Hyperthermia
Hyperthermia – the deliberate increase in temperature of a part of the body or the whole body as a therapeutic measure – has been around for a while. Today I would like to talk about how hyperthermia may be of relevance to CLL patients. I will provide some provocative leads to support my hypothesis, but please be aware this is only a hypothesis at this point. I am not aware of any formal clinical trials looking into hyperthermia as a possible therapy option for CLL patients.
The 2006 article in the prestigious Journal of American Medical Association (JAMA) asks this question: “How could Lance Armstrong, who was diagnosed with very advanced metastatic testicular cancer, be treated so successfully that he could subsequently win multiple grueling Tours de France?” The abstract of the JAMA article is below.
JAMA. 2006;296:445-448.
Hyperthermic Biology and Cancer Therapies. A Hypothesis for the “Lance Armstrong Effect”
Donald S. Coffey, PhD; Robert H. Getzenberg, PhD; Theodore L. DeWeese, MD
Department of Urology, and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Md 21287, USA.
There is perhaps no more important question in cancer research than to understand the molecular basis of how the majority of patients with testicular cancer can be treated so effectively. For instance, how could Lance Armstrong, who was diagnosed with very advanced metastatic testicular cancer, be treated so successfully that he could subsequently win multiple grueling Tours de France? Although such therapeutic success is now common for many patients with this type of advanced testicular cancer, this type of outcome is unattainable for the majority of patients with other types of advanced solid tumors. What accounts for the astounding therapeutic success with testicular cancer, and can this outcome be explained both at the cellular and molecular levels? Understanding the basis for the “Lance Armstrong effect” may provide therapeutic targets to enhance cures of other common advanced solid tumors that remain so refractory to the best systemic treatments.
PMID: 16868303
The JAMA article is interesting reading. Send me a personal email if you would like to read the full text of the article. I have excerpted some of the highlights below.
- Warm-blooded animals like us evolved with normalbody temperatures that are often far higher than the ambient temperature. Maintaining this temperature differential is a very costly energy price for the animal.
- When mammals are infected with pathogens, they have adapted to produce increased body temperature (fever), which increases the proper function of the immune system and therefore ability to kill off invading pathogens.
- Fever temperatures are lowered to make us feel better but might be detrimental in fighting infections.
- Many cancer cells are more easily killed than normal cells if they are incubated above 42°C (107.6F)
- Human testes are a few degrees lower in temperature than the rest of the body and testicular cells are very sensitive to temperature increase.
- The Lance Armstrong effect might be due to the fact testicular germ cells die when heated to even the normal body temperature of 37°C (98.6F).
- When testicular cancer metastasizes to other parts of the body (in Lance’s case to his lungs and brain), it therefore becomes stressed by heat, making the cancer easier to destroy when it is treated with radiation or chemotherapy
Do CLL cells also like to be slightly cooler than normal?
Extrapolating from the JAMA article, the million dollar questions for us are these: are CLL cells also temperature sensitive? Do they also prefer to be slightly cooler than “normal” body temperature of 37C (98.6F)? Are they easier to kill by chemotherapy if at the same time they are also subjected to higher temperature?
Anecdotal information from patients
I started pondering about this whole business when looking over my huge database of anecdotal CLL patient stories. It struck me that many patients report their “normal” body temperature is significantly below 37C. Unfortunately this is only anecdotal information and you are smart to bear that in mind as you read the rest of this article.
In my husband PC’s case, I know his temperature used to average just about 98.4 before the diagnosis of CLL. Below is a chart of his temperature over a period of little over 3 months. First couple of weeks is baseline (color coded black), when he had pretty high tumor load. Subsequent months (colored red) represent his temperature as he went through monthly cycles of Humax-CD20 + fludarabine therapy. (HF can be considered to be similar to RF; since PC was hypersensitive to Rituxan he had to substitute Humax-CD20 in place of Rituxan).
As you can see, his average temperature gradually increased as therapy progressed and then stayed at the higher level for the period of time while he was getting therapy – and presumably the CLL tumor load was significantly reduced over this period of time.
Are CLL cells temperature-sensitive?
If for the sake of argument we accept that like testicular cells CLL cells too prefer to be at a slightly cooler temperature, the next question is whether they are more readily killed when forced to be at higher temperature. The second part of this question is equally important: do CLL cells die more readily at elevated temperature, compared to normal B-cells? In other words, is there a window of opportunity here? Can we kill CLL cells preferentially?
Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 6693
Abstract # 6693
Differential sensitivity of B-CLL cells and normal B cells to hyperthermia
D. Schoeler, C. Weber, A. Tornack, F. Schriever and F. Ringel
Charité Campus Virchow, Berlin, Germany
Background: Inhibition of apoptosis is a major cause why B-cell chronic lymphocytic leukemia (B-CLL) still can not be cured with conventional chemotherapy. Therefore, innovative approaches to this clinical enigma are needed. Whole body hyperthermia (WBH) as a part of a systemic Cancer Multistep Therapy (sCMT) is under investigation in a variety of advanced solid tumors. The aim of the current study was to examine whether B-CLL cells and normalperipherallymphocytes have a differential sensitivity to hyperthermia in vitro. Methods: Peripheral blood B cells of patients with B-CLL (n=38) and normal donors (n=21) were isolated by Ficoll gradient centrifugation and were incubated in vitro at different temperatures (37-42°C) over defined time periods (15-300 minutes). Apoptosis and necrosis of anti-CD19-labelled B cells were quantified by Annexin-V-FITC and Propidiumiodide respectively, using flow cytometry. Nuclear fragmentation demonstrating apoptosis was visualized by DAPI-staining using fluorescence microscopy. Apoptosis via mitochondrial pathway was monitored by JC-1. Induction of cDNAs encoding for the heat shock proteins (hsp) 27, 60, 70, 90, and 105 was quantified using RT-PCR. Results: In B-CLL cells apoptosis was induced at 40°C and higher with an optimal temperature at 42°C. Induction of programmed cell death could be observed as early as after a 15 min incubation at 42°C. Interestingly, B-CLL cells differed in their ability to undergo heat-induced apoptosis from normal B-lymphocytes. After a 2 hour incubation at 42°C 56 ± 15% of all B-CLL cells but only 12 ± 9% of normal B cells underwent apoptosis (p<0,0001). Of note was, that in both, normal and malignant B-cells, heat-treatment induced hsp 27, 70, and 90. Interestingly, high hsp 27 levels in untreated CLL cells were shown to be positively correlated with hyperthermia induced apoptosis. Conclusions: B-CLL cells are more susceptible for heat-induced apoptosis than normalperipheral B cells. We hypothesize, that our data may encourage innovative studies examining whole body hyperthermia as an experimental approach to treat patients with B-CLL.
It seems this temperature sensitivity is not limited to CLL cells alone. Below is an abstract that says pretty much the same thing about AML (acute myeloid leukemia) cells. In fact, they suggest this difference can be used to clean stem cells collected from patients for autologous transplants. Contamination of stem cells with cancer cells is one of the major problems associated with autologous stem cell transplants.
Differences in heat sensitivity between normal and acute myeloid leukemic stem cells: Feasibility of hyperthermic purging of leukemic cells from autologous stem cell grafts
Experimental Hematology, Volume 31, Issue 5, Pages 421-427
PK Wierenga – 2003
Objectives. In autologous stem cell transplantation contamination of the graft with malignant cells is frequently noticed and necessitates the use of in vivo or in vitro purging modalities. The hematopoietic recovery after transplantation depends on the number of stem and progenitor cells in the transplant. Therefore, in the present study the effects of hyperthermic treatment on the human normal and acute myeloid leukemic (AML) stem cell compartment were investigated.
Methods. Normal bone marrow and AML blasts were heat treated up to 120 minutes at 43°C. The surviving fractions of the different stem cell subsets were determined using in vitro methylcellulose and cobblestone area-forming cell (CAFC) clonogenic assays, as well as the in vivo NOD/SCID repopulating assay. The leukemic nature of the colonies from AML cells was confirmed by RT-PCR analysis. In order to increase the therapeutic index of the hyperthermic purging modality, the heat treatment was preceded by a 3-hour incubation at 37°C with the ether lipid ET-18-OCH3 (25 μg/mL).
Results. It could be demonstrated that normal progenitor cells are far more resistant to hyperthermiathan leukemic progenitor cells (56%±7% vs 9.9%±2.6% survival after 60 minutes at 43°C, respectively). Furthermore, normal hematopoieticstem cells appear to be extremely resistant to the heat treatment (94%±9% survivalafter 60 minutes at 43°C). In contrast, in the leukemic stem cell compartment no significant differences in heat sensitivity between the stem cells and progenitor subsets could be observed (12.3%±2.9% vs 9.9%±2.6% survivalafter 60 minutes at 43°C, respectively). The combined treatment resulted in a survival for normal progenitor and stem cells of 32%±6% and 85%±15% after 60 minutes at 43°C, respectively. Under these conditions the number of leukemic stem cells was reduced to 1%±0.3%. After 120 minutes at 43°C, no AML-colonies could be detected anymore.
Conclusions. Our data demonstrate that leukemic stem cells have an increased hyperthermic sensitivity compared to their normal counterparts and that this difference can be further increased in combination with ET-18-OCH3. These striking differences in heat sensitivity warrant the use of hyperthermia as a clinically applicable purging modality in autologous stem cell transplantation.
Theoretical explanation for temperature sensitivity
Most of us know by now that high ZAP70 is not a good prognostic indicator. Patients whose CLL cells express high levels of ZAP70 have more aggressive CLL. ZAP70 protein is thought to facilitate signaling through the b-cell receptor (BCR) which in turn turns up the ability of the cell to have lots of baby cancer cells. It is proposed that ZAP70 protein comes unglued when the temperature is increased. At higher temperatures the protein is not folded properly and cannot do its job.
The abstract below from Kipps et al suggests that when ZAP70 gets all messed up, it requires the services of a heat shock protein (HSP90) that acts as a busy housekeeper re-folding the ZAP70 protein just right. This raises the immediate question: what if ZAP70 becomes unglued due to higher temperature and at the same time we prevent the housekeeper HSP90 from doing its job and re-fold the ZAP70? Without the constant stimulation of the ZAP70 protein can we bring to a halt the ability of CLL cells to multiply?
Bottom line, will treatment with drugs such as 17-AAG which block the function of HSP90 be more effective if at the same time we also use hyperthermia forcing the ZAP70 protein on CLL cells to get messed up? Please read an earlier article we published on our CLL Topics website that discusses in detail the clinical trials underway at Ohio State using 17-AAG and its sister drug 17-DMAG
Blood. 2005 Oct 1;106(7):2506-12. Epub 2005 Jun 21.
ZAP-70 is a novel conditional heat shock protein 90 (Hsp90) client: inhibition of Hsp90 leads to ZAP-70 degradation, apoptosis, and impaired signaling in chronic lymphocytic leukemia.
Castro JE, Prada CE, Loria O, Kamal A, Chen L, Burrows FJ, Kipps TJ.
Moores University of California San Diego (UCSD) Cancer Center, University of California, CA 92093-0960, USA. je-castro@ucsd.edu
The zeta-associated protein of 70 kDa (ZAP-70) is expressed in patients with aggressive chronic lymphocytic leukemia (CLL).We found that ZAP-70+ CLL cells expressed activated heat-shock protein 90 (Hsp90) with high binding affinity for Hsp90 inhibitors, such as 17-allyl-amino-demethoxy-geldanamycin (17-AAG), whereas normal lymphocytes or ZAP-70- CLL cells expressed nonactivated Hsp90. Activated Hsp90 bound and stabilized ZAP-70, which behaved like an Hsp90 client protein only in CLL cells. Treatment with Hsp90 inhibitors such as 17-AAG and 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) induced ZAP-70 degradation and apoptosis in CLL cellsbut not in T cells, and also impaired B-cell receptor signaling in leukemia cells. Transduction of ZAP-70- CLL cells with an adenovirus encoding ZAP-70 activated Hsp90 and specifically rendered the leukemia cells sensitive to 17-AAG. These data indicate that Hsp90 is necessary for ZAP-70 expression and activity; that ZAP-70 is unique among Hsp90 clients, in that its chaperone-dependency is conditionalon the cell type in which it is expressed; and also that ZAP-70 is required for cell survival and signaling in CLL. Additionally, ZAP-70 expression in CLL cells confers markedly heightened sensitivity to 17-AAG or 17-DMAG, suggesting that these or other Hsp90 inhibitors could be valuable therapeutically in patients with aggressive CLL.
PMID: 15972449
How hyperthermia is done
Hyperthermia can be limited to small portions of the body, or it can be applied to the whole body. Temperature can get as high as 107F! WARNING: Do not do this at home on your own! When the body is raised to high temperatures such as this it is quite possible to have heart attack or do damage to your brain. I am very serious about this warning folks.
But under strictly supervised medical conditions it is possible to increase body temperature to these levels with little risk. The question is this: will medically supervised whole body hyperthermia increase the effectiveness of chemotherapy in CLL?
Below are some links that can teach you more about use of hyperthermia in treating cancer.
Hyperthermia and breast cancer (Video)
Hyperthermia as cancer therapy article
Cancer treatment Centers of America – local hyperthermia
An expensive book on hyperthermia (May I borrow it if you decide to buy it?)
New approaches to hyperthermia
In much of the prior work whole body hyperthermia is done by immersing the patient in hot baths, wrapping him in warm blankets etc.
More recently new approaches have been suggested for raising body temperature. For example, it has been suggested that if metallic nano particles (very tiny particles of metals such as gold) are attached to targeted drugs such as Rituxan, it might be possible to tag CLL cells with these metal particles, which can then be heated to higher temperature by means of radio-frequency fields. Anyone who has used a microwave oven knows better than to put a metalcontainer in there and switch on the microwave. In this approach we are proposing tagging the CLL cells with tiny metal particles (the CLL specific tagging is brought about by Rituxansince it targets only B-cells carrying the CD20 marker). Turn on the RF field and every B-cell tagged with a metal particle will cook to a much higher temperature and get killed.
Low tech approaches to hyperthermia
As I said above, whole body hyperthermia can be very dangerous without medical supervision. But how about heating only small sections of your body to higher temperature? Using heated poultices to reduce pain and increase healing is an ancient practice. Many “alternate medicine” sites talk about heated castor oil packs effective in shrinking swollen nodes. Much is made of the need for castor oil of a particular level of purity etc.
Frankly, I think the same effect can be achieved by using a small electric heating pad or hot water bottle. As long as you are careful not to give yourself a burn by jacking up the temperature too high, a heating pad kept at a nice warm clip held in place for an hour or so can possibly heat up the local CLL cells in the swollen lymph node to the point where they are more likely to die. The role of the castor oil is merely to increase the thermal capacity of the bundle of rags soaked with it, so the whole mess stays warm for quite a while. You can get the same effect without the mess by using a warming pad or hot water bottle.
How about vigorous exercise?
Heat stroke is a concern primarily during hot weather, but even in the relatively cool environmental temperature of 50 F, healthy marathon runners can have body temperatures as high as 103.8 F. One runner who was still conscious is reported to have developed a temperature of 107.8 F after finishing a marathon, but most people cannot tolerate temperatures that high.
I cannot conclude this article without a tip of the hat to our exercise jock and Rituxan poster boy Malcolm. I have lost count of the number of times Malcolm has had single agent Rituxan therapy. This single drug has been sufficient to keep Malcolm out of trouble for 7 – 8 years now. The other bit of the puzzle? Malcolm insists of biking to and from the doctors office. 20 miles of biking at a good clip is surely sufficient to get Maloclm’s body nicely heated, right about the same time as his CLL cells are being attacked by the Rituxan. Way to go Malcolm! It seems he has developed his own technique for getting synergy between Rituxan therapy and whole body hyperthermia.
Did Lance Armstrong win multiple grueling Tours de France races becasue his testicular cancer was cured, or was his testicular cacner cured because of all the high intensity exercise involved in preparing for the races and winning them? Which came first, the chicken or the egg? I wonder if anyone kept track of Lance’s body temperature after one of his marathon biking sessions. Must have been toasty in there, way too hot for testicualr cancer cells I would think.
If regular and vigorous exercise helps kill CLL cells, terrific. If all it accomplishes is improve your metabolism, make your heart and lungs that much stronger, give you that youthful look you have always wanted, what is not to like?
45 comments on "The Lance Armstrong Effect"
Chaya,
I had not read anything about hyperthermia as a cancer treatment before. It is interesting because I like to spend 20 minutes after a workout in a 170-190F sauna. Thought I was flushing out toxins, but it would be nice if it is stressing out my CLL B cells, too.
Thanks,
Jim
Chaya, I found your article on heat treatment interesting especially because I have zap70 with painful nodes. I sleep with a heating pad every night and it is not only comforting but the increase in circulation caused by the heat makes me feel physically better. I also keep a heating pad on my enlarged spleen for much of the night and don’t know how I would sleep without it at this point. The heat is a wonderful thing.
Chaya, thank you so much for this information, I’m thinking I might get off my duff and exercise now. Mike
Very interesting information. I read somewhere in my research about alternate therapies that increasing body heat helps kill leukemia cells and wondered if that explained the intense hot flashes I have – my body is trying to get rid of them? I do saunas when I can, cardio exercise several times a week, and am a huge fan of soaking in hot tubs. In any case, as Chaya said, taking these measures can only be helpful in general. Thank you!
Being the therapeutic nihilist that I am, I applaud your effort to present a cautious and balanced approach to this hypothesis.
The possibility of using the principles of hypothermia for a diffuse disease such as CLL/SLL clearly must be very carefully considered as it is likely that the involved cells are literally “everywhere”, so that indiscriminate application of heat energy presents numerous risks to innocent tissues.
No one could dispute the likely benefit of vigorous exercise. The possibility that exercise may enhance the efficacy of any particular therapy (such as monoclonal antibody induced attacks upon specifically marked cell types) seems real enough.
I suspect that hyperthermia may first play a major role in such things as enhancing the harvesting of “clean” stem cells should autologous stem cell transplants make a comeback and in such therapeutic interventions as are proposed by the theory of the kanzius machine wherein the cancer cells are tagged for treatment that can be diffusely applied without affecting other body cells (similar in theory to using Zevalin or Bexxar).
As a caution, I would remind people that using public saunas and hot tubs may pose a risk of unwanted infections, so everyone should be careful of their hygiene if they choose to try to elevate body temperature by those means. On the other hand, waiting to use acetamenophen when suffering the “shakes and bakes” during chemoimmunotherapy may not be such a bad idea so long as one is being monitored and remains well hydrated…my mother always said “feed a cold and starve a fever”.
Thanks for the review,
Rick
Don’t laugh too hard: I, too, pondered the effect of hyperthermia on CLL, so when the war broke out I seriously considered volunteering as a civilian for work in the Baghdad “green zone” — where temperatures around 100 degrees F are common much of the year.
During a recent bout of Legionnaires Disease/severe pneumonia my body temp soared to approx. 104F at one point. Prior to that, I had been scheduled to start my first round of chemo due to quickly declining platelets. After I recovered, it was found that my platelets had recovered & my white cell counts were more stable & lower than before the illness.
Could the ‘hyperthermia’ have been the reason? One can only speculate but now, some months later some decline in platelets is being seen again.
Like Malcolm, I’m an avid cyclist. While I never managed to ride to chemotherapy appointments last summer, (benedryl makes me too groggy to do anything more strenuous than napping,) I did manage to ride over 1200 miles during my 5 months of treatment.
Living in Tucson, I have experience riding in warmth weather. Typically, I commute to work by bike 2-4 times a week. Since my diagnosis three years ago, I’ve stopped commuting to work in the heat of summer, figuring my ride home in afternoon temps greater than 100 degrees might not be the best thing for a body living with CLL.
Looks like I might have to consider riding through the summer heat this year.
Thanks for the information
Steve
Chaya,
So far, I am fortunate enough to be in the “indolent” stage with no chemo needed. I read this article with interest, since I have always had a lower body temperature. Guess it might be time to raise it with some exercise!
Peggy
I have been getting in a hot tub every evening for 15-45 minutes for over twenty years at a temperature of 109/110 degrees. I know this is not recommended, but my body has become adjusted to it and any temperature less doesn’t feel hot enough. I was diagnosed with CLL in Jan 1997. I have had no symptoms and no treatment. My white count has gradually increased over the years and is now at 29,000. I go every 4-6 months for blood tests. I am 75 years old and consider myself very very lucky. The hot tub may have nothing to do with my CLL, but I’m not sure.
Thanks for the information.
Ed
Recently diagnosed with what looks to be a bit more “indolent” type but have stopped exercising all together. I think I’ll reconsider that and get moving again.
My normal temperature is about 97.4. For as long as I can remember, I cannot stand being hot. I have been known to turn on the a/c in winter because I can’t breathe.
Now, when I’m on chemo and my blood work is screwed up, all that changes.
I am addicted to walking but walk the malls. I hate my treadmill.
If my CLL/SLL could be helped by the heat, I would be first in line.
St Louis summers can be very hot. I am going to try to be out in it this year.
Chaya, thanks for the update.
Rita
I have also become an obsessive cyclist and have wondered the same. It is nice to see this theory thought through by Chaya!
Another thought from the alternative world…
The theory that low thyroid (labs are not considered to be entirely accurate indicators in this theory) will result in low temperature, low metabolism etc. (I have been hypothyroid for decades).
Elaine
My Cll was discovered in 1990. In 1996 I had six treatments of FC with Dr. Keating.
I was a world class runner but since 1990 have been an avid cyclist. I ride about five hours a week in hot humid Florida. At this time my Cbc is normal.I am 60 years old. Twenty years with CLL and 12 or so since chemo.
As the earlier comment stated ..there is no downside to exercise… stonger heart ,etc .MAYBE CHAYA has alerted us to another possible arrow in our quiver.
Thanks Chaya for all you do.
Marty
I would like to second that caution about public saunas and hot tubs. They are often teeming with germs and the last thing I would recommend to an immune compromised patient. If you are wealthy enough to afford personal hot tubs or suanas, great, but please make sure you are very scrupulous about keeping them clean.
If private hot tub or sauna is out of your reach, get on your sneakers and work out, followed by a good hot shower. I gurantee you will feel better!
Chaya,
Thanks again, as always. I’m particularly curious about “tagging”. If we happen to be fortunate enough to be stage 0 , w&w, and not being treated with Rituxan, etc., are they ways to infuse a harmless substance to circulate within the body; and what might it be? I would be willing to be a guinea pig for that.
Jim
HI Chaya,
Thanks again for your work. I found the “Lance Armstrong Effect” very interesting because, like so many of your contacts, my “normal” body temperature is a degree below 98.6. I’ve recently started doing “hot” yoga three times a week. I think I’ll keep it up!
Joanne
I actually suspected when I was diagnosed a couple of years ago that taking hot baths might generate shock proteins and possibly other “emergency” responses that might make the body more resistant my CLL. I also run a couple of miles each day on my treadmill. It has long been known that aerobic exercise is protective against breast cancer for the same reasons. So far I am asymptomatic at 60K WBC.
Steve
Hi Chaya,
I hate to spoil the hyperthermia party but I must inject some reality about human body temperature regulation into this discussion. Playing with hyperthermia is a very serious issue. I have worked with warming and cooling the body during bypass surgery and have done research with malignant hyperthermia in humans and pigs.
Malignant hyperthermia is a disease of skeletal muscle. When the muscle is exposed to certain anesthetic agents, it acts metabolically as if all the large muscle groups are running a marathon. Inside the large muscle, temperatures easily reach 107 F. Think of the muscle as the car engine, the blood as radiator fluid, and the lungs as the radiator. The muscle transfers heat to the blood, the blood is cooled by the surface area of the lung and the inhaled air. If the heart or lungs can’t keep up, the other high blood flow organs start to absorb the excess heat (brain, liver, spleen, gut, and kidneys. The core temperature starts to rise and the brain starts to fry. Irreversible brain damage is a risk at 105 F and almost a sure thing at 108 F.
Peripheral body temperature is used as a buffer to maintain our core body temperature at a constant level. Blood flow, skin surface area, and to some extent the lungs are used to conserve or waste heat. Any topically applied heat or ice only has a local effect and in reality is unlikely to reach any deep muscle and definitely not the core temperature. Core temperature can only be effected if the groins and axilla are packed in heat or ice for an extended period of time due to the close approximation of some larger blood vessels. Your body will fight every step of the way to maintain core temperature (frost bite and thermal injuries are extreme examples). We get away with it during bypass surgery because anesthetic agents suspend normal temperature auto-regulation.
CLL is a diverse disease with a common name. While some strongly feel that their exercise routine has helped to keep their version of CLL in check, I suspect there is also something in their form of CLL that is different than others. Regular vigorous exercise is not going to control CD 38/ZAP 70 positive CLL. Local application of heat or sensible time in the spa or hot tub may make you feel good, but it isn’t changing your core body temp or your blood temperature. Deep nodes and marrow would be in that grouping as well.
Heat is like any therapeutic drug. There is a therapeutic range. If you exceed the therapeutic range, the drug turns into a poison that has the potential to kill. Heat is in the therapeutic range for testicular cancer due to the unique nature of the cells. Remember, fertility experts advise men to wear boxers instead of briefs as a first step since the testicular temperature can get to high for normal reproduction when the testicles are held close to the body. However blood is the radiator fluid of our body’s heating and cooling system. It is designed to withstand the working range of our system (95-105 F). CLL may be more susceptible to heat than a regular blood cell but it is at a level that the rest of the body will not tolerate.
My bottom line is that you should exercise – it is good for you. Use heat if it makes you feel better but don’t do it to “kill” your CLL. Stay away from public hot tubs and sweat tents. If you are using a sauna, make sure your heart and lungs can take it and be advised of the risk of fungus and other pathogens. There may be a potential use for heat in the treatment of CLL in the future but this idea is only at the dream stage at this point. Please leave it to the researchers to come up with a safe way to exploit this potential weapon.
Steven
The last comment by Steven raised an interesting point. Is it even possible to heat up a node, say an axillary node by using a good heating pad. Does the heat penetrate that deeply? If anyone has any more information on the question of nodes responding to sources of external heat, I would love to hear them. I am considering trying heat on a persistant axillary node, to see if it helps or not.
Chaya, thanks so much for posting this interesting article.
Steven:
Thank you for re-iterating all the caveats and cautions I had in my article. They bear repeating. Were you concerned I was “throwing a hyperthermia party” without adequate cautions? I hope not.
Whether it is possible or not to heat swollen nodes with a hot pad depends on where they are. Many times it is not possible to feel deep abdominal nodes by physical palpitation. I am pretty sure such deeply buried nodes will be impossible to heat via an externally applied heat source (such as a hot water bottle). But if the node in question is close to the surface and therefore accessible, I would think it is possible to raise its temperature significantly. Local hyperthermia as a way of relieving muscle aches etc is well documented. I am told sports clinics etc also use locally applied ultra-sound to achieve the same thing. But I do not know enough about the safety issues involved in the use of ultrasound devices.
Bottom line, I cannot see the harm in regular and vigorous exercise once your doctor has cleared you for it and you are smart about not getting into heat stroke situations. Similarly, I cannot see the harm in application of a hot water bottle or heating pad (follow the directions folks! Do NOT give yourselves a painful burn!). I have already voiced my reservations about public saunas and hot tubs.
Will hyperthermia synergize with chemotherapy drugs? Credible published literature seems to think so, including guidance from sources such as the NCI (links in my article). If anything, conventional hyperthermia should be easier to do in leukemia patients (compared to patients with solid cancers) since blood circulates close to the surface of skin significant amount of the time.
Will the synergy with hyperthermia be greater in the case of drugs such as 17-DMAG and 17-AAG which target the very heat shock proteins that help CLL cells survive death by hyperthermia? As I said, this is a hypothesis and to my mind a credible one. Will more new fangled approaches such as the nano particles and RF fields pan out? Only time will tell, if we ever get to clinical trials with such approaches.
Hi Chaya,
Sorry for the confusion. The party comment was not intended to be directed at the article, I think it was interesting and well cautioned and written. I was more concerned about the direction of the comments seemed to be taking regarding home experimentation with heat applied to the body in various ways despite your cautions. I was afraid that people might get thermal skin burns trying to heat up surface lymph nodes. The skin is the first line of defense of the immune system. We already have a weakened immune system due to CLL. Chemotherapy weakens it even further. Our skin may be more sensitive to thermal burns for these reasons.
As far as the axillary node is concerned, the axillary artery and veins will be a heat sink to dissipate some of the heat away from the area. Therapeutic ultrasound may be able to penetrate several centimeters for a local node but it will have no effect on the marrow or deep lymph nodes. A radiofrequency (RF) needle probe commonly used in surgical and pain management procedures could easily heat a single node above 42 C. But how would this be any different than surgically incising the node? It still does not address CLL in the blood, bone marrow, and hidden nodes.
Again, my sincere apology for any misunderstanding on my first post. I just was concerned that no one gets hurt trying to apply heat to their body.
Steven
As a physician who has some familiarity with Dr. Karan’s work on Malignant Hyperthermia and as one who has spent many times ordering the application of ice packs to the groin and axilla (and cooling blankets in more recent years) I simply want to emphasize the valid concern that he raises about the dangers of “home grown” attempts to carry hyperthermia too far.
While there may be a role for “holding the acetamenophen” when one has the “shakes and bakes” with chemoimmunotherapy, one must still monitor the body temperature (which using most methods available at home only reflects the actual core temperature) and the state of hydration, cardiac function and mental status. Any suggestion of altered cardiovascular tone or mental status cannot be ignored.
The concept of utilizing some means to “heat up” only the malignant cells (a large part of he theory behind the Kanzius machine) may some day have some merit. Trying to behave like lobsters in the pot does carry a definite risk.
Dr. Karan’s discussion covers this well.
Rick
Steven, Rick:
Thank you both for your comments. I really mean that.
I am delighted at the level of the discussions Updates articles are generating. This was the whole point of going to a format that allowed feedback from our readers, a feature that was missing in the original CLL Topics website.
I do worry about getting sucked into “cool” science and not doing enough by way of sounding the caveats and cautions. It is good to know we have at least a couple of trained MDs that keep a careful eye out for stuff than can get dangerous. I am also happy to report we have more than one CLL expert who monitors Updates and works with me on any issues that I need to fix.
With all your help, I hope to continue providing credible information that is free of snake oil. I am not a physician, but the oath “DO NO HARM” is very important to me.
I’d like to first say that I am very grateful that CLL Topics now provides this forum for us to interact with each other.
I wondered if anyone has had much experience with infrared saunas. I saw Dr Mehmet OZ on Oprah, talking about the therapeutics effects. here is a link to a brief explanation of the efficacy of saunas—burns caloris and get heart rate up too!
Nancy
Tulsa
I spent some time last night thinking about this discussion. I re-read the comments posted by our members, with and without MD’s.
For starters, I want to clarify “Malignant hyperthermia” that Steven and Rick mentioned is a specific condition brought about in a subset of surgery patients who respond badly to anesthesia drugs. In almost all cases, anesthesia drugs are implicated in onset of MH. There is no doubt that malignant hyperthermia is very dangerous. But malignant hyperthermia is not the subject of this article or the subsequent discussion by members. We are talking about the hypothesis that it may be possible to find synergy between some of the chemotherapy drugs already under investigation for CLL and hyperthermia, whether it is medically supervised whole body hyperthermia or the lowly hot pad applied to the pesky node in your armpit.
In my original article and the discussion that followed members talked about exercise, hot water bottles, castor oil packs, heating pads, saunas and hot tubs. All of these approaches are available to the general population, without the need for a prescription from a card carrying member of the medical profession. All of these approaches are used by zillions of people. Can they be dangerous if used inappropriately? You bet! A couch potato that has been sedentary most of his life is foolish if he decides to get into an aggressive exercise regimen without getting a check-up first and starting slow in any case. You can give yourself a pretty bad burn by ratcheting up the power on the electric hot pad. Heat stroke is dangerous. Most exercise gurus tell you to be sure you have a buddy with you when you work out, even if you are a jock in good shape. We already talked about the dangers of public saunas and hot baths, also known as germ incubators.
Bottom line, we are talking about people using commonsense to protect themselves in each of these situations. Each and every one of the undertakings discussed here (exercise, hot pads, saunas etc) can cause damage if you do not put brain in gear first. But the same is true of crossing the street, for heavens sake!
“Updates” is an adult patient site where we try to provide usable information to serious, sensible, layperson CLL patients. I try very hard to screen out snake oil and garbage. Every effort is made to provide proper cautions and caveats. But is there a way I can protect you from all harm, especially harm caused by people being plain foolish? I am afraid I can not protect you under those circumstances. Can you burn yourself with a hot pad? Yes!! Does that mean we cannot or must not discuss the possibility of synergy between chemotherapy and even locally applied hyperthermia (as in using a hot pad on that swollen lymph node right under your jaw after you get your recent chemotherapy infusion)?
Getting a burn from a too-hot heating pad is indeed painful. I will tell you what else is painful. Having CLL; having my friends and family die from it; having to read all this complicated stuff about chemotherapy drugs and why they don’t quite do the job; having to sort through all the nonsense that is out there on the internet, trying to find the few usable and actionable items that may make a difference; trying to get a conversation going with our physicians on best practices, often times educating them in the process of educating ourselves; getting researchers to include CLL patients in their trials, take this damn disease seriously! I would love to see the day when Updates is obsolete, no longer needed, because our medical researchers have found a cure for CLL, one that has little risk and high probability of success. I am afraid we are not quite there yet.
Am I a board certified MD? No, I am not, and that is something you should all remember as you read my articles. But I am a scientist and proud of it. I am not smoking illegal substances when I opine that there may be potential for medically supervised hyperthermia having synergy with drugs such as 17-DMAG and 17-AAG that block heat shock proteins, which are in turn important for proper action of pesky ZAP70 type tumor enhancers. If I bought that lottery ticket I keep talking about and if I won the big jack pot, I would be funding a well designed clinical trial along those lines. In the absence of that, the best I can do is write somewhat wistfully about concepts that may never get their chance.
The whole point of having the member discussion feature is to air these issues and have them put in perspective. I do not want to shut down free exchange of ideas and questions by getting too politically correct or getting too heavy on jargon. I do not want anyone feeling too intimidated to post here. I must assume a certain level of commonsense and responsibility on the part of my readers, or else I am probably smart to shut this website down and avoid any responsibility. Your feedback on this important issue is both welcome and requested!
Friends,
We can get in tune with our bodies without a specific educational degree. If body temperature, as a factor, arose in the minds of so many (as it did in my own), it is worth placing the idea on the table.
I bought an infrared sauna from Sam’s Club five months back. If I make any connections or receive significant effects, I will certainly post it.
Chaya, just keep moving forward. The connection between hyperthermia and CLL Therapy seems loaded with possibility.
A valid point brought to my attention by a good friend: people with diabetes are at a disadvantage when judging the level of heat that is safe, and therefore more likely to suffer burns if they are not extra vigilant in the use of heat pads, saunas and the like. Wound healing is also more of an issue in diabetic patients.
I should know, I am a diabetic myself. And CLL patients are generally at an age when they are more likely to have issues with sugar metabolism.
People, please be safe out there!
Chaya,
Keep all the new and exciting information coming. You are our link to the medical and research world that most of us aren’t privy to. We can decide for ourselves what we want to do with it. But we want to have the chance to learn about cutting edge research when comes hot off the press. You do all the hard work for us by sifting through it and making it “easy to digest” for us lay people. You go, girl!
Chaya,
Looks like a promising area for some research that could deal with some of these questions raise. I very much appreciate the information and it is worth a try for me to see what a little heat might do to swollen nodes that are rather noticeable but would love to see hypotheses like these tested. I do research but not in this area so it would be take a good lab group to begin a study with some well constructed hypotheses. I personally always talk these ideas over with my physicians, both allopathic and naturopathic.
Jerry M.
Chaya,
I find these discussions stimulating and therapeutic. They give me the feeling that a lot of us are taking this journey together.
I should have said in a prvious post that I have a one-person sauna in my basement that is easy to open up for drying. In the past I used the sauna at a health club, but too many people used it to sweat out their colds.
Jim
Chaya,
You were VERY careful at the onset of this article by stating:
“but please be aware this is only a hypothesis at this point. I am not aware of any formal clinical trials looking into hyperthermia as a possible therapy option for CLL patients.”
You are doing a job here that I for one appreciate greatly. I feel it is your desire to explore every area possible to help find a cure for this incurable cancer. You are careful to point out possible risks and warnings and that is wise.
I applaud your dignity and strong desire to see Topics go in a direction that is helpful to all.
Keep up the good work.
Mark
Reading the comments following this article I noticed how many stated they had stopped exercising. I feel we should be doing all that is in our control to maintain our health and recently read a book concerning this called Anticancer: A New Way of Life by David Servan-Schreiber MD, PhD, a cancer survivor. I emailed Chaya about it and she suggested I write a short review. I read an excerpt in AARP magazine a couple of months age and bought the book on Amazon. It deals with various lifestyle changes including diet, exercise and stress management. The author shares his personal experiences and those of others with cancer. He backs up his information citing various research. I found it helpful and am trying to incorporate some of his suggetions into my daily routine.
Friday – Sunday, 8/28 – 8/30. PELOTONIA. Columbus,Ohio Cycling star LANCE ARMSTRONG is expected to participate in this bicycle-oriented fund raiser benefiting The Ohio State Comprehensive Cancer Center, The James Hospital, and Solove Research Institute. Three distinct ride experiences, each with some rolling hills and a couple of challenging hills: one-day 50-mile route; one-day 100-mile route to Athens; and a two-day 180-mile route to Athens and back. Fully supported with food, water stops, mechanical, and medical assistance, luggage assistance, entertainment at finish and overnight lodging for two-day riders. Register to ride or volunteer online. NetJets. 351 W. Nationwide Blvd.; Columbus, OH 43215. (614) 221-6171.
In part, this fund raiser will benefit CLL research and treatment at the above Ohio State University medical facilities in Columbus, Ohio!
When I received my diagnosis in 1998, I decided that there must be something more beneficial than simply “watch and wait”. My now-retired hemotologist suggested learning about CLL (thank you Granny Barb, Chaya and PC). When I asked him about diet, he suggested high fiber and low fat. I did not ask and he did not mention exercise.
Besides trying to counter CLL, research has proven many other good reasons for both young and old to exercise and eat intelligently. The challenge is to heed the research and take action.
One of the keys to a successful exercise program is to find a variety of aerobic, strength-building, impact and stretching exercises that you like and will continue. These four types provide cardio-vascular strength, muscle strength/tone, bone health, flexibility plus calorie burning, lower bp, better sleep, less depression, etc.
One of my personal favorites is riding my old 1974 exercise bike — good in all kinds of weather but very boring unless you also read or watch TV.
Here are five very good books and lastly a video you may find helpful:
1.”Regaining the Power of Youth at Any Age” by Kenneth H. Cooper, M.D. — $14.95
2.”SuperFoods Rx” (blueberries, oats, soy, yogurt, etc.)by Steven Pratt, M.D. and Kathy Mathews
3.”SuperFoods HealthStyle” (includes exercise, etc.) by Pratt and Mathews
4.”SuperFoods Diet” by Wendy Bazilian, DrPH, MA, RD, Pratt and Mathews
5.”Cholesterol Down” (nine dietary items and 30 minutes of walking daily) by Janet Bond Brill, PhD, RD.
6.”Be BoneWise” a 33 minute VHS or DVD with exercises and routines that avoid movements that are unsafe for people with osteoporis. Available for $19.95 via The National Osteoporis Foundation
amazon.com has books 2 through 5 discounted to under $20 each and #2 is even available there in Spanish!
superfoodsrx site-map has many links about the superfoods, recipes, health tips, etc.
Treadmill desks (as recently researched and implemented at the Mayo Clinic) are a way to slowly walk while working.
Happy Boston Marathon Day!
Hi to all!
This is my first here.
I was diagnosed over 2 yrs ago – still in W&W.
From my own observations- I have had my temperature as low as 35 deg. C. quite often. After a holiday in hot Portugal my WC count went down. I am also a sauna goer- and have noticed that when my nodes are enlarged- they soften and shrink after a sauna visit. We had quite a cold winter and my count went up- now its warmer and it’s gone down again – seems to be some connection.
Maybe someday some specialists will look into this…
All the best to you all from Poland. :)
Andy
Hi Chaya,
Thank you so much for this article. It really hits home for me since i am ZAP70 positive and I am very interested in the physical activity connection to CLL. I too feel much better when i exercise. I am currently in training with Team In Training for Western NY LLS ride in Lake Tahoe. I did 100 miles last week. Our goal is to do 100 miles in a DAY on June 7th. This has been a wonderful experience to be a part of – getting in shape (with the help of my primary dr. who is one of three coaches for our team of 22 bike riders)and raising money for LLS. I shared your article with my fellow cancer patient friends and teammates – and they are all very impressed by you and your dedication to CLL. For all of you who think you are too tired – i was too – but with a group pushing me – my fatigue has lifted – i am doing it and now i can hope that i am killing some cancer cells along the way! THANK YOU CHAYA!
Shannon, dx 10/2006, w&w
Hi Chaya,
Thanks for this very interesting discussion. My axillary temperature is also abnormally low – nurses often think the thermometer is faulty. I know that several studies have shown that regular walking after adjuvant therapy for colon cancer greatly improves disease free survival – perhaps the heat effect. Now I’m wondering – not entirely facetiously – are hot flashes beneficial to my Cll? Is the core body temperature affected here? – it certainly feels like being on fire.
Mary C
Chaya- I finally read your article. It’s wonderful! Of course I agree after 52 Rituxan treatments- I feel good. You didn’t mention the running, weight lifting and riding my bike on weekend 50 milers or bike riding to work! -:) Obviously I’m convinced that exercise helps. One additional note: I was doing all of this before my CLL diagnosis…
I’m so glad my wife and I could attend the Conference, talk to you and hear you speak!
Sincerely,
Malcolm
I just find it fascinating that so many people note a difference in their “normal” temperature after contracting CLL.
My SLL showed up after an extended illness where I ran a temperature of around 100 for a couple months. (Local MD said it was some kind of virus and there wasn’t much he could do but let it run its course.) When the fever finally broke, my new “normal” was in the mid 97s. (97.2-97.6) and about 4 months later I was the proud owner of extensive adenopathy. I was always a very steady 98.6 before except when sick. I am still wondering what the deal is.
The doctor has cleared me for exercise; my heart is the best thing on me right now! But I haven’t done it. Can’t hurt, could help… This may be the kick in the butt I need.
Mark
Thanks Chaya for another interesting dialogue.
I finally got back to my computer to check out “hyperthermia”. I am not a medical professional
I am a lifelong sauna/sweatlodge/steam bath/ hot tub user.
Heat therapy seems to drain the lymphatics and relieve sore or swollen nodes.
I don’t sit in as hot a room for as long as I did when i was younger, but I intuit that hyperthermia ( a new tag for an old practice) is good for me. I now use a homemade infrared sauna, made with 5 150 watt heat lamps (plans found on the internet) or hot baths when hard work causes mucscle aches.
Rich
Enjoy the discussion about heat therapy as a possible help for our disease. I’m un mutated with Zap-70 going strong. I’m under 50.
I really enjoyed reading Steven Karan’s detailed precautions about using heat as a treatment.
Personally, I love the idea of at least trying. Correct me if I’m wrong here but isn’t this a lethal disease with no sure cure? Isn’t it appropriate that we intelligently push the limits if there is any chance for a cure. Isn’t that what clinical trials are all about. Intelligently pushing the limits? And isn’t there a psychological benfit of trying stuff like this?
On a recent Winter snow everywhere Boy Scout campout we stayed close to a volcanic heated Swimming pool in the Sierra Nevadas of California. We were all cold to the bone and all of us stayed in the pool for about an hour until we were nice and toasty.
the next day I noticed that my nodes were about 1/3rd smaller. It was very noticable. I wasn’t sure if it was from the cold or the volcanic microchemicals. Now i know why.
So now I try to soak in the hot tub and AT MY OWN RISK I contemplate what makes sense for me. I took my temperature the entire hour. I stopped when my temp got to 101.
I will keep at this……….. measureing and seeing if I find something that works for me AT MY OWN RISK.
If I had smoldering CLL, why push the limits. If I had prognostics that are unfavorable as I do, that’s another story………. For myself, I see no option other than to push the limits. AT MY OWN RISK. I still dream of a normal lifespan, but I know the odds are against me…… Especially if I don’t put myself where good things can happen.
With liability the way it is in our Country and considering the lack or research when it comes to Chaya’s suggestion, we probably have no other guidance other than to try at our own risk.. And certainly….. Take it slow. Certainly a strong dose of common sense is in order here.
Thanks for the article Chaya. Going on an educated hunch is alright with me.. At least Until there’s a cure.
Thanks to all and God speed towards a cure,
Leo
Thanks for this. My husband and I are fascinated by this information. I’ve a friend selling her solo carbon sauna and moving to Hawaii. I have it here to use til then. I am keeping a record of my temps. My whole life I’ve been on the low side…never in the 97s or 98s. When I waken it is between 95.6–96.5. In the a.m. I ride my stationary bike 1/2 hour and/or do pilates which raises it to 96s or 97s. After 1/2 hour of sauna it reaches 98.4 and once even to 98.8. I keep track and am careful. (I like my meat rare, but not my OWN meat.) I look forward to my next CBC to see if there is a change. I had a scare and a strange CBC result last month…it scared me bec. my WBC (usually stable between 5-10) doubled from the month before almost to the 20 which it was at diagnosis. Maybe bec. I ran out of my green tea supply. But my Neuts soared to way above normal. Have not heard back from my hem/onc why that might be. I will report in again after my next CBC, if interested. Thank you again, Chaya.
Being well as possible, Fran
The topic is in here, just bare with me:
This is a great article Chaya, as is this update and comment site for CLL topics. The late precious PC, you and your devoted daughter are Godsends to all CLLers. When I was Dx, I got a pat on the knee and told me to “go enjoy the plane ride” and not to “worry about what the mechanics and engineers were doing.”
In my numb state, I still asked for information to read, a pamphlet, a website, a book, a group, anyone, anything, but I was told there was “nothing”. After my initial shock, the ‘why me’ and a state of total confused chaos, I began my search.
I heard a radio station talking about Granny Barb and CLL. My search didn’t stop until I was able to have email correspondence with Barb and a couple phone calls. Sadly our last phone appointment never happened as she died. On our previous calls she had said they had gone about her treatment in the wrong way and that it was killing her. She did kindly offer loads of information and instruct me on how prepare to go to a doctor visits, to have my questions in hand and space to write answers, and to not be afraid to ask lots of questions. I felt empowered with information though since was basically cut off at the knees. There is no time.
No one likes chronic conditions, especially the patient. And yes CLL is annoying on so many levels, we are really much more than a draining liability. And even if we do not have financial resources, we have lives and, our lives have meaning. Health care is not just another life-style for the “rich and famous” or is it? (rant!)
Needless to say, for one with limited health care coverage and even less in resources, my lone journey was quite difficult. After Dx, if I needed a hand I had to look at the end of my arm. I felt very isolated, and was told I was just one of the “unlucky” ones. That is until I stumbled across CLLtopics several years ago during yet more searches; I needed information, education, someone who understood and cared, and I found that and more at CLLtopics.org.
Maybe a more detailed index would help me in my searches on the site, or maybe I’m asking my questions in the wrong way. And maybe no one has asked before, or has the same problem. I guess I’ll chance a slap down and ask my dumb questions.
I think it is great that there are M.D.s commenting as well and offering their professional opinions. I do hope all keep in mind, that before CLLtopics and Updates.CLLtopics, not much was known and what little there was, was not easily found. I think it is great that people share the little things, like a home made sauna – maybe something doable with limited funds.
One of the saddest things I think is when the medical profession on one hand may blame all things that happen to a CLLer on CLL, where another may claim other symptoms are not related. It is sad when I have been told that I worry too much about CTs, x-rays, etc., all claiming it’s ‘very little’ seemingly to ‘forget’ the cumulative factor. This stuff and the insurance or lack of, the mountain of paperwork and lack of resources is much more stressful than living with CLL. What do doctors mean when they say CLL is the leukemia of “1,000 knife cuts”? Do they not hear their own words?
RE: the hyperthermia treatment discussion and other loose questions:
I was not aware of the details of the Armstrong Effect, but thanks to Chaya, her daughter, and this website forums like this, I am learning more every day.
Are CLLers better off drinking hot water as opposed to ice water?
Better to sweat out the overheat than to put on an ice pack?
I have not participated in religious ceremony of sweat-lodge since I was told the heat was not good for cancer. Many years ago I owned a small one- person sauna but sold that for the same reason. Now this information. It is confusing.
In trying to learn more, I noticed on the NCI website mention of “…Radiofrequency ablation (RFA) is probably the most commonly used type of local hyperthermia. It uses high-energy radio waves for treatment…”
But also in this search on hyperthermia treatments, I saw Royal Raymond Rife. And no, I’m not going to go all snake oil and all that, but this sparked an interest as I remember my grandmother talking about Rife. She’s had breast cancer in her forties. A major radical mastectomy left her movements limited, she continued to live a healthy active life, to age 90; she died in the late 1980s. (She lived in LA, CA.) It’s funny how you hear something as a kid and then decades later it is bunk and snake oil (and maybe it still is), but I thought I’d share per the coincidence. Maybe related, maybe oil and water.
Some questions I have that I have not been able to find an answer to, and who knows maybe I’m alone on this, but will throw it out there and maybe someone knows.
Following my first and only IVIG 2 weeks ago, my WBC jumped 20k in less than a week. (?) I’m told I do not have the progression gene (?), yet in a stuck w&w, I have watched as my WBC has gone from 17k to over 180k in a few years.
The week prior, I was not told anything about needing an infusion or what it was for. I just got a call that I needed to came in for an infusion. I remembered Granny Barb, made several calls, asked questions of many until I got details, went to CLLtopics.org and this updates site to learn all I could, as well as other searches. I felt confident when I went in for my first IVIG or infusion of any kind. Now with no feedback from the doctor and not another appointment for 4+ months, I am bewildered. Is it normal for one’s WBC to spike following an IVIG?
At least Chaya (CLLtopics and Updates) is getting the questions out there and sharing what is known and allowing others to share. I now read that CLLers should get all their teeth with root canals pulled to cure their CLL. Are there facts to back this up? Or is this cutting off a finger to cure a hangnail? It seems what may work for one CLLer may not work for another, but it also seems that many know the search is on leaving lots doors open for snake oil sales people or maybe there’s a few egos at work. And how does the CLLer know and decipher when the medical profession is at such odds.
For the many years Chaya has dedicated to this topic, she has offered information and thankfully has shared her personal insights, and yes, expertise, and experiences via ‘Harvey’. Maybe an uneducated one like me lacking in bucks, and those doing so much research and the medical professional so involved we can weed out the ‘stuff’ and to have this place where the facts come together to show what works, what is proven and what is bunk, we can figure this all out.
There does seem to be a link between having infections with high fevers (above 104 F) and spontaneous cancer remissions. An article in the Jan 2009 ‘American Scientist’ (the journal of Sigma Xi, the Scientific Research Society) entitled “Healing Heat: Harnessing Infection to Fight Cancer” discusses the link. The discussion was centered around solid tumors and efforts in the 1890s to treat them by inducing infection and fever. Are CLL patients usually advised to reduce any fever that arises?
I found this discussion to be interesting, as I also seem to run a low-ish body temperature. The highest temp I found in my charts was 97.5, and the lowest was 95.8 when I had a strep infection.
Tina
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