After more than 25 years involved in the fight against cancer, Jorge Contreras admits that for the first time he feels that he is immersed in something which is truly new and exciting. This 51-year-old doctor coordinates the Spanish Society of Oncology Radiotherapy (SEOR), which wants to introduce hyperthermia into this country as a standard treatment. It believes this is a revolutionary technique in treating cancer.
Dr Contreras, a specialist in oncology radiotherapy at the Regional Hospital (where he trains other doctors), is also the director of the Magna Clinic in Marbella, which has become a pioneer in Spain for using hyperthermia in the private sector.
–How can hyperthermia help in the treatment of cancer?
–Hyperthermia is a treatment which involves raising the temperature above the physiological one in a controlled manner. It is used to place the tumour in a vulnerable situation, without damaging the cells as lasers and radiotherapy do. The cell experiences this heat as metabolic stress which means it repairs more rapidly. This situation of vulnerability makes the cells, and also our immune system, more sensitive to cancer treatments. The hyperthermia makes the radiothearpy or chemotherapy treatment more effective. It can be the fourth pillar in the treatment of cancer, after surgery, radiotherapy and chemotherapy.
–When was hyperthermia first used to treat cancer?
–About 25 or 30 years ago, when I was starting out in medicine, people were already talking about it. At a pre-clinical level, in the laboratories, they were heating tissues and observing the change in the reproduction of proteins. What they didn’t do was take the step of extrapolating that to humans. Why? Because in those days there was no technology or machines. Twenty-five years ago they were experimenting with heat treatment in physiotherapy and for cosmetic purposes. However, even during the time of Hippocrates it was said that illnesses could be cured by heat, by producing a fever. It is a way of stimulating the immune system. It’s a step forward. What we are looking for is a way of stimulating the immune system and increasing the effectiveness of the treatment we are applying. I would never tell any patient to stop their conventional treatment.
–How far has it been developed in Spain?
–We’re behind other countries such as the USA, Germany, Italy, the Scandinavian countries and Japan. We have started to treat patients at the Carlos Haya hospital in a clinical trial. We have seen some cases which were very severe and where the results have been spectacular.
–Are there any side effects?
–Hyperthermia has to be applied by a professional, by someone who has been well-trained and is experienced. The increase in temperature has to be properly controlled, to make sure there is no risk.
–For which types of cancer is this treatment most suitable?
–It increases the effects of chemo and radiotherapy in situations in which, a priori, there was not going to be a good result. It has been tested on colorectal cancer, pancreas, breast, cutaneous tumours (skin and melanoma), brain tumours and sarcomas.
–It’s about a year since the hyperthermia working group was created by SEOR. What are the objectives?
–Firstly, to raise awareness. Many colleagues don’t know anything about this. We have held working meetings and created a website (www.hipertermiaoncologica.es). Secondly, to develop research projects. We have carried out factibility and tolerance studies in Malaga and Huelva. Now another two studies are under way in Spain. Another objective is to establish alliances with other scientific societies in Spain and abroad, and above all with the pharmaceutical industry. And establish the conditions for a regulation. We want there to be quality controls and for at least an oncologist and radiophysicist to be present.
–How many patients have been treated at the Magna Clinic?
–We have only been using this treatment for about a year, but we have treated approximately 15 patients a month. People have come from all over Spain and even from Switzerland.
–Will the day come when it is used by the national health service?
–I’m convinced it will, but in several years’ time. I certainly hope so. In countries such as Italy, the Netherlands and Germany it is already in use in the national health service.
–What do you think research should be focusing on in the fight against cancer?
–Chemotherapy has achieved a great deal, but it has gone as far as it can now. The line of research should focus on immunotherapy. Cancer is the growth of a normal tissue which degenerates and goes out of control in our bodies. If our immune system works, it eliminates this degeneration. It occurs because, whether for genetic reasons, tobacco, eating habits, sunshine or whatever, there is an alteration and these cells grow progressively, slowly and adapting themselves to their environment. The body starts to see them as something normal and doesn’t reject them. That’s where I believe immunological treatments come into their own. Hyperthermia produces this response. The tumour hates the heat, it becomes angry. It’s like pouring water into an ants’ nest and all the ants run away. The tumour starts to reproduce itself more rapidly and to express a series of receivers which make it visible to the immune system.