There are more opportunities for finding healing in this technological day and age, so much so that treatments for cancer have slowly evolved and become more rapid. In this episode, we get into the use of hyperthermia to help improve the effectiveness of particular chemotherapies and radiation therapy. Dr. Joseph Pinzone, the Medical Director of the Hyperthermia Cancer Institute in Los Angeles, California, takes us into a deeper dive on hyperthermia or the use of heat to facilitate rapid healing of tumors. He talks about cancer biology and explains to whom hyperthermia is applicable.

Listen to the podcast here:

Facilitating Rapid Cancer Healing Through Hyperthermia with Dr. Joseph Pinzone

I’m excited and inspired because our podcast, Adventures in Health, has been featured in 39 different countries including Peru. If you’re out there around the world reading, Adventures in Health, know that we’re keeping an eye on you. We appreciate you reading. We’re sending you tons of love and gratitude. If you’re reading right now and you haven’t had the opportunity to share this with someone, share this blog with someone who you think might need a little bit of extra inspiration, a little bit extra health and healing in their life. What I’ve found, and this is a chip or a trick out there for anyone reading, is when you tell someone to do something, especially if it’s someone you love, for some reason they never want to listen. The easy trick or workaround, I’ve always found now everyone I love, if they read this, they’re going to know I’m doing it. The easy workaround I’ve found is if you send someone a podcast or a video or anything it could be that’s a third party sharing what you think they need to know. It often resonates because it almost creates this degree of separation where the person you love can almost discover it for themselves. We have this very interesting thing in our psychology as human beings where we want to feel we’re the one in charge and discovering things for ourselves. 

When someone tells us something, even if it’s the best idea you’ve ever heard and you know it’s good for you, you’d still cringe and go, “I’ve got to figure it out myself.” Here’s a trick, share these episodes with people you love as a way to work around having to tell them right to their face when they don’t want to listen. Thank you for sharing. Thank you for reviewing this podcast. It helps us spread the message and spread the word. Our special guest is Dr. Joseph Pinzone. He’s the lead doctor at a place in Santa Monica called the Hyperthermia Cancer Institute. I like to think of the Hyperthermia Cancer Institute as a facility that’s making waves in cancer healing. What they’re doing at this facility is they’re using ultrasound waves to increase the temperature of tumors and facilitate more rapid healing of the tumors. 

What’s even more cool about this is it’s been around for quite a long time. Most doctors haven’t heard of it. It’s not a very well-known therapy. However, it is FDA approved and covered by most insurances. What this means is it’s already been approved. It’s been around for a long time. There are tons of science to back its efficacy and the icing and the cherry on the cake is it works in conjunction with traditional therapies you might already be investing in. If you’re doing chemotherapy, you don’t have to stop doing chemotherapy to invest in hyperthermia treatment. It’s going to work in conjunction with the chemotherapy to help you heal and recover faster. If you’re out there and you or someone you love is going through a cancer diagnosis first, I’m sending you lots of love so you can have a speedy recovery. 

Second, make sure you share this with them and let them know that you care. Let them know that you love them. If we keep sharing amazing information from people like Dr. Joseph Pinzone and his team who are helping people in these ways, we’re going to create the snowball effect where healing becomes easier and easier, more accessible, and more in the forefront of the conversation. It’s no longer we have to jump through eight million hoops to figure out what’s going on with us. We can all create this beautiful information of healing out there. Please share this with anyone out in your world who might need a little bit of extra assistance in their cancer healing. Other than that, please welcome Dr. Joseph Pinzone and all his wonderful wisdom. 

 

Dr. Joseph Pinzone, welcome to the show. How are you doing? 

I’m fine. Thank you so much for inviting me. 

Thank you for having us in your office. It’s where we get to go on adventures. We’re doing calls over the internet lots of times. I always find it’s nice to speak with someone in person. There’s a whole different level of conversation that you can get into being in the presence of someone else. Thank you for having us. 

It’s in keeping with the Adventures in Health. 

For our audience who don’t know who you are or aren’t familiar with what you do, do you mind giving them who you are, what you do and we’ll roll it from there? 

My training is in internal medicine. I also have a fellowship in endocrinology. However, for the first part of my career, I was in Academic Medicine for about a dozen years or so. I had funded research program in cancer research. I tried to understand the reason why breast cancer would spread to the bone and that was gratifying. I also had an eye towards business. I have an MBA as well. I was recruited by a biopharmaceutical company where I was involved in the launch of a supportive care drug for patients with cancer. I did that for about four years. I enjoyed that tremendously and left to start my own business. That included a variety of different endeavors including continuation of practice and some work back with some biopharmaceutical companies and now this venture called Hyperthermia Cancer Institute. 

I’ve got two main questions for you. First is why did you get into medicine in the first place and we’ll go into a deeper dive on the hyperthermia. 

Interestingly, I can’t remember a time when I didn’t want to be a doctor. I can remember pretty far back in my life. There’s something organic that was driving me towards medicine. It was never a question in my mind. As I begin to get more into medicine, I realized two things. One, how little we know both in terms of the traditional medical concepts and also how to apply them, which we’re becoming much enlightened on. That’s what drove me to research, which was I would read things in textbooks. I went to med school early enough where so many things were unexplained that are currently explained. There are many things yet that we have to explain and to concur. The research and the technology that we see in the digital world, there’s an analogous one in the biopharmaceutical world where it’s exponentially accelerating. The short answer is I’ve always wanted to be a doctor. The long answer is I’m thrilled that I am a doctor and this is the golden age where we have so much promise ahead of ourselves. 

Hyperthermia is typically used in conjunction with chemotherapy and radiation therapy, and that’s really where it is most powerful. Click To Tweet

I would love to get a little bit deeper into the hyperthermia work that you are doing with cancer. First, what is hyperthermia? From there, how is it helping us with cancer? 

Hyperthermia is simply stated the application of heat to tumors. The observation centuries ago when people would have infectious diseases that were very common and resulted in high fevers for a long time. Some people would recover from those infectious diseases. It was noticed that a small percentage of patients who had solid tumors and there were often no treatments. There were most of the time no cures. They would have what we now turn tumor lysis syndrome after their body was heated for a long time. Not to overstate it, it was the rare occurrence, but in occasional people, those tumors would reduce or even disappear. That concept was fascinating. 

Over the past 30 to 40 years, there were a number of ways that it was developed technologically to apply heat to tumors. One of the ways is to do it in a localized fashion, which is what we do here at Hyperthermia Cancer Institute where we use ultrasound. It’s at a different frequency than diagnostic ultrasound, an ultrasound that’s used to diagnose things. This particular application of ultrasound waves will generate heat that penetrates to approximately eight centimeters. It allows us to go quite deep in the body and consequently we can access many tumors. I’ll talk in a bit about cancer biology and what the heat does to the tumor. 

This is typically used in conjunction with chemotherapy and radiation therapy. That’s where it’s most powerful. There’s quite a bit of data that this helps improve the effectiveness of particular chemotherapies and of radiation therapy. We’ll talk more about the mechanism of that along the way. That’s generally how we do it here. There’s also another application of heat. Here’s where you realize how important and central heat is to think about how to get chemotherapy and cancer therapy in general to work. We don’t do this here, but I mentioned it because there’s another way that heat is applied, which is heated chemotherapy. It’s often applied at the time of surgery into the abdomen for various tumors and seems to improve the effectiveness of that chemotherapy during surgery and often after surgery. That’s called HIPEC. 

Immediately what came into my mind when you’re describing originally what they noticed as people got sick, their body heated up. Would you say in your opinion that one of the primary pathways this is working on is intrinsic to who we are and that our body’s response to illness or foreign invasion is to heat itself up to heal? 

In the case of infectious diseases, it’s very primary. Let’s talk about cancer biology a little bit so that we could put the application of heat in context. Cancer is quite a dichotomous disease. It’s at once part of you, it’s your own cells. They have a variety of genes that are mutated. They do appear in some situations as foreign. The fact of the matter is in very small tumors where you have surgery that can cure them, it’s surprising to most people, but in many of those cases, those tumors have been shedding cells into the bloodstream for a long period of time. It’s our immune system that takes care of those tumors. However, there are some tumors, the ones that are not cured or that progress prior to being detected that are able to evade the immune system. 

AIH 59 | Hyperthermia In Cancer Healing Hyperthermia In Cancer Healing: When heat is applied to tumors, the blood flow to the tumor increases.

 

In those situations, when tumors form the dichotomy is that on the one hand, they’re very difficult often to get rid of. Otherwise, we’d have a cure for every cancer which we don’t. On the other hand, there are many aspects of those tumors that make them fragile. That’s why the newer targeted therapies that allow the immune system to see what the cancer is actively trying to evade are novel and powerful. When we think about heat and applying heat, one of the things that happen in tumors because they are lacking in the integrity of normal cells, is they don’t form blood vessels and they don’t form cellular structures that are extraordinarily organized. Consequently, particularly in the center of tumors, a lot of those blood vessels collapse and there’s not good blood flow to those tumors. Some of those cells are able to survive in environments that are pretty low in oxygenation. 

When we apply heat to those tumors, a number of things happen. First, we often are able to increase the blood flow to the tumor. That does a number of things. That brings chemotherapy to parts of the tumor that it couldn’t get to before. It also brings immune cells to parts of the tumor that they couldn’t get to before. The other important things that happen is there is some direct cytotoxicity, meaning cell killing that happens when you heat something to 109 degrees. That’s an approximation of what we get the tumor to. It’s a range that’s probably the upper limit of the range. If you think about that temperature, that’s a higher temperature than a fever. It’s a lower temperature than the hottest California day. We do it in a directed fashion. We do it for 30 to 60 minutes depending on the treatment. 

When we do it in a sustained way, although we do have some cytotoxicity, it’s not nearly typically to the level that the chemotherapy does it or that the radiation therapy does it. In the case of applying chemotherapy and particularly applying radiation therapy, what happens is the DNA is disrupted. Sometimes people think of it as getting nicked and when that cell goes to divide, it goes into programmed cell death called apoptosis. The therapies that we use are often affecting normal cells as well. Although they primarily affect cells that the traditional chemotherapies, for example, and radiation primarily affects cells that are tumor cells because they are a bit more sensitive to them. It’s because the cells that are turning over tend to be affected, which is why many people do get nausea and diarrhea. The gut cells turn over a lot and lose their hair because hair cells turn over a lot. 

Any cells that turn over a lot often are affected by systemic therapies or by local therapies. When you apply heat to them, not only do you amplify the effect of the cell killing, but when you have proteins that drive all of the cells actions within the cellular environment, they do it typically through enzymes. Enzymes are typically proteins. If you apply heat, those enzymes don’t work as well. After applying radiation therapy or after applying traditional chemotherapy, the DNA wants to repair itself. When you add heat on top of those therapies, it helps to prevent those repair mechanisms. It increases the effectiveness of chemotherapy. It increases the effectiveness of radiation therapy. I say that with the idea that does it much of the time. Like any therapy, there’s no therapy that’s going to come with a guarantee. 

This is often overlooked because many patients don’t know about it. It’s been around in the form that we use in this localized application again for over many years. Many physicians don’t know about it. It’s wonderful that you all are having us on because it’s not applicable to all patients. The idea of exploring all your options, that’s important. Patients are encouraged to speak primarily to their doctor. If their doctor doesn’t understand it, I’m certainly delighted to speak with their doctor. Patients, in my opinion, are also encouraged to contact us. I’d like to leave you with some contact information from us because we’re going to help them sort it through. We’re going to work hand in glove with their doctor to determine whether or not the application of heat in the way we do it is appropriate for them. 

The research and the technology that we see in the digital world is analogous in the biopharmaceutical world where it's accelerating. Click To Tweet

It’s not an alternative to these traditional methodologies that people are accustomed to and used to, but it’s helping them work better. You mentioned that it’s not for everyone or every situation. When is this for someone versus when is it not for someone so anyone reading who might have a cancer diagnosis, they can get a sense for, “Is this for me or is this not for me? 

When we heat tissue, there are a couple of things to realize. There’s a hierarchy of absorption of heat and the tissue that absorbs it most efficiently is the bone and the aspect of the human body. I’m going to say it that way and you’ll see why. Where we can’t transmit the ultrasound waves is through air. We don’t treat tumors that are within the head. Brain tumors and other tumors that are within the skull, it’s not applicable to those. Similarly for most lung cancers, unless they’ve spread and we’re treating another localized area that is accessible. If you had small lung cancer that’s centrally located and we have to treat through ribs, muscle and through air, it’s not going to be appropriate for that particular patient. There are some patients with lung cancer in whom it is appropriate. It depends on their clinical situation. We can help them sort through that. 

It sounds like if you have to go through a bone, it’s diminishing the effect of heat because the bone would be absorbing the heat. Does it work for cancers within the bone? 

One clarification that you brought up is for sarcomas and other tumors of the bone that we can easily access and aim the heat towards the tumor. That might well be appropriate. I’m always going to caveat it with might because it does depend on the patient’s clinical situation. Tumors that are within the abdomen, we can get to those. Tumors that have gone to lymph nodes, we can get to those. Tumors that are in the head and neck but not in the skullfor example, tumors of the tongue, squamous tumors, melanoma of the skin, we can get to those tumors. If a patient is uncertain, they should contact us, potentially have a consultation with me and we can help decide that together. 

Let’s say someone has, for example, a brain cancer. You can’t treat that one. I don’t know if this works with the way it spreads, but let’s say it’s in lymph nodes and other places you can treat. Have you noticed any effects of treating one area helps the other to heal as well? 

I don’t think science is quite advanced enough to answer that. However, there are two things that in theory are our next areas of research to answer. One of them is exactly what you stated, which is if we’re able to open up some blood vessels and if what has been described on a cellular level of enhancing an immune reaction to that other tumor, even if it’s a metastasis, can that prime the immune system to go attack the other tumors? We don’t know the answer. It’s a possibility and that’s part of some future research. That is certainly an intriguing question. Here’s where we do often work with oncologists is the newer biological therapies that are immunomodulatory, that allow the immune system to work around the active suppression that the tumor is providing and opens it up so the immune system can react to cancer. 

AIH 59 | Hyperthermia In Cancer Healing Fireballs in my Eucharist: Fight Cancer Smarter

With those therapies, we’re creating our regimens carefully with the oncologist. I will leave it as beyond the studies that were done earlier with traditional cytotoxic chemotherapies, which are different than the ones that modulate the immune system. Although we don’t know the answer, we are hopeful that we are in fact doing some good in those people who are getting that form of chemotherapy because of the immune responses that have been seen at a cellular level. That’s different from the clinical outcome of, “We’re going to shrink this tumor.” Having said that, in many tumors, we have robust data that we are able to, in many cases, have an improved response and in some cases have improved survival. 

Because most therapies are researched initially in patients who are far advanced, we know that in a pretty far advanced head and neck cancer, specifically in rectal cancer, but in colorectal cancer broadlyin breast cancer and in melanoma, we have very robust data and more in sarcomas. The body of evidence is beginning to build. We’re very excited to be able to bring this back into the fold. I say it that way because this therapy was utilized in a much broader way in the ’80s and ’90s and fell away for a variety of reasons. It’s still used quite a lot in Europe, but we’re now having a bit of a resurgence. We’re trying to lead that charge. 

don’t know if you are allowed to answer this next question, but do you have any stories of patients coming in here? Obviously, you won’t name names or anything like that. What did they experience as a result of receiving hypothermia in conjunction with whatever other treatment plans they might have been under? 

Do we have success stories? We have many. It’s important to think about the treatment of cancer as a team effort. Because we’re used as adjunctive therapy with other therapies, it’s impossible to pull apart on a patient by patient basis what contribution the hyperthermia has had. We have seen situations that do bear out what we’ve seen when the studies were done with larger numbers of patients where these individual patients are getting robust responses that may not have been what they’ve experienced before hyperthermia. One of the success stories that help us to understand whether or not hyperthermia is adding anything is we had a patient with a rare type of tumor within the abdomen who had very stable tumor marker numbers. Tumor markers are typically proteins that you can measure in the blood and they roughly correlate with the tumor burden, the amount of tumor tissue that’s in your body. 

We have a couple of people who were on longer-term maintenance chemotherapy regimens for various tumors. One I’m thinking of is in the abdomen, but we have other stories like this where those tumor markers were quite stable. We added heat to the chemotherapy and the tumor markers went down. It’s not perfect, but those patients had very advanced tumors. It was clear in those situations that there was an absolute temporal correlation with adding heat and getting better interim outcomes. Eventually in many of those patients, what we’re aiming to look for is did the scan get better? Did the tumor get better? 

Let me add one important thing and this is anecdotal. We are evidence-driven, but that does not mean that we are going to ignore the anecdotal data that is presented to us. There are a number of patients who have reported to us independently because they’re certainly not talking to each other that they both feel better. This sense of wellbeing that you and I were talking about is part of their experience. In the tumors that are accessible, and here’s a place where I can attest to some, although anecdotal, objective data. The tumor seems to soften and what exactly that means, on its way to shrinking. 

This is very exciting, but we’re on the precipice now of getting some more momentum clinically with this modality so that we can begin to design rational, targeted, powerful studies that are not designed back in the ’80s and ’90s. Not that nobody’s doing research now, but we’re aiming to be at the forefront of this so that we can begin to design these robust therapies in the context of all these new treatments with incorporating all of the aspects that might be beneficial to patients. As well as some of the potential adverse effects, which we should talk about. 

One question I do have and this is looking to the future, is I know you guys are working on creating a larger base of evidence around hyperthermia and what’s that doing and expanding that. Is there anything else you or your facility might be looking at in terms of adjunctive therapies for cancer? 

Right now, our main focus is on hyperthermia. We aim to be at the forefront and be the best center that we can be, hopefully, the best nationally and internationally as we proceed. That’s where we’re at the moment. We’ve had great success in growing both in awareness and in the number of patients that we treat. I do want to spend a moment on potential adverse effects. When somebody comes in, the machine that we use delivers the ultrasound waves. It’s delivered through a water bolus, meaning you could think of it in a plastic bag that sits on the skin and it delivers through that bag of water and that water is cooled. 

We cool the skin so that we can deliver more of the heat deeper. We are actively monitoring that patient with thermal probes that are on the skin and we’re also in verbal contact with that patient. Is there a risk that you can get a burn? There is a small risk. The way to lessen that risk is to be in good communication. If there’s any question, we can stop the machine on a dime, pick it up. It has proven to be, in general, quite safe in our hands. We’re continually developing better and better ways to apply this therapy. 

It's important to think about the treatment of cancer as a team effort. Click To Tweet

I know you have a book. I’d love to share that with our community. In your own words, what is that book about and how did it come to be? 

The book is called Fireballs in my Eucharist. It is available on Amazon. The story behind it was when I was doing my residency, I was taking a medical history from a patient. I asked her about her prior medical history. She was enumerating the different challenges and issues that she faced. She said, I have fireballs in my Eucharist.” I said, “Please tell me more.” She said, I had these things growing and they removed them.” It clicked in my mind what that meant. She had fibroids in her uterus. That was a signal that I could not ignore that patient education and becoming an informed patient primarily through interactions with your primary doctor or the doctor that’s responsible for that disease. 

In cancer, that’s mostly the oncologist is absolutely critical. Any information that you get, you’re going to get information all over the place, needs to filter through that doctor. What I did was I tried my best to put the best practices approach to how do you approach cancer in a way that provides you with useful information to increase the power and effectiveness of your decisions. Again, the book is called Fireballs in my Eucharist: Fight Cancer Smarter. It’s available on Amazon. I hope it is useful to the people that look it up and purchase it. 

I’ve got one more question for you and we’ll share with everyone how they can get connected with the center here. This is a question I ask everyone because it’s so integral to who we are as human beings. What’s your inspiration? 

My inspiration is straightforward. What I want to do with my life is to improve the lives of others. The boundaries that I’m going to operate in are medicine. The modality or the particular thing that I focus on at any given time is going to evolve organically with the technology. It’s going to evolve organically with how my thinking evolves. For this period, it’s a focus on how do we help cancer patients to increase their options and to enhance the effectiveness of the therapy that they’re receiving. 

When we get those patients that come back and their family members, some of whom are doctors, and they say, “I love being here.” It’s a gentle therapy in general. We have a calm environment. When they get the news that their tumor has shrunk, which happens often enough, we are thrilled with them. That is where the inspiration comes from. It comes from human interaction with those people. The fact that we have an absolutely stellar team here from the moment that people call and interact with us, we plain old try to help them any way we can. 

I’m going to second that you do have an amazing team. I say that, one because I believe, but two because I used to work with a couple of people on your team who are sitting in this room. I know they’re some of the most loving, caring, kindhearted people who do want to help people get well. I appreciate you saying that you are evolving what you’re doing as your thinking evolves as the research evolves. That’s an important quality to embody, which is we’re going to change and adapt as we believe that something is going to help our patients get better. How can people find the center? How can they come to get treatment if they are in need? 

One of two main ways, the direct access to us if you’d like to contact us directly is either through our website, which is HCIOncology.com. There’s a way to email through that website or call us at (888) 580-5900. We are on social media. You can feel free to follow us on Facebook or Instagram. We are delighted if you call us and if we can help you in any way, even if you don’t become a patient here, we’d be happy to try. 

Thank you, Dr. Pinzone. If you are out there reading this and you or a loved one or a friend or someone you know is dealing with a cancer diagnosis, please reach out and at the very least become a more informed patient. If this is something that works in conjunction with what you’re doing and your healing strategy, take the leap because there are wonderful people here who want you to get better and want you to get well. Thank you, doctor. 

You are welcome. I wanted to say the name of our center, which is Hyperthermia Cancer Institute. If you search that, you can get to us and we’ll get back with you soon. Thank you. 

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About Dr. Joseph Pinzone

AIH 59 | Hyperthermia In Cancer HealingDr. Joseph Pinzone is the Medical Director of the Hyperthermia Cancer Institute (HCI), a premier hyperthermia center located in Los Angeles, California. He is also Assistant Clinical Professor of Medicine at the David Geffen School of Medicine at UCLA and a Fellow of the American College of Physicians.

Dr. Pinzone is dedicated to using hyperthermia to optimize the care and clinical outcomes of patients with cancer and aims to lead the field of thermal oncology. He has been involved in tumor biology research and treating patients with cancer for over 20 years. His optimism defines his approach to his patient care and is driven by the accelerating progress we are making in the field of cancer therapy.

“We are continuously improving cancer therapy by discovering new treatments, improving our understanding the mechanisms of established treatments, and learning how to optimally combine treatments to yield the best outcome for patients.”

Dr. Pinzone graduated from New York University School of Medicine and completed internship and residency in Internal Medicine at Columbia-Presbyterian Medical Center. He then completed fellowship in Endocrinology, Diabetes & Metabolism at Massachusetts General Hospital and Harvard University where he achieved a National Research Service Award from the National Institutes of Health (NIH) to investigate the cause of pituitary tumors.

After fellowship, Dr. Pinzone joined the faculty of The George Washington University School of Medicine where he practiced and taught Endocrinology and Internal Medicine. While at GW, he achieved a Master of Business Administration with honors and secured a 5-year research grant from the NIH to study breast cancer.

Dr. Pinzone then joined the faculty of The Ohio State University College of Medicine where his clinical work focused on patients with pituitary conditions. He also headed a molecular biology laboratory where he investigated why breast cancer spreads to bone. While at OSU, Dr. Pinzone taught both Internal Medicine and Endocrinology.

During his time in academic medicine, Dr. Pinzone taught and mentored medical students and physicians, as well as clinical and research scientists. He published multiple peer-reviewed scientific papers and lectured on many clinical and research topics.

Dr. Pinzone was then recruited to Amgen, Inc. where he was Clinical Research Medical Director. He worked in the Hematology/Oncology Therapeutic Area as the North American Medical Leader for the launch of Xgeva® which is used to treat patients with solid tumors to prevent skeletal-related events. He worked in the Bone therapeutic area and focused on Prolia® which is used to treat patients with osteoporosis.

With a diverse background in many aspects of medical care and innovation, Dr. Pinzone now combines his skills in patient care and teaching as well as clinical and basic science research. As Medical Director of our hyperthermia center, he is motivated to accomplish four goals. First, to offer patients cutting-edge cancer care with hyperthermia. Second, to continue to expand the premiere center for thermal oncology. Third, to increase the awareness of hyperthermia among patients and healthcare providers. Fourth, to innovate and generate novel insights on how best to use hyperthermia in the rapidly advancing field of cancer care.

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