber kein Feind, sondern eher ein Freund ist, der uns bei der Heilung hilft.   Diese durch unzählige Forschungsstudien belegte Erkenntnis dient als Grundlage für Behandlungen mit Ganzkörperhyperthermie am Medical Center Cologne und anderen medizinischen Einrichtungen in Europa, Japan und auf der ganzen Welt.

• Welche Rolle Fieber für die immunität spielt

  Forschungen ergeben eindeutig, dass Fieber ein Schutzmechanismus ist, der eine wichtige Rolle bei der Bekämpfung von Infektionen, Heilung von Wunden und Zerstörung von bösartigen Zellen spielt. Fieber ist ein wichtiges Alarmsignal, mit dem die Immunabwehr in Gang gebracht wird.   Fieber ist eine grundlegende Abwehrreaktion auf Infektionen bei fast allen Tieren. Die amerikanische Nationalbibliothek für Medizin (U.S. National Library of Medicine) bestätigt dies, indem sie Fieber als „eine ungewöhnliche Erhöhung der Körpertemperatur“ definiert, die „für gewöhnlich als Reaktion auf einen pathologischen Prozess [z.B. eine Infektion] auftritt“ Dennoch wird Fieber von Laien häufig als Auslöser für die Krankheit interpretiert – da sie nicht wissen, dass das Fieber nicht der Grund für die Infektion, sondern nur die Reaktion des Körpers auf diese zur Bekämpfung derselben ist.

• Wie Fieber die Immunfunktion aktiviert

  Wie bereits ausführlich am Anfang dieses Kapitels beschrieben, ist Fieber ein Signal, das die Immunaktivität des Körpers als Reaktion auf Infektionen, Krankheiten, Verletzungen oder bösartige Tumore aktiviert. Bei einer Körpertemperatur von 38,5°C verdoppelt das Immunsystem die Leistung seiner Funktionen und reagiert so auf Impulse, die tief aus dem Hirnstamm entsendet werden.   Eine erhöhte Körpertemperatur bewirkt so die Aktivierung diverser Funktionen der Immunabwehr, mit eingeschlossen sind chemische Botenstoffe wie Interleukin, die das Immunsystem in Gang setzen, dendritische Zellen, die die Infektion oder den Tumor iden- tifizieren, Hitzeschockproteine, die weiße Blutkörperchen aktivieren und T-Zellen, die den Virus bzw. die Krebszellen vernichten.

  The immune system can only develop fully if it is put under “stress” by defending the child against invading microbes such as viruses and bacteria. When a child experiences any type of infection, the immune system must augment its defense mechanisms and step up its activities and metabolism. In childhood, fever is important because it plays a role in immune development and maturation so the system can function properly life-long.   A number of researchers have suggested that averting childhood infections and fever through inoculations for benign illnesses such as chicken pox and rubella may be a factor in increased vulnerability to cancer in adulthood.

  • A British study published in 1977 of 300 women with ovarian cancer found lower incidence of measles, mumps and rubella compared to non-cancerous patients.
  • Another study published in The Lancet in 1985 of 500 patients reported that approximately 6% of cancer patients had not develop measles in childhood compared with less than 1% of noncancerous participants in the study.
  • A third study in the American Journal of Epidemiology (1986) reported that children with leukemia had experienced fewer infections in their first year of infancy, suggesting the importance of stimulating the immune system early in life.

Hyperthermie in der Krebsbehandlung

• Referenzen

  Kluger MJ. Fever: Role of pyrogens and cryogens. Physiol Rev. 1991; 71(1): 93–127. Roberts Jr NJ. The immunological consequences of fever. In: Mackowiak PA, ed. In Fever: Basic mechanisms and management. New York: Raven. 1991:125. Roberts Jr NJ. Impact of temperature elevation on immunologic defenses. Rev Infect Dis. 1991; 13(3): 462–72. National Library of Medicine, MeSH Database, available at  http://www.ncbi.nlm.nih.gov/sites/mesh. Accessed 07-20-1 Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation. 2001;9(2):55-64. Kleef, R. & Hager, D. Incidence of Malignancies and Missing History of Fever in Baronzio, G.F. & Hager, E. (2006). Hyperthermia in Cancer Treatment: A Primer. New York: Springer US. Laurence JZ. The diagnosis of surgical cancer (Lister Prize say for 1854). London: Churchill. 1854; 56.

  ---

  Ralf Kleef and E. Dieter Hager. Fever, Pyrogens and Cancer. NCBI. Bookshelf » Madame Curie Bioscience Database, Oncology. Epublished 20__. Available at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=eurekah&part=A59581. Accessed 07-14-10. Remy W, Hammerschmidt K, Zänker KS. et al. Tumorträger haben selten Infekte in der Anamnese [in ….]. Med Klinik. 1983; 78: 95–98. Kölmel K, Gefeller O, Haverkamp B. Febrile infections and malignant melanoma: Results of a case-control study. Melanoma Res. 1992; 2: 207–211. Schlehofer B, Blettner M, Becker N. et al. Medical risk factors and development of brain tumors. Cancer. 1992; 69: 2541–2547. Dinarello CA. Endogenous pyrogens. In: Mackowiak PA, ed. Fever: Basic mechanisms and management. New York: Raven. 1991: 23. Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am. 1996; 10(2): 433–49. Burdon RH. The heat shock proteins. Endeavour. 1988; 12(3): 133–8. .   Dressel R, Heine L, Elsner L. et al. Induction of heat shock protein 70 genes in human lymphocytes during fever therapy. Eur J Clin Invest. 1996; 26(6): 499–505.. Newhouse ML, Pearson RM, Fullerton JM. et al. A case control study of carcinoma of the ovary. Brit J Preventive Social Med. 1977; 31: 148–153. [PubMed]   ROnne T. Measles virus infection without rash in children is related to disease in adult life. The Lancet. 1985; 8419i: 1–5. van Steensel-Moll HA, Valkenburg HA, van Zanen GE. Childhood leukemia and infectious diseases in the first year of life: A register based case-control study. Am J Epidemiol. 1986; 124: 590–594. Flöistrup, H., Swartz ,J., Bergström, A, ,Alm, J.S,, Scheynius, A., van Hage, M., Waser, M., Braun-Fahrländer, C., Schram-Bijkerk, D., Huber, M., Zutavern ,A., von Mutius, E., Ublagger, E., Riedler, J., Michaels, K.B., Pershagen, G., & The Parsifal Study Group. (2006). Allergic disease and sensitization in Steiner school children.  J Allergy Clin Immunol. 117(1),59-66. Gorter R. Unpublished clinical data. Medical Center Cologne, Cologne, Germany. 2010. Ader, R., & Cohen, N. (1975). Behaviorally conditioned immunosuppression. Psychosomatic medicine.37(4), 333-340. Ader, R. (2003). Conditioned immunomodulation: research needs and directions. Brain Behav Immun. 17, Suppl 1,S51-7. Goebel, M.U., Trebst, A.E., Steiner, J., Xie, Y.F., Exton, M.S., Frede, S., Canbay, A., Michel, M.C., Heeman, U., & Schedlowski, M. (2002). Behavioral conditioning of immunosuppression is possible in humans. The FASEB Journal,16, 1869-1873. Hiramoto, R., Rogers, C., Demissie, S., Hsueh, C,M., Hiramoto, N., Lorden, J. & Ghanta, V. (1996). The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity. Int J Neurosci. 84(1-4):229-45. Sevan-Schreiber D. Anticancer: A New Way of Life. New York: Viking. 2008: 1.   Hildesheim A, Han CL, Brinton LA, Kurman RJ, Schiller JT. Human papillomavirus type 16 and risk of preinvasive and invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol. 1997 Nov;90(5):748-54. Zhu Y, Jin Y, Guo X, Bai X, Chen T, Wang J, Qian G, Groopman JD, Gu J, Li J, Tu H. Comparison study of complete sequences of hepatitis B virus identifies new mutations in core gene associated with hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010 Aug 10. [Epub ahead of print].    Webb PM, Hengels KJ, Moller H, Newell DG, Palli D, Elder JB, Coleman MP, De Backer G, Forman D. The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology. 1994 Nov;107(5):1335-44.   Beasley, R. K., Clayton, T., Crane, J., von Mutius, J., Lai, C.K., Montefort, S., Stewart, A., & Phasae Three Study Group. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet, 20 (372), 1039-1048.

Therapeutische koorts

“Geef mij het vermogen om koorts op te wekken en ik genees alle ziekten.” Parmenides, Grieks arts en wijsgeer, 510 v.Chr. Parmenides, Greek physician and philosopher, 510 BC

De heilzame werking van koorts en warmtetherapie is al sinds de oudheid bekend. De antieke Griekse geneeskunde, de Romeinse warme zwavelbaden, de Finse sauna’s, de Europese en Amerikaanse behandelingen in kuuroorden, de Japanse warme baden, de inheems- Amerikaanse zweethutten en therapeutische warme bronnen overal ter wereld zijn voorbeelden van manieren waarop verschillende culturen eenvoudige vormen van warmte hebben gebruikt voor zowel zuivering als genezing.

• Koorts: vriend of vijand?

  In onze cultuur heerst er een alomtegenwoordige angst voor koorts. Veel mensen beschouwen koorts als de oorzaak van een ziekte in plaats van de natuurlijke poging van het lichaam tot genezing ervan. Wanneer een patiënt door koorts wordt geteisterd staat de moeder, vader, geliefde, vriend of verzorger er meestal met een machteloos gevoel bij. Geen wonder dat we bij het eerste teken van koorts snel grijpen naar medicijnen als aspirine of paracetamol (NSAID’s – nietsteroide, ontstekingsremmende geneesmiddelen). Het medicijn staat voor hoop en herstel. Het toedienen van medicamenten impliceert dat er een remedie is. (Zoals ook advertenties dat doen.)   De boodschap luidt dat als je de koorts maar vermindert de ziekte wel overgaat. Dus krijgt de verzorger het gevoel dat het goed is om koortsonderdrukkende medicamenten te geven. Men gelooft immers dat het verminderen van koorts een manier is om ziekte te bestrijden.   Ironisch genoeg is de angst voor koorts misplaatst. Koorts kan geen kwaad, behalve wanneer hij wekenlang te hoog is (40,0 °C of hoger). Koorts geeft het immuunsysteem het signaal de afweer te versterken en zet het genezingsproces in beweging. In feite is koorts de natuurlijke reactie van alle zoogdieren op een infectie of ziekte. Dit geldt voor katten en honden, olifanten en tijgers, paarden en mensen. Onderzoek heeft duidelijk gemaakt dat koorts niet de vijand maar juist de vriend van genezing is.   Deze wetenschappelijke grondgedachte, die door duizenden onderzoeksstudies wordt onderbouwd, vormt de grondslag voor de hyperthermiebehandeling in het Medical Center Cologne en andere medische centra in Europa, Japan en over de gehele wereld.

• Hoe koorts de immuunfunctie activeert

  Zoals reeds eerder in dit hoofdstuk is beschreven, is koorts in feite het signaal dat in reactie op infecties, ziekten, verwondingen of maligne tumoren de immuunactiviteit gevechtsklaar maakt.

  Bij 38,5 °C verdubbelt het immuunsysteem zijn functies in een respons op impulsen die diep uit de hersenstam komen.   Er is aangetoond dat de toename van de lichaamstemperatuur verschillende aspecten van de immuunfunctie inschakelt, waaronder chemische boodschappers zoals interleukine, die het immuun-systeem mobiliseren,7dendritische cellen die de infectie of de tumor identificeren, warmteschokeiwitten die witte bloedcellen active- ren77 en T-cellen die virussen en kankercellen vernietigen.

• De rol van koorts in de ontwikkeling van het immuunsysteem

  Bij een pasgeboren baby is het immuunsysteem onvolgroeid en onderontwikkeld. Er worden bijvoorbeeld geen antilichamen aange- maakt door het lichaam van de baby, maar de baby vertrouwt hiervoor op de antistoffen die voor de geboorte door de moeder via de placenta zijn doorgegeven.   De antistoffen van de moeder raken uitgeput tegen de tijd dat de baby ongeveer zes maanden is. Op dat punt moet het immuunsysteem van het kind leren hoe het moet reageren op invasieve infecties zoals bacteriën, virussen en parasieten en op bedreigingen in het lichaam, zoals abnormale en carcinomateuze cellen.   Net als ieder orgaansysteem moet het immuunsysteem zich volledig ontwikkelen wil het kind gezond blijven.   Gemiddeld krijgt iedere baby in zijn eerste levensjaar ongeveer zeven virusinfecties. Onderzoekers beschouwen koorts tegenwoordig als een ‘noodzakelijke poging van de natuur’ om de ontwikkeling van het immuunsysteem te bevorderen en bevestigen dat juist dit proces de immuunrespons activeert.79 Uit cohortstudies blijkt dat een kind vóór het zesde jaar minstens vier tot vijf perioden van hoge koorts moet krijgen om een naar behoren werkend immuunsysteem te ontwikkelen.   De ontwikkeling van immuniteit is te vergelijken met de opbouw van de spieren en het skelet, die alleen dan correct verloopt wanneer ze voortdurend worden gebruikt en er regelmatig bij activiteit of spel een zware inspanning wordt geleverd. Dat is de reden waarom we kinderen aanmoedigen om aan sport te doen. Een kind dat aan bed of aan een rolstoel is gekluisterd heeft ten gevolge van onderbelasting niet de mogelijkheid om een goed ontwikkeld skelet of spierstelsel te ontwikkelen.   Het immuunsysteem kan zich alleen ten volle ontwikkelen als het ‘onder druk’ wordt gezet door het kind te verdedigen tegen binnendringende microben zoals virussen en bacteriën. Wanneer een kind de een of andere infectie krijgt, moet het immuunsysteem zijn afweermechanismen uitbreiden en zijn activiteiten en stofwisseling op een hoger plan brengen.   In de kinderjaren is koorts belangrijk omdat die een rol speelt bij de ontwikkeling en volgroeiing van het immuunsysteem zodat die een leven lang naar behoren kan functioneren.

Hyperthermie in de behandeling van kanker

• Referenties

  Kluger MJ. Fever: Role of pyrogens and cryogens. Physiol Rev. 1991; 71(1): 93–127. Roberts Jr NJ. The immunological consequences of fever. In: Mackowiak PA, ed. In Fever: Basic mechanisms and management. New York: Raven. 1991:125. Roberts Jr NJ. Impact of temperature elevation on immunologic defenses. Rev Infect Dis. 1991; 13(3): 462–72. National Library of Medicine, MeSH Database, available at http://www.ncbi.nlm.nih.gov/sites/mesh. Accessed 07-20-1 Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation. 2001;9(2):55-64. Kleef, R. & Hager, D. Incidence of Malignancies and Missing History of Fever in Baronzio, G.F. & Hager, E. (2006). Hyperthermia in Cancer Treatment: A Primer. New York: Springer US. Laurence JZ. The diagnosis of surgical cancer (Lister Prize say for 1854). London: Churchill. 1854; 56.

  ---

  Ralf Kleef and E. Dieter Hager. Fever, Pyrogens and Cancer. NCBI. Bookshelf » Madame Curie Bioscience Database, Oncology. Epublished 20__. Available at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=eurekah&part=A59581. Accessed 07-14-10. Remy W, Hammerschmidt K, Zänker KS. et al. Tumorträger haben selten Infekte in der Anamnese [in ….]. Med Klinik. 1983; 78: 95–98. Kölmel K, Gefeller O, Haverkamp B. Febrile infections and malignant melanoma: Results of a case-control study. Melanoma Res. 1992; 2: 207–211. Schlehofer B, Blettner M, Becker N. et al. Medical risk factors and development of brain tumors. Cancer. 1992; 69: 2541–2547. Dinarello CA. Endogenous pyrogens. In: Mackowiak PA, ed. Fever: Basic mechanisms and management. New York: Raven. 1991: 23. Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am. 1996; 10(2): 433–49. Burdon RH. The heat shock proteins. Endeavour. 1988; 12(3): 133–8. . Dressel R, Heine L, Elsner L. et al. Induction of heat shock protein 70 genes in human lymphocytes during fever therapy. Eur J Clin Invest. 1996; 26(6): 499–505.. Newhouse ML, Pearson RM, Fullerton JM. et al. A case control study of carcinoma of the ovary. Brit J Preventive Social Med. 1977; 31: 148–153. [PubMed] ROnne T. Measles virus infection without rash in children is related to disease in adult life. The Lancet. 1985; 8419i: 1–5. van Steensel-Moll HA, Valkenburg HA, van Zanen GE. Childhood leukemia and infectious diseases in the first year of life: A register based case-control study. Am J Epidemiol. 1986; 124: 590–594. Flöistrup, H., Swartz ,J., Bergström, A, ,Alm, J.S,, Scheynius, A., van Hage, M., Waser, M., Braun-Fahrländer, C., Schram-Bijkerk, D., Huber, M., Zutavern ,A., von Mutius, E., Ublagger, E., Riedler, J., Michaels, K.B., Pershagen, G., & The Parsifal Study Group. (2006). Allergic disease and sensitization in Steiner school children. J Allergy Clin Immunol. 117(1),59-66. Gorter R. Unpublished clinical data. Medical Center Cologne, Cologne, Germany. 2010. Ader, R., & Cohen, N. (1975). Behaviorally conditioned immunosuppression. Psychosomatic medicine.37(4), 333-340. Ader, R. (2003). Conditioned immunomodulation: research needs and directions. Brain Behav Immun. 17, Suppl 1,S51-7. Goebel, M.U., Trebst, A.E., Steiner, J., Xie, Y.F., Exton, M.S., Frede, S., Canbay, A., Michel, M.C., Heeman, U., & Schedlowski, M. (2002). Behavioral conditioning of immunosuppression is possible in humans. The FASEB Journal,16, 1869-1873. Hiramoto, R., Rogers, C., Demissie, S., Hsueh, C,M., Hiramoto, N., Lorden, J. & Ghanta, V. (1996). The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity. Int J Neurosci. 84(1-4):229-45. Sevan-Schreiber D. Anticancer: A New Way of Life. New York: Viking. 2008: 1. Hildesheim A, Han CL, Brinton LA, Kurman RJ, Schiller JT. Human papillomavirus type 16 and risk of preinvasive and invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol. 1997 Nov;90(5):748-54. Zhu Y, Jin Y, Guo X, Bai X, Chen T, Wang J, Qian G, Groopman JD, Gu J, Li J, Tu H. Comparison study of complete sequences of hepatitis B virus identifies new mutations in core gene associated with hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010 Aug 10. [Epub ahead of print]. Webb PM, Hengels KJ, Moller H, Newell DG, Palli D, Elder JB, Coleman MP, De Backer G, Forman D. The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology. 1994 Nov;107(5):1335-44. Beasley, R. K., Clayton, T., Crane, J., von Mutius, J., Lai, C.K., Montefort, S., Stewart, A., & Phasae Three Study Group. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet, 20 (372), 1039-1048.

Terapötik Ateş

Sadece ateş yaratarak, tüm hastalıkları tedavi edebilirdim.

Ateş ve sıcak terapisi antik çağlardan beri sağlık üzerindeki faydalı etkileriyle tanınmışlardır. Antik Yunan tıbbı, Romalıların sıcak sülfür banyoları, Fin hamamları, Avrupa ve Amerika SPA uygulamaları, Japon jakuzileri, Kızılderili Amerikalı terleme çadırları ve dünya çapındaki tarapatik sıcak su kaynakları, değişik kültürlerin basit ısı formlarını hem temizlenme, hem de iyileşme amaçlı kullanış tarzlarının örnekleridir. Geleneksel olarak, iki sıcaklık terapisi türü vardır: tüm vücut ve lokal uygulamaları. Kitabın bu bölümünde, kanser tedavisinde kullanılan her iki yaklaşıma da getirilen modern yenilikleri tartışacağız.

• Ateş: Düşman mı, Dost mu?

  Kültürümüzde, ateşe karşı yaygın bir korku var. Çoğu insan ateşi, vücudun doğal iyileşme girişiminden ziyade, bir hastalık sebebi olarak görmekte. Ateş hastaya azap verirken, başında bekleyen anneyi, babayı, sevgiliyi, arkadaşı da güçsüz bırakır. Ateşin ilk işaretleriyle birlikte, aspirin ya da Tylenol (NSAID’ler—nonsteroidal, antienflamatuvar ilaçlar) gibi ilaçlara hemen uzanışımız boşuna değildir. İlaç bizim açımızdan umut ve iyileşmeyi temsil eder. Ilaç vermek tedavi demektir. (Ve tabi aynı zamanda da reklam.) Verilen mesaj, ateşi düşürebilmeniz durumunda hastalığın geçeceğidir. Dolayısıyla bakıcı hastaya ateş düşürücü ilaç vererek iyi bir şey yaptığını düşünür. Ateşin düşürülmesinin hastalıkla savaşmanın bir yolu olduğu inancı yaygındır.   Ne gariptir ki, ateşe dair beslenen korku hatalıdır. Ateş çok yüksek (40.0°C ya da daha fazla) olmadığı ve haftalarca sürmediği sürece, hiç bir zararı yoktur. Ateş bağışıklık sisteminin savunmalarını artırdığının ve iyileşme sürecini harekete geçirdiğinin bir işaretidir. Aslında, ateş memelilerin tümünün enfeksiyona ya da hastalığa karşı verdiği doğal bir tepkidir. Bu kediler ve köpekler, filler ve kaplanlar, atlar ve insanlar için geçerlidir.   Yapılan incelemeler ateşin düşman olmadığını, iyileşmenin dostu olduğunu göstermiştir. Binlerce araştırmayla desteklenen bu bilimsel mantık, Köln Tıp Merkezi’ndeki ve Avrupa, J aponya ve dünya çapındaki diğer tıp merkezlerinde uygulanan hipertermi tedavisinin temelini oluşturmaktadır.

• Ateşin Bağışıklıktaki Rolü

  Araştırmalar ateşin enfeksiyonla savaşta, yara iyileştirmede ve malignitelerin yok edilmesinde önemli rol oynayan koruyucu bir mekanizma olduğunu gösteriyor.   Ateş bağışıklık tepkisini artırmak için gerekli sinyaldir.   Ateş, neredeyse tüm hayvanlarda enfeksiyona karşı gösterilen koruyucu bir tepkidir. Birleşik Devletler Ulusal Tıp Odası, ateşi “genelde patolojik bir süreç sonucunda (örn. enfeksiyon) vücut sıcaklığının anormal yükselmesi” şeklinde betimleyerek, bunu tasdikledi. Ancak, jüri – ateşin vücudun enfeksiyonla savaşta en temel tepkisi olduğunu fark etmeyerek – ateşi hastalık sebebi olarak addetti.

  Ateşe Dair NIH Raporu

  Ateşin rolüne getirilen en anlayışlı bakışlardan biri Ulusal Sağlık Enstitütüleri (NIH) araştırma ekibinden geldi. Araştırmacılar, kanser riskine dair tıp literatürünü derinlemesine inceledi. Riskin daha az enfeksiyon yaşayan bireylerde artıyor gibi göründüğünü raporladılar. “Bulaşıcı hastalık vakası ile kanser riski arasında ters ilinti” saptadılar. Diğer bir deyişle, olağan çocukluk hastalıklarını ve ateşi yaşamayan insanlar daha yüksek kanser riskiyle karşı karşıya gibi görünüyor.

  Ateşi sık sık aspirin ya da antibiyotik kullanarak önlemek aslında bağışıklık fonksiyonuna zarar verebilir. NIH ekibi, “ateşin çocukluk yıllarında ya da yetişkinlikte oluşması, kişiyi ilerleyen dönemlerde meydana gelebilecek malign hastalıklara karşı koruyabilir” sonucuna vardı. Aynı zamanda, “spontan gerilemelerin sık sık ateşli enfeksiyonları takip ettiğini” işaret ettiler.  Son raporları, tıp ve araştırma literatürlerinden alınmış yüzlerce referansı içeriyor.

• Ateş Üzerine Yüz Yıllık Araştırma

  Bu konu bir dizi araştırmacı tarafından, kanser hastalarının çoğunun “dikkate değer derecede hastalanmadan geçirilmiş bir geçmişleri” olduğuna dair 1854’te yayınlanan haberlerden itibaren, yüz elli yıldan uzun bir süredir takip altında tutulmaktadır.” Son dönemde yapılan bir kaç inceleme, kansere yakalanan insanların bundan evvel ender hastalandıklarını ifade ederek, iddiayı doğruladı.   Eğer bu temel dayanağın yüz elli yıldır fark edilmemesi size şaşırtıcı görünüyorsa, denizciler arasında yaşanan skorbütün vitamin C eksikliği olduğunun kabulünün, gemi doktoru tarafından yapılan ilk saptamanın ardından yüz yıldan uzun süre aldığını anımsayın. Doktorun tavsiyeleri, diğer bir bahriyeli doktorun benzer bulgular yakalamasıyla birlikte, tam 105 yıl sonra uygulamaya alınmıştır.   Aynı şekilde, kansere karşı güçlü bir bağışıklık savunma geliştirilmesinde ateşin önemine dair yapılan araştırmalar 1854, 1910, 1934 ve 1936’da tıp literatüründe yayınlandı, her inceleme yüzlerce hasta üzerinde yapıldı. Araştırmacılar mütemadiyen, geçmişlerinde bulaşıcı hastalık ya da ateş yaşamamış hastalarda kanser riskinin arttığı sonucuna vardılar. Yakın tarihli incelemelerin büyük çoğunluğu bu bulguları güçlendirdi.

  • 1983’te yayınlanan bir Alman araştırması, kanser riskinin temel bulaşıcı hastalıklara yakalanmayan hastalarda iki kattan daha fazla arttığını keşfetti (risk 2.6 kat daha fazla). Kanser riski, hayatı boyunca sıradan bir soğukalgınlığı yaşamayan hastalarda beş kattan daha fazla yükseliyordu (tahmini risk oranı 5.7) ve hiç ateşlenmeyen hastalarda bu oran on beş katıydı (tahmini risk oranı 15.1).
  • Deri kanseri hastalarına ilişkin yapılan, 1992’de Melanoma Research’de yayınlanan inceleme, kanserli ve kansersiz beş yüz kıyaslanabilir hastanın tıbbi geçmişlerini değerlendirme altına aldı. Araştırmacılar, ateşli enfeksiyon yaşayan hastaların malin melanoma yakalanma şanslarının çok daha düşük olduğunu keşfetti.
  • 1992’de Cancer dergisinde yayınlanan araştırma, beyin tümörü olan iki yüzden falza hastanın tıbbi geçmişlerini değerlendirdi. Bunları benzer ancak kanser olmayan dört yüzden fazla hastayla kıyasladı. Enfeksiyon ve soğuk algınlığı yaşayanların kanser riskleri diğerlerinden yüzde 70 daha düşüktü.

• Ateş Bağışıklık Fonksiyonunu Nasıl Etkinleştirir

  Kitabın bu bölümünde daha önce betimlendiği üzere, ateş aslında bağışıklık sistemini enfeksiyon, hastalık, yaralanma ya da maligniteye karşı harekete geçiren bir sinyaldir. 101.3°F (38.5°C)’de bağışıklık sistemi, beyin sapının derinliklerinden gelen içtepilere karşılık, fonksiyonlarını iki katına çıkartır.   Vücut sıcaklığındaki bu artışın virüslerle kanser hücrelerini yok etmek için bağışıklık sistemini harekete geçiren interlökin gibi kimyasal ulaklar , enfeksiyon ya da maligniteyi belirleyen dendritik hücreler, beyaz hücreleri faal hale geçiren ısı-şok proteinleri ve virüs ve kanser hücrelerini yok edecek T hücreleri de dahil olmak üzere, çeşitli bağışıklık fonksiyonu öğelerini yardıma çağırdığını göstermiştir.

Kanser tedavisinde hipertermi

• Ateş Baskılamanın Etkileri

  Ateş, aspirin, Tylenol ya da antibiyotikler gibi ilaçlarla engellendiğinde, uzun vadede sağlıktan ödün verilir çünkü bağışıklık gelişimi zayıflatılmıştır. Kanser hastalarında ateş eksikliği. Medical Center Cologne’nda değerlendirilen klinik vakalarda, kanser hastalarının büyük çoğunluğu hiç hastalanmadıklarını ve işten rahatsızlandıklarından dolayı tek bir gün dahi uzak kalmadıklarını söylüyorlar. Genellikle, boğazları ağrıdığı, üşüttükleri ya da öksürdüklerinde bir kaç gün izin almış olabiliyorlar ancak bu rahatsızlıklara hiç bir zaman ateş eşlik etmemiş. Çünkü ateş çıktığında, bu aspirin, Tylenol ya da antibiyotiklerle bastırılmış.   Kanser hastalarının çoğu aynı zamanda düşük iç beden sıcaklığı ve sirkadiyen sıcaklık ritmi eksikliği de yaşıyor. Tüm bunlar, sıcaklığın bağışıklık sisteminin faal hale geçebilmesi için gerekli olan seviyeye çıkartılmasının başarılamadığının göstergesidir. Bağışıklık sistemini, çocuklarımızda ateş baskılayan ilaçlar kullanarak, farkında olmaksızın tepki vermemeye şartlandırmış olmamız olasıdır. Ateş mekanizmasının engellenmesi. İşin şaşırtıcı yanı, bağışıklık sistemi tekrarlayan belirtilere (örn. belirli bir takım ilaç tedavilerine) tepki olarak kendisini kapatmak ya da açmak yönünde eğitilebilir. Bu eğitilmiş ya da “şartlandırılmış” tepki Dr. Robert Ader ve iş arkadaşlarının yirmi beş yıldan dahauzun bir süre önce yaynlanan çalışmalarında ispatlanmıştır. Araştırmacılar, bağışıklık sisteminin aslında “klasik şartlandırma”yla devre dışı bırakılabileceğini keşfettiler. Bu keşfi çocuklarda kullanılan ateş baskılayıcı ilaç tedavileriyle ilintilendirirsek, çıkarım şudur ki zaman içerisinde ateş ilacın sık kullanımıyla kalıcı bir şekilde devredışı bırakılabilir. Olağan çocuk hastalıklarından kaçınmak için aşı kullanıldığında da, çocukların ateşleri engellenir. Bu bakış açısıyla, çocuk ne zaman ateşlense, ateş süreci gelişemeden durdurulur. Bağışıklık Tepkisini Baskılamak. Zaman içerisinde, beden en ufak bir ateş işareti karşısında ateşi baskılamaya şartlanır. Ateş bağışıklık sisteminin kilit savunmalarının çoğunu tetikleyen bir ipucu olduğundan, bu aynı zamanda bağışıklık tepkisinin de kısa kesildiği ve hiç faal hale getirilmediği anlamına gelir. Kansere Karşı Savunmaların Kaybedilmesi. Artık biliyoruz ki vücutlarımız hayatımızın her günü kanser hücresi üretmektedir. Dönemsel soğuk algınlıklarında ya da nezle olduğumuzda ve vücudumuza ateşlenme fırsatı tanıdığımızda, bu malignitelerin ve geçmek bilmeyen enfeksiyonların temizlenmesine ek fırsat yaratır. Eğer bağışıklık sistemi hiç harekete geçirilmezse, kanser hücrelerini sayısal olarak henüz azken yok etme şansını da kaçırmış oluruz. Artan Kronik Enfeksiyon Riski. Ateşi baskılamak, bakteriyel ve viral enfeksiyonların kronik hal almalarına da sebep olabilir. Ateş olmaksızın, enfeksiyöz hücrelerden bazıları kurtulup yıkıma başlar, etrafta salınıp durur ve sayıca çoğalır. Şunu unutmayın ki her ne kadar antibiyotikleri temel koruyucumuz olarak düşünüyor olsak da, aslında bizi koruyan bağışıklık sistemimizdir. Antibiyotikler sadece enfektiyöz yükü azaltır, böylece bağışıklık sistemi mikroplarla daha kolay başa çıkar. Kansere Bağlı Enfeksiyonlar. Insan papillom virüsü, viral hepatit ve H. pilori bakterisi gibi kronik enfeksiyonların belirli türleri, kanserin lokal gelişimiyle bağlantılandırılmıştır. Meslektaş incelemesinden çıkan literatürde, kanserle şu üç enfektiyöz aracı arasındaki bağlantıya gönderme yapan yirmi binden fazla makale bulunmaktadır.

  • Kronik insan papillom virüsü enfeksiyonu, serviks kanserlerinin yaklaşık yüzde 40 ila 80’iyle alakalı bulunmuştur.
  • Çeşitli hepatit viral enfeksiyonlar, karaciğer kanseri gelişimiyle ilintilendirilmiştir.
  • H. pilori bakteriyel enfeksiyon, gastrik kanserlerin tahmini yüzde 40 ila 80’inde sebepsel etken olarak belirlenmiştir.

  Alerjiler, astım ve kanser.

   Hiç ateşlenmeyen çocukların, yaklaşık yüzde 30’unda besin alerjisi, saman nezlesi ve kontakt dermatit (atopik dermatit) gelişmiştir. Çocuk humması epizotları yaşayan çocukların ise sadece yüzde 5’inde bu tür alerjik reaksiyonlar gözlemlenmiştir. Ateş baskılayıcı ilaçların aşırı kullanımının alerji ve otoimmün durum risklerini artırdığı keşfedilmiştir.

  Astım olaylarında artış.

   Çocukluk yıllarında Tylenol kullanımının etkilerine dair yapılan, 2008 senesinde İngiliz dergisi Lancet’de yayınlanan yakın tarihli bir inceleme, otuz bir ülkeden yaşları altı ila yedi arasında değişen 205,487 çocuğun sağlığı hakkında bir rapor sunmuştur.

  İncelemede dölyatağı içi fetal gelişimi ve ilk bebeklik yılları boyunca Tylenol’e (asetaminofen) maruz kalmanın artan astım semptom riskleriyle ilintili olduğunu ortaya koydu. Risk “doza bağlıydı” – Tylenol ne kadar sık kullanılmışsa, astımın oluşma riski bir o kadar fazlaydı.  Tylenol kullanımı, hem hayatın ilk yıllarında hem de altı ila yedi yaşındaki çocuklarda, rinokonjunktivite ve egzama semptom risklerinin artışıyla bağıntılandırıldı. Bu veriler ateşin baskılanmasıyla, bağışıklık sisteminin zarar gördüğünü ve fonksiyonunun azaldığını belirtmektedir.

• Referanslar

  Kluger MJ. Fever: Role of pyrogens and cryogens. Physiol Rev. 1991; 71(1): 93–127. Roberts Jr NJ. The immunological consequences of fever. In: Mackowiak PA, ed. In Fever: Basic mechanisms and management. New York: Raven. 1991:125. Roberts Jr NJ. Impact of temperature elevation on immunologic defenses. Rev Infect Dis. 1991; 13(3): 462–72. National Library of Medicine, MeSH Database, available at http://www.ncbi.nlm.nih.gov/sites/mesh. Accessed 07-20-1 Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation. 2001;9(2):55-64. Kleef, R. & Hager, D. Incidence of Malignancies and Missing History of Fever in Baronzio, G.F. & Hager, E. (2006). Hyperthermia in Cancer Treatment: A Primer. New York: Springer US. Laurence JZ. The diagnosis of surgical cancer (Lister Prize say for 1854). London: Churchill. 1854; 56.

  ---

  Ralf Kleef and E. Dieter Hager. Fever, Pyrogens and Cancer. NCBI. Bookshelf » Madame Curie Bioscience Database, Oncology. Epublished 20__. Available at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=eurekah&part=A59581. Accessed 07-14-10. Remy W, Hammerschmidt K, Zänker KS. et al. Tumorträger haben selten Infekte in der Anamnese [in ….]. Med Klinik. 1983; 78: 95–98. Kölmel K, Gefeller O, Haverkamp B. Febrile infections and malignant melanoma: Results of a case-control study. Melanoma Res. 1992; 2: 207–211. Schlehofer B, Blettner M, Becker N. et al. Medical risk factors and development of brain tumors. Cancer. 1992; 69: 2541–2547. Dinarello CA. Endogenous pyrogens. In: Mackowiak PA, ed. Fever: Basic mechanisms and management. New York: Raven. 1991: 23. Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am. 1996; 10(2): 433–49. Burdon RH. The heat shock proteins. Endeavour. 1988; 12(3): 133–8. . Dressel R, Heine L, Elsner L. et al. Induction of heat shock protein 70 genes in human lymphocytes during fever therapy. Eur J Clin Invest. 1996; 26(6): 499–505.. Newhouse ML, Pearson RM, Fullerton JM. et al. A case control study of carcinoma of the ovary. Brit J Preventive Social Med. 1977; 31: 148–153. [PubMed] ROnne T. Measles virus infection without rash in children is related to disease in adult life. The Lancet. 1985; 8419i: 1–5. van Steensel-Moll HA, Valkenburg HA, van Zanen GE. Childhood leukemia and infectious diseases in the first year of life: A register based case-control study. Am J Epidemiol. 1986; 124: 590–594. Flöistrup, H., Swartz ,J., Bergström, A, ,Alm, J.S,, Scheynius, A., van Hage, M., Waser, M., Braun-Fahrländer, C., Schram-Bijkerk, D., Huber, M., Zutavern ,A., von Mutius, E., Ublagger, E., Riedler, J., Michaels, K.B., Pershagen, G., & The Parsifal Study Group. (2006). Allergic disease and sensitization in Steiner school children. J Allergy Clin Immunol. 117(1),59-66. Gorter R. Unpublished clinical data. Medical Center Cologne, Cologne, Germany. 2010. Ader, R., & Cohen, N. (1975). Behaviorally conditioned immunosuppression. Psychosomatic medicine.37(4), 333-340. Ader, R. (2003). Conditioned immunomodulation: research needs and directions. Brain Behav Immun. 17, Suppl 1,S51-7. Goebel, M.U., Trebst, A.E., Steiner, J., Xie, Y.F., Exton, M.S., Frede, S., Canbay, A., Michel, M.C., Heeman, U., & Schedlowski, M. (2002). Behavioral conditioning of immunosuppression is possible in humans. The FASEB Journal,16, 1869-1873. Hiramoto, R., Rogers, C., Demissie, S., Hsueh, C,M., Hiramoto, N., Lorden, J. & Ghanta, V. (1996). The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity. Int J Neurosci. 84(1-4):229-45. Sevan-Schreiber D. Anticancer: A New Way of Life. New York: Viking. 2008: 1. Hildesheim A, Han CL, Brinton LA, Kurman RJ, Schiller JT. Human papillomavirus type 16 and risk of preinvasive and invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol. 1997 Nov;90(5):748-54. Zhu Y, Jin Y, Guo X, Bai X, Chen T, Wang J, Qian G, Groopman JD, Gu J, Li J, Tu H. Comparison study of complete sequences of hepatitis B virus identifies new mutations in core gene associated with hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010 Aug 10. [Epub ahead of print]. Webb PM, Hengels KJ, Moller H, Newell DG, Palli D, Elder JB, Coleman MP, De Backer G, Forman D. The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology. 1994 Nov;107(5):1335-44. Beasley, R. K., Clayton, T., Crane, J., von Mutius, J., Lai, C.K., Montefort, S., Stewart, A., & Phasae Three Study Group. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet, 20 (372), 1039-1048.

Пиротерапия

“Я бы вылечил все болезни, если бы только смог вызывать повышенную температуру” ” Парменид, Греческий врач и философ, 510 до н.э. ”

Положительное влияние пиро- и термотерапии на здоровье заметили еще в античности. Медицина Древней Греции, Римские серо-водородные бани (Roman sulfur hot baths), Финские сауны, Европейская и Американская СПА-терапия, Японские горячие ванны, парильни индейцев в Америке, горячие минеральные источники по всему миру – примеры того, как разные культуры использовали простые формы тепловой терапии, как для мытья, так и для исцеления. Обычно, существовало два вида применения термотерапии – для всего тела и для его частей. В этой главе, будет рассказано о новых современных подходах к обоим видам терапии, как части лечения рака.

• Высокая температура: Друг или Враг?

  противовоспалительный препарат). Медицина предоставляет надежду и выздоровление. Прием лекарственных средств предполагает излечение. (Так же как и их реклама).   Идея такова: Если понизить температуру, болезнь пройдет. Итак, ухаживающий за больным, чувствует себя уполномоченным давать пациентам жаропонижающие препараты. В этом и заключается суть веры в то, что понижение температуры – это способ борьбы с болезнью. Иронично то, что страх температуры не стоит внимания. До тех пор, пока она не становиться слишком высокой (около 104 °F (40.0 °C) или еще выше, в течение нескольких недель подряд, она не причиняет никакого вреда. Жар дает иммунной системе сигнал о необходимости повышения защитных функций и приводит в движение процесс выздоровления. На самом деле, лихорадка является естественной реакцией всех млекопитающих на инфекцию или болезнь. Это относится к кошкам, собакам, слонам, тиграм, лошадям и людям. Исследования точно показали, что повышенная температура не является нашим врагом, а наоборот другом исцеления.   Это логическое обоснование, доказанное тысячами научных исследований, составляет основу гипертермического лечения в Медицинском Центре Кёльн и других медицинских центрах в Европе, Японии и по всему миру.

• Значение высокой температуры для иммунитета

  Благодаря научным исследованиям становится очевидным, что повышенная температура– это защитный механизм, который играет важную роль в борьбе с инфекциями, заживании ран и разрушении злокачественности. Лихорадка – это необходимый сигнал, усиливающий иммунную реакцию.   Жар – это основная защитная реакция на инфекцию практически у всех животных. Национальная медицинская библиотека США подтверждает это, давая определение – «Чрезмерное повышение температуры тела обычно является результатом патологического процесса [т.е. инфекции]».   Несмотря на это, присяжные предполагали, что высокая температура была причиной болезни, не понимая, что лихорадка – это первичная реакция организма в борьбе с инфекцией.

• Как лихорадка активирует иммунную систему

  Как уже было подробно описано выше в этой главе, на самом деле, повышенная температура – это сигнал, который побуждает иммунную систему к активной реакции на инфекцию, болезнь, раны или злокачественность.   При температуре 38.5° C (101.3° F) иммунная система удваивает свои функции, в ответ на импульсы, исходящие из глубины стволовой части головного мозга.   Это увеличение температуры тела, как показывает практика, призывает различные аспекты иммунных функций, включая химические носители информации, такие как интерлейкины, что приводит иммунную систему в действие. < br/> Дендритные клетки могут распознавать инфекцию или злокачественность, белки теплового шока активируют белые кровяные тельцаи Т-клетки, для уничтожения вирусов и клеток рака

Гипертермии в лечении рака

• ссылки

  Kluger MJ. Fever: Role of pyrogens and cryogens. Physiol Rev. 1991; 71(1): 93–127. Roberts Jr NJ. The immunological consequences of fever. In: Mackowiak PA, ed. In Fever: Basic mechanisms and management. New York: Raven. 1991:125. Roberts Jr NJ. Impact of temperature elevation on immunologic defenses. Rev Infect Dis. 1991; 13(3): 462–72. National Library of Medicine, MeSH Database, available at http://www.ncbi.nlm.nih.gov/sites/mesh. Accessed 07-20-1 Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation. 2001;9(2):55-64. Kleef, R. & Hager, D. Incidence of Malignancies and Missing History of Fever in Baronzio, G.F. & Hager, E. (2006). Hyperthermia in Cancer Treatment: A Primer. New York: Springer US. Laurence JZ. The diagnosis of surgical cancer (Lister Prize say for 1854). London: Churchill. 1854; 56. Ralf Kleef and E. Dieter Hager. Fever, Pyrogens and Cancer. NCBI. Bookshelf » Madame Curie Bioscience Database, Oncology. Epublished 20__. Available at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=eurekah&part=A59581. Accessed 07-14-10. Remy W, Hammerschmidt K, Zänker KS. et al. Tumorträger haben selten Infekte in der Anamnese [in ….]. Med Klinik. 1983; 78: 95–98. Kölmel K, Gefeller O, Haverkamp B. Febrile infections and malignant melanoma: Results of a case-control study. Melanoma Res. 1992; 2: 207–211. Schlehofer B, Blettner M, Becker N. et al. Medical risk factors and development of brain tumors. Cancer. 1992; 69: 2541–2547. Dinarello CA. Endogenous pyrogens. In: Mackowiak PA, ed. Fever: Basic mechanisms and management. New York: Raven. 1991: 23. Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am. 1996; 10(2): 433–49. Burdon RH. The heat shock proteins. Endeavour. 1988; 12(3): 133–8. . Dressel R, Heine L, Elsner L. et al. Induction of heat shock protein 70 genes in human lymphocytes during fever therapy. Eur J Clin Invest. 1996; 26(6): 499–505.. Newhouse ML, Pearson RM, Fullerton JM. et al. A case control study of carcinoma of the ovary. Brit J Preventive Social Med. 1977; 31: 148–153. [PubMed] ROnne T. Measles virus infection without rash in children is related to disease in adult life. The Lancet. 1985; 8419i: 1–5. van Steensel-Moll HA, Valkenburg HA, van Zanen GE. Childhood leukemia and infectious diseases in the first year of life: A register based case-control study. Am J Epidemiol. 1986; 124: 590–594. Flöistrup, H., Swartz ,J., Bergström, A, ,Alm, J.S,, Scheynius, A., van Hage, M., Waser, M., Braun-Fahrländer, C., Schram-Bijkerk, D., Huber, M., Zutavern ,A., von Mutius, E., Ublagger, E., Riedler, J., Michaels, K.B., Pershagen, G., & The Parsifal Study Group. (2006). Allergic disease and sensitization in Steiner school children. J Allergy Clin Immunol. 117(1),59-66. Gorter R. Unpublished clinical data. Medical Center Cologne, Cologne, Germany. 2010. Ader, R., & Cohen, N. (1975). Behaviorally conditioned immunosuppression. Psychosomatic medicine.37(4), 333-340. Ader, R. (2003). Conditioned immunomodulation: research needs and directions. Brain Behav Immun. 17, Suppl 1,S51-7. Goebel, M.U., Trebst, A.E., Steiner, J., Xie, Y.F., Exton, M.S., Frede, S., Canbay, A., Michel, M.C., Heeman, U., & Schedlowski, M. (2002). Behavioral conditioning of immunosuppression is possible in humans. The FASEB Journal,16, 1869-1873. Hiramoto, R., Rogers, C., Demissie, S., Hsueh, C,M., Hiramoto, N., Lorden, J. & Ghanta, V. (1996). The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity. Int J Neurosci. 84(1-4):229-45. Sevan-Schreiber D. Anticancer: A New Way of Life. New York: Viking. 2008: 1. Hildesheim A, Han CL, Brinton LA, Kurman RJ, Schiller JT. Human papillomavirus type 16 and risk of preinvasive and invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol. 1997 Nov;90(5):748-54. Zhu Y, Jin Y, Guo X, Bai X, Chen T, Wang J, Qian G, Groopman JD, Gu J, Li J, Tu H. Comparison study of complete sequences of hepatitis B virus identifies new mutations in core gene associated with hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010 Aug 10. [Epub ahead of print]. Webb PM, Hengels KJ, Moller H, Newell DG, Palli D, Elder JB, Coleman MP, De Backer G, Forman D. The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology. 1994 Nov;107(5):1335-44. Beasley, R. K., Clayton, T., Crane, J., von Mutius, J., Lai, C.K., Montefort, S., Stewart, A., & Phasae Three Study Group. (2008). Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years: analysis from Phase Three of the ISAAC programme. Lancet, 20 (372), 1039-1048.

Febbre terapeutica

“Curerei tutte le malattie, se solo potessi produrre la febbre.” Parmenide, medico e filosofo greco, 510 a.C.

La febbre e la terapia del calore sono state riconosciute per i loro effetti benefici sulla salute fin dall’antichità. L’antica medicina greca, i bagni sulfurei caldi dei romani, le saune finlandesi, i trattamenti termali europei e americani, le vasche calde giapponesi, le capanne di essudazione degli indiani d’America, le sorgenti calde terapeutiche di tutto il mondo, sono esempi di come le varie culture hanno usato forme semplici di calore come mezzo, sia per pulire, che per guarire.

• La febbre: un amico o un nemico?

  Nella nostra cultura c’è un certo timore nei confronti della febbre. Molti la vedono come la causa della malattia, invece di riconoscere in essa il tentativo naturale del corpo di guarire. Mentre il paziente ha la febbre, la madre, il padre, il partner, l’amico, la badante avvertono una certa sensazione d’impotenza. Non c’è da stupirsi che al primo segno di febbre corriamo a prendere farmaci come l’aspirina o il Tylenol (farmaci anti-infiammatori non-steroidei). La medicina rappresenta la speranza e la guarigione. Dare farmaci significa curare (dice così anche la pubblicità).   Il messaggio è: se riesci a ridurre la febbre la malattia se ne andrà. Così, chi si prende cura del paziente dandogli un farmaco antifebbrile, si sente capace di fare qualcosa. Di solito si pensa che ridurre la febbre sia un modo di combattere la malattia.   Ma, ironia della sorte, la paura della febbre è fuori luogo. A meno che non si raggiungano temperature troppo alte (40 °C e oltre) per settimane, non avviene nulla di male. La febbre segnala al sistema immunitario di approntare difese maggiori, e mette in movimento il processo di guarigione. In effetti, si tratta di una risposta naturale di tutti i mammiferi alle infezioni e alle malattie. Così succede nei gatti e nei cani, negli elefanti e nelle tigri, nei cavalli, e negli esseri umani.   La ricerca ha dimostrato che la febbre non è un nemico, è l’amico della guarigione. Questa conclusione scientifica, confermata da migliaia di studi, fornisce la base per il trattamento di ipertermia che viene praticato al Medical Center Cologne e in altri centri medici in Europa, in Giappone e in tutto il mondo.

• In che modo la febbre attiva la funzione immunitaria

  Come già descritto in dettaglio in questo capitolo, la febbre è effettivamente il segnale che un’attività immunitaria sta operando in risposta a un’infezione, una malattia, una ferita o una neoplasia. A 38.5° C il sistema immunitario raddoppia le sue funzioni, reagendo ad impulsi dalle profondità del tronco cerebrale.

  È stato dimostrato che questo aumento della temperatura corporea agisce su vari elementi della funzione immunitaria, tra cui messaggeri chimici come l’interleuchina, che mette in azione il sistema immunitario, le cellule dendritiche, che identificano l’infezione o le neoplasie, le proteine da shock termico, che attivano i globuli bianchi e le cellule T, che distruggono i virus e le cellule del cancro.

L'ipertermia nella cura del cancro

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