**2.3. What to learn from nano-scale energy-liberation?**

The general idea of microscopic heating is simple: the heating energy is not liberated in a sudden single step, but regulated and multiple small energy liberation does the same job, (see Figure 18). In our case, the forwarded energy selectively targets the most influential areas. Instead of the high, general energy pumping into the lesion, the energy is liberated at the membranes of the malignant cells.

The microscopic effects, instead of the large energy liberation, is one of the most update thinking in energy source developments.

The conventional engines in vehicles use the energy of explosion of different chemicals (e.g. petrol, diesel, kerosene). The explosion by a spark or heating over their activation energy liberates large energy in a short time, and only a small fraction of this could be applied beneficially, most of the energy is radiated, conducted or lost in various other ways. One of the largest losses is the heat-exchange by the high temperature, which somehow has to be used again (e.g. intercooler, turbo). The latest solution, however, is the set of microscopic explosions, promoting the chemical reactions individually by a membrane control (i.e. fuel cell solution) and using the energy step-by-step as a sum of the micro-reactions. The relatively low efficacy combusting engines are intended to be replaced by the fuel-cell energy-sources combined with electric motors, which are based on the membrane regulated microscopic reactions of gases. (Mostly hydrogen and oxygen gases are in use.)

20 Hyperthermia

oncothermia safe and effective

nothing".

distribution and the gained temperature are very different [159]. The reason is simple: provide the same energy to identical volume but the blood-flow is different in every case so it will result in different temperature. The physiology modifies the temperature! It is not

The measurement of the power is missing, due to the fact that cooling is immeasurable and has a modifying effect on the temperature. This makes the temperature measurement in the target important, as this is the only parameter which gives us some idea about the absorbed energy, (see Figure 17.). This (generally invasive, measurement) makes it possible to have orienting value of the absorbed power in general, and sometimes it is important for safety to avoid the unwanted hot spots as well. For the successful energy dose control we have to know the energy taken away by the cooling. This underlines the importance of the control of the surface cooling triggered by the actual physiological conditions in the subcutaneous capillary bed.

possible to match the specific absorption rate (SAR) and the developed temperature.

**Figure 17.** The control of both the energies together with the physiological parameters make

investigators in other novel fields of cancer treatment."

the membranes of the malignant cells.

thinking in energy source developments.

**2.3. What to learn from nano-scale energy-liberation?** 

The full unsuccessful temperature focusing together with the intensive cooling process in conventional hyperthermia is, borrowing the words from Shakespeare, "much ado about

Dr. Storm a recognised specialist of hyperthermia formulated **[**78**]** a general opinion: "The mistakes made by the hyperthermia community may serve as lessons, not to be repeated by

The general idea of microscopic heating is simple: the heating energy is not liberated in a sudden single step, but regulated and multiple small energy liberation does the same job, (see Figure 18). In our case, the forwarded energy selectively targets the most influential areas. Instead of the high, general energy pumping into the lesion, the energy is liberated at

The microscopic effects, instead of the large energy liberation, is one of the most update

The conventional engines in vehicles use the energy of explosion of different chemicals (e.g. petrol, diesel, kerosene). The explosion by a spark or heating over their activation energy In fact, life "invented" the controlled energy-liberation by micro-processes, blocking the sudden, explosion-like energy liberation, driving the processes small subsequent energyconversion steps instead. In the living objects the energy is liberated gradually in a "ladder" of multistep processes, and this is also moderated by surface reactions.

**Figure 18.** The difference between macro- and micro-liberation of energy. The latter is much more efficient.

The applied power and its efficacy are usually not connected. Good examples can be found in our everyday life, in systems like the standard light bulbs and the energy safe ones using a fraction of the power for the same light*;* or the various power-consumptions of cars, having equal performance, or the various fuel consumption of them having the same engine-power. The incandescent bulb creates light by high-temperature filament, which heats up the environment, having only 10% efficacy.

Fluorescent technology solves this task more smartly: it makes the energy-liberation selective where the effect radiates light only (see Figure 19.). Fluorescent particles turn the UV from mercury excitation to visible light. The full process has approx. 45% efficacy.

The LED technology is even more effective, because no intermediate mercury-plasma is used, direct annihilation of the electrons and electron-holes emit the light with over 90% efficacy! (see Figure 20*.)*

Local Hyperthermia in Oncology – To Choose or not to Choose? 23

professional life, however, when somebody regards the certificate of studies as a goal, its

Mixing the tool with the action creates false goal in hyperthermia application: increase the temperature alone. This "auto-suggestion" creates such a situation when magnetic resonant imaging (MRI) is applied to control the temperature during the treatment, instead of using

In hyperthermia applications the macroscopic heating centers on the equal (homogeneous) temperature of the entire targeted volume, irrespective of its content and the ratio of the tumor-cells in the target, (see Figure 21**.**/a.). However, the target volume has only a small fraction of active malignant cells, and the heating process would be enough for those alone, avoiding heating (and wasting energy) to the other part of the target-volume. The microheating concept works differently, and heats the selected malignant cells only absorbing the

In this case, the lost energy is minimal; the efficacy of the energy utilization and its control is maximal. The energy is concentrated in this case directly to the chemical reactions and does not involve the above listed losses. The energy liberated by the micro reactions is used for the desired job in full, while the explosion-like, huge energy-supply in short time cannot be used optimally, due to the intensity of the immediate offer for the available energy is too much for prompt use. This causes a large demand of waste and a low efficacy of the desired effect. The problem of the heating, however, is that it shows a false, specious effect of applications in biology. When the liberated energy is not used as active biochemical or biophysical driving-force then the waste appears as a simple growth of the temperature in the target. This deceptive illusion seems to have higher efficacy. This, of course, heats everything in the target. The excess energy is wasted in the neighborhood of the malignancy and gaining the average energy of all the parts in the target, irrespective its malignancy or its electrolyte state. This is a typical wasting of energy, using it for the actually not-necessary energizing of healthy parts. This massive heating forces the homeostatic feedback

this capable imaginary method to see what is happening in the tumor indeed.

**3. Bioelectromagnetic selection – To select or not to select?** 

**Figure 21.** The schematics of macroscopic and microscopic heating of tumor

mechanisms acting against the growth of drastic temperature growths.

application, the aim of the study is lost.

energy non-equally in the target (see Figure 21/b.*)*.

**Figure 19.** Fluorescent technology. The energy is liberated by micro-"explosions", excited by an UV radiation of the mercury-plasma

**Figure 20.** LED technology. The energy is liberated by micro-"explosions" by using the energy of the excited electrons

This way, the more intensive light (virtually higher temperature micro-explosions) need less energy by the block of the wasted energy to heat up the environment instead of the visible light emission: the same light-emission needs 60W, 13 W and 5 W in cases of incandescent, fluorescent or LED light-sources.

The present main-stream thinking of oncological hyperthermia is a typical loss of aims by illusions: the temperature only makes conditions that are implements and not the aim. The question "Tool or goal?" has become relevant to study the temperature alone. By a simple example of mixing the tool and the goal in our everyday life: the graduation is a tool for our professional life, however, when somebody regards the certificate of studies as a goal, its application, the aim of the study is lost.

Mixing the tool with the action creates false goal in hyperthermia application: increase the temperature alone. This "auto-suggestion" creates such a situation when magnetic resonant imaging (MRI) is applied to control the temperature during the treatment, instead of using this capable imaginary method to see what is happening in the tumor indeed.
