In active fever therapy is the increase in body temperature achieved by administering fever-causing substances. The body itself produces a fever, in contrast to the passive hyperthermia method (local hyperthermia (oncothermia) or whole-body hyperthermia), and therefore is the active fever therapy also called endogenous hyperthermia. The fever-causing substances are bacterial toxins. These produce in the heat regulatory center of our brain - mainly in the anterior hypothalamus - a setpoint increase. Which in turn increases the body's core temperature. This mechanism is similar to a normal fever response. Fever itself is not a disease but a symptom and usually has a life-sustaining and health-promoting function. Many of the pathogens the body comes in contact with are counteracted with febrile reactions. Fever is a successful defense against the pathogen and subsequently improves the immune response. Interesting for cancer patients is the observation that cancer patients before the onset of their disease less often experience febrile infections as compared to the average population (see the studies by Abel in 1987, Remy 1983 or Kölmel 1992). Furthermore, studies show that after fever – particularly fever caused by staphylococci - spontaneous tumor regression occurs (see Stephenson in 1971, Nauts 1984). There is therapeutic experience with artificially produced fever since the end of the 19th Century (Coley). Until the introduction of cytostatics in the middle of the 20th Century fever therapy was of significant value in the systemic treatment of cancer. Today, findings report good results with sarcomas, lymphomas, renal cell carcinoma, and ovarian cancers. Also for breast cancer and colon cancer, there is evidence of favorable response with fever therapy.
In addition to the medical examination and consultation , blood pressure, pulse, EKG and pulmonary (lung) function are measured and a relevant laboratory work-up (thyroid, liver and kidney function, electrolytes, coagulation, blood count, ESR and CRP) takes place. In the days before treatment, patients should drink a lot and use a light diet. On the morning of the treatment patients are admitted to the hospital. The patients receive a pyrogen (fever-causing substance) intravenously injected. For this purpose, patients receive a venous access (needle), usually in the forearm (cubital veins). Through this needle the patient receives fluids (saline solution, electrolyte solution, etc.) during the treatment. Temperature, pulse and blood pressure are regularly monitored.
After the administration of pyrogens in about 15 minutes to 2 hours patients will start to shiver. This phase usually lasts 10-45 minutes. The temperature then increases to values between 38 to 40° C (100.4 and 104ºF). This generally lasts for 1 - 2 hours. After the fever therapy, patients will be monitored until the morning of the next day. They will continue to receive electrolytes and any other necessary medications either through the existing IV access or by drinking fluid.
Laboratory tests take place during and after treatment and when needed patients may receive medications (usually with electrolytes).
Contraindications for the active fever therapy are:
heart failure, severe heart rhythm disturbances, angina pectoris, recent myocardial infarction, vital capacity less than 60%, acute hepatitis, or nephritis, liver cirrhosis or renal failure, tendency to fever-convulsions and epilepsy, brain tumors, cerebral edema, multiple sclerosis, severe cerebral ischemia , thrombosis, thrombophlebitis, hyperthyroidism, Karnofsky index below 60%, cachexia, pregnancy.
As with naturally occurring fever the following can take place: general and localized sensation of heat and tightness, sweating, headache, muscle cramps, joint pain, abdominal and limb pain, increased blood pressure, increased pulse rate, heart rhythm disturbances and nausea. These side effects are usually transient and can be mitigated or remedied with medication.