CONTACTS 
020204 -

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS A4 0000. ref SDS A3 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  On 090218 1205 Millie requests explanation of treatment plan.
040902 -        Doctor Rugo's letter to Kaiser on 090129 discussed hyperthermia
040903 -        with Doxil, reported on 090130. ref SDS 62 TZ6H  Has the plan
040904 -        changed to use "lower dose" radiation rather than Doxil.  Will
040905 -        both be used, or some other agent?  At this time, the record is
040906 -        confusing about scope.  Please explain initial assessment, and
040907 -        prognosis.  If this has already been submitted to Doctor
040908 -        Johnson and Doctor Rugo, send a copy to Millie. ref SDS A3 TH5W
040910 -         ..
040911 -    2.  On 090218 1205 Millie reports to medical team good meeting with
040912 -        Doctor Johnson at Kaiser on 090213.  He seemed optimistic that
040913 -        Millie might have 3 - 6 months of recovery, but will need
040914 -        treatment from Doctor Rugo for cancer as a "chronic disease." A
040915 -        week or so ago on 090210, Lena called to scheduling meeting
040916 -        with Doctor Rugo on 090312 0830, reflecting comprehensive
040917 -        follow up ordered by Kaiser during the meeting on 090203.
040918 -        ref SDS A3 TH6U
040920 -         ..
040921 -    3.  On 090218 1205 Millie asks UCSF about obtaining records from Mt
040922 -        Diablo Medical Center of prior radiation in 2002, which Doctor
040923 -        Hsu discussed doing during the meeting at UCSF on 090205.
040924 -        ref SDS 96 PN8H, and which cites Doctor Benz 2nd opinion at
040925 -        UCSF on 041018 saying Millie likely cannot tolerate more
040926 -        radiation. ref SDS 96 YO9G  Was that so long ago, there is risk
040927 -        from additional radiation now? ref SDS A3 TH6X
040929 -         ..
040930 -    4.  On 090218 1205 Millie asks UCSF about responding, ref SDS A3
040931 -        TH7V, to the letter a week ago on 090209 requesting explanation
040932 -        of side effects from radiation and hyperthermia, ref SDS 99
040933 -        745R, following Doctor Hsu's comments during the meeting on
040934 -        090205. ref SDS 96 GM4N  Does the treatment plan address this
040935 -        prospectively, or as needed?  For example, as noted in the
040936 -        letter on 090209, research found that side effects of radiation
040937 -        are sometimes treated with Vitamin E plus pentoxifylline
040938 -        (Trental), ref SDS 99 745R, which can be problematic with
040939 -        Coumadin, so Gloria in the Coagulation Control Clinic at Kaiser
040940 -        will need input. ref SDS A3 TH7V
040942 -         ..
040943 -    5.  On 090218 1205 Millie looking forward to starting treatment on
040944 -        090219, and despite worry about delays that prevent treatment
040945 -        from being effective. ref SDS A3 TH7Y  Millie Thanks Doctor Hsu
040946 -        for expediting care, reported on 090203, ref SDS 82 XX5I, and
040947 -        to Doctor Rugo for guidance through troubled waters, shown by
040948 -        UCSF letter on 090202 1722. ref SDS 77 Y15J
040950 -         ..
040951 -    6.  On 090220 Millie's letter to Doctor Hsu requests...
040952 -
040953 -           a.  Computer file of picture showing typical configuration
040954 -               of hyperthermia treatment. ref SDS A4 XX5O
040955 -
040956 -           b.  Computer file of picture showing typical configuration
040957 -               of radiation treatment. ref SDS A4 XX5O
040959 -                ..
040960 -           c.  Summary/general explanatoin of radiation and
040961 -               hyperthermia treatments.  Radiation on 090219 took much
040962 -               longer than radiation Millie had in 2002, so there seems
040963 -               to be a qualitative difference in technology and
040964 -               process.  Initially assumed IBC in the skin is not
040965 -               treated with radiation, and is directed instead to treat
040966 -               lymphadenopathy.  After today, seems like maybe UCSF is
040967 -               treating IBC with both radiation and hyperthermia??  Can
040968 -               you please clarify. ref SDS A4 EA4Q
040970 -                ..
040971 -           d.  Hyperthermia is a sonar process of some kind.
040972 -               ref SDS A4 EA4T
040974 -                ..
040975 -           e.  Orders for Millie's radiation and hyperthermia
040976 -               treatments, similar to "Chemotherapy Orders" received
040977 -               for treatments in the Infusion Clinic the past 2 years.
040978 -               If possible, UCSF should submit a computer file to
040979 -               reduce the time and cost for adding the treatment plan
040980 -               to patient history. ref SDS A4 EA4W
040982 -                ..
040983 -           f.  Metrics for evaluating when treatment concludes.
040984 -               ref SDS A4 EA5P
040986 -                ..
040987 -               When Millie was treated at Kaiser with capecitabine and
040988 -               Taxotere from Apr - Sep 2005, IBC rash seemed totally
040989 -               resolved by visual examination.  There was then a
040990 -               mastectomy in October 2005.  Biopsy of removed tissue
040991 -               affirmatively reported no findings of IBC.  Yet, years
040992 -               later Millie is being treated again for IBC. ref SDS A4
040993 -               EA5T This raises two questions...
040995 -                    ..
040996 -               1.  How comprehensively can the current treatment
040997 -                   resolve IBC, and how is this assessed, beyond simple
040998 -                   visual inspection, and drop in the cancer marker?
040999 -                   Is there an xray, PET scan, or other diagnostic that
041000 -                   shows where we are for planning follow on steps?
041001 -                   ref SDS A4 EA5T
041003 -                    ..
041004 -               2.  Can hyperthermia treatment be done again, if IBC
041005 -                   pops up later, as obviously happened to me?  Will
041006 -                   there be follow up at least for a month or so in
041007 -                   radiation oncology, in case IBC does recur in the
041008 -                   near term? ref SDS A4 WF5I
041009 -
041010 -
041011 -
0411 -

SUBJECTS
Spec Medical Physics Hyperthermia with  Rdiation Strategy Treatment

1503 -
150401 -  ..
150402 - Complexity IBC Involvement Requires Hyperthermia 4 Weeks
150403 - Treatment Strategy Hyperthermia and Lower Dose Radiation
150404 -
150405 - Follow up ref SDS A4 XX5O, ref SDS A3 TH5W.
150406 -
150407 - Millie received a UCSF memo dated 090209 from Chris, ref OF 2 0001,
150408 - responding to Millie's letter this morning, asking for the treatment
150409 - orders, ref SDS A4 EA4W, following up the earlier request on 090218.
150410 - ref SDS A3 TH5W
150412 -  ..
150413 - This UCSF memo may be notes for the meeting on 090209. ref SDS A0 0G5I
150415 -         ..
150416 -        HYPERTHERMIA - SPECIAL MEDICAL PHYSICS CONSULT REQUEST
150418 -         ..
150419 -    1.  [patient] presented with recurrent breast cancer to the left
150420 -        chest wall and arm.  Because of the complexity of the disease
150421 -        and prior therapy, a conference was scheduled with the patient.
150422 -        Doctor Hsu, and Medical Physicist Chris Diederich, and Abby
150423 -        Kwok.  After discussion (Special Medical Physics Consult) the
150424 -        following treatment strategy was proposed. ref OF 2 0001
150426 -  ..
150427 - Doctor Hsu and Doctor Chang met with Millie on 090205.  Doctor Hsu
150428 - indicated Millie would be treated with hyperthermia and lower dose
150429 - radiation 4 days per week, and for approximately 4 weeks.  There may
150430 - have been discussion of details in the UCSF memo dated 090209, but the
150431 - record on 090205 could not capture that content due to the hectic pace
150432 - of discussion on 090205.
150433 -
150434 -            [On 090223 0237 Millie's letter to the medical team thanks
150435 -            Chris for submitting the UCSF memo on 090209 that seems to
150436 -            explain the treatment plan for hyperthermia. ref SDS A5
150437 -            T47U  Millie requests similar plan for radiation treatment
150438 -            that complements hyperthermia. ref SDS A5 3N9J
150440 -             ..
150441 -            [On 090226 1342 Millie received radiation treatment plan
150442 -            that complements hyperthermia plan for Millie to recover
150443 -            from IBC. ref SDS A6 PR4Y
150445 -             ..
150446 -            [On 090326 0058 Chris commended for timely submission of
150447 -            documentation on hyperthermia. ref SDS A9 DV5U
150449 -             ..
150450 -            [On 090326 0054 Millie's letter reports that hyperthermia
150451 -            treatment plan was submitted to primary care physician at
150452 -            Kaiser. ref SDS A8 6A6P
150454 -  ..
150455 - The UCSF memo on 090209 may reflect discussion among staff during the
150456 - follow up meeting on 090209 at which time xrays and CT scans were
150457 - accomplished for planning.
150459 -  ..
150460 - As a result, the UCSF memo on 090209 may represent UCSF understandings
150461 - from the meeting with the patient on 090209, there is no other record
150462 - in patient history of those understandings.
150464 -  ..
150465 - UCSF memo 090209 continues...
150466 -
150467 -    2.  Hyperthermia to be delivered sequential to radiation therapy
150468 -        using both the 16 multielement microwave applicator at 915 MHz
150469 -        (Bolus setting - 42.5C) and ultrasound applicator at 3.5 MHz
150470 -        (bolus setting - 41 - 42C).  The microwave applicator is to be
150471 -        used in partitions with very superficial disease, mainly arm,
150472 -        lateral and inferior and chest wall. ref OF 2 VU31
150474 -         ..
150475 -    3.  Ultrasound will be applied more medial sites where the disease
150476 -        is thickest. ref OF 2 8G67
150478 -         ..
150479 -    4.  Hyperthermia teatment prescribed of 60 min with temperature 40 -
150480 -        45C targeted within tumor or target volume to be delivered
150481 -        twice weekly to each site during the course of therapy.
150482 -        ref OF 2 8G71
150484 -         ..
150485 -    5.  The patient is to receive treatment 4 days/week. ref OF 2 8G75
150487 -         ..
150488 -    6.  Temperature sensing at multiple points required for therapy
150489 -        control, and thermal dose should be calculated after each
150490 -        treatment.  The bolus temperature shape and applicator operator
150491 -        parameters should be adjusted as required each treatment as a
150492 -        treatment device to conform or tailor thermal dose and
150493 -        temperature elevatio to the target volume in response to
150494 -        temperature and patient feedback. ref OF 2 8G79
150496 -         ..
150497 -    7.  The orientation of the applicator, target volume, and location
150498 -        of temperature sensors are recorded specifically for each
150499 -        treatment (simple simulation) and required for treatment
150500 -        control and documentation. ref OF 2 8G86
150502 -         ..
150503 -    8.  The procedure was described to the patient and intended to be
150504 -        implemented for future treatments.  This procedure was
150505 -        requested and performed above. ref OF 2 VU54
150507 -  ..
150508 - Actually, UCSF did not explain either radiation nor hyperthermia to
150509 - the patient.  As a result, this was requested in Millie's letter to
150510 - the medical team on 090218. ref SDS A3 TH5W
150511 -
150512 -
150513 -
150514 -
150515 -
1506 -

SUBJECTS
Default Null Subject Account for Blank Record

1603 -
160401 -  ..
160402 - Hyperthermia Paper Explain Cancer Treatment for Millie IBC
160403 -
160404 - Follow up ref SDS 59 BR57.
160405 -
160406 - On 090129 investigation indicated hyperthermia is an FDA approved
160407 - "alternative treatment" for IBC. ref SDS 59 BR57
160409 -  ..
160410 - Chris submitted another paper published by BSD dated 020101.
160411 - ref OF 1 0001
160412 -
160413 -            [On 090223 0237 Millie requests similar paper on radiation
160414 -            treatments given with hyperthermia. ref SDS A5 T49U
160415 -
160417 -         ..
160418 -        Hyperthermia as a Cancer Therapy
160419 -
160420 -
160421 -              http://www.memorialcare.org/long_beach/services/todd_cancer/pdf/hyperthermia.pdf
160423 -         ..
160424 -        Microwave hyperthermia is a non-ionizing form of radiation
160425 -        therapy that can substantially improve results from cancer
160426 -        treatment.  In Phase III clinical trials where hyperthermia was
160427 -        combined with ionizing radiation treatments, hyperthermia
160428 -        improved 2-year local control of melanoma from 28% to 46%,
160429 -        complete response for recurrent breast cancer from 38% to 60%,
160430 -        2-year survival for glioblastoma (brain cancer) from 15% to 31%
160431 -        and complete response for advanced cervical cancer from 57% to
160432 -        83%, as compared to the use of ionizing radiation therapy
160433 -        alone. ref OF 1 0001
160435 -  ..
160436 - On 090312 0800 Chris advised during a meeting at UCSF with Doctor Hsu
160437 - that hyperthermia can be used repeatedly without adverse side
160438 - effects, and combined with
160440 -         ..
160441 -        Vulnerability of Cancerous Tumors
160442 -
160443 -        Cancerous tumors are growths of mutated cells that often
160444 -        require far more energy to survive than do normal cells.  As
160445 -        cancer cells multiply unchecked, they can quickly outstrip the
160446 -        capacity of their existing blood vessels to supply enough
160447 -        oxygen and nutrients to support them.  In response, malignant
160448 -        tumors stimulate growth of additional blood vessels.  However,
160449 -        these new blood vessels are mutated chaotic structures, as
160450 -        compared to blood vessels of normal tissues—of odd sizes, with
160451 -        loops and even blind ends.  Because of this irregular blood
160452 -        vessel structure and rapid tumor growth, there are often large
160453 -        areas in tumors where the blood supply is deficient.
160454 -        ref OF 1 QY5I
160456 -         ..
160457 -        Cancerous tumors that do not have an adequate blood supply
160458 -        become oxygen starved (hypoxic) because blood is the source of
160459 -        oxygen delivery for cells.  They also become acidic because
160460 -        hypoxic tumors cannot adequately expel waste through the blood.
160461 -        These tumors can even experience wide fluctuations in blood
160462 -        flow as their unstable blood vessels periodically collapse,
160463 -        making them acutely oxygen deficient for periods of time.
160464 -        Oxygen starved cancer cells are difficult to kill with ionizing
160465 -        radiation (which creates oxygen radicals that attack tumor DNA)
160466 -        or chemotherapy (where blood transport is required to deliver
160467 -        the drug).  Destroying blood/oxygen depleted cancer is a very
160468 -        high priority in cancer therapy because hypoxic cancer cells
160469 -        are especially dangerous, prone to metastasize and spread the
160470 -        cancer to other parts of the body. ref OF 1 NS7H
160472 -         ..
160473 -        Fever High Temperature
160474 -        How Hyperthermia Kills Cancer Cells
160475 -
160476 -        Hyperthermia destroys cancer cells by raising the tumor
160477 -        temperature to a "high fever" range, similar to the way the
160478 -        body uses fever naturally when combating other forms of
160479 -        disease.  Because the body's means of dissipating heat is
160480 -        through cooling from blood circulation, sluggish or irregular
160481 -        blood flow leaves cancerous tumors vulnerable to destruction at
160482 -        elevated temperatures that are safe for surrounding healthy
160483 -        tissues with normal, efficient blood cooling systems.
160484 -        ref OF 1 004P
160486 -  ..
160487 - Does Millie's loss of lymphatics affect the hyperthermia process of
160488 - using heat to kill cancer cells by enabling healthy cells to dissipate
160489 - heat through normal blood circulation.  Millie has been hospitalized
160490 - numberous times in the Emergency Department with lymphedema and
160491 - Cellulitis when the left arm is traumatized.  Will elevated heat on
160492 - the left arm and the left chest wall present a risk?
160494 -             ..
160495 -            [On 090402 1947 Millie reports high fever with temerpatrue
160496 -            99.7 for second time; may reflect continuing treatment with
160497 -            hyperthermia that kills cancer cells with elevated
160498 -            temperature. ref SDS B0 H93P
160500 -  ..
160501 - Hyperthermia as a Cancer Therapy continued...
160502 -
160503 -        Scientists attribute the destruction of cancer cells at
160504 -        hyperthermic temperatures to damage in the plasma membrane, the
160505 -        cytoskeleton and the cell nucleus.  Cancer cells are vulnerable
160506 -        to hyperthermia therapy particularly due to their high acidity
160507 -        caused by the inability to properly expel waste created by
160508 -        anaerobic metabolism.  Hyperthermia attacks acidic cells,
160509 -        disrupting the stability of cellular proteins and killing them.
160510 -        ref OF 1 00EI
160512 -  ..
160513 - On 090213 Millie's primary care physician at Kaiser advised that
160514 - Millie's IBC cancer cells mutated to survive a 6th relapse.  Mutated
160515 - cancer resists chemotherapy drugs approved for use at Kaiser.
160516 - ref SDS A2 R75G  The doctor described hyperthermia as palliation
160517 - treatment. ref SDS A2 WZ6K  Review today indicates hyperthermia
160518 - combined with ionizing radiation provides effective treatment even for
160519 - mutated cancer cells that resist treatment with chemotherapy.
160520 - ref SDS 0 00FS  Since hyperthermia combined with radiation and/or
160521 - chemotherapy "kills" cancer cells, ref SDS 0 00EI, this does not seem
160522 - to fit the model of "palliation" as mere relief from suffering while
160523 - cancer progresses toward near term demise.  "Killing" cancer cells
160524 - through heat sounds like aggressive curative therapy. ref SDS 0 GK6F
160526 -  ..
160527 - Hyperthermia as a Cancer Therapy continued...
160529 -         ..
160530 -        How Hyperthermia Increases Effectiveness of Ionizing Radiation
160531 -
160532 -        Hyperthermic temperatures increase blood circulation in tumors
160533 -        as the body's response to the stimulus of heat.  This increased
160534 -        presence of oxygen-bearing blood in tumor tissues is critical
160535 -        for making ionizing radiation more effective.  Ionizing
160536 -        radiation destroys tumor cells substantially through the
160537 -        formation of oxygen radicals that attack tumor cell DNA.
160538 -        Oxygen-starved cells are three-times more resistant to ionizing
160539 -        radiation than are normal cells.  It has been demonstrated that
160540 -        low oxygen levels in human tumors (hypoxia) is directly linked
160541 -        to failure in achieving local tumor control through ionizing
160542 -        radiation, and the degree of oxygen deficiency in cancerous
160543 -        tumors is a key predictor of the efficacy of ionizing radiation
160544 -        therapy. ref OF 1 00FS
160546 -         ..
160547 -        While oxygen radicals attack cancer cell DNA, hyperthermia acts
160548 -        further to create an accumulation of proteins in the cell
160549 -        nucleus that bind to the nuclear matrix, disrupting the repair
160550 -        of radiation-induced DNA damage.  Hyperthermia provides
160551 -        additional potentiation of ionizing radiation due to the growth
160552 -        cycle of cancer cells.  During the S-phase of cell division
160553 -        when cancer cells are aggressively resistant to the effects of
160554 -        ionizing radiation, they are susceptible to the destructive
160555 -        effects of hyperthermia. ref OF 1 00AQ
160557 -         ..
160558 -        The conditions that enhance the effects of hyperthermia are
160559 -        typically those that reduce the effects of ionizing radiation.
160560 -        Low blood flow tumor tissues resistant to ionizing radiation
160561 -        are sensitive to hyperthermia, while tumor tissues with high
160562 -        blood flow are sensitive to ionizing radiation.  This highly
160563 -        complementary interaction is compelling reason for combining
160564 -        hyperthermia and ionizing radiation (thermoradiotherapy).  In
160565 -        vivo studies have demonstrated that the effects of ionizing
160566 -        radiation can be enhanced by a factor between 1.2 and 5, making
160567 -        hyperthermia the most potent sensitizer to ionizing radiation
160568 -        therapy known. ref OF 1 0106
160570 -  ..
160571 - On 090213 Millie's primary care physician at Kaiser advised that
160572 - Millie's IBC cancer cells mutated to survive a 6th relapse.  Mutated
160573 - cancer resists chemotherapy drugs approved for use at Kaiser.
160574 - ref SDS A2 R75G  The doctor described hyperthermia as palliation
160575 - treatment. ref SDS A2 WZ6K  Review today indicates hyperthermia
160576 - combined with ionizing radiation provides effective treatment even for
160577 - mutated cancer cells that resist treatment with chemotherapy.
160578 - ref SDS 0 00FS  Since hyperthermia combined with radiation and/or
160579 - chemotherapy "kills" cancer cells, ref SDS 0 00EI, this does not seem
160580 - to fit the model of "palliation" as mere relief from suffering while
160581 - cancer progresses toward near term demise.  "Killing" cancer cells
160582 - through heat sounds like aggressive curative therapy. ref SDS 0 GK6F
160584 -  ..
160585 - Hyperthermia as a Cancer Therapy continued...
160587 -         ..
160588 -        How Hyperthermia Increases the Effectiveness of Chemotherapy
160589 -
160590 -        For chemotherapy drugs that depend on blood transport for
160591 -        delivery, hyperthermia used in combination with chemotherapy
160592 -        (thermochemotherapy) enhances blood flow in tumor tissues,
160593 -        increasing the uptake of chemotherapy drugs in tumor membranes.
160594 -        Hyperthermia also induces disassembly of the cytoskeleton,
160595 -        which enlarges the tumor pores for easier drug entry.  Once
160596 -        delivered, hyperthermic temperatures can be used as a drug
160597 -        activator, accelerating chemical reactions through heat and
160598 -        drawing essential oxygen molecules to tumor tissue for chemical
160599 -        reaction with the drug.  Reviews have been given of the
160600 -        interactions of hyperthermia with a wide range of chemotherapy
160601 -        drugs including doxorubicin, mitomycin C, mitoxantrone,
160602 -        bleomycin, cisplatin, nitrosoureas and cyclophosphamide.
160603 -        Hyperthermia has demonstrated the ability to enhance drug
160604 -        toxicity in cells rendered resistant to many drugs used in
160605 -        chemotherapy. ref OF 1 0129
160607 -  ..
160608 - On 090129 0830 Doctor Rugo submitted a letter initially considering
160609 - hyperthermia with Doxil chemotherapy for treating Millie, reported in
160610 - Millie's letter to the medical team on 090130. ref SDS 62 HK3V
160612 -  ..
160613 - On 090213 Millie's primary care physician at Kaiser advised that
160614 - Millie's IBC cancer cells mutated to survive a 6th relapse.  Mutated
160615 - cancer resists chemotherapy drugs approved for use at Kaiser.
160616 - ref SDS A2 R75G  The doctor described hyperthermia as palliation
160617 - treatment. ref SDS A2 WZ6K  Review today indicates hyperthermia
160618 - combined with ionizing radiation provides effective treatment even for
160619 - mutated cancer cells that resist treatment with chemotherapy.
160620 - ref SDS 0 00FS  Since hyperthermia combined with radiation and/or
160621 - chemotherapy "kills" cancer cells, ref SDS 0 00EI, this does not seem
160622 - to fit the model of "palliation" as mere relief from suffering while
160623 - cancer progresses toward near term demise.  "Killing" cancer cells
160624 - through heat sounds like aggressive curative therapy. ref SDS 0 GK6F
160626 -  ..
160627 - Hyperthermia as a Cancer Therapy continued...
160628 -
160629 -        Hyperthermia is proving a role as a valuable companion therapy
160630 -        when chemotherapy drugs are injected into the blood in
160631 -        encapsulations called "liposomes".  Research has shown that
160632 -        when a liposome-encapsulated drug is used in combination with
160633 -        hyperthermia therapy directed on a tumor, drug penetration can
160634 -        dramatically increase.  Research is also being conducted on
160635 -        heat-activated liposomes that use hyperthermic temperatures as
160636 -        the release mechanism for the encapsulated drug when they reach
160637 -        the tumor. ref OF 1 0155
160639 -         ..
160640 -        Hyperthermia can be employed synergistically with chemotherapy
160641 -        in strategies to treat bulky tumors.  The cores and other
160642 -        regions of these tumors are often difficult to penetrate with
160643 -        drugs because of low blood flow in up to a third of the mass of
160644 -        the tumor.  In addition, chemotherapeutic drugs act best on
160645 -        rapidly dividing cells.  As blood starved cancer cells are
160646 -        growth retarded, chemotherapy has limited efficacy against
160647 -        them.  Hyperthermia is able to attack cancer cells in
160648 -        blood-deficient regions of the tumor while the drug permeates
160649 -        tissues with higher blood flow nearer the surface, providing
160650 -        potentiation of drug uptake. ref OF 1 0176
160652 -         ..
160653 -        Hyperthermia and Biological Therapies
160654 -
160655 -        Gene therapy research is showing hyperthermia to be an
160656 -        activator to turn on new biological therapies, speeding gene
160657 -        production by thousands of times (heat mediated gene therapy).
160658 -        Hyperthermia plays an essential role in the development of
160659 -        anti-tumor vaccines that are based on heat shock proteins.
160660 -        Research is showing hyperthermia to be an angiogenesis
160661 -        inhibitor, preventing cancer from inducing growth of new blood
160662 -        vessels to expand its blood supply.  Hyperthermia has further
160663 -        demonstrated use as a companion therapy for drug angiogenesis
160664 -        inhibitors, used in the final destruction of depleted cancer
160665 -        cells that survive blood starved conditions. ref OF 1 0164
160667 -  ..
160668 - On 090204 research cited potential for biological therapies to support
160669 - Millie's treatment strategies. ref SDS 92 4S3P
160671 -  ..
160672 - The BSD paper suggests vaccine therapies can be enhanced with
160673 - hyperthermia.
160674 -
160675 -            [On 090312 0800 Doctor Hsu discusses treatment with
160676 -            vaccines and hyperthermia. ref SDS A7 F991
160678 -  ..
160679 - Hyperthermia as a Cancer Therapy continued...
160681 -         ..
160682 -        Hyperthermia and Quality of Life
160683 -        Palliation Relieve Pain Without Hope for Recovery Hyperthermia
160684 -
160685 -        A recent study by the National Academy of Sciences has pointed
160686 -        out the shortcomings of the single-minded search for cancer
160687 -        cure while ignoring existing patients who need treatment for
160688 -        pain and other conditions associated with cancer.  A
160689 -        substantial improvement in both palliation and durability of
160690 -        palliation has been observed when hyperthermia is added to
160691 -        ionizing radiation treatments.  Some scientists have noted that
160692 -        hyperthermia stimulates the immune system, assisting patients
160693 -        in recovery from toxic cancer therapies such as chemotherapy
160694 -        and ionizing radiation.  Even in situations where there is no
160695 -        hope for survival, hyperthermia may provide benefit through
160696 -        alleviation of such effects as bleeding, pain and infection.
160697 -        ref OF 1 01G6
160699 -  ..
160700 - Examination at UCSF on 090129 reported findings of elevated vitals
160701 - signal Millie is suffering rising pain from progression of IBC
160702 - disease, ref SDS 62 AY7T, and was reported by Doctor Rugo in a letter
160703 - to Kaiser advising that pain from progression of disease required
160704 - treatment for the 6th relapse of IBC, shown in the record the next day
160705 - on 090130. ref SDS 62 TZ6H
160707 -  ..
160708 - On 090201 Millie reports IBC getting worse by the hour; asks for
160709 - advice to treat rising pain. ref SDS 64 KN9T  Requests treatment the
160710 - next day at UCSF on 090202. ref SDS 64 KN9W
160712 -  ..
160713 - On 090213 1100 primary care physician at Kaiser describes hyperthermia
160714 - provides palliation to relieve suffering, ref SDS A2 GD3I, expects
160715 - less than 1 year to live. ref SDS A2 9L7N
160716 -
160717 -
160718 -
160719 -
160720 -
160721 -
160722 -
160723 -
160724 -
160725 -
1608 -