Clinical Hyperthermia Practice Guidelines Workshop The goal of this workshop is to provide practical training for hyperthermia therapy personnel, including physicians, nurses, radiation therapists, and physicists. All speakers have clinical experience in their fields. Lectures from well-known experts on clinical, physics, and biology of hyperthermia will provide participants a comprehensive overview of practice guidelines to deliver safe and effective hyperthermia treatments. This multi-disciplinary workshop will also include talks on clinical workflow and reimbursement. The workshop is the first of its kind organized by STM and is open to STM2019 participants of all thermal therapy backgrounds.
How to Establish a Hyperthermia Program
Zeljko Vujaskovic, MD, PhD
Practice Guidelines for Superficial Hyperthermia
Jason K. Molitoris, MD
Practice Guidelines for Deep Hyperthermia
Mark Hurwitz, MD
Practice Guidelines for Interstitial Hyperthermia
John Hayes, MD
Equipment, Planning, and Execution of Microwave Superficial Hyperthermia Treatment
Paul Stauffer, MSEE, CCE
Equipment, Planning, and Execution of RF Deep Hyperthermia Treatment
Dario B. Rodrigues, PhD
Assessment of Hyperthermia Treatments based on Hypoxia Imaging
Mark Dewhirst, DVM, PhD
Clinical Workflow, Documentation and Reimbursement of Hyperthermia Treatments
Siteman Cancer Center now offering superficial and interstitial hyperthermia, using the Pyrexar Medical BSD-500, to their cancer patients. The cancer center is located at the Barnes-Jewish Hospital within the Washington University Medical Center complex in the Central West End area of St. Louis, Missouri.
Although the system will be utilized to treat a variety of indications, Dr. Imran Zoberi, Chief of Hyperthermia Service and Clinical Director of Radiation Oncology at Barnes-Jewish, is targeting recurrent chest wall tumors. Treatment issues for recurrent breast cancer include radiation dosage limitations, post-surgical skin folds, scaring and lesions that can make this form of recurrent breast cancer a challenge to treat. Dr. Zoberi, along with William Straube, Research Associate Professor of Radiation Oncology, have been long-time users of hyperthermia as an adjunct to radiotherapy. The new BSD-500 has replaced a retired Labthermics Sonotherm 1000.
According to a randomized phase III clinical trial (Jones study) published in the Journal of Clinical Oncology and conclusions of a meta-analysis published in the International Journal of Radiation Oncology, Biology and Physics, adding hyperthermia to radiation therapy can potentially double complete response over using radiation alone in recurrent breast cancer.
One of our goals at Pyrexar Medical is to connect and share all of the great advancements in hyperthermia from around the world. We believe that access to information, sharing of data and participating in a global effort can give access to hyperthermia to more people.
We have started a new section on our website called Opinion Leaders. The purpose of this section is to initiate conversation and make new connections among physicians and researchers currently in the field. We want to create a community for those centers who want to add hyperthermia to their standard of care. We also believe this may give researchers an accelerated path to clinical studies by offering a larger patient database.
Current hyperthermia-focused conferences are in place but often lack the critical mass to expand hyperthermia centers in a meaningful way. There also lacks the global data sharing necessary to move phase III studies forward. For example, the Hyperthermia European Adjuvant Trial (HEAT) is a randomized clinical phase III study comparing chemotherapy vs chemotherapy plus hyperthermia in the treatment of pancreatic cancer. Initiated in 2012 and with an estimated enrollment of 336 participants, the study hopes to fully populate sometime this year. Seven years to generate a viable population study and another two years of data analysis. Could future studies move more rapidly if we had a global collaboration?
We hope we can advance this concept in the near future. Today, we want you to meet Dr. Nagraj Huilgol, our first entry in our Opinion Leaders directory.
A friendly reminder that the main Hyperthermia Conference Events in the US and Europe are right around the corner. These conferences are a gathering of the best in hyperthermia research and an excellent resource for those interested in the field of thermal oncology.
We just returned from a trip to India to attend the SCRAC (Society of Cancer Research and Communication) meeting in the coastal town of Juhu, Mumbai, India. We had the opportunity to meet radiation oncologists and cancer specialists from the region, and to present our pitch for hyperthermia. We have received positive indications that there will be several Pyrexar Medical Hyperthermia suites installed in India in 2019.
India is projected to be the world's most populous country by 2024. Surpassing the population of China, it is expected to be home to more than 1.7 billion people by 2050. With this continuing growth, the demand for health services also grows. The opportunities in the country are vast and it appears hyperthermia has a chance to gain a foothold as a valuable adjunct cancer treatment.
SCRAC 2019 Program
Introduction to MRI Imaging - Dr. Mitusha Verma; Nanavati Hospital Texture analysis - a novel technique in Radio-genomics - Dr. Balaji Ganeshan; Chief Executive Officer TexRAD Ltd UK Introduction to MRI with Hyperthermia - Mr. Mark Falkowski, CEO; Pyrexar Medical MRI to study heat induced changes for diagnostics and MRTI - Dr. Nagraj Huilgol; Nanavati Hospital Group discussion to explore the possibilities to harness heat for diagnostics.
Last month the local affiliate in Salt Lake City, UT (headquarters for Pyrexar Medical) aired a five-part series on the use of hyperthermia in the treatment of cancer. The report focused on one of our customer sites, Gamma West Cancer Services, and their use of interstitial hyperthermia in combination with brachytherapy.
Key points from this series
Hyperthermia is a safe and highly effective cancer treatment
Several patients featured in the story had no expectation of survival before hyperthermia
Excellent adjunct treatment for Brachytherapy with similar treatment planning
We have added English language captions to the video series. This is an excellent opportunity to share this life-saving information on your social media websites. The more individuals that learn about this treatment, the more lives we can change.
Part 5 of the ABC news series on hyperthermia is probably the most important. In the past, we have talked about phase III clinical studies, and have shown peer-reviewed evidence that adding hyperthermia to radiotherapy and chemotherapy improves outcomes and extends life. We know it energizes the bodies immune system to fight the cancer on its own. We know it is well excepted as a cancer treatment in Europe and Asia.
But none of that matters. No matter how effective hyperthermia treatment is, it will not save your mother, your father, sister, brother, aunt, uncle, grandmother, grandfather or your child, if it remains relatively unknown in the U.S. Whether you know it or not, you have a choice in your medical treatment. It takes research and advocacy and the sharing of information. In this news series, you met four people who are here today because someone advocated for them and for hyperthermia.
You can help more people survive cancer. Share this story. Shed some light that there are hyperthermia treatment protocols for most cancers that have solid tumors. Tell people that hyperthermia was once an ancient medical treatment, or that it uses some of the most advanced image-guided technology in medicine. Tell them there are 30 years of scientifically proven evidence, it has FDA approval, its available in university hospitals and cancer centers in this country and can be covered by insurance. Tell them there is a map that will show them where the closest center is located. It is that simple.
Thank you to all of the generous individuals that were involved in making this story happen. Thank you to the ABC Good4Utah news team for taking on topics that help others. To Gamma West Cancer Services for not backing away from patients that others have given up on. And to my co-workers at Pyrexar Medical, particularly Paul Turner, who continues to improve this technology, and has for over 40 years. Thank you.
Pyrexar is working very hard to bring innovation to our products. But nothing is more important than sharing the message of hope that hyperthermia treatment can bring to cancer patients. Although there is a long, successful history of this therapy, few Americans know about it. We want to know why?
Although hyperthermia system sales have been accelerating in the last two years in Asia, Europeans have had a long history of using this technology. In part 4 we meet Professor Dr. Peter Wust of Charité Universitätsmedizin Berlin who has been treating patients with hyperthermia for over three decades. The team at Charité are the world's leading experts in this type of cancer treatment. You can learn more about the treatment options at the Charité in their patient brochure.
In Part 3 of the hyperthermia news report, produced by Salt Lake City's ABC station Good4Utah, we meet Randy. Randy is a great example of what hyperthermia could do for cancer patients around the world. Randy was diagnosed with rectal cancer that had metastasized to his colon and lungs. The tumor was too large to be surgically removed. As in most cases with cancers this advanced, the doctor's tried to make the patient comfortable with pain killers and recommended hospice care. I cannot imagine what that must feel like to hear that your life is at its end.
But Randy had an advocate in his sister and, through an internet search, found Dr. Hayes of Gamma West Cancer Services. Dr. Hayes had a plan, treat the primary tumor with brachytherapy and hyperthermia to provided the best outcome. Not only did the treatment shrink the primary tumor and kill the cancer, but also the other tumors continue to shrink or have completely disappeared. Randy has a new lease on life.
I want to repeat this point. The primary tumor was treated with brachytherapy radiation and interstitial hyperthermia. The metastatic sites of the colon and lung received no treatment, no radiation, and no chemotherapy. How did the other cancers disappear? Immune Modulation. Hyperthermia restarted the immune systems ability to recognize the cancer. Any stray cancer cells that may find a new stronghold in the body were attacked by the body's own immune system.
When I have asked other doctors why hyperthermia is not used in all cancer treatment, the response I get is radiation and chemotherapy work "pretty well". Our hope is hyperthermia will play more of a role in first line treatment as a non-pharmaceutical radiosensitizer (with little to no toxicity).
Part 2 of the ABC News series visits two patients with life threatening recurrent cancers. In this installment, we meet Jack, an avid race car driver whose prostate cancer returned after treatment two years ago. Jack understands the devastating effects of cancer, he lost four siblings to the disease. Jack approached his cancer treatment like he approached racing, he planned to win. Jack is a winner, thanks to his willingness to seek out the best treatment solution, even though far away from home.
Meet Nicole, faced with the recurrence of an aggressive head/neck cancer. One solution was to remove her tongue to save her life. Luckily she found Dr. Hayes who offered a different solution. Using brachytherapy and hyperthermia, Nicole kept her tongue and her ability to speak and swallow normally. Both patients are now one year cancer free.
The ABC affiliate in Salt Lake City, Utah has produced a five-part series on the resurgence of hyperthermia in the treatment of cancer. Part 1 of 5 aired this evening and features the Pyrexar BSD-500 Interstitial Hyperthermia System used as an adjunct to brachytherapy in the treatment of advanced recurrent prostate cancer. Reporter Surae Chinn - @suraechinn asks Dr. Hayes of Gamma West Cancer Services to explain how he and his team use hyperthermia to improve cancer outcomes. See the video and full transcript at www.Good4Utah.com
As you may know, recurrent cancer is a challenge as the indication often proves to be radio-resistant. With this in mind, Dr. Hayes has accepted patients that many have given up on. It is his experience that adding hyperthermia at therapeutic temperatures for one hour will increase oxygenation, increase blood flow and perfusion, inhibit DNA repair and stimulate the body's immune response, making his treatment more effective than other oncologists in the area. Gamma West is able to provide interstitial radiotherapy (brachytherapy) followed quickly by interstitial hyperthermia, in as few as two treatments in a single day.
It is important to share these stories as hyperthermia has proven to change lives and extend life.
We just returned from Taiwan after attending the TASTRO - Taiwan Society for Therapeutic Radiology and Oncology annual conference. The event was held at the Tiangong Hall in the Kaohsiung Junhong Hotel in Kaohsiung City. Presenters at the two day conference covered a range of topics including the Best of ASTRO topics (Head and Neck Cancer, Abdomen/Pelvis, Chest). We also enjoyed the presentation on the use of brachytherapy in early stage breast cancer. We believe that interstitial hyperthermia, and the immune response trigger of heat, can play an important role in this treatment protocol. But the main focus of the event centered around proton therapy.
Dr. Zeljko Vujaskovic presented "Thermal Therapy in Cancer Treatment" as the keynote speaker of the event.
Univ. of Maryland Featured Speaker
Taiwan Society for Therapeutic Radiation Oncology Annual Conference
Ames Medical Represents Pyrexar
Our sales agent for Taiwan, Ames Medical, put together an excellent booth presentation for the Pyrexar product line
The highlight of the conference was a keynote presentation by Dr. Zeljko Vujaskovic from the University of Maryland Proton Center. Dr. Vujaskovic provided an overview of the development of Thermal Therapy, with an emphasis on its reemerging role in cancer treatment. Dr. Vujaskovic and his team have developed the world's first center to combine proton therapy and thermal therapy treatment in a single facility. The team has recently started treating patients in the new thermal suite and early results are positive. The University of Maryland has used the BSD-500 for many years and the recent addition of a BSD-2000 last spring will allow them to treat cases using hyperthermia in the superficial, interstitial, and deep regional modes.
A special thanks to our Taiwan sales organization AMES Medical. They did a tremendous job hosting our team and creating a comprehensive marketing and sales presentation in the conference booth.
Plus: AIRO - Italian Association of Radiotherapy Oncology
We were also represented this month at the AIRO by our distributor Tema Sinergia. The 28th Annual AIRO was held Nov. 2-4 at the Rimini Conference Center, Rimini, Italy. The event is co-located with the 31st National Congress AIRB and the 10th National AIRO Youth Congress.
Thank you to the Tema Sinergia team for their great work.
We just returned from the 60th Annual ASTRO in San Antonio, Texas and wanted to share our experience. First, it was a great show for Pyrexar. We had immediate traffic in the booth and for the first time we did not have to explain the benefits of hyperthermia as a drug-free radiosensitizer or hyperthermia’s role as an immune modulator. Second, the recent announcement from the University of Maryland Proton Center of its new BSD-2000 hyperthermia suite and the follow-up article in DotMED.com created an immediate draw to the booth.
The theme of this year's booth centered squarely on the advances of image guided thermal therapy and the BSD-2000 3D/MR, shown in the featured booth graphic, with hands on access to the Sigma Eye/MR Applicator and the newly redesigned Sigma 30 for the BSD-2000 and BSD-2000 3D/MR. The Sigma 30 is a 30cm applicator designed for limbs (soft tissue sarcoma) and pediatric applications.
The crowds and the physical space was about 20% smaller this year. The quality of the show still maintained its excellence as an important platform for scientific review and new product introductions. Many of the large radiation equipment manufacturers focused more on software than hardware.
Stopping by the booth were hyperthermia luminaries, Dr. Zeljko Vujaskovic from University of Maryland, Dr. Mark Hurwitz from Thomas Jefferson Sidney Kimmel Cancer Center and Dr. Niloy Datta, Kantonsspital Aarau, Switzerland. Dr. Datta presented a poster titled "Therapeutic Options for Locally Advanced Cervix Cancer: A Systematic Review and Network Meta-analysis" at the new ASTRO Digital Poster Pavilion.
We would also like to thank our partners Sennewald Medizintechnik (Germany/Europe/Russia) for their participation in the booth. As well as Orientech (China); Tema Sinergie (Italy); Hanbeam Technology (South Korea) and our newest partners Sukosol (Thailand) and HuaLong BioMed (Taiwan), for bringing in a constant flow of prospects from around the globe.
Next stop is the 2018 Taiwan Radiation Oncology Annual Symposium sponsored by TASTRO - Taiwan Society for Therapeutic Radiation Oncology, held in Kaohsiung City, Taiwan Nov. 10 - 11. Our Taiwan partner Ames Medical will have a booth and Dr. Zeljko Vujaskovic is a featured speaker presenting his work in hyperthermia and its role in proton therapy.
In an announcement this week, the University of Maryland's Proton Center has established the world's first combined Hyperthermia/Proton Beam therapy center. The therapy suite features the BSD-2000 Deep Regional Hyperthermia system as a complement to the center's 122,000 sq. ft., five bay, $270M, Varian ProBeam Proton system.
Proton therapy is a precise form of radiation for the treatment of solid, localized tumors. Unlike X-ray (photon) technology, protons deliver a maximum radiation dose that stops at the tumor site. This enables our physicians to target the cancer cells with millimeter precision while sparing normal, healthy surrounding tissue in the rest of your body.
Hyperthermia, as an adjunct therapy, is expected to provide the same functionality as it would for traditional radiotherapy by increasing tumor oxygenation; boosting effective dose by 150%; preventing DNA repair to damaged cancer cells and by awakening the bodies immune system to the identify and destroy cancer. The big difference is the belief that Hyperthermia + Proton = Carbon Ion as theorized in a paper Could hyperthermia with proton therapy mimic carbon ion therapy? by Dr. Niloy Datta.
This is an exciting advancement for hyperthermia to the forefront of cancer treatment.