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BMJ 2006; 333 doi: (Published 03 August 2006) Cite this as: BMJ 2006;333:295
  1. Alison Tonks (, associate editor

    Learning from Lance Armstrong: heat treatments for cancer

    After cyclist Lance Armstrong survived advanced metastatic testicular cancer he went on to become one of the world's most successful athletes. Many others have also made dramatic recoveries from testicular cancer when, stage for stage, tumours from any other site would have killed them. What makes testicular cancer so easy to treat? One theory is that testicular cancer cells, like normal testicular germ cells, are very sensitive to heat. Once they spread inside the body away from the cooling protection of the scrotum, the cancer cells become weaker and potentially more sensitive to cancer treatments such as radiation or cytotoxic chemotherapy.

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    Credit: SIPA/REX

    The theory, otherwise known as the Lance Armstrong effect, is certainly biologically plausible, according to three cancer scientists from the United States. Heat is an important regulator in many biological systems, including cancers, although heat treatments have always been impracticable because of the potential for collateral damage. Now technologies are at last emerging that could help bring thermal therapy for cancer within reach, write the scientists. One of them uses nanoparticles filled with magnetic iron that can be heated up with an external magnetic field once they reach their target. The hope is that thermal therapy will make cancer cells more vulnerable to established treatments including immunotherapy, thereby extending the remarkable Lance Armstrong effect to patients with other disseminated tumours.

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    Credit: JAMA

    Faulty cardiac devices are often best left alone

    About two million people worldwide have an implantable cardiac device such as a pacemaker or cardioverter defibrillator. Defects noticed after marketing have led to recalls or warnings affecting about 200 000 of the devices. Few data exist on what happens to people with defective devices, so researchers are reduced to guesswork and mathematical modelling to help them decide whether to risk replacing the devices.

    The latest study concludes that it's often safer to leave well …

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