Researchers at Wits University have successfully enhanced the effectiveness of heat therapy to help treat cervical cancer – the second most common cancer among South African women, with 10 700 new cases diagnosed and 5 870 deaths annually in the country – after trialling the treatment for a decade.
The Wits team first began testing Modulated Electro-Hyperthermia (mEHT) for cervical cancer treatment in 2014, said Dr Carrie Anne Minnaar, who led the study at the Donald Gordon Medical Centre.
“With the large numbers and advanced stage of cervical cancer in SA, especially in the public healthcare setting – and the limited treatment resources – compounded by the HIV incidence, we desperately need a way to improve the outcomes, without additional burden or costs, and without increasing the treatment toxicity. mEHT has potential to achieve this, so we developed a trial to test it out,” she told IOL.
They explored the addition of mEHT to standard treatment protocols for locally advanced cervical cancer and monitored participants for five years post-treatment, with positive results.
Their decade-long study is groundbreaking, said Minnaar, being the first phase 3 trial on mEHT, the first hyperthermia trial conducted in Africa, and the first to include HIV-positive participants.
The recently announced results are promising, she added. “We have had positive results for certain tumour types in our practice. But the best evidence is the 10-year trial which found it’s possible to increase the five-year disease-free-status of cervical cancer patients by more than 200% when we add this treatment to chemoradiotherapy.
“It also found that adding mEHT to chemotherapy and radiation can cost-effectively improve a patient’s quality of life and chances of achieving a five-year disease-free survival status.”
What is modulated electro-hyperthermia?
mEHT uses modulated radiofrequency waves to create an electromagnetic field that heats tumours to between 39 and 41 degrees Celsius without affecting healthy tissue.
The heat makes the tumour more susceptible to radiation and, in some cases, chemotherapy, while also slowing the cancer’s ability to repair itself.
Additionally, mEHT can trigger an immune response to the cancer, enhancing the overall impact of the treatment.
Unlike traditional hyperthermia, mEHT selectively targets the tumour, making it a more affordable, simpler option. This allows for the integration of hyperthermia into standard cancer treatments, increasing their effectiveness without adding significant side effects.
Who are the ideal candidates?
“The treatment works best in locally advanced disease, or disease from stage IIB onwards,” said Minnaar. “Early stages are well managed with standard treatments. It is also better if the mEHT is combined with radiation.”
The procedure
“The treatment is timed to align with the radiation, where the patient will lie on the bed and expose only the region that is being treated.
“An adjustable electrode with a water bolus will then be placed over the treatment area in direct contact with the skin. During the treatment, which usually lasts an hour, the patient will feel warmth where the bolus has been placed, however, the warmth should never feel uncomfortable, it should feel like the number one setting on an electric blanket.”
Most people get up straight away. Occasionally patients may feel a little lightheaded or drowsy and if the patient has had treatment to the brain, there may be a headache for a short period.
After the mEHT treatment, the patient goes straight to the radiation department for radiation.
Side effects and risks
Compared with the other treatments cancer patients need to go through, mEHT is safe, and side effects are uncommon. In fewer than 2% of patients, a small burn may develop on the skin, about 1cm in diameter.
In people with a thick adipose layer there is a 10% chance of a burn in the fatty tissue, manifesting as a round bump or nodule in the fatty tissue that is sensitive to touch.
Impact on cervical cancer
While access to mEHT technology and trained professionals is still emerging in South Africa, the release of the team’s results is expected to accelerate its adoption.
This advancement is particularly important given the inequity in access to screening and treatment in South Africa, she added. By incorporating mEHT into the national healthcare system, there is potential to improve outcomes for many women with cervical cancer.
IOL article – Cervical cancer breakthrough in South Africa using heat therapy (Open access)
See more from MedicalBrief archives:
High rates of cervical cancer found in women living with HIV
Cervical cancer can be eliminated by 2040: UK health boss
Invasive cervical cancer rates high in women living with HIV in Africa and Latin America