HYPERTHERMIA - Infrared light & Heating therapy

[George999]

Hawk, You have asked for evidence, here it is:

Radiofrequency radiation (900 MHz) induces Egr-1 gene expression and affects cell-cycle control in human neuroblastoma cells.
Buttiglione M, Roca L, Montemurno E, Vitiello F, Capozzi V, Cibelli G.

Department of Pharmacology and Human Physiology, University of Bari, Italy.

Many environmental signals, including ionizing radiation and UV rays, induce activation of Egr-1 gene, thus affecting cell growth and apoptosis. The paucity and the controversial knowledge about the effect of electromagnetic fields (EMF) exposure of nerve cells prompted us to investigate the bioeffects of radiofrequency (RF) radiation on SH-SY5Y neuroblastoma cells. The effect of a modulated RF field of 900 MHz, generated by a wire patch cell (WPC) antenna exposure system on Egr-1 gene expression, was studied as a function of time. Short-term exposures induced a transient increase in Egr-1 mRNA level paralleled with activation of the MAPK subtypes ERK1/2 and SAPK/JNK. The effects of RF radiations on cell growth rate and apoptosis were also studied. Exposure to RF radiation had an anti-proliferative activity in SH-SY5Y cells with a significant effect observed at 24 h. RF radiation impaired cell cycle progression, reaching a significant G2-M arrest. In addition, the appearance of the sub-G1 peak, a hallmark of apoptosis, was highlighted after a 24-h exposure, together with a significant decrease in mRNA levels of Bcl-2 and survivin genes, both interfering with signaling between G2-M arrest and apoptosis. Our results provide evidence that exposure to a 900 MHz-modulated RF radiation affect both Egr-1 gene expression and cell regulatory functions, involving apoptosis inhibitors like Bcl-2 and survivin, thus providing important insights into a potentially broad mechanism for controlling in vitro cell viability. 2007 Wiley-Liss, Inc.

PMID: 17559061 [PubMed - indexed for MEDLINE]

The above study demonstrates, I believe, that application of microwave energy can have other components than simply hyperthermia.  There is no inference in the abstract that the observed results are due to induced hyperthermia and there seems to be the assumption from the beginning that they are characteristic rather of application of RF energy on living tissue and not induced hyperthermia.

Microwave radiation can alter protein conformation without bulk heating.
de Pomerai DI, Smith B, Dawe A, North K, Smith T, Archer DB, Duce IR, Jones D, Candido EP.

School of Life and Environmental Sciences, University of Nottingham, University Park, NG7 2RD, Nottingham, UK.

Exposure to microwave radiation enhances the aggregation of bovine serum albumin in vitro in a time- and temperature-dependent manner. Microwave radiation also promotes amyloid fibril formation by bovine insulin at 60 degrees C. These alterations in protein conformation are not accompanied by measurable temperature changes, consistent with estimates from field modelling of the specific absorbed radiation (15-20 mW kg(-1)). Limited denaturation of cellular proteins could explain our previous observation that modest heat-shock responses are induced by microwave exposure in Caenorhabditis elegans. We also show that heat-shock responses both to heat and microwaves are suppressed after RNA interference ablating heat-shock factor function.

PMID: 12753912 [PubMed - indexed for MEDLINE]

Here again in this study we see evidence of NON-HYPERTHERMIA effects of RF radiation.  This whole issue is so very complex and, with all due respect, I find it highly simplistic to argue that therapeutic microwave results ONLY in hyperthermia and can produce no other biological changes.  In fact, I find the second study highly interesting in that it alludes to "Limited denaturation of cellular proteins".  If indeed RF can induce changes in collagen independent of hyperthermia, then perhaps it can induce accelerated collagen turnover which just might explain the claimed efficacy of the Italian Peyronies study.  And if Peyronies itself is caused by faulty glucose metabolism, it would be reasonable to expect that those who demonstrated dramatic improvement in the study would later develop Peyronies symptoms all over again which just might explain why the whole thing was never pursued further.  Induced collagen turnover would be all but invisible in healthy tissue, but fibrotic tissue would reveal it dramatically.  OK, Hawk, I admit that this last part is just wild speculation on my part, but thats just how my brain operates.  

I stand by my statement.  - George

[j]

I said that heat might break unwanted molecular bonds, but I don't think that was the idea behind the original study. What I recall is that it was based on the knowledge that temperatures around 43C will cause the death of cancer cells but leave normal healthy cells unharmed - and Peyronie's/Dupuytren's fibroblasts have some characteristics in common with cancer cells.

Remember that microwaves and infrared are in some sense the same thing - just 2 different frequency ranges of electromagnetic radiation.  Microwaves are the high end of the radio spectrum - directly above them lies infrared - and just above that, the low end of the visible spectrum.  Microwaves can be bent, focused and refracted much like visible light.  

I don't know the science of why microwaves are used for hyperthermia instead of IR.  I tried IR because it was possible to due so at low cost, with off-the-shelf components.  Microwaves do penetrate more effectively than infrared - light won't penetrate the walls of your garage, but transmitter in your garage door opener does so easily.  So for tissue far below the surface, microwaves are more effective. For tissue at or near the surface, I don't know why there would be a difference.

[George999]

j, I think we have a good discussion going here and I would like to comment further on it, but before I do, I really think it is probably time for Hawk to come in and move some of our recent posts back over to "Alternative Therapies" where they probably belong.  - George

[George999]

j, Remember, first of all, the problem in the case of Peyronies is not so much with the cells, since they are normal and not cancerous, the problem is with the extracellular matrix and an excessive build up of collagen.  It is highly unlikely that the cells at issue with Peyronies would respond to hyperthermia in the same way as cancer cells.  Remember also that the effects rendered in the second study I pointed out from the UK were demonstrated to be ENTIRELY unrelated to induced hyperthermia and were directly due to the RF frequency being delivered, not the heat being caused by that RF energy.  In the case of the study I referred to, the Microwave radiation was actually CAUSING fibrosis WITHOUT inducing any hyperthermia, but my point was and is that this demonstrates that Microwave radiation can and does effect tissue by components other than its ability to heat that tissue AND it can directly affect the extracellular matrix, which in the case of Peyronies is mostly glycated collagen.  Certainly all of this does NOT preclude the very real possibility of benefit from hyperthermia itself.  But it does leave open the possibility that the participants in the Italian study could have been getting a double benefit, from both the induced hyperthermia AND from the unique effects of microwave radiation on tissue.  And of course, as I pointed out before, they could also have been fudging the numbers on the results.  Who knows?  But if ANYONE can get the kind of spectacular improvement they got within just a few months just from the use of hyperthermia, I would certainly like to hear about it and I am sure many others would also.  - George

[Hawk]

First, I have been punished enough for this lively debate that broke out under "Oral Treatments" .  It took 40 minutes to figure out where to prune and trim that topic and to execute the move.

I am ready to wind down and am satisfied with the points:

George thinks he has found enough evidence to conclude it is likely that the type of heat energy made a significant impact on the Hyperthermia study.  He admits to some wild speculation,

Induced collagen turnover would be all but invisible in healthy tissue, but fibrotic tissue would reveal it dramatically.  OK, Hawk, I admit that this last part is just wild speculation on my part, but thats just how my brain operates.

I don't entirely fault wild speculation.  It can be both a asset and a liability.

Hawk thinks that while it is possible that the type of heat energy played a role (almost anything is possible), I think there is easily enough established documentation on temperature and fibrotic conditions, temperature and circulation, Peyronies Disease and circulation, temperature and cell death, and the abnormal longevity of Peyronies Disease cells, to establish the strong likelihood that temperature made any impact that was made in that study.  When stacked against the lack of established evidence for the type of heat being a factor on fibrotic tissue or cell life, I think that temperature is the obvious choice.

Peyronies Disease cells have been established in several studies to be prolific and to be absent the normal programmed cell death of typical cells, a condition found in cancer cells.

The fact is, that I have always questioned the entire study from method thru evaluation of results to conclusion.  Like J, after a while you have to ask what is with the Italian studies.  Europe gives us one-time miracles from hyperthermia, to ALC, Leriche technique that never spark enough interest for follow-up or fail to be reproduced.  

I still think ALC and hyperthermia are a no-lose treatments that will likely not hurt and possibly help.

[George999]

Hawk thinks that while it is possible that the type of heat energy played a role (almost anything is possible), I think there is easily enough established documentation on temperature and fibrotic conditions, temperature and circulation, Peyronies Disease and circulation, temperature and cell death, and the abnormal longevity of Peyronies Disease cells to establish the strong likelihood that temperature made any impact that was made in that study.  When stacked against the lack of established evidence for the type of heat being a factor on fibrotic tissue or cell life, I think that temperature is the obvious choice.

Peyronies Disease cells have been established in several studies to be prolific and to be absent the normal programmed cell death of typical cells, a condition found in cancer cells.

I just did a quick look for research on Peyronies and hyperthermia and came up with only one hit:

Role of hyperthermia in the treatment of Peyronie's disease: a preliminary study.
Perugia G, Liberti M, Vicini P, Colistro F, Gentile V.

Department of Urology, University of Rome La Sapienza, Rome, Italy.

OBJECTIVE: Previous experience in the treatment of plaque with hyperthermia in orthopaedics led the authors to investigate the effectiveness of this approach in patients with Peyronie's disease. PATIENTS AND METHODS: The study population comprised 60 patients (aged 36-76 years) with advanced Peyronie's disease. Patients were divided into two groups (A and B), with 30 in each. Group A patients underwent local hyperthermia treatment, with 30-min treatment sessions twice a week for 5 weeks. Patients received a total of 10 applications, which reached a local temperature of 39-40 degrees C. A second cycle was repeated after a 1-month interval for a total of 20 treatment sessions. Group B patients were treated with intra-plaque infiltrations using 10 mg verapamil; they received one infiltration once a week for 3 months. Differences between the two groups, as well as between variables (before and after treatment), were analysed using Student t-test and Fisher test. RESULTS: Hyperthermia significantly reduced plaque size and penile curvature and led to an increase in mean scores of erectile function (EF) domain, while verapamil had no such effects. Haemodynamic parameters were not significantly modified in either group. Hyperthermia caused significantly fewer side effects than verapamil infiltrations and was significantly more effective in preventing disease progression. There were no significant differences between the two groups in terms of pain reduction during erection. CONCLUSIONS: Results of this study stress the efficacy of hyperthermia in the treatment of advanced Peyronie's disease.

PMID: 16019862 [PubMed - indexed for MEDLINE]

Do note that this is another one of those famous Italian studies.  I forthrightly acknowledge that there are a raft of hyperthermia/fibrosis studies out there, but in reviewing the listing I fail to find anything that look particularly applicable or interesting.  So if you wouldn't mind, I would appreciate you pointing out the documentation on fibrosis and hyperthermia.

I would also like to see any scrap of evidence you can find for Peyronies disease responding to improvements in circulation.  I can't find any.

Additionally, where is the research that establishes the "absent the normal programmed cell death" factor for "Peyronies" cells.  I am aware of the phenomenon of Collagen accumulation whereby cells involved in Peyronies are damaged to the point that they "sprout" abnormal amounts of Collagen on their surfaces.  I am also aware that the Collagen that becomes glycated does not turnover as often as normal Collagen.  But I have never seen anything attributing "immortality" to other than cancer cells.  I would really appreciate any studies ANYONE can find on this.

If we are going to dig into the area of Hyperthermia as it relates to Peyronies, lets do it right and get all of the relevant research out on the table.  Hawk asked for documentation and I provided what I can find.  I think now its time we see rest of the documentation for these other claims being made.

-  George

[Hawk]

I appreciate your tenacity on this topic but some of this, and some of what you just stated, we have already covered. Additionally, I have a few other priorities other than digging this stuff out for further discussion.  This is why I said I was winding down on this in my last post.  Due to this I will simply say the following for now.  If I think time justifies it I will add more.

Check out our resource library for information on heat reducing scar tissue in general.  It is in the documents on scarring and is good reading.  Other information on heat/scarring/fibrosis is widely documented as you already mentioned.  Capsulitus (frozen shoulder) is but one brief example.  I have a close friend that is an orthopedic surgeon and I have a good rapport with the head of a great physical therapy department that I may approach about these general issues.  

Also in the resource library is a document making a connection between circulation /oxygen/TGF B-1 and fibrosis of the penis. https://www.peyroniesforum.net/index.php/topic,130.0.html  I have had leading urologists mention circulation and fibrosis as though it is an understood.  With VED's, Viagra, arginine, nocturnal erections, etc. surely you do not discount the connection between circulation and Peyronies Disease.

I think the findings on cellular longevity (not the word I am looking for) of Peyronies Disease cells was on Pub Med but I cannot be sure.  It may have even used the word "immortality". It discussed the absence of apoptosis in Peyronies Disease cells and drew a similarity to keloids as I recall.  It may well have also been referenced as part of an earlier discussion on this forum.

That is it for now.  I am off to enjoy life with grand children, wife, son etc.

Cheers

[George999]

Hawk, Thanks for the references, they explain a lot.  At this point I am ready to concede that hyperthermia can be effective and that increased circulation may play a role in that.  I still have major doubts about the apoptosis (or rather lack of) factor though.  I would really like to see a reference to lack of appropriate cellular apoptosis in relation to Peyronies.  That would be interesting.  I am also wondering why hyperthermia has not been broken out into a separate topic since there is apparently significant interest in it.  - George

[George999]

Thanks Hawk,  That is certainly a very good reference and exactly what I was looking for.  I really do think it is important to get all these factors documented on the forum.  I *did* do a search of the forum yesterday and was unable to turn anything up.  So this is an important step.  I think the next question, which probably actually belongs under the "Causes" thread, is just how all these things tie together.  Is the p53 protein, cell immortality phenomenon a genuine causal factor or just a link in the chain?

1)  We know that lack of oxygen can cause an over expression of TGF-beta-1, in which case normalizing circulation and oxygen levels would fully address the problem.

2)  We also know that faulty glucose metabolism can cause glycation which can also cause over expression of TGF-beta-1, in which case only addressing glucose metabolism AND resulting glycation would fully address the problem.

3)  And of course, one could conceive a combination of these two pathways exacerbating the TGF-beta-1 problem.

3)  But where does the p53 protein fit into this equation.  Upstream or downstream?  Actually it causes me to wonder if what is going on with the p53 protiein is being induced by the TGF-beta-1, which could explain why both hyperthermia and antiglycants like Pentox and ALC have shown effectiveness against Peyronies.  That would certainly be interesting to look into.  We do know that there are things which normally modulate the activity of p53.  In fact chemotherapy in the oncology world typically attacks p53.  And there is a new drug coming out now that can precisely modulate p53 WITHOUT damaging normal tissue.

4)  When I look at the research in this area, I see that, indeed, TGF-beta-1 DOES modulate p53!  But the really strange thing is that increases in TGF-beta-1 affect p53 in a way that cause it to ACCELERATE apoptosis, which is just the reverse of what is actually happening.  This is exactly the scenario one finds with cancer.  High level of TGF-beta-1 which SHOULD be causing mass apoptosis, but instead a complete absence of normal apoptosis.  What is going on here!  Could it be that if levels of TGF-beta-1 get too high, they lose their ability to exert control over p53?  Could it be that p53 could develop TGF-beta resistance in a similar way to cells developing insulin resistance?  In that case, the solution would be to restore normal levels of TGF-beta-1.  And this could be an explanation of why hyperthermia has been shown to work against fibrosis.  Hyperthermia -> Increased circulation -> Increased oxygen -> Lowered levels of TGF-beta-1 -> Restoral of p53 modulation -> Normalized apoptosis of fibroblasts.

All these bits of research are really just pieces of the bigger picture and if they can be successfully stitched together the whole reveals much more than the pieces.  - George

[Tim468]

I think I have caught up with the on-going debate between Hawk and George regarding hyperthermia and mangosteen, glycation and p53, and apoptosis and blood flow, on oxygen delivery and the effects of stretch on TGF-Beta 3 expression (oops, they missed that last one).

Several thoughts...

Doing science in the lab has taught me a lot of humility, especially when I come face to face with truly great minds in science who are able to look at what I have done and see more than I did, because of their holistic viewpoints of science and physiology. I have learned that it is ALWAYS more complicated than we think. Yet, doing science requires a reductionist approach. When someone studies the effects of, say, PGE2 on muscle function - how do you go after that? What you do is typically done in several ways. First, you use an agonist to replicate the presumed effect. For example, you might take some muscle and incubate it with PGE2, and then with a PGE2 analog. Second, you use a PGE2 blocker to see if you can prevent the effect. Third, you have to look at what a similar molecule does. Only in this way do we start to see what adding or removing/blocking of a molecule leads to. But assumptions always get in the way.

A friend once "proved" that a certain type of bacteria "caused" high blood pressure in the lungs, but he then found that when he infused polystyrene beads of the same size into the pigs, he got the same response. That was how we came to see that pigs have white cells resident in the lungs that respond to ANYTHING, not just bacteria.

Again and again (in fact, I dare say EVERY time) I have found that it is like peeling an onion - every new discovery leads to yet another discovery.

Ultimately, I think that we spend too much time and energy trying to find the "answer" when in fact there are many answers and truths to be learned. George is probably right about the role of glycation, but I doubt it underlies all Peyronie's Disease, because it can't. There is never a single answer to any of this. Similarly, I think Hawk is overly simplistic to suggest that heat is heat - it can't be. By definition (because her are human) we cannot know all of what happens to people under biological stress. I could see heat loosening sulfhydryl bonds in collagen and allowing natural degradation to occur more easily (and improvement of Peyronie's). I could also imagine heat-induced aggregation of macromolecules leading to sludging in small capillaries, and thus leading to local hypoxic damage to tissue (and worsening of Peyronie's). And in physiology, if you can imagine it, then it can happen, probably.

Hawk, I think that what George offers us is his desire and ability to integrate data from other fields that help improve the anti-oxidant and anti-glycation status of our health in a way that will probably be beneficial to our health, and probably not hurtful. There are no data to support the notion that any of it will "cure" Peyronie's Disease. And to the extent that it "makes sense" to some of us (perhaps most of all to George!) then I guess it stands to risk misinforming those incapable of discriminant thinking here. I believe that this is true of the VED though, also.

The main difference is that with the VED we have testimonials, which carry their own risks (ie, they can be wrong, and are without controls to compare against). The problem with inductive reasoning like George's is that... it can be wrong.

But overall, I think that we are on to something here. We can try un-hurtful things and see if they help - and create more testimonials. I think that George's holistic biological approach is useful, in that it helps me think about alternative mechanisms. Certainly, the link between diabetes and Peyronie's is not only due to reduced blood flow. Or, it could be that simple... But wait! Nothing is ever simple.

The trouble then is sorting out the meaning of the variety of ideas and data presented here. Our very human tendency to not completely do anything as well as we should will also really complicate things (I have never been able to take anything EVERY day of the week). Was the iontophoresis not as good for me as the published data because I didn't follow their protocol? Is my tendency to cheat on sweets now and then why George's diet is not yielding the same results (oh, BTW, he and I both still have Peyronie's)? I don't know. All we can be is uncertain.

Tim

[headinthesky]

I said that heat might break unwanted molecular bonds, but I don't think that was the idea behind the original study. What I recall is that it was based on the knowledge that temperatures around 43C will cause the death of cancer cells but leave normal healthy cells unharmed - and Peyronie's/Dupuytren's fibroblasts have some characteristics in common with cancer cells.

Remember that microwaves and infrared are in some sense the same thing - just 2 different frequency ranges of electromagnetic radiation.  Microwaves are the high end of the radio spectrum - directly above them lies infrared - and just above that, the low end of the visible spectrum.  Microwaves can be bent, focused and refracted much like visible light.  

I don't know the science of why microwaves are used for hyperthermia instead of IR.  I tried IR because it was possible to due so at low cost, with off-the-shelf components.  Microwaves do penetrate more effectively than infrared - light won't penetrate the walls of your garage, but transmitter in your garage door opener does so easily.  So for tissue far below the surface, microwaves are more effective. For tissue at or near the surface, I don't know why there would be a difference.

The frequencies are *much* different, microwave is a "heavier", and can affect cells, vs IR which does not. Cells all have a certain resonance frequency which can't be attained using IR, which using microwaves will. Think of a microwave oven - it targets the resonance frequency of water, the water vibrates at that resonance frequency which then causes the water molecules to jump and moves - which releases energy in the forms of heat. They're targeting the resonance frequency of plaque - which is mostly made of calcium, and other sterols such as the high and low density forms of cholesterol - mostly LD. Finding the "optimum" resonance frequency of the plaque is the problem, and can be very damaging to other cells in trying to find out, since it's not a uniform composition. It's almost the same conditions which allow atherosclerosis.

Don't use IR or microwave, or any type of sub-visual or over visual wavelengths on yourself, you don't know what exactly that resonance is targeting - could even be DNA ( which is what radiation is/does).

[headinthesky]

We know that Trauma is a key factor in initiating Peyronies.  That makes me more than a little suspicious of techniques that employ trauma in there delivery.  Both needles used to administer things like Verapamil or Collagenase and ultrasound or other waveforms used to attack plaque are literally inflicting trauma in the process.  This sounds to me like it could turn into some sort of chronic treatment scheme.  Sorry to inject skepticism here, but I can't help but wondering if we are not barking up the wrong tree with these approaches.  - George

Which is what I was getting at. Something like heat therapy could cause other damage and lead to necrosis.

[tommarkey]

I think this may have been posted before but there is a trial with hyperthermia planned or ongoing in Brazil, can't find anything else on it so hope that they are still going ahead with it.

http://www.controlled-trials.com/ISRCTN82950322/

I'am very happy with somethings that i read here lately. Many studies are ongoing. Traction, hyperthermia, the XIAFLEX that some users are participating, the hope about pentox. All these things indicate that in a close future an efective treatment will be avaible to us.

I'm studying medicine at this university that is doing the hyperthermia's study. I don't know the doctor that is commanding the study, i think that he just work in the hospital, not teachs. I will try to contact him to know about this study, mainly the previous results, and then i post here again.

It has almost 2 weeks that i'm doing an "alternative" hyperthermia treatment in my home, that i planned, with the little shower (i don't know the name in english!) that is connected in the shower and 50 C water. In the last days i start to feel pain in my nodule, twinges sporadically... (I did not feel pain since my peyronie stabilized, almost two years ago). I don't know if this is good or not... But i will continue at least more 3 weeks... Then i will do an ultrasonography to follow the evolution of my plaques (I do one to each 3 months).

Thanks, and always apologies for my english.

Tommarkey

[Hawk]

Be carful not to use too high of a heat setting.  The past studies have used low heat.  There are also warnings that high heat can lead to tissue death.

[Old Man]

terryd:

What I am about relate will probably bring up comments that massaging scar tissue won't work. But, recently, I underwent surgery for Dupuytrens Contractures. I have undergone several weeks of occupational therapy wherein the therapist uses cocoa butter to thoroughly massage my hand. This is done after a 15 minute heat treatment in a machine that uses hot air and a corn product to warm the hand. The hand is bombarded with this product by the heated air being blown around inside the cabinet.

Today, the scar tissue that remains is barely visible and the incision line is virtually gone. The results so far are entirely satisfactory for me. I know that this has absolutely nothing to do with Peyronies Disease symptoms, but it demonstrates that massaging a scar on the external part of ones body can and will respond to physical massaging.

Don't think that Peyronies Disease would respond in the same way since there is no way to get ones penis into a machine such as is used on the hand, etc.

Old Man

[royswales]

Hi

has any one any experience of hypertherapy treatment? The trials in Italy in 2006 seemed to give some hope but I would like to hear from any one who has tried it lately?
Thanks

Royswales

[Hawk]

Hi

has any one any experience of hypertherapy treatment?

I assume you mean hyperthermia.  Go to search and type in the term.  You will find a lot posted about it.  In short, I know of no one that can document improvement directly associated to hyperthermia but many use it with caution along with VED or Traction or other treatments.

[royswales]

Hyperthermia

I have been trying to apply heat in the form of hot water which I have put into a plastic tube (I checked the temperature ensuring no more than 41 degrees) for 20 minutes. It has only been for a few says now - no difference yet.
I thought that the Italian trial sounded promising and would have hoped that another scientific trial could have been started to corroborate the results of the first.

I was just hoping to hear from any one else on the site who had tried any form of hyperthermia.

[George999]

I believe there is a Brazilian trial going on now.  - George

[newguy]

All - This hyperthermia technique sounds interesting. The trial listed in the pdf certainly put it in a positive light, though it was very smallscale. Hopefully ongoing studies will eventually give us a better idea of whether this can be useful to us.

[Jackieo]

newguy:  here is a novice's take on the hypothermia debate.  I am very new to this entire scene.  I most recently joined the VED club.

I experimented at first to become acquainted the the..."equipment" and I found that taking a hot "relaxing" shower prior to stretching afforded me a longer no-pain stretching period.  I equate it to taking a steam prior to a massage....warm and relax (although the plaque is deep-seated I think the heat does permeate to some depth).  Maybe I am wrong, but the application of heat (the hand-held shower directly on my penis) prior to stretching works for me....followed by a warm rinse after.
This is what I call a very-small control group!
Jackieo

[newguy]

Jackieo - Thanks very much for your thoughts. I suppose there are still a great number of unknowns, but heat can no doubt be of some use, prior to VED use, and traction.

[Thin Man]

Hey Skunkworks,

Could you share the heat study with us?

Maybe that's something we'd actually like to know about.

TM

[skunkworks]

Went to try and find it and discovered it was already on this forum.

https://www.peyroniesforum.net/index.php?topic=294.0

Hyperthermia significantly reduced plaque size and penile curvature (Table I, Figure 1)
and increased mean scores of EF domain (Table I, Figure 1), while verapamil did not
cause any change in these parameters. Haemodynamic parameters were not significantly
modified in either group (Table I, Figure 2). Hyperthermia caused significantly fewer side
effects than verapamil infiltrations and was significantly more effective in preventing disease
progression. There were no significant differences between the two groups in the reduction
of pain during erection.

[slowandsteady]

It would be interesting to look at how hyperthermia affects autoimmune disease.

In rats, whole body hyperthermia lessens the impact of an induced autoimmune response PMID 18402844):

CONCLUSIONS: Whole-body hyperthermia attenuates experimental myocarditis in the rat. The beneficial effect of whole-body hyperthermia may be related to immunomodulatory effect and direct cardiomyocyte protection.

Sauna anyone?

In a mouse study on autoimmune encephalomyelitis (PMID 11299319):

The stress response (SR) can block inflammatory gene expression by preventing activation of transcription factor nuclear factor-kappa B (NF-kappaB). ... The HSR attenuated leukocyte infiltration into CNS assessed by quantitation of perivascular infiltrates, and by reduced staining for CD4 and CD25 immunopositive T-cells. T-cell activation, assessed by the production of interferon gamma (IFNgamma) in response to MOG(35-55), was also decreased by the HSR.

s&s

[TheSolution]

I did my own hyperthermia in bath. 107 for 25 minutes. This was a mistake, but it helped. But please lower temperature. My balls turned black and I suffered some slight burns. The 107 temp was too high. 104 is highest that spas can go and is much safer. Its time and temp. So don't kill the cells in your penis.

But the results were good. My tunica has had a major dent or wrinkle that was causing 25 curve to the right. I have no hard plaque on outside to the touch, but ultrasound shows distributed bands inside. Was a recent injury from a wild girl on top (note - never allow any girl on top, nice and gentle is not in some girls vocabulary). This was devastating to me and extremely painful. But after 2 times in spa, I made myself get hard watching porn right after and noticed my curve was 10 degrees and the tunica wrinkle gone. 5 hrs later, the tunica was much better than ever before and that wrinkle has not come back. Curve is now stable for 2 weeks at 10-15 degrees. Some morning are a problem and so I get in 100-103 degree bath and warm it up before I make an erection occur. This is helping stretch it out. I never force the stretch though, that's a mistake. Just let the erection make it happen. The heat is really helping.

I am going to try some heat before bed. Will put heat pad over shorts (never direct or burns can occur).

I think this works for tunica problems. My scarring of the tunica was causing some of my bend and a ton of pain. Pain is way down. Almost livable again. I am going in spa at 100 deg now 4-5 times daily for 15 minutes to keep it flexible. 104 is too hot for multiple times. The health club is 103 and right next to my house.

Please don't do 107 deg. Its dangerous. Could have lost my unit. It was embarrassing going to urgent care with completely black balls. The problem with 107 is that it was probably 109 as my temp probe is + or - 2 deg. 110 causes 3rd degree burns after 5 minutes. I also had trouble with the erection after 107 and struggled to help it. My penis was probably at 107 by that point and was overheating.

Hope this helps for some. I think its great for certain types of injuries and maybe not for others. Try and see if the erection is less bent. But don't force. I tried that a few weeks earlier and the pain after that was a 10 as I ripped it worse. let your unit fix the bend naturally.

[PTMAN]

Let me preface by saying that I'm aware this topic has been covered to some degree, as I have read what is on this site addressing this issue. I felt it was woefully lacking in coverage. I have been researching sporadically for quite some time, the role of nitric oxide in recovery of Peyronie's Disease plaques, but as I am severely lacking in cellular physiology background, I get lost with all the terms, i.e., NO, iNOS, NOS, "expression of", etc. Just can't get my head around it. I therefore need help from this forum from someone with this background. I promise, I'll get to the point soon. But for now can someone look into the below study, which is eerily similar to every other article I've found, and either confirm or deny my rudimentary understanding, that elevation of NO levels have some anti-plaque formation, and possibly a plaque "breakdown" capability?
In other words, if some device greatly increased NO locally, is this a good thing, or a bad thing?
Happy reading, and thanks in advance for the assistance!
PTMAN

Abstract:

The myofibroblast shares phenotypic features of both fibroblasts and smooth muscle cells. It plays a critical role in collagen deposition and wound healing and disappears by apoptosis when the wound is closed. Its abnormal persistence leads to hypertrophic scar formation and other fibrotic conditions. Myofibroblasts are present in the fibrotic plaque of the tunica albuginea (TA) of the penis in men with Peyronie's disease (Peyronies Disease), a localized fibrosis that is accompanied by a spontaneous induction of the inducible nitric oxide synthase (iNOS), also observed in the TGF1-elicited, Peyronies Disease-like lesion in the rat model. iNOS expression counteracts fibrosis, by producing nitric oxide (NO) that reduces collagen deposition in part by neutralization of profibrotic reactive oxygen species. In this study we investigated whether fibroblast differentiation into myofibroblasts is enhanced in the human and rat Peyronies Disease-like plaque and in cultures of human tissue fibroblasts. We also examined whether NO reduces this cell differentiation and collagen synthesis. The myofibroblast content in the fibroblast population was measured by quantitative immunohistochemistry as the ratio between-smooth muscle actin (ASMA; myofibroblast marker) and vimentin (general fibroblast marker) levels. We found that myofibroblast content was considerably increased in the human and TGF1-induced rat plaques as compared to control TA. Inhibition of iNOS activity by chronic administration of l-iminoethyl-l-lysine to rats with TGF1-induced TA lesion increased myofibroblast abundance and collagen I synthesis measured in plaque and TA homogenates from animals injected with a collagen I promoter construct driving the expression of-galactosidase. Fibroblast differentiation into myofibroblasts occurred with passage in the cell cultures from the human Peyronies Disease plaque, but was minimal in cultures from the TA. Induction of iNOS in Peyronies Disease and TA cultures with a cytokine cocktail and a NO donor,S-nitroso-N-acetyl penicillamine (SNAP), was detected by immunohistochemistry. Both treatments reduced the total number of cells and the number of ASMA positive cells, whereas only SNAP decreased collagen I immunostaining. These results support the hypotheses that myofibroblasts play a role in the development of the Peyronies Disease plaque and that the antifibrotic effects of NO may be mediated at least in part by the reduction of myofibroblast abundance and lead to a reduction in collagen I synthesis.

[slowandsteady]

In other words, if some device greatly increased NO locally, is this a good thing, or a bad thing?

I think the study is saying that NO production is helpful against Peyronies Disease. The wikipedia entry for the biological functions of NO might be helpful to read.

From that article:

Vasodilation
Nitric Oxide (NO) is of critical importance as a mediator of vasodilation in blood vessels. It is induced by several factors, and once synthesized by eNOS it results in phosphorylation of several proteins that cause smooth muscle relaxation. The vasodilatory actions of nitric oxide plays a key role in renal control of extracellular fluid homeostasis and is essential for the regulation of blood flow and blood pressure. [4]. This also plays a role in erection of the penis.

eNOS synthesizes NO, but it requires l-arginine. NO is also a potent oxidant, but one that the body makes use of, for signaling or for killing bacteria. It's not my impression that people suffer from out-of-control NO production that damages the body (please correct me if I'm wrong). Levels of NO are usually low in diabetes, and diabetes is known to be a risk factor in Peyronies Disease. I think low NO is bad for Peyronies Disease. The article states: "Diminished supply of Nitric Oxide can lead to vascular damage, such as endothelial dysfunction and vascular inflammation."

On the other hand, some viruses need relatively much l-arginine for reproduction, so taking too much l-arginine might not always be helpful. Maybe pycnogenol helps the l-arginine go farther without feeding the viruses. Pycnogenol also increases NO production and inhibits at least some viruses, so that's at least potentially a better way to go.

[PTMAN]

slowandsteady,
Thands for weighing in. This is a very interesting topic for me, as I believe this discussion could lead to a helpful adjunct treatment, or at least the possibility. To me, that's what this forum is here for.
If I'm understanding the lingo correctly, iNOS leads to NO, which in turn controls fibroblast activity, which forms the collagen that peyronie's plaque is made of. If for some reason the precursers of NO become depleted, collagen derived plaques develope =>(peyronie's disease). The information in this article does not go so far as to theorize that drastic increase of NO would degrade the plaques, but others that I have read have. It states something to the effect of "allowing for uptake of fibrotic plaque by the body and replacement with more normal elastic tissue."  Wish I had saved the article as I'm finding it difficult to find again! But I know what I read. This is all contengent upon my being right about this information:

(Myofibroblasts are present in the fibrotic plaque of the tunica albuginea (TA) of the penis in men with Peyronie's disease (Peyronies Disease), a localized fibrosis that is accompanied by a spontaneous induction of the inducible nitric oxide synthase (iNOS), also observed in the TGF1-elicited, Peyronies Disease-like lesion in the rat model. iNOS expression counteracts fibrosis, by producing nitric oxide (NO) that reduces collagen deposition in part by neutralization of profibrotic reactive oxygen species.)

In doing research on this disease, and treatments for it, low and behold I found out that the mechanism for at least 2 drugs (probably more) was production of NO!      1.) Trental     2.) L-Arginine
Seems to support my theory, doesn't it? I really think this is important. Can someone tell me if I'm on base or off...
thanks P.T.

[skunkworks]

On Trental:

The mechanism is not fully understood; pentox blocks the transforming growth factor (TGF) B1- mediated pathway of inflammation, prevents deposition of collagen type 1, and acts as a nonspecific (PDE) inhibitor.

[slowandsteady]

PTMAN, see this post of mine.

[rockwall]

This is my first post on this forum although I have been lurking for years even back to the old BTC forum.

Some have already noted this Brazilian study that is currently underway.
I contacted the doctor conducting this study to determine if this infrared treatment was efficatious in his oppinion.

His Reply

"Thanks for your email.

I can assure you that this treatment really cure Peyronie's disease, but it is a long process (at least 2 or more years) of daily treatment. But infortunately infrared lamp alone does not work as well as the combined therapy. I have made some amendments to the protocol existing in the internet. In fact I have increased the goal to be reached in testosterone level to the highest normal level in order to have best results and the same with vit D levels.
I think that I you really wish to carry out this treatment you can send to me your lab exams, some photographs of your penis during erection ( from a lateral view and from above to measure the curvature in both perspectives) and also an echography of your penis to measure the size of plaques. You may also have to not fulfil the exclusion criteria already stated and you will have to consult an urologist to examine your prostate (rectal exam and prostate echography) .  

You can also write to Prof. Abraham Morgentaler from Harvard University ([email protected]) asking him if he will accept to participate in my trial because you are not the only suffer of Peyronie's disease from USA who sent to me emails seeking help.

I hope I could help you more

Sincerely

Carlos C. Cusmanich, MD"

Best to all,
Rockwall

[ohno]

Good work!! Does anyone know the best kind of vitamin D to take?

[pichou]

The best Vitamin D To Take is Vitamin D3

[despise]

I really am confident that Hyperthermia treatment works, only because i have seen what it does. I need to find out how many degrees my hot bath is coming out to because i don't want to cause any tissue damage. Are there baths that can get so hot that its dangerous? I live in a hotel so im hoping that wouldn't be that case.

[skunkworks]

I think you should all read the hyperthermia studies very closely. Tissue necrosis sets in quite quickly at certain temps.

[despise]

kk read it all. I found my themometer and the heat of the baths I have been taking are over 110 ferehnheit. The themometer wouldn't show me how much because it would just stop after 110. I haven't felt any pain or anything but now I'm worried ive already caused cell damage.

[nemo]

I would not be worried about your bath.  I too tried hyperthermia a couple years ago and then freaked out because I read those studies warning about not going above 105 degrees.  I tested the rice sock I was using and it was hotter than that, so I freaked out thinking my weiner was going to fall off or something.  

Truth be told, I don't believe a hot bath is going to do you any harm - and if it were so hot as to do you harm, it would hurt like hell and you'd never get into it or jump out of it immediately.  A burn is a burn, and if your skin is not showing signs of a burn, I don't think you have anything to worry about.

Nemo

[skunkworks]

I think it would be idiotic to risk further harm to an already damaged part of your body.

Despise in particular, you need to take more care. If your baths are over 110 you are risking permanent cell damage.

This study used temperature between 102 - 104 degrees F.  The researchers conclude temperatures of 107.6 degrees F are safe for limited periods but stress that temperatures of just 113 degrees F can result in irreversible cell damage.

https://www.peyroniesforum.net/index.php/topic,915.msg13542.html#msg13542

[slowandsteady]

Does temperature hot enough to cause damage really hurt, or do you really have to measure to be safe?

[Fred22]

On the other hand, some viruses need relatively much l-arginine for reproduction, so taking too much l-arginine might not always be helpful.

For example, if one has genital herpes, l-arginine is not recommended as it may contribute to causing an outbreak.
Fred

[PTMAN]

O.K., I'm finally back! Sorry it took so long. I've been really busy with work, family, etc...
Thanks to all for weighing in.
I promised I would get to the point, and tonight's the night
It seems the consensus here is that N.O. is a good thing for Peyronie's Disease, especially for stopping further plaque from developing. My question is still, will it "denature" or "disolve" the plaque that has already formed? If I'm understanding all the info I've read out there on the net, the answer is yes.
The reason for my intense interest in this question is this. I have access to a machine used in Physical Therapy called Anodyne Therapy. Google it if you want. The way it works is that a 3" by 4" pad is placed on the skin which shines infrared light into the deeper tissue. The light forces these tissues to release their stored up N.O.  
Local N.O. content is thereby greatly increased for a period of time (several hours or days, depending where you read). I have had much success with this treatment on diabetic feet and lower legs with restoring sensation lost to neuropathy. The action is again, increasing nitric oxide production locally.
An added benefit is local vasodilation for a period of hours, improving circulation.
I've been mulling this topic in my mind for some months now.
Surely the answer, or "magic bullet", hasn't been within my reach all this time?
Now I must decide- will the treatment make my Peyronie's worse?
If not, will I choose to "experiment" on myself?
I read where someone else on the forum tried to use an Infrared light bulb on himself, but found the heat produced to be prohibitive. He was doing the best he could with what he had.
The Anodyne people have solved this problem, as the pads have rows and rows of small infrared bulbs, and a control knob to set intensity. A small amount of heat is released as a byproduct, but is not the intended mechanism. I will try to find some info on the net and post here for your convenience.
Please respond if you have thoughts on this topic, either positive or negative.
As you can tell, I'm pretty stoked about the prospects.             Thanks, PTMAN

[PTMAN]

Promised some web info... Here's some


Anodyne Therapy



Anodyne therapy is a unique light therapy used for the treatment of pain. This infrared therapy effectively brings pain relief without the use of drugs and is non-invasive. It does this by harnessing the healing power of infrared light. Infrared light emits wave lengths of energy and it can penetrate up to 5cm into the body.




This monochromatic infra-red photo-thermal energy improves circulation to nerves and tissues in the area where the treatment pads are placed and so reduces neuropathic pain, stiffness, muscle spasms and areas of chronic pain.

The key to the dramatic improvement in blood flow with Anodyne light therapy is Nitric Oxide. The infrared light therapy helps the body to release this gas from the blood cells. Nitric Oxide gas is the body's most powerful vasodilator and also known to be one of the main pain relieving ingredients in pain medications such as morphine. Nitric Oxide molecules relax the arteries, help regulate blood pressure, fights free radicals, and discourages platelets from clumping together in the blood vessels. By increasing the production of nitric oxide and improving circulation, Anodyne therapy relieves pain.

The Anodyne treatment system is simple and painless. Four flexible pads, each containing 60 small infrared lights, are placed directly on the skin over the area of pain or injury. Therapy pads are flexible so they can fit the shape of parts of the body. The pad is in direct contact with the skin so the light can be better absorbed by the skin. Energy from the lights penetrates beneath the skin and is absorbed by deep tissue causing the body to release nitric oxide, making the blood vessels become larger. After just 30 minutes of treatment, blood flow is enhanced by 400 percent, and this boost in local circulation persists for several hours after the pads are removed.

Anodyne light therapy provides a painless, non - invasive treatment for anyone where an increase in circulation would help with relief of pain and inflammation or a condition characterized by poor circulation

It is fast becoming a popular treatments for diabetic peripheral neuropathy and a wide variety of other clinical conditions such as fibromyalgia, carpal tunnel syndrome, strains and sprains, and wounds of any nature. Anodyne infrared therapy is used by the US military to treat elite soldiers in the Navy SEALs, Army Rangers, and Special Forces. Hospitals and nursing homes use it to relieve most any kind of chronic pain. Anodyne therapy can be used during occupational therapy treatments to make other therapy more bearable, such as improving strength, flexibility, movement and function.

The manufacturer also emphasizes that Anodyne Therapy has been clinically proven to increase local microcirculation and reduce pain. It says there are several clinical studies that demonstrate significant clinical outcomes including restoration of protective sensation in patients with diabetic peripheral neuropathy, pain reduction, increased nerve conduction and faster healing of diabetic ulcers and other chronic wounds.


Interesting, no?

[PTMAN]

Here's some more...


Anodyne Therapy works as a non-invasive, drug-free method to increase local circulation to nerves and tissues and reduce neuropathic pain. Treatment in Anodyne Neuropathy Care Centers® is reimbursed by most private insurance companies and Medicare. Patients may be able to get a home system through their insurance or Medicare if they have objective improvement in their condition after a clinical course of treatment.

Anodyne Therapy works by using monochromatic infrared energy (MIRE) to release nitric oxide from the patient's red blood cells. This improves nerve function and is important for making new blood vessels and healing wounds. It is reported that "low levels of nitric oxide are common in people with diabetes and are a major factor in the poor circulation, loss of sensation, chronic falls, foot ulcers and pain of diabetic peripheral neuropathy."

The manufacturer also emphasizes that Anodyne Therapy has been clinically proven to increase local microcirculation and reduce pain. It says there are several clinical studies that demonstrate significant clinical outcomes including restoration of protective sensation in patients with diabetic peripheral neuropathy, pain reduction, increased nerve conduction and faster healing of diabetic ulcers and other chronic wounds. Podiatrists also tout the product's benefits.

The Anodyne Therapy works by using a device - a box with eight pads. The light from the diodes on the pads is absorbed by hemoglobin in the blood, causing the release of nitric oxide. Nitric Oxide causes dilation of the blood vessels and increases blood flow to the affected area. Ultimately, the treatment can help form new blood vessels in the treated area, allowing the wound to heal faster.


THERE'S THAT NITRIC OXIDE THING AGAIN

[ohno]

I've been using a heating pad (thermotex infrared) for about 2 months (in conjunction with traction -4 hours a day, pentox and arginine and vitamin d) and have seen limited improvement but time is of course the issue here. I would like to try this anodyne treatment. Do you know if it is available to the public and what the cost might be - I looked at their site and it didn't seem like they sell to the public. Thanks and good luck.

[George999]

I would like to try this anodyne treatment. Do you know if it is available to the public and what the cost might be - I looked at their site and it didn't seem like they sell to the public. Thanks and good luck.

This looks VERY interesting to me, I really think it just might be useful, but   ->$$$$$$$

Certainly worth it of course if it works, but I think this time I will let someone else do the test drive.  - George

[rockwall]

In the Anodyne home model procedure manual it states "Anodyne is much easier to use than earlier forms of infrared and,
unlike traditional infrared (which can be placed no closer than
twelve inches from the skin without burns), Anodyne is designed
to be placed in direct contact with the skin without serious risk
of burns, if used properly in accordance with the Instructions
for Use."
Traditional infrared I would assume to be a heat lamp. I purchased mine at Home depot for about $25. Fairly aggressive daily treatment for 30-40 min per session on both my hand and penis for 3-weeks has not apparently burned me yet. And for the big question. I think it is helping slightly especially with the Dupuyren"s but it is only three weeks and the Brazilian Doctor who has a current trial using this method said that he assures me that it works but, it takes 2+ years. I am hoping for progress in the interim.
I agree with George if the price is not listed I probably can't afford it.

Rockwall

[George999]

I agree with George if the price is not listed I probably can't afford it.

Rockwall

Actually, those $$$$$$$ are a hidden link to the price ...  - George

[hb]

I found a web site that sells a home system. The prices vary from $597 to $1399. The Freedom 300 Model at $597 should be adequate.

[Fred22]

I found a web site that sells a home system. The prices vary from $597 to $1399. The Freedom 300 Model at $597 should be adequate.

If you decide to get it, keep us posted.  This sounds interesting to me.

Fred