Patient K, 26 came to our clinic in April 2005 with diagnosis AIDS infection of IVA stage, persistent adenopathy, gepatomegaly. Complains on axillary lympth nodes increase, undue fatigability, decrease of work capacity, insomnia, loss of appetite.
CD 4+lymphocytes level was 438 cells, and viral load was 450000 copies of RNA in milliliter of blood serum.
Patient was prescribed treatment course, including 5 PG procedures in the first year, according to the scheme, developed in clinic.
After 3 PG procedures, the patient axillary lympth node size decreased significantly, appetite recovered, immunity grew, viral loading decreased.
In 2 months before the 4th PG procedure, the CD+4 lymphocites level was 746 cells, and viral loading - 6800 RNA copies in milliliter of blood serum. The patient noticed significant decrease of fatigability, increase of work capacity (he works as a long distance driver), sleep normalization, good appetite. First was made the 4th PG procedure, and then in a half of year - the 5th one. After it the level of CD+4lymphocites grew up to 960 cells, viral loading reduced down to 670 RNA copies in milliliter of blood serum.
The patient was recommended one procedure of General hyperthermia a year.
In June 2007 patient K was done the 6th procedure. At present he feels good, lives full life, without any health complaints. Antiretrovirus pharmacotheraphy was not carried out. The figures of general biochemical immunological analysis are in the normal limits. At the moment patient viral loading is 920 RNA copies in milliliter of blood serum.
Staging conclusion: as a result of hyperthermal theraphy the immune deficiency (AIDS) had been eliminated and its prophylaxis is carried out.
4.1 Infectious diseases. Hepatitis C.
Taking into account unsatisfactory results of hepatitis C treatment with application of modern chemotherapeutical medicines (hard tolerance, occurrence of medicine resistance, treatment reaction non-stability), we offered hepatitis C virus intensive thermal treatment method (ITT).
41 patients, 29 men and 12 women aged from 18 to 49, who were carried out 92 ITT procedures, as a whole, concerning hepatitis C. No one patient got antivirus therapy. In great majority of cases hepatitis was a concomitant disease at the secondary immunodeficiency of different genesis as well as at AIDS infection, chronosepsis. The diagnostics of viral hepatitis C was based on clinical, laboratory data, and PCR results, which were the basic ones at diagnosis identification.
On the example of the patient P.V. (20 years old, has been ill for about 1.5 year) we will show the dynamic of viral load after ITT courses.
0n admission to the clinic 3.05.04 viral -load was 1.25,104 RNA HCV copies /ml blood serum. Three courses of ITT were carried out.
6.05.04 – the second procedure of ITT was carried out. Exposition time at the temperature higher than 43°C, i.e, 43.5°was 5 minutes. Viral loading in twenty-four hours was 72, 102 copies in milliliter.
18.07.04 – the second course of ITT was carried out. Exposition time at the temperature higher than 43°C, i.e, 43.4°C was 4 minutes. Viral load in twenty- four hours was<200 copies in milliliter.
12 patients were examined for viral RNA level in blood serum by PCR method. RNA level of the last 29 patients was not determined because of technical reasons. The other 11 patients had the dynamic of viral load such as in fig. 22. Viral load of one patient (female, E.K., 18) insignificantly decreased after three courses of ITT (43.2-43.5°C). Unfortunately, the majority of patients do not follow the recommendations about periodical examination and fall out of our field of view. We had an opportunity to observe only 10 out of 41 patient’s state of health of this group in dynamic for the period maximum 7 years. All 10 patients had improvement of general state, normalization of functional parameters of the liver and stabilization at a low viral load values.
The few presented observations make it possible to hope, that further investigations of ITT application perhaps, combined with antiviral medicines, can substantially improve the results of hepatitis C treatment.
Those, who are interested in historical questions of hyperthermal treatment methods in different medical branches (fig. 22) we refer to F.B. Ballusek monographs (2001,2004), where the achievement and complexities (including the ones of non- medical nature), which researches and doctors -hyperthermists both in Russia and abroad had faces are reasonably described. Intensive thermal treatment of persons with oncological pathology can be used as follows:
· as anti-relapse treatment after the eхtensive tumor excision;
· as cytoreductive procedure, aimed at non- respectable tumor transformation into the respectable tumor state(it can be applied only to small size tumors and tumors not of all localizations);
· as immunopotentiating procedure to provide the possibility of further
chemo and radiation therapy;
· before application of other methods of tumor impact to increase malignant cells sensitivity to these methods.
ITT application aimed at relapse prevention.
You cannot subject patient with large- volume tumor tissue (including the metastatic one) to intensive thermal treatment, because upon the tumor tissue disassimilation after such procedure there is a high probability of development of endogenous intoxication , which to master is rather difficult and sometimes impossible. But if the patient was made radical or conditionally radical surgery on critical tumor mass excision, in this case the probability of the micrometastases availability (intensive thermal treatment is used to destroy the micrometastases) remains very high. The use of chemotherapy is ineffective, and the patient endures the procedure very hard. ITT should be made as soon as possible after the operation.There were cases in our practice, when we conducted ITT in 10-12 days after surgical intervention. Let’s give some clinical observations.
Man, M.N., 43 came to the clinic, with diagnosis rhabdomyosarcoma of a greater pectoral muscle from the left, the state after partial tumor removal in January 2003. In February 2003 two ITT procedures were carried out with increase of body temperature up to 43.3 and 43.4°C. In April 2003 radical operation was made – destruction of large and small pectoral muscles from the left, lymphadenectomy of axillary nodes. At histological study tumor pathomorphism of “obscure’’ Genesis was found. In May 2003 two procedures of ITT were carried out (t 43.3 and 43.4 °C). Since that time the patient had one ITT procedure twice a year .The last procedure was made in October 2008. Before each procedure full clinicolaboratory examination is carried out. There are no data for metastasis and recurrence. The other methods of treatment were not used. The man is capable of working.
Man, K.V., 52 was admitted to the clinic with diagnosis eye melanoma. In February 2004 enucleation was carried out. Two or three times a year he took ITT procedure (42.8-43.1°C). There are no data for relapses or metastases. He keeps on working as an engineer.
Man U.D, 57 Diagnosis: stomach cancer, ḻḻḻ stage. In April 2003 subtotal gastrectomy was carried out. From May 2003 till October 2008 he took 12 procedures of ITT (42.7-43.3°C). He did not get any other treatment. The last complex examination was made in September 2008. There are no data for relapses or tumor metastasis.Capable of working (taxi driver).
Man, D.V., 54 Diagnosis: cancer of medium ampular department of the rectum, stage iii. In March 2004 anterior resection of rectum was performed. From June 2004 till October 2008 he took 8 procedures of ITT (42.9-43.5°C). The last complex examination was carried out in September 2008 (colonoscopy, CT scan of the abdominen, retroperitoneal space, thoracic cage). There are no data for relapses or metastasis of process.
Man, K.D., 29 Diagnosis: shin angioreticulosarcoma, histologically confirmed in January 2003. From March 2003 the conduction of ITT had started. In July 2003 multiple metastatic destruction and mediastinum lymph nodes was diagnosed. The TGT was carried out in the area of basic localization of the tumor (shin), the summary dose was 46 gram. From March 2003 to September 2008 twenty- three sessions of ITT (t 43.2-43.7°C) were carried out. At present the patient is on disability (group III). The general state is satisfactory, in summer time rides bicycle a lot. There was no progression of metastatic defeat (according to the CT data on September, 2008)
Man, R.U., 58 Diagnosis: liver cancer with multiple metastases in lungs, diaphysis of shoulder bone, pathologic fracture. In June 2005 nephrectomy was carried out. The presence of metastases was diagnosed in August 2005. From September 2005 till October 2008 took 12 sessions of ITT (42.9-43.4°C). The condition is stable. The invalid of group III .Actively keeps house. According to data for October, 2008 there were no signs of further progressing of the process.
There are a small number of clinical examples, which don’t inspire optimism concerning neither the periods, nor the quality of life. And we cannot console ourselves with the thought, that by using ITT, we achieved a complete recovery. However, the systematic and repeated conduction of ITT gave the patients the possibility to have quite a long (against the statistics) and quality life.
Cytoreductive effect of ITT
As it turned out, not only chemotherapy and radiation therapy have cytoreductive effect. This property is inherent in the intensive thermal treatment. Three-five sessions of preparative ITT are endured much easier, than chemo or radiation therapy, and allow to reduce the volume of tumor, that gives the opportunity to perform surgery.
Below are the clinical observations.
Woman, I.T., 63 Diagnosis: breast cancer T4 NO MO (classification of N.V Blinov, 1998) .In the municipal oncology Unit of city hospital the patient was offered to take 4-6 courses of polychemotherapy with a subsequent decision of a question on a possible operation. From this type of treatment the patient refused to. In May 2003 five sessions of ITT were carried out with an interval between sessions of 5-6 days (t 42.9- 43.5 °C). After that the tumor has decreased significantly in size, what made it possible to perform radical mastectomy in June 2003. The post-operative period proceeded without complications. The patient was observed to 2007, taking 1-2 sessions of ITT annually. The condition is satisfactory, actively engaged in housekeeping.
Woman, I.V., 44 Diagnosis: breast cancer T3 N1 MO. She refused the offered preoperative telegammatherapy. Three sessions of ITT was carried out. In September 2004 after that the shape of tumor changed (T1 NO MO) and radical mastectonomy had been carried out. Two-three times a year ITT was being carried out. Complex examination, carried out in September, did not reveal recurrence and metastases. Capable of working (administrator of large industrial enterprise).
Man, C.C., 43 Diagnosis: cancer of low ampulatory department of the rectum (adenocarcinoma). The operation had not been carried out, because of non-resectability of tumor. Three sessions of ITT was performed (t 43.0-43.3°C), after that without technical difficulties sphincter preserving resection of the rectum was executed.
Although the observation period was still small, but there was a fact of transition of non-resectable tumor in respectable due to the carried sessions of ITT.
Man, M.V., 57 Diagnosis: prostate cancer (adenocarcinoma). In the preoperative period 3 sessions of ITT were carried out (t 42.9-43.2°C). In June 2004 the transvesical prostatectomy was carried out. In histological study of the operational material the tumor was not found. Pre and postoperative histological study was executed by one and the same pathologist. The pockets of multiple sclerosis, small foci of necrosis were found, that was regarded as post hyperthermic pathomorphism. The patient is able to work (middle-level manager).
In surgical material of the last four observations pathologists had found multiple necrosis, foci of sclerosis, i.e signs of pathomorphism, obviously associated with influence of ITT.
Immunostimulating effect of ITT
We have numerous observations of patients with persistent leuko and thrombocitopenia, caused by chemotherapy or radiation therapy. Often these complications are difficult to traditional methods of correction, forcing to refuse from conducting the necessary treatment. Implementation of 1-3 sessions of ITT leads to normalization of the blood indicators and allows you to continue therapy.
Woman, M.N., 49 Diagnosis: cancer of lung, multiple metastases in the liver, in the body of the 5th lumbar vertebra, in the ishial bone. The carried out 4 courses of PCT gave a certain stabilizing result. When conducting the 5th course, the resistant
leukopenia (1.2,109) and thrombocytopenia (50 thousand) were identified, not allowed to continue PCT. Traditional methods stimulation of hemopoiesis did not give necessary effect. Two sessions of ITT with an interval of 6 days (t 42.2-42.4°C) were carried out. On the forth day after the second session of ITT the leukocyte level increased to 4.9, 109 and platelets to 250 thousand, that allowed to continue the pallative course of PCT.
Nevertherless, the diagnosis“cancer” is always “late”! What is the solution?
We are all constantly surrounded by myriad of bacteria and viruses, threatening us with infections, which is capable of causing substantial damage to the health and reduce the period of life, when the immunity is weakened. Chronic and unrecognized infections take many years of active life. Substantial damage to the immunity cause antibiotics. Its uncontrolled use does not stand any immune system.
Also does harm labor without rest and sleep. Low immunity reflects badly on the appearance. This is shelled, cracked skin, earthy color of the face, dim split hair, brittle layer of nails, poor posture, ugly walk, lackluster eyes, painful condition of the gums and teeth. The desire to relax in a different climatic zone with the change of time zone and dietary also does not add to the health and increases the risk of cancer. There is no man, who would not be afraid to probability of occurrence of cancer. How to be and what to do? How to be a person, who had been removed the tumor surgically brilliant, but there is no certainty, that metastases are not aware itself?
The great French surgeon Rene Leriche (Leriche, 1879-1955) considered, that the disease is a drama in two acts. The first act is played out in silence, at the lights turned off and curtains closed. When something appears and worries, that, as a rule, is already the second act.
In recent years, thanks to the rapid development of molecular genetics of cancer, appeared methods, allowing to determine the beginning of the appearance the cancer cell in the organism.
In any organism constantly appear mutated cells with signs oft malignancy, that is why any healthy person (including non-smoker) has cancer cells, and it can be defined, using tumor markers. In any case, when the level of tumor markers increases, appears “oncological alertness”. Determination of tumor markers is available as well in America, Europe as in Russia. Well, defined, - what to do? How to get rid of these insignificant malignant cellular colonies, which cannot be seen by other means of diagnostics?
Surgery is not good, because you don’t know, what to “cut off”. Radiation therapy is also not good, because you don’t know, what to irradiate. Chemotherapy -you will“ grow bold” and “spoil the blood”. What remains? To enhance the anti-tumor immunity under the control of the markers? Not bad. But there is one more method.
This is general peak hyperthermia of high level, which is safe for the patient, kills cancer cells, wherever they were, increases immunity, improves the functions of vital organs and tissues, and thoroughly cleans up, sanifies the entire organism. You can apply it periodically, thereby excluding the probability of cancer occurence.
Thermal treatment is effective for cancer viral and allergic practice, when it is necessary to achieve necrobiosis and apoptiosis of malignant cells, inhibit infection or destroy paraproteins and patholodical immunoglobulins. In addition, hyperthermia fights with a premature ageing of the whole organism.
The use of general peak hyperthermia in the treatment of severe forms of atopic bronchial asthma.
It is known, that the peculiarity of the medico-social situation of our time is a steady increase of frequency of immunoallergological diseases, in particular, bronchial asthma (Volkov B.T., Sterlis A.K 1996 and others). Our researches, carried out by the program Isaak, in 1996-1999 confirm this observation. It turned out, that each fourth child out of the 14258 questioned Siberian schoolchildren had symptoms of bronchial asthma (25.6%). It is not surprising, that according to the summary statistical data of the Russian and foreign authors, that the frequency of B.A among adult population is 5-7 %. And there is a tendency of increase of a serious hormone dependent forms of asthma. This confirms, that existing in the pulmonology methods of asthma treatment, that use modern
pharmacological remedies (antibiotics, hormones, beta 2 mimetics, mucolytics, immunocorrectors etc) are not effective enough, because they influence not the main pathogenetic bonds of B.A, they have influence only on specific clinical symptoms of serious disease of the organism. Thereupon, increased the currency of the revision of many of the positions of the essence of B.A strategy and tactics of treatment of patients with B.A, of exception of “symptomatic” therapy of clinical manifestations of disease. This message is an illustration of validity of strategy and tactics in treatment of patients with B.A. In this respect a perspective direction is application in treatment of serious forms of hormone dependent B.A of intensive technology, developed by us, based on implementation of the General peak hypertermia (42-43.5°C). The scientific proof of the expediency of application of GPH of such a high level is the installed capacity of artificially induced hyperthermical condition, forced to destroy and remove from the body of the patient pathogenic factors of bronchospasm and inflammation, cut off imbalance in the immune status. As a result of a single session of GPH, already in twenty-four hours happens the treating of the basic clinical manifestations of BA even with heavy complicated of its forms. Patients stop taking hormones and other drugs. 28 patients of B.A. of varying degrees of severity, age and sex had been treated for 5 years. All the patients after heat treatment were observed: treating all manifestations of B.A, normalization of parameters of spirogram, elimination of the need to take hormones, bronchial spasmolytics and other pharmacological agents. In addition, it happened fairly positive change of indicators of immune status and disappearance of allergens. This is evidence of patogenetic effect of GPH (fig. 23).
Figure 23 Reduction of content of allergens (A) and immune complexes (B) in the blood of the patient with bronchial asthma.
Thus, the clinical consequences of the application of thermal methods in treatment of bronchial asthma are:
•Rapid relieve of the basic manifestations of bronchial asthma even with heavy (complicated) of its forms.
•Effective destruction and removal from the body patogenic factors (CES, allergens, patoimunnoglabuolins, patoooligopeptids), participating in the development of bronchial asthma.
•Fast recovery of functional ability of the lung, proved spirografically.
•Elimination of hormonal drugs addiction.
•Elimination of imbalance of the immune system, arising from use of hormonal drugs.
•The possibility to implement the rehabilitation, out of hospital stage after twenty-four hours after GPH. You may hope, that the offered method of treatment of B.A, will find its place in combination with other options of treatment of this disease.
4.4 Study of narcomania
Treating the abstinent syndrome in drug addicts.
The abstinent syndrome is a critical, conditionally lethal state after the abolition of drugs in persons with physical (chemical) addiction. There are known ways of treatment of abstinent syndrome, based on many day treatment (from 7 days to 6 weeks) of the application of “low” doses of the drug substitute, large dozes of hypnotics, holinolytics, adrenaline blockers, tranquilizers and symptomatic therapy (Rahman, 1967) .It is also known method of treatment of abstinent syndrome for drug addicts (Morosov, Bogolepov 1984), in which intramuscular introduction of sulphosin, pirogenal, piroxen, potassium chlorine, sodium thiosulphate, unitol and other means, increasing the temperature of the body are used, which are combined with therapeutic procedures (sauna, bath, showers).
The disadvantages of this methods of treatment of narcotic abstinent syndrome are:
– polypragmasy, when medicines of symptomatic therapy are used;
– long- lasting, not less than 7 days getting over the sufferings of the patient – anxiety, stress, excitement, slobber, vomiting, diarrhea, pain in the bones and joints, tachycardia and other symptoms of “breaking”;
– do not provide a removal of physical addiction, but only facilitated pathological manifestations of abstinent syndrome;
– in the latter method the potential of hyperthermia are implemented only partially, although pirogenal and thermal effects in the form of baths and shower are used.
The advantages of GPH as way of removal of abstinent syndrome at drug addicts are:
1.The elimination of manifestations of abstinent syndrome and physical addiction after one-two-three sessions of general peak hyperthermia.
2. The exclusion of the suffering of drug addict during the removal of abstinent syndrome and after the application of general hyperthermia.
3.The elimination of polypragmasia before and after the application of GPH.
4. Clinically significant decrease of the intensity of the psycho-emotional, vegetative and organ disorder after t removal of abstinent syndrome.
As examples, we will present the following cases from the practice. Patient K, 21. Diagnosis: opium drug addiction ӀӀ stage. Abstinent syndrome. Abuse of preparations of Indian hemp. Viral hepatitis in remission. Takes marijuana from the age of 16,opium substitutes intravenously from 18.The maximum daily dose of opium is 3.0 g of dry substance with the addition of 150 mg of dimedrol.
Entered the resuscitation Department 24.09.97.Pre procedure preparation 1 hour prior to the implementation of the method included: rheopolyglucin 400 ml, 250 ml 10% glucose solution with vitamins (B6 5%- 10 ml, C 5%-10ml), panangin 20 ml. Induction in anesthesia- ketalar 100 mg, intubation of trachea and lung ventilation was in the mode of moderate hyperventilation with the level of oxygen saturation in the blood 100-96% (pulse oximeter Siemence). The temperature in the esophagus was 36.8°C, arduan was 4 mg. General anesthesia was maintained at the level III I by the fractional introduction of fentanyl 1ml intravenously. Warming of the patient was carried out in the bath with water (46°C) at a pace 1°C for 3-5 minutes. When the temperature in the esophagus was 43.6°C, the period of warming was terminated. The patient was removed from the bath. 450 ml of unfrozen plasma and 150 ml of polarizing mixture (10% of glucose solution –250ml, potassium –14 mmol, insulin 10 units) was transplanted intravenously. In 4 hours after the beginning of the procedure the patient was in conscious. The patient was extruded. In the first and following twenty-four hours the use of analgetics, sedatives, drugs and tranquilizers were not required. The subjective evaluation of the patient: “I did not expect, that it would be so easy”. The conclusion of the expert in narcomania: “There are no symptoms of abstinence, mental and somatic state are restored quickly”.
Patient Ya, 26.Diagnosis:opium drug addiction of II stage. Had been using opium since 1993 in the maximum (to the present day) daily doze of 8-10 g of raw opium with the addition of 200 mg of dimedrol. Occasionally used heroine, marijuana, cocaine. The patient entered the resuscitation Department in 29.10.97. Pre procedure preparation included: rheopolyglucin 400 ml, 4% solution of potassium chloride 20 ml, vitamins B6 and C in 10 ml of 5% solution. Induction in the anesthesia- ketalar 100 mg after intubation of the trachea and lung ventilation was in the mode of moderate hyperventilation with the level of oxygen saturation in the blood 100-96%. Anesthesia in the stage of III-I was maintained be the fractional introduction of fentanyl to 1 ml, initial temperature in the esophagus was 36° C. The warming of the patient was carried out in the bath with water (46°C) at a pace 1C for 3-5 minutes. On reaching the temperature of 43.5° C in the esophagus active warming was terminated. The patient was removed from the bath. The intravenous infusion was 550 ml of unfrozen donor plasma, 500 ml of crystalloid with panangin (40 ml), potassium chloride (4%-40 ml), in conscious after 4 hours after the beginning of the procedure. The patient was extruded. In the first and the following twenty-four hours the use of analgesics, sedatives, drugs and tranquilizers and other psychotropic drugs was not required. Subjectively the patient marks, that he endured the abstinent syndrome very easily, that he had not assumed, looking back at his past experience. The conclusion of the expert in narcomania: “After the removal of abstinent syndrome with the help of hyperthermia method the clinical features of the post-procedure period varies with quickness of reduction of disposition of abstinent phenomena, the quick restoration of sleep, vegetative disorders, violations of psycho- emotional sphere, and absence of attraction to drugs, weak intensity of the pain syndrome”.