Dr. Joseph Pinzone: Revolutionizing Cancer Treatment Through The Power of Hyperthermia Therapy

WELCOME TO EPISODE 204

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EPISODE TRANSCRIPT 

Freddie Kimmel (00:01.023)
Ladies and gentlemen, welcome to the beautifully broken podcast. I am sitting here, not in the same room. I'm in Austin, Texas. I believe Dr. Joseph Pinzone is in California, if that's correct. Welcome to the show.

Dr. Joseph Pinzone (00:11.79)
that correct. Thank you very much for having me on.

Freddie Kimmel (00:15.647)
Yeah, what a tree I've, I've, I'm going to do this. Pretend I'm walking down the street. We bump into each other and, and we start introducing, I'm like, Freddie, I do podcasting. I'm an advocate for wellness and healing technologies. Dr. Pinzone, what do you do?

Dr. Joseph Pinzone (00:32.43)
So one of the things I do among many is I help patients who are living with cancer to improve the traditional treatments that they might be given. And I do that through employing a modality called hyperthermia.

Freddie Kimmel (00:52.319)
beautiful. And if you had to explain again to the layman, what is hyperthermia?

Dr. Joseph Pinzone (00:58.35)
Well, you know, it's interesting because in this country you do have to specify the type of hyperthermia and what I mean by that is we have an FDA approved device that delivers local regional hyperthermia meaning that we target particular tumor so it's local therapy doesn't treat the whole body. It's not whole body hyperthermia. I'm not aware of

that actually existing in the same way that I would treat somebody and I'll explain that as we go. And basically what we do is we use ultrasound and it has the same physics as diagnostic ultrasound. So the reason you probably have never heard of somebody having an ultrasound of the lung is as soon as you hit air, an ultrasound wave will stop. Similarly, you can't really get an ultrasound of the brain because bone would have that

bounce off. In our case, bone is a heat sink. We don't go through air, but we could treat every other part of the body with hyperthermia. And so that's breast cancer, prostate cancer, colon cancer, head and neck cancer. The list goes on and on and on and on. So our device is FDA approved to treat all solid tumors in combination with chemotherapy or radiation therapy. And the mechanism is fascinating. So we're not burning anything.

We are leveraging the ability to change physiology with fever or in this case, slightly over the fever threshold of heat. So just to give you an idea, when we apply our device over a particular body part that has a tumor below the skin or on the skin for that matter, we aim to heat that tumor

to 106 to 109 degrees, okay? And 41 to 43 Celsius. And when we do that, something very interesting happens. It increases the blood flow. Now, why would that be important? Because cancer is very dichotomous. So if you were to take any given cancer cell, it might actually be pretty fragile, but...

Dr. Joseph Pinzone (03:28.046)
cancer is like evolution in a bottle infused with lightning. It just, those cells just mutate, right? So if I took a small little tumor and I did a hundred biopsies and I did a genomic analysis, what genes are, you know, expressed and some of which may of course be different than normal cells, cancer cells, they would actually be different in the hundred biopsies, overlapping granted, but a little bit different. And so the point is cancer has so many different facets to it.

that it's not a normal, it's not like creating an organ. So what happens is when cancer creates blood vessels as it has to, it doesn't do it really well. And so the walls of the blood vessels are very, very porous. They're not a good integrity. And so they collapse, particularly at the center of the tumor.

On imaging, sometimes you get central necrosis, meaning the center of the tumor dies. But often enough, you get a mutational pressure that allows those cancer cells to live at a low oxygen environment. So now you've got a haven where some of the stem cells can live. They can't really get penetrated well by chemotherapy. And radiation uses oxygen.

to damage DNA. That's a major way radiation works. Yes, it definitely the energy of the radiation does some cell killing while the patient's on the radiation table, but so much of it occurs after the radiation. So here's how we work. I'm going to do it as a 1A, 1B, and then a 2 and a 3 in terms of mechans. So 1A and 1B are based on the same physical principle, which is we increase blood flow. And a lot of people think, that's

can't be good. Well, those cells, remember, they don't really like oxygen anymore. A. B. It's very hard to get the chemo penetrated into that portion of the tumor, that is the center of the tumor. So when we do that, while somebody's getting chemotherapy, we get more of the chemotherapy to enter the center of the tumor. That's a good thing. So that's one A. One B.

Dr. Joseph Pinzone (05:51.854)
same principle, increase the blood flow while someone's getting radiation. I'm just doing A and B because it's chemo versus radiation. So we radiosensitize. Translation of that is we make radiation work better. So once the radiation, and many types of chemo as well, but radiation for sure, a major way that it works, as I mentioned, is it takes oxygen, it creates oxygen -free radicals on DNA, and now you've got damaged DNA.

Freddie Kimmel (05:59.455)
Mm -hmm.

Dr. Joseph Pinzone (06:21.198)
Granted people will often ask doesn't radiation doesn't chemo do that to normal cells in some cases it does it Preferentially does it to cells that are already a bit broken that are already dividing very quickly, right? So now that you've got the damaged DNA whether it's from radiation or whether it's in chemotherapy You're in a race to be able to get those cells to try to divide

because if they divide while the DNA is broken, okay, then they're gonna go into apoptosis, which is programmed cell death. But every cell in our body has the ability to repair DNA. If it didn't, we'd all get cancer in the first week of life. So even cancer cells can repair DNA. So mechanism number two is heat slows the enzymatic repair of the DNA, okay?

Freddie Kimmel (06:52.415)
Mm -hmm.

Dr. Joseph Pinzone (07:17.39)
And then mechanism number three is a bit of a head fake. So here's where you've got a fully accepted Western, I say fully accepted, not everybody accepts it, but it's FDA approved. It's typically paid for by insurance. People are just not aware. Okay. That's why we're doing this. And we don't even really understand a lot of that exists, how it works. So that's what we're going through now.

So you can consider that a biohack. And I know people like that word. And it's fine with me. It's no problem. Because this next one, the third one, is really a headache. So basically what we're doing is we're heating a tumor and we're giving it the equivalent of a fever. So now you've got heat shock proteins. Their name tells it all. So they will be secreted.

in the case of a fever or in the case of external heat. Now, we're not talking heat on the skin. If you have a melanoma, sure, that counts, heating the skin. But your skin's a really good insulator. So for us to get down 10 centimeters, we go right through fat. So it doesn't even include the fat. But 10 centimeters, which is almost four inches, right between three and four inches. We are getting very deep into the body, much deeper than you can by just sitting in a bath or anything like that.

Freddie Kimmel (08:18.207)
Mm -hmm.

Dr. Joseph Pinzone (08:44.878)
And when you give that part of the body a fever and you get the heat shock proteins that are secreted, then all of a sudden it stimulates the immune system. And the immune system has to be very specific in certain kinds of infections and in the case of cancer. So now you've got dendritic cells, part of the immune system, among other antigen presenting cells, taking these mutated proteins and showing them.

This is an active process. It happens in infection too, right? Showing them to T cells. So now the T cells can go back and attack the tumor. Now, all of what I just said sounds good on paper, but like everything else, there's no guarantees. I have seen this work incredibly well. We have hundreds upon hundreds of studies that have demonstrated the efficacy. And I can quote you some of the data as we go along in our talk, but I wanted to make sure we got the

Freddie Kimmel (09:29.567)
Mm -hmm.

Dr. Joseph Pinzone (09:43.086)
full answer to your question about what is the mechanism. Pretty well worked out. We got those three mechanisms and they're really cool. And when they work, man, we hit it out of the park.

Freddie Kimmel (09:55.231)
That's incredible. I, you know, I had no idea that it was a spot treatment in my understanding from my experience of hyperthermia. We hear about, especially, Switzerland has a few centers. I've had friends do whole body hyperthermia for autoimmunity and severe Lyme disease in which the infection had crossed the blood brain barrier, neurological symptoms. And it was, man, when they would tell me the story of them trying to withstand.

this therapy and cool packs in different areas so they could remain cognizant and just suffer through it. I was like, wow, this is a feat. This sounds much better and much more accessible.

Dr. Joseph Pinzone (10:36.43)
Well, you know, it's very interesting that you should say that. So here's the thing. There. To my understanding, the only FDA approved hyperthermia in this country is local regional hyperthermia. And we have one of the devices that that is FDA approved. The deal with whole body hyperthermia is it's a fascinating concept. So let me go through it. In this day and age, there's no place that I'm aware of.

that does that in this country. And I say it that way because I have also heard various stories of people having their body temperature raise, right? So it depends what you think the sweet spot is. And, you know, it's been fairly well defined in cancer that 106 to 109. So you really can't survive very long if that were the case, right? Doesn't mean you can't get to fever temperatures as dangerous as that might be. But

Freddie Kimmel (11:26.783)
Yeah.

Dr. Joseph Pinzone (11:33.71)
If we do harken back to William B. Coley, okay, he was a surgeon in New York in the late 1800s and the early part of the 20th century. They still have the William B. Coley award because he created the first cancer vaccine. So let me tell you about whole body hypothermia. It's not done anymore, okay, but he noticed a young girl with sarcoma.

a type of cancer, not a common type, but a type of which there are many subtypes. And she contracted a strep infection called erycipolis. And correlation does not always mean causation, but he noticed that her cancer regressed, not just the one area, but multiple areas. And there are documentations back

in the time of patients getting very, very serious infections when they were before antibiotics, you know, the 17th, 18th century smallpox, for example, you might be febrile 205 for three weeks. And if you were lucky enough to survive, what was noted back then is a very small percentage of people who had tumors that they know scans of what's called breast cancer or something that you could help it. Very small percentage.

Freddie Kimmel (12:56.191)
Mm -hmm.

Dr. Joseph Pinzone (13:03.598)
had regression total or partial, temporary or permanent, but it was there and it was undeniable. Now nobody knew what to do with it. Coley took it and then started injecting streptococcus into the tumor. Now he quickly realized probably better not to give someone erycimplous because they don't always do so well. So he killed the streptococcus, combined it with a bacterium known today as Neisseria, he's called something else back then.

Freddie Kimmel (13:06.591)
Mm -hmm.

Freddie Kimmel (13:11.871)
Yeah.

Dr. Joseph Pinzone (13:32.75)
gram positive, gram negative, put them together, those heat killed strings, and that was the first cancer vaccine. And when he passed in 19, I think it was 36, it sort of just never got revived, but he got probably a 50 % durable, I mean, 10 year response rate where the tumor that he injected as well as the metastasis, that's called an abscopal effect, Latin for away from the scope, right?

Freddie Kimmel (13:39.967)
Wow.

Dr. Joseph Pinzone (14:01.838)
they regressed. It was absolutely astounding. And in those situations, it was probably a combination of the immune reaction against the bug and the durable fever that people got. So now what we do is we leverage the fever part of it and we leverage it in a local way.

Freddie Kimmel (14:10.815)
Mm -hmm.

Yeah.

Freddie Kimmel (14:18.847)
Yeah, it's so fascinating. You know, every time I have these conversations, I'm reminded of the systems within the body that allow for the body to fight cancer, which already exists, which we're seeing that these treatments aren't necessarily what we could theorize or build a working theory. Are they doing the work? Are they doing the magic or is it the body's fever that's really activating a terrain in which the body can have a better battle against this tumor, the cancer. Are you aware of the

God, I think it's G207. It's an oncolytic virus, which means it's an engineered virus to target cancer cells ignoring healthy cells. So this is something I think it's a derivative of the herpes virus in which it's been used in certain brain cancers, correct?

Dr. Joseph Pinzone (15:02.99)
You know, I have a vague notion of what you're talking about, but I don't know a lot about it. So just in full disclosure to everybody here, I have, I'm an internal medicine doctor and I have a subspecialty in endocrinology. Now, I'm the primary doctor for endocrine tumors, much like an urologist might be for prostate cancer, until let's say, you know, those things, God forbid, get metastasized, then they do, patients do end up going to oncologists.

Freddie Kimmel (15:23.071)
Mm -hmm.

Dr. Joseph Pinzone (15:29.838)
But I ran an NIH funded lab in breast cancer. So I know a lot about tumor biology, but I don't know the ins and outs of oncology like an oncologist would, and I don't practice oncology by any means. But that's an important, but what you're quoting is we have so many things on the horizon that are allowing us to really understand how do we leverage the body's

Freddie Kimmel (15:40.991)
Yeah, great, great disclaimer.

Dr. Joseph Pinzone (15:59.47)
own systems to be able to attack the cancer. That's what the new immunotherapies are about, right? And they don't work on typically, I'm not an expert and I'm not an oncologist, remind people of what I just said. But my understanding is they don't really work on a large percentage of people in many cancers. But when they work, where they really work, you have to be susceptible. But let me answer your question about

can we leverage the body's own system, right? Now, we all know the story through various people of notoriety that testicular cancer is pretty darn curable. 100%, nothing's 100%, but it's pretty curable. Well, the testes live a few degrees below what the body temperature is, right? That's why the scrotum is there. So it's almost an auto

Freddie Kimmel (16:47.711)
Yeah.

Dr. Joseph Pinzone (16:58.478)
hypothermia when those tumors invade the inside of the body because now they're living at 97 .6 degrees okay and so they're they're they're living at or excuse me 98 .6 degrees 37 degrees Celsius right and you know average temperature and so that's higher than testicular cells normally live at in the scrotum right that's the whole idea of keeping them away from the body.

Freddie Kimmel (17:08.959)
Hmm

Freddie Kimmel (17:26.591)
Mmm.

Dr. Joseph Pinzone (17:28.238)
So now they're exquisitely sensitive to chemotherapy and they're living in an environment that's higher in temperature than they would normally live in. So it's very difficult to look at correlation and causation, but reasonable evidence to say, that's really interesting. There may be something to that differential of temperature.

that makes those testicular cancer cells more sensitive to chemo because they live in a higher temperature environment. We don't know for sure.

Freddie Kimmel (18:03.487)
Yeah. Yeah. So, you know, having gone through testicular cancer and etaposides as platin treatment myself with a retro peritoneal lymph node dissection, it is fascinating. It's also fascinating because before they had that combo of chemo, it was a terrible diagnosis, you know, early seventies because it's such a rapidly progressing cancer. Does that happen to your point? Because all of a sudden we're in this perfect Petri dish, you know, that's a

Dr. Joseph Pinzone (18:09.134)
Yeah. Yeah.

Freddie Kimmel (18:30.751)
better temperature than where the testicle cell normally existed. Really fascinating.

Dr. Joseph Pinzone (18:35.822)
Right, and so just the same as our modality, hyperthermia, is meant to improve the efficacy, the effectiveness of chemotherapy, of radiation therapy, we don't use hyper, you know, in general we don't use hyperthermia alone, but boy it does often, I have to use that word because there's no 100%, nobody should be making any

Promises in medicine, that's not a good sign. No, no. No, no, no. And your doctor shouldn't do it either. And you shouldn't walk away with that even if you do. But again, we really facilitate the entry of the chemo. We facilitate the damage of the DNA that's meant to happen with the, I'm so sorry, yeah, with the radiation.

Freddie Kimmel (19:05.919)
Never. Yeah, we don't do that here.

Freddie Kimmel (19:31.487)
No, it's okay.

Yeah. Yeah. No, it's fine. It was looking, I got like a hundred different ways for people to get a hold of me here. I put everything on, I put everything on do not disturb. But I love it. Technology always gets its way in. I want to look at this idea of this localized treatment in the body. Can you give me a scope of what that would look like? Are there limitations? I know we've said, maybe we didn't say this, but from my understanding, this is a solid tumor.

Dr. Joseph Pinzone (19:42.83)
Yeah.

Freddie Kimmel (20:02.111)
therapy. This does not work on a blood cancer or leukemia. Is that true?

Dr. Joseph Pinzone (20:06.19)
Correct. Yes, leukemia or lymphoma, there's a reason for that. So those cancers are by definition systemic. Now, someone might argue look stage four cancer, you know, that's systemic as well, your local therapy. But you have a target, you have a collection of cells, you kind of have that lymphoma too, but it just never worked out that we are, we're FDA approved just in solid tumors. You're absolutely right.

Freddie Kimmel (20:20.095)
Mm -hmm.

Dr. Joseph Pinzone (20:35.726)
And it gives us a good solid target to aim at. And it also, look, if you've got early stage cancer, let's do everything we can. You got one shot to get rid of it. If it comes back, I'm not saying that you can't get rid of it, but it's typically much harder because cancer continues to mutate with time, right? So really, if you got curable cancer, the idea is to try to cure it the first shot, of course. I mean, it goes without saying, but it is really critically important.

Freddie Kimmel (20:35.903)
Okay.

Freddie Kimmel (20:55.711)
Mm -hmm.

Dr. Joseph Pinzone (21:04.046)
If you have stage four cancer, take the other extreme, you know, we can still be very useful to you because for example, people get, you know, many, many, many liver metastases. Well, you can't live without a liver. So, you know, again, we're, we're part of the solution. Cancer right now, we're still, you know, except for some very specific targeted therapies like you were alluding to with oncolytic viruses, with

targeted therapy that targets specific molecular pathways, right? I think 50 years from now medical students are going to look at their, you know, attending doctors and say, did we really do surgery for cancer? Right? Because what's going to happen, you know, the, the bio equivalent of Moore's law, my understanding is, I mean, you could argue this either way, but it seems to be accelerating faster. So once we start to be able to genotype on a regular basis and

we understand what mutations are actionable and we have more tools because we're now being able to create through technology, AI funded or AI based technologies, we're able to improve our ability to create targeted molecules that will target that aberrant pathway. We can then start to stack therapies. We can have some AI algorithms. Say you could use

this, this, this, this, this, then you're going to anticipate this mutation, this, this, this, this, you're done. We don't have that right now for most cancers. And for, you know, we have standard of care, which is where we're at. I mean, it works, but it's on a continuum, right? It works better in some people and not as well in others.

Freddie Kimmel (22:34.687)
Mm -hmm.

Yeah.

Freddie Kimmel (22:49.439)
Yeah. As you said at the beginning of the podcast, we put a hundred people in the room with the same type of cancer and we look at that tumor and the variables, the bio individuality, the cancer is very, very different. So again, I like this idea of, I'm very drawn to the idea of supporting the body systems and supporting the terrain. If it are there limitations, with this treatment in a solid tumor as in.

the number of metastases, like how much time can you spend on a body? And maybe even another follow -up question would be, what would it look like for someone to incorporate this treatment into their cancer journey?

Dr. Joseph Pinzone (23:30.67)
Yeah, so I look at it as thinking about how best when the patient and I together create a treatment plan, my approach is very straightforward. And that is I'm the recommender, they are the boss. Having said that, as much as I want and need them to be comfortable, I also have to be comfortable. So.

I have the luxury of having a good amount of time to spend with people. We have a good back and forth. Hyperthermia has a very favorable adverse effect profile. I mean, we're heating to just above fever temperatures. We don't heat enough to get a third degree burn. Have I seen blisters? Yes, they occur very unusually. Do sometimes people get some bone pain if we're over a bone? Sure. Do they have, you know, some warmth?

Afterwards, yes, do we get one off things that happen? Sure. But basically it's a gentle therapy among the types of therapies that people are getting. And so we're not so much limited in that. What we're limited in is a few things. Number one, does insurance pay for it? Usually, yes. If not, it's not an inexpensive therapy. So that's one thing to think about. Number two, pretty time intensive.

So some of the early studies vary in terms of how they were done because early on this modality was given over to radiation oncology departments. And that's not a bad thing, but early on people, the radiation oncologists needed to understand it. So the way they understand things with a physics mindset is they were often put probes inside the body. We don't do that anymore. We measure skin temperature and we have, you know, different algorithms to know

reasonably well how much we're heating at depth. So it's a little bit different. But the point is a lot of the studies were done twice a week. Some of the studies were done, you know, every time you get radiation, you get hyperthermia. So we really create a treatment plan. And what I find is that the more people do hyperthermia, the better the outcome typically. And again, that's going to be

Freddie Kimmel (25:31.166)
Mm -hmm.

Dr. Joseph Pinzone (25:56.174)
a little bit variable in terms of how the studies were done. So we're very time intensive and it takes about an hour to do one to do a treatment. And so we really want to be able to treat you as a patient through your radiation therapy, potentially somewhat beyond. And I'm very upfront with people because there's no specific data that says you should treat beyond. But remember,

that DNA, if it is not dividing and it gets repaired, you've got a problem because it's not going to go into apoptosis. So radiation therapy usually is maybe a month, sometimes it's only five days. Chemotherapy can last for months. So if somebody lives around the corner and they have free time or they make free time and their insurance covers it, okay, those limitations, we can certainly overcome them.

And I always talk to patients as though they live around the corner, fully acknowledging, I don't waste people's time, I don't waste people's money, I give them all the data. We create the plan that's practical for them. And so the reason that I'm going through all this ad nauseum is because it brings up the idea of can we treat different metastases? So I would say we are beholden to the underlying therapy. If that's working,

we have a good chance of making it work better. Okay. If it's not working, we're probably not going to be able to in and of ourselves, in and of our own therapy, help the patient. The reason I bring that up is because roughly, and we've not studied this, we don't do studies, we're a clinic. Okay. We're not involved in studies at the moment. There are other places that are, there are many places that were early on in the eighties and nineties and early two thousands. And they continue on by the way. but

I have personally seen various people in whom we have pretty substantial evidence that we're helping them and we're hit a home run. So I'll give you two examples, okay? Three examples. So number one, we had a woman with breast cancer and she got neoadjuvant, meaning before surgery, chemotherapy. And she had the breast cancer and there was

Dr. Joseph Pinzone (28:19.438)
possibly some lymph node involvement and it was a left -sided breast cancer left -sided lymph nodes. So we just treated the breast because we weren't sure if the left -sided lymph nodes were involved. The breast tumor went away with chemo. Again, the bulk of the credit goes to the underlying therapy. We're there to help. But her lymph nodes popped up. We then switched to hyperthermia after probably a month and a half.

to the lymph nodes and those disappear. That's pretty good evidence that we help that patient. That's not a typical result. Example number two, we had a gentleman with stage three rectal cancer. And so insurance typically will pay for one treatment per day. Well, this gentleman decided that it was in his best interest to pay for two treatments per day. And he did it throughout the

four months of neoadjuvant chemotherapy. And the reason he did two treatments is because he had a lymph node that was right in the middle of his body, right below his belly button, between his belly button and his back. And because we treated the rectum, that was the main area that he had the tumor, that was the only other visible part that he had. He had 10 ,000 cells in a lymph node somewhere. And the chemo was doing the systemic work. Again, bulk of the credit goes to the chemo.

But nonetheless, he got to the point where he avoided a life changing operation. I mean, he had the operation mind you, but he avoided a life changing operation of the tumor was so small, they didn't have to sacrifice much of the rectum. So he remained continent, which was really, really important to him. So that's another example. And the last example is we had a lady with HER2 positive breast cancer. So she had tried Perceptin.

then her septum plus progeta, then cad sila. All her two aimed therapies. They worked and then they didn't work. She was referred from a radiation oncologist because she had an open chest wound, a chest wall recurrence. That's where we have really good data in breast cancer. Now she also had a liver lesion, she also had a bone lesion. So we treated for about three months. With the okay of her radiation oncologist, she came to me and said, Dr. Alexander, I really want to try this last

Dr. Joseph Pinzone (30:46.062)
her to therapy called and hurts you. So I said, look, we got to talk to radiation oncologist. We talked to radiation oncologist. she said, sure, go for it. We tried it. Chest wall came to normal skin, normal skin. When just before it was normal skin, we realized that the liver lesion was shrinking. So again, we're not claiming magic. We're just, you know, so we switched to liver, got rid of that. Nothing seemed to be touching the bone. So we,

after about a month and a half went to the bone. Again, this lady really did live, not right around the corner, but live in commuting distance, right? So after about a year of treatment, I know this sounds quite something, she went from stage four disease to no evidence of disease. Okay. She then came less frequently, stayed on the in her two, and then she outlived the in her two studies. So they didn't know what to do with the in her two. They

Freddie Kimmel (31:31.455)
Mm -hmm.

Dr. Joseph Pinzone (31:44.43)
gave it less frequently. They wanted her to stay on a dad nauseam. At some point she cut it off. She said, look, I gotta just be me if it comes back, it comes back to this day and we've not heard back from her. And this was a couple of years ago. So I mean, again, sure. Could it, you can't separate two therapies. Could it evolve in the end her tube? It's possible. She had tried three other regimens that target her two before. So again, I think, and again, that's not typical results, but it's so cool.

Freddie Kimmel (32:06.591)
Yeah.

Dr. Joseph Pinzone (32:13.934)
So, you know.

Freddie Kimmel (32:14.303)
Yeah. Well, I'm just, again, I'm reminded of the extremely small, if non -existent adverse reaction list. So if it's something that we can possibly get some coverage for, again, if the time is, if the person can manage being at the center physically, I don't understand why people wouldn't do that. How do you, do you plan to open other centers in the United States? Cause right now there's just one, correct?

Dr. Joseph Pinzone (32:32.59)
huh. huh.

Dr. Joseph Pinzone (32:43.822)
There's two actually we just yes I'm seeing in my fairly newly opened within the last six months center in Irvine California we have our initial one in Santa Monica and and we have a second one in Irvine. Our plan is to open more centers and there are a number of reasons why the this particular therapy didn't take off.

Freddie Kimmel (32:44.863)
There's two.

Dr. Joseph Pinzone (33:12.782)
And there are a number of reasons why the main, we definitely get referrals from some oncologists and some radiation oncologists, but the vast majority of patients we get are patients advocating for themselves. And it's really interesting because what has happened since 1987, so we've been FDA approved. This technology that we use, our device, has been FDA approved since 1987. And it's been known, so it's not like it's foreign.

Okay. But it really, because there was in the radiation oncology space, it just never really took off. And then you had a bunch of guidelines that got put in place. So now you're in a situation where typically the quarterback of a person's cancer care is their oncologist. And if they don't know about us, and if we're not incorporated in the guideline,

You know, even though, look, doctors are great people. They, nobody want, I mean, I don't mean to say that they're practicing critical medicine, but they're following guidelines, which is an appropriate thing to do. Certainly they're thinking outside the box, they're now looking for mutations, but it doesn't happen universally. And I can understand the psychology. You know, it's hard if they don't know about a therapy, even if we're FDA approved, if we're not in the guidelines.

How does that affect the therapy? So it's tough a lot of times for doctors to wrap their minds around it. But I have conversations with my colleagues all the time. And many of them, and I get varied responses, but we're here. We're typically covered. We don't make any promises, but we do have some really good results. And sometimes we don't have good results, just like when you go to the oncologist, it's not really any different. But as you said, so.

I think you framed it perfectly. That's exactly what I say to the patient. I say, look, if it's covered, if you can swing it, we give you an edge. And whether it be the stage four cancer where we're going to, I never say people can't be cured. That's not for me to say. You know, we have to be realistic stage four cancer. That's a heavy lift. Okay. But if you have, if you're aiming for cure, again, I kind of go with the one shot theory. Best to get it on the first shot.

Freddie Kimmel (35:38.975)
Yeah.

Dr. Joseph Pinzone (35:40.334)
So anyway, no real reason not to try this. Agreed.

Freddie Kimmel (35:45.279)
Yeah, I have a question for you. How is this, if it's FDA approved, can we talk about data first? You mentioned efficacy and how would people frame that? Because a lot of times when you'll go in and let's just use maybe it's testicular cancer, like, you know, Freddie, based on cell makeup and the genome and yada, yada, yada, your odds look like this. It's like, what are, and because we're going to use a topocytes and cisplatin or because we're going to use this type of radiation,

Dr. Joseph Pinzone (35:52.846)
Sure, yeah. Right.

Freddie Kimmel (36:14.527)
What are the data slash stats look like on hyperthermia?

Dr. Joseph Pinzone (36:19.694)
Sure, so when a therapy or a therapeutic modality is first investigated, typically it's investigated in patients who have advanced disease. One of the reasons why is because patients with early disease typically have a much longer lifespan and typically they're often cured. And so it's just not practical to be able to do a study

earlier stage patients. So most of the data comes from later stage patients. And again, respect the fact that when I talk about the data, I'm talking about the tumor that was treated. Unlike William Coley, who got that at scope of that, we can't really claim to do that. I wish and the immune reaction would tell you that maybe we can, but that's not what we see. Having said that, what the data tells us is that as an example, most of the outcomes

are the percent of complete response. So for example, if we looked at breast cancer, you get an increase in complete response by 44%. So in one study, and again, most studies, by the way, show efficacy of hyperthermia when it's compared with radiation alone or chemotherapy alone. So when you combine it with hyperthermia,

most studies show some benefit. So as an example, one study that we quote, increased the complete response rate of typically chest wall tumors from 41 % getting rid of it altogether to 59%. So that's an increase of 44%. Now, if you have, and so head and neck cancer.

it increases it from 41 % to 83%. Okay, that's 100 % increase. But you know, percentages are a little deceiving, you have to apply them to the under underlying likelihood that you're going to get rid of that cancer, right? cervical cancer, increased complete response rate by 28 % rectal cancer, interestingly, increased five year survival. Again, one study I'm

Dr. Joseph Pinzone (38:44.078)
They're somewhat cherry picked. Okay. These are representative of most of the studies. Some are, don't show a response. None of them show significant harm that I'm aware of. But increased five year survivable by 46%. Now, and again, these are all with radiation. One of the reasons why we quote the radiation data is because it's pretty standardized how those are done. Chemotherapy, there are,

Generally similar results percentage wise. The studies are a little bit earlier, not always phase three trials. Some of them are. But we're FDA approved to be used with chemo. We do that, the machine does the same thing. It opens up the blood vessels the same way whether you're getting chemo or radiation. So those are some of the data that we quote and say, you know, it's all well and good, but.

Freddie Kimmel (39:31.807)
Mm -hmm.

Dr. Joseph Pinzone (39:42.894)
it doesn't go from 41 % to 100%. It goes from 41 % to 59%. So if you then, now, if I only treated people that met the criteria for a study, patients come walk through the door, they're not going to all be study patients, right? They just have cancer. So you have to apply it in a judicious way. So we've had patients where they've had too numerous to count liver lesions. Well, that's not going to be a 41 % chance of getting rid of all those tumors.

Freddie Kimmel (39:59.519)
Mm -hmm.

Dr. Joseph Pinzone (40:12.686)
It might be a 10 % okay again maybe I'm just making that up and maybe it's less maybe it's slightly more what have you it's not great but if we increase that by 50 % that goes to 15%. I've seen it happen and I've also seen it not happen so you know I think the real thing is to have an honest conversation with people we've had most of our patients say look I'm gonna take any edge I could get.

And again, if they have the coverage, they have the time with stats like that, you know, even if it's one of the tumors, and you don't know till you try it, right? And so if you have three different tumors, like the lady with her two positive breast cancer that I showed you, we're looking at one at a time. So if we're getting major effects on one and not on the others, again, sadly, that's almost like, you know, an internal experiment.

Freddie Kimmel (40:41.087)
Hmm.

Freddie Kimmel (41:00.287)
Mm -hmm.

Dr. Joseph Pinzone (41:09.358)
we're probably helping because that tumor shrunk, the other ones maybe didn't. So then we switched to another tumor fully recognizing that patients could end up getting a new tumor. So again, we understand the terrain. It's fraught with issues, but those issues are openly discussed in my office. And we're always dealing with risk benefit and feasibility.

Freddie Kimmel (41:34.207)
I'm assuming because this is such a specialized therapy and they're already under the, most times under the Gara, under the guide of oncologists that you're not having a conversation about lifestyle adjustments, food, hydration, nutrition, sleep hygiene.

Dr. Joseph Pinzone (41:53.71)
Correct. Those are not things that I have primary knowledge about in the sphere of cancer. And so I stick to what I know. I understand tumor biology. I understand the application of low levels of heat vis -a -vis hyperthermia. And that's what I stick to. And any questions that patients have, they ask me all the time questions about their underlying therapy. And the first thing I say is, remember I'm not an oncologist. So.

Freddie Kimmel (41:59.359)
Great.

Dr. Joseph Pinzone (42:23.694)
here's the way you might want to phrase the question. So one of the two first that patients get by coming to our clinic is everything cuts both ways, right? So there's some advantage to me not being an oncologist in the sense that I am a, an educated physician who has a special interest in knowledge in tumor biology, but I don't apply things. I don't have treatments to apply. So I have a little bit.

of a arm's length view of those treatments, which helps me help the patients formulate questions for their oncologist. And that's a lot of the value that we add beyond the hyperthermia.

Freddie Kimmel (43:08.543)
Yeah. Yeah. Beautiful. That makes a lot of sense to me. I also, my other question about this integration or adding this therapy into a paradigm, how is this met within the standard medical model, especially within the United States? You know, we get a varying degree of people wanting to say, well, I want to do this and this and this. And, you know, again, the internet, it's like, it's rife with all these therapies that

that may or may not be beneficial. How do you have that conversation with a doctor or an oncologist in which you try to show them there is validity here?

Dr. Joseph Pinzone (43:37.806)
Yeah, right.

Dr. Joseph Pinzone (43:45.166)
Yeah.

Yeah, so it's very interesting because the vast majority of patients come into us and we advocate full disclosure. We also let the patients know that in our experience, they can expect one of three responses. Either the oncologist or radiation oncologist, because radiation oncologists often are involved in the patients that we're treating, will know about hyperthermia and embrace it. So that is not particularly common because hyperthermia is

you know, although it was part of the radiation oncology textbook up until the last, one of the main ones up until the last edition, they kind of cut it out. And so not a lot of radiation oncologists were, and so there's not a lot of centers in the US, right? So not a lot of them have exposure. So they, so it's, it's unusual to get an embrace of this, but it's not unheard of. I mean, many oncologists and many radiation oncologists do embrace hypothermia, but it's not the most common response.

Another bucket of responses would be, well, you know, you do what you think is right. If it's not hurting the therapy I'm doing now, you know, that's great. Have at it. And, you know, I can, I can live with both of those responses. I can live with anything. I mean, people, people can say what they want, but I've had a third bucket where oncologists and this is

This is not typical either, by the way. But I've had oncologists and radiation oncologists say to a patient, if you do hyperthermia, I will not treat you. They're so against it. Because, and so in those situations, sometimes I get to talk to the doctor, sometimes they don't want to talk to me. So it's a quirk, I think, in human nature. And doctors are human. And so...

Dr. Joseph Pinzone (45:44.75)
When that happens, I just say, look, your main therapy is your oncology. And there's a very big pressure for a patient to not upset their oncologist. Not every patient tells their oncologist they're doing hypothermia. Not every patient wants their oncologist to know. I mean, it's a patient -specific, again, we advocate full transparency, recognizing that we're going to get some of those responses.

you know, it puts a patient in a very awkward position. We're pretty low pressure here. I mean, you know, if you want to come and it fits and everybody's cool, let's do it. But, you know, what the reason I don't like that second response is not only is it heavy handed and tense, but if somebody tells me, you know, I remember 10 years into my practice, I would think, well, if I haven't heard of it, you know, how good could it be 20 years into my practice? I was like, you know what?

Probably a lot I haven't heard about. So if somebody said to me, look, I've got an FDA approved therapy here, I would do one of two things. Either I don't have time to look at it, which is fair, it's FDA approved. Okay, great. Then at least it's FDA approved your insurance to pay for it. Probably it works, you know, that thing. Or I would look into it. So those things to me are reasonable responses, but you know, people are people. And so we get a...

variety of responses from our colleagues. And frankly, we get a variety of responses from patients. Most of them love it. I mean, you know, what's not to love other than the time commitment? You know, assuming it's covered, right? I mean, so but some people don't want to and there's no pressure to do it. We're here as a resource. We're here to give you an edge. If that edge is going to turn your life upside down, if that edge is, you know, too scary to you, if that edge is whatever.

then you can't adequately engage in it. It's okay. But if you can, why not?

Freddie Kimmel (47:49.919)
Yeah, I understand both sides of it. You know, I think a version of myself 10 years ago would really dig my feet into the sand and say, well, my doctor works for me. I pay my doctor. You're my employee. You don't get to tell me what to do. And then there's another side of me that says, you know, when you have a, goodness, you know, when you have the guy that's in Tiger Woods ear.

telling them exactly what to do. You're, you are pairing with a professional because you want the elite of the elite seeing the terrain in your, on your side. So they're not going to let you wander off and take advice from Instagram. So I really do under, you know, in this world, I think it's so interesting to be able to hold both conversations and multiple truths at the same time. It's just an exercise or a, or a life skill. so I can understand it all. I,

I want how many you've mentioned how many centers are there in the US you said there's not many.

Dr. Joseph Pinzone (48:48.59)
Yeah. So there's one other modality that uses microwaves and there are a few centers, maybe four or five throughout the United States. So, so really when you add them all up and, and, and most of those centers are within academic centers and they really, so even though the therapies are FDA approved to be used in all solid tumors in combination with chemo radiation, and you say to yourself,

Freddie Kimmel (48:56.735)
Okay.

Dr. Joseph Pinzone (49:17.998)
you know, there are probably relatively few people where this does not apply to some, some it doesn't apply to right. A central lung tumor I can't treat as an example, but why not? And so what I find, and this is not primary knowledge, but from what patients tell me, they often don't, they often use them at the other centers in pretty narrow circumstances. But again, I'm not at those centers. I don't know that from a primary perspective. It's, and I,

I can understand that as well. I mean, look, you want to be able to be evidence -based. On the other hand, devices, let me say machines, devices are a bit different than drugs, especially devices that have fairly favorable adverse effect profiles. Because with medications, the FDA typically will, first of all,

They don't tell doctors how to practice. So if you had a particular drug and you wanted to give it off label, you can do that as a doctor. Now the insurance company may or may not pay for it, mind you, but you can do it. You do anything, anything you think is medically appropriate. With devices, it's a little bit different. The device is going to do what the device does. So, you know, it gets, there tends to be a bit more latitude. Whereas the FDA will typically want drug A to be

investigated in this cancer in this stage many times because there's a very specific pathway that they're targeting especially with the newer drugs right so you can't just say well we're going to give it to every cancer patient with a solid tumor because there's a whole side effect profile on the other side of it and it targets a very specific pathway and if that patient doesn't have that pathway and it's not researched in that way that's a lot different than applying the device

that's going to do the same thing in every tumor and again has its own limit. But by the way, I'll reiterate, we have our own limitations. So it's just, it's one of those things where you've got to just have a really open conversation with people and just go with the flow and be there as a resource for people that are comfortable and want to embrace it.

Freddie Kimmel (51:38.879)
Yeah. I understand that. It's a head scratcher to me with the numbers like 44 % improvement, 59 % improvement, 83 % improvement that it's left out of the modern medical literature as far as training. You know, this Charlie Munger, very famous financial investor. Show me, yeah, yeah, yeah, yeah. Show me the incentive and I'll show you the outcome. So I...

Dr. Joseph Pinzone (51:58.766)
Warren Buffett's partner.

Freddie Kimmel (52:08.223)
I wonder what it takes, you know, to change this model and get this integrated more places that it, that it is a tool in the toolbox. That's all I'm saying. I'm really interested in that conversation and see how it could evolve. Do you have any ideas or any dreams to have this be adopted on a broader level?

Dr. Joseph Pinzone (52:26.158)
Yes, I do. I think probably we couldn't have had a resurgence 20 years ago because I think we're so internet driven in terms of awareness. The thing that I think patients find refreshing and I think my colleagues do when I do get to talk to them is very rarely do they shut things down when I talk to them, my colleagues. And patients, because they understand that I've been well trained,

in Western medicine, I also go with the evidence. I don't over promise things. And so I think the organic nature of having a genuineness about how, when and where this should be applied and whether it should be applied and the fact that the patient needs to needs to be an advocate because it's so time intensive actually favors the real organic growth of what we're doing because we can

legitimately put it in the patient's hands because they have me as a backstop and I'm always going to tell them the pluses and minuses. Okay. So that's where it starts. Where I think it begins to gain steam is as we progress, we're going to, you know, just the same as your podcast, you kind of get a ground swell and then all of a sudden there's some notoriety around it. So I think that's where it's going to happen. And then

And I say it that way because we're already FDA approved, right? So even though, look, there's a million studies I'd love to do, and there are studies being done like with immunotherapy. Until we get a critical mass of patients involved, we simply won't have the numbers, regardless of whether we have the funding. So the point is, sure, eventually I'd like there to be more studies where we're like, okay, look, now with this particular therapy, or this class of therapy, we can do that.

this, that, or the other thing, which is being researched. So that would be kind of an end game for me. In the meanwhile, it's groundswell from social media. It's groundswell from things like informative podcasts and people listening to me again, they can not call our center. I would encourage them to call our center, but you know, it's, it's, it's however you're going to incorporate how you want to deal with the engagement of your illness.

Dr. Joseph Pinzone (54:54.478)
And we're just, we're open for business. We're ready to roll.

Freddie Kimmel (55:00.159)
Yeah, that's great. Well, I certainly appreciate, I appreciate the low pressure energy behind the message. I appreciate the fact that, you know, that you're there to offer data and your experience. And it's, I really love the idea that it's, it's, you're giving a person a choice. And I think there's a real piece of empowerment there and there's, doesn't feel like there's this, this

Dr. Joseph Pinzone (55:07.854)
Yeah.

Freddie Kimmel (55:26.783)
fictitious timeline around needing to do this today or tomorrow. This is an option. This is a tool in the toolbox. As you said, we've been approved since the eighties. It's got great data behind it. And so I celebrate the way in which you're doing business and which you're giving the message for it. I think it's really amazing.

Dr. Joseph Pinzone (55:45.134)
Well, thank you very much. And I think, you know, what patients will find when they come in is they get the added benefit of another cook. Consider me a sous chef, by the way. But another cook in there that's not going to it's not going to overinterpret. It's not going to do anything other than help them to understand their disease better so that I can better help them and they could feel more comfortable interacting with their oncologist. So again, that's the added benefit. The main

thing that we're doing is we're doing hypothermia. The added benefit is we get to have conversations with patients and help guide them in terms of how they approach questions and such.

Freddie Kimmel (56:23.967)
Yeah. Can I just recap the mechanisms of action? So from my understanding, it's increasing, helping to increase blood flow. So we're getting more of the medicinal, more of the chemo to the tumor. It's the heat is slowing the enzyme repair of the damaged DNA. And then we're also, we did increase blood flow. What else was there? What are other mechanisms?

Dr. Joseph Pinzone (56:46.126)
There was the ability to radiosensitize because radiation needs oxygen to work optimally. And so there's a low oxygen tension at the center of the tumor. So it takes the oxygen and it forms oxygen -free radicals, specific toxic chemicals that damage DNA and it needs oxygen to do that. So we helped to radiosensitize. And then also we have the immune reaction.

Freddie Kimmel (56:51.999)
Yes. Okay.

Freddie Kimmel (57:12.639)
Yes. Yeah. I love it. Well, I really have had such, it's been such a treat having you on the podcast and asking all these kids. I feel really, I feel really empowered having this data. Cause I get a lot of questions all the time. People like Freddie, this isn't working. What do I do? Where do I go? I'm, I'm overwhelmed by information. Right. So I think it's really good to have these conversations. It's an excellent jumping off point for people to explore.

Dr. Joseph Pinzone (57:33.326)
Sure.

Freddie Kimmel (57:39.999)
If you had a little magic wand and you could turn everybody who's going through cancer right now, you can wave your magic wand. You can tune in a television station to your channel, Dr. Joseph Pinzone. What would you say to people right now that are going through cancer and oncology?

Dr. Joseph Pinzone (57:55.406)
Yeah, I would say that probably the most important thing you can do is to slow down, use your faculties to help your doctor help you by formulating the right questions. I actually, before I ever came into the hypothermia world, I wrote a book called Fireballs in My Eucharist, where I go through

how to fight cancer smarter, and I helped tee up how to ask the right questions. To me, that's the message that I'd like to get across to patients. And the way I came up with the title is, I was in my residency and I was getting a history from a patient in the emergency room and she was telling me about what she had and she said, and I had fireballs in my Eucharist. And what she meant to say was she had fibroids in her uterus. And that's when I realized.

patients really need to drill down into what exactly they have so that they can come back up and help the experts in their life, their physicians, help them better. And they do that by not becoming doctors, by formulating the questions that have a good technical backing and a good emotional backing for what is ailing them in their life.

Freddie Kimmel (59:19.551)
Yeah. Yeah. I think that's beautiful statement. Ask better questions. We'll get better, higher quality answers. and then the final question, the beautifully broken podcast, putting the beautiful pieces back together and whatever format you see fit, what does it mean to you to be beautifully broken?

Dr. Joseph Pinzone (59:40.43)
I think what that means is that we're born flawed. And I think the people who have the most success and peace in life embrace their flaws. And that allows them to lower their defenses and find out what are their strengths. So they leverage their strengths and then they fill in the gaps with others around them who have

strengths that are needed in that situation, which is why if you're really good at formulating questions, great. If you're a doctor with cancer, you're going to have better questions in general because you're in the know, although everything cuts both ways. But that's why you bring a family member with you. That's why, you know, if you have a family member who's I've helped many family members now by being their doctor, by helping them to ask the right questions. Right. So beautifully broken means we're all flawed. Lean into it.

so that you can understand your strength and you can then get others to bolster with their strengths. And now you're really cooking with gas.

Freddie Kimmel (01:00:49.055)
Yeah, beautiful. It's been such a treat. Remind people where they can find you and where they can reach out and find the center.

Dr. Joseph Pinzone (01:00:59.278)
So the best thing to do is to log on to our website at hcioncology .com. And right there, you will be able to put in a query to us. You'll be able to call our center. And actually,

Since I don't call our center regularly, let me make sure I get you the correct number to call. Yep. Yeah, there you go.

Freddie Kimmel (01:01:32.991)
sure. wait, I got the contact button up here. I have 888 -786 -0997. That's 888 -786 -0997. And we've got a location in Santa Monica as well as Irvine.

Dr. Joseph Pinzone (01:01:41.102)
Correct.

Dr. Joseph Pinzone (01:01:47.982)
Correct and it's HCI Oncology all one word HCI oncology .com

Freddie Kimmel (01:01:55.807)
Perfect. Perfect. Such a treat. Thank you so much, Joseph.

Dr. Joseph Pinzone (01:02:00.11)
All right, my pleasure. Thank you for having me.

Freddie Kimmel (01:02:03.167)
Big love.

Dr. Joseph Pinzone (01:02:05.102)
Right back at you.