Advanced Metastatic Colon Cancer
Short summary
58-year-old male suffers from advanced metastatic colon cancer with weakness, severe anemia and synchronic liver metastases. A good partial response has been accomplished by the combination chemotherapy and the antiangiogenic antibody Avastin. In the meantime, the patient has been started on a therapeutic protocol based on hyperthermia. In the expert's opinion, There is no evidence that hyperthermia is of any benefit in this patient.
Patient's questions
- Is hyperthermia considered to be experimental treatment? Complementary? Is there an indication in cancer therapy?
- Is there any scientific evidence that hyperthermia can prolong life in cancer patients? Or improve quality of life?
- Is there any scientific evidence that hyperthermia treatment can help this specific patient? Is the treatment necessary for this patient?
Medical Background
Male, 58 years old.
This patient is apparently suffering from advanced metastatic colon cancer with weakness, severe anemia and synchronic liver metastases in both lobes of the liver. The disease had been first diagnosed by CT and PET CT scans, the histology was achieved by colonoscopic puncture of a tumour in the cecum. Apparently, a good partial response of the metastatic disease has been accomplished by the internationally accepted combination chemotherapy with a FOLFOX regimen and the addition of the antiangiogenic antibody Avastin.
This patient is apparently suffering from advanced metastatic colon cancer with weakness, severe anemia and synchronic liver metastases in both lobes of the liver. The disease had been first diagnosed by CT and PET CT scans, the histology was achieved by colonoscopic puncture of a tumour in the cecum. Apparently, a good partial response of the metastatic disease has been accomplished by the internationally accepted combination chemotherapy with a FOLFOX regimen and the addition of the antiangiogenic antibody Avastin.
In the meantime, the patient has been started on a therapeutic protocol based on hyperthermia in Bad Aibling, ( St. George Clinic ).
Medical opinion
Questions:
- Is hyperthermia considered to be experimental treatment? Complementary? Is there an indication in cancer therapy?
It seems fair to say that hyperthermia can be a slightly effective therapeutic modality in rare oncologic situations such as locally advanced soft tissue sarcomas, where hyperthermia adds to the effects of radiotherapy and chemotherapy. Studies of Prof. Rolf Issels in Munich have shown that survival could be slightly improved in localized but primarily inoperable soft tissue sarcomas. But even in this disease, hyperthermia is not generally accepted nor performed. The definition of complementary therapy is a bit obscure, but hyperthermia should not be regarded as a complementary therapy.
- Is there any scientific evidence that hyperthermia can prolong life in cancer patients? Or improve quality of life?
Yes there is, as indicated above. But only in the relatively rare clinical situation of locally advanced sarcoma, not in metastasized epithelial cancers.
- Is there any scientific evidence that hyperthermia treatment can help this specific patient? Is the treatment necessary for this patient?
These last questions have to be answered with a clear “no”. There is no evidence that local, regional or systemic hyperthermia is of any not in metastasized epithelial cancers benefit in a patient with colon cancer with inoperable liver metastases.
I am, as a summary, quite sure that the patient’s insurance company does not have to cover this unproven method for metastasized colon cancer.
