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Tumor necrosis by controlled ebullism
Medical Hypotheses (2005) 64, 318–319
http://intl.elsevierhealth.com/journals/mehy
Tumor necrosis by controlled ebullism A. Babich* 298 Thorncliff Road, Kenmore, New York 14223-1208, USA Received 27 March 2003; accepted 25 March 2004
Summary In the early days of manned space flight, experiments were done in which dogs and chimpanzees were exposed to near vacuum in anticipation of possible manned space flight accidents. These specimens experienced what was termed “ebullism”. This syndrome involved boiling of body fluids resulting in extreme dehydration and circulatory failure. Whereas malignant tumors are typically warmer than normal tissue, it should be possible to destroy them while sparing normal tissue through this phenomenon by subjecting patients to low pressure slightly greater than that which would produce systemic ebullism c 2004 Elsevier Ltd. All rights reserved.
One of the most significant problems faced by modern medicine is achieving the destruction of malignant tumors. One method by which, this might be achieved is through the phenomenon known as “ebullism” (i.e. “boiling out ”– not to be confused with “ebullism”). This phenomenon occurs when ambient pressure falls below the vapor pressure of water at body temperature (47 mm Hg). Experiments on dogs and chimpanzees done in anticipation of accidents during manned space flight showed that the result of this was the accumulation of water vapor in the peritoneal cavity and subcutaneous spaces, expulsion of steam from the nostrils, and circulatory failure due to “Vaporlock”. Death followed within minutes due to ischemia in vital organs along with massive dehydration,, unless the animals were recompressed and rehydrated [1–12]. The possibility for using this phenomenon for therapeutic purposes arises from the fact that a
*
Tel.: +1-716-873-5953.
rapidly growing tumor will have a significantly higher temperature than surrounding healthy tissue, a fact utilized in the past when screening for mammary tumors was done by thermography. Accordingly so, it should be possible to produce ebullism within malignant tissue at a pressure somewhat more than 47 mm Hg thus sparing surrounding healthy tissue. How much more would depend on the estimated temperature of the tumor and thus the vapor pressure of the intra-cellular fluid of the malignant cells. This would be similar to that of pure water which would be 47 mm Hg at 37 C, 52.4 mm Hg at 39 C, and 55.3 mm Hg at 40 C [13]. However, even the tiniest differences in pressure and temperature can be used to bring about selective ebullism. In the aforementioned animal experiments, ebullism was observed in varying extents in different parts of the same specimens apparently resulting from temperature differences in various tissues as well as pressure differences caused by the differing elasticities of various tissues. Tumor necrosis may follow through several mechanisms:
0306-9877/$ - see front matter c 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.mehy.2004.03.019
Tumor necrosis by controlled ebullism • dehydration of the malignant cells themselves; • dehydration of blood cells passing through the tumor along with adjacent vascular endothelium thus resulting in coagulation and infarction along the vascular tree feeding the tumor; • water vapor entering the capillary bed within the tumor causing “Vapor-lock” thus blocking blood flow and depriving the tumor of nutrients during the treatment; • microscopic vapor bubbles forming within tumor cells and rupturing their membranes. A patient treated in this manner would first have to breathe pure oxygen for 2 h to avoid decompression sickness. He would then be placed in a low pressure chamber and be gradually be decompressed to near 50 mm Hg. Hypoxia would be avoided by breathing pure oxygen through an endotracheal tube or an endobronchial tube at a somewhat higher pressure but not more than 2 psi (100 mm Hg) above the ambient pressure. Distention of the chest could be avoided by use of a tight binding around it. Higher pressures would be inadvisable due to the risk of barotrauma and unnecessary as a partial pressure of oxygen of 100 mm Hg in the trachea approximates normal ventilation [14]. The stomach would most likely be irrigated with chilled water to prevent systemic dehydration and to prevent boiling of stomach contents remembering that ebullism in the abdomen resulted in projectile vomiting in the animal experiments (sometimes metaphorically referred to as “exploding” in vacuum). There remains much to be determined about this possible therapeutic approach. In particular, whether the caloric output of even a fast-growing tumor would be enough to cause useful ebullism in a reasonable time. Also, whether repeated treatments would have cumulative effect. Nonetheless, the approach seems to merit further study.
319
References [1] Bancroft RW. Physiological responses to near vacuum. AFSAM TR-66-301, USAF School of Aerospace Medicine, Brooks AFB; 1996. [2] Bancroft RW, Dunn II JE. Experimental animal decompressions to a near vacuum environment. AF-SAM-TR65-48, USAF School of Aerospace Medicine, Brooks AFB; 1965. [3] Burch BH, Kemph JP, Vail EG, et al. Some effects of explosive ecompression and subsequent exposure to 30 mm Hg upon the hearts of dogs. J Aviation Med 1952;23: 157–9. [4] Bancroft RW, Dunn II JE. Experimental animal decompressions to a near vacuum environment. Aerospace Med 1965;36:720–5. [5] Dunn II JE, Bancroft RW, Haymaker W, Foft JW. Experimental animal decompressiens to less than 2 mm hg absolute (pathological effects). AF-SAM-TR-65*48, USAF School of Aerospace Medicine, Brooks AFB; 1965. [6] Dunn II JE, Bancroft RW, Haymaker W, Foft JW. Experimental animal decompressions to less than 2 mm Hg Absolute (pathological effects). Aerospace Med 1965;36: 725–32. [7] Edelmann A, Hitchcock FA. Observation on dogs exposed to an ambient pressure of 30 mm Hg. J Appl Physiol 1952;4:807–12. [8] Hitchcock FA. Studies in explosive decompression, physiological an pathological effects. WADC-TR-53-191, Wright Air Development Center, Wright-patterson AFB; 1953. [9] Hitchcock FA, Kemph JP. The boiling of body liquids at extremely high altitudes. J Aviation Med 1955;26:289–97. [10] Kemph JP, Burch BH, Beman FM, Hitchcock FA. Further observations of dogs explosively decompressed. to an ambient pressure of 30 mm Hg. J Aviation Med 1954;25: 107–12. [11] Koestle AG. The effect on the chimpanzee of rapid decompression to a near vacuum. NASA-CR-329, National Aeronautics and Space Administration; 1965. [12] Ward JE. The true nature of the boiling of body fluids in space. J Aviation Med 1956;27:429–39. [13] Robert C. West, editor. CRC handbook of chemistry and physics. Cleveland: Chemical Rubber Company. [14] Luft JC. Aviation physiology – the effect of altitude. Handbook of physiology, Section, 3, vol. II. Washington: American Physiological Society; 1965.
http://intl.elsevierhealth.com/journals/mehy
Tumor necrosis by controlled ebullism A. Babich* 298 Thorncliff Road, Kenmore, New York 14223-1208, USA Received 27 March 2003; accepted 25 March 2004
Summary In the early days of manned space flight, experiments were done in which dogs and chimpanzees were exposed to near vacuum in anticipation of possible manned space flight accidents. These specimens experienced what was termed “ebullism”. This syndrome involved boiling of body fluids resulting in extreme dehydration and circulatory failure. Whereas malignant tumors are typically warmer than normal tissue, it should be possible to destroy them while sparing normal tissue through this phenomenon by subjecting patients to low pressure slightly greater than that which would produce systemic ebullism c 2004 Elsevier Ltd. All rights reserved.
One of the most significant problems faced by modern medicine is achieving the destruction of malignant tumors. One method by which, this might be achieved is through the phenomenon known as “ebullism” (i.e. “boiling out ”– not to be confused with “ebullism”). This phenomenon occurs when ambient pressure falls below the vapor pressure of water at body temperature (47 mm Hg). Experiments on dogs and chimpanzees done in anticipation of accidents during manned space flight showed that the result of this was the accumulation of water vapor in the peritoneal cavity and subcutaneous spaces, expulsion of steam from the nostrils, and circulatory failure due to “Vaporlock”. Death followed within minutes due to ischemia in vital organs along with massive dehydration,, unless the animals were recompressed and rehydrated [1–12]. The possibility for using this phenomenon for therapeutic purposes arises from the fact that a
*
Tel.: +1-716-873-5953.
rapidly growing tumor will have a significantly higher temperature than surrounding healthy tissue, a fact utilized in the past when screening for mammary tumors was done by thermography. Accordingly so, it should be possible to produce ebullism within malignant tissue at a pressure somewhat more than 47 mm Hg thus sparing surrounding healthy tissue. How much more would depend on the estimated temperature of the tumor and thus the vapor pressure of the intra-cellular fluid of the malignant cells. This would be similar to that of pure water which would be 47 mm Hg at 37 C, 52.4 mm Hg at 39 C, and 55.3 mm Hg at 40 C [13]. However, even the tiniest differences in pressure and temperature can be used to bring about selective ebullism. In the aforementioned animal experiments, ebullism was observed in varying extents in different parts of the same specimens apparently resulting from temperature differences in various tissues as well as pressure differences caused by the differing elasticities of various tissues. Tumor necrosis may follow through several mechanisms:
0306-9877/$ - see front matter c 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.mehy.2004.03.019
Tumor necrosis by controlled ebullism • dehydration of the malignant cells themselves; • dehydration of blood cells passing through the tumor along with adjacent vascular endothelium thus resulting in coagulation and infarction along the vascular tree feeding the tumor; • water vapor entering the capillary bed within the tumor causing “Vapor-lock” thus blocking blood flow and depriving the tumor of nutrients during the treatment; • microscopic vapor bubbles forming within tumor cells and rupturing their membranes. A patient treated in this manner would first have to breathe pure oxygen for 2 h to avoid decompression sickness. He would then be placed in a low pressure chamber and be gradually be decompressed to near 50 mm Hg. Hypoxia would be avoided by breathing pure oxygen through an endotracheal tube or an endobronchial tube at a somewhat higher pressure but not more than 2 psi (100 mm Hg) above the ambient pressure. Distention of the chest could be avoided by use of a tight binding around it. Higher pressures would be inadvisable due to the risk of barotrauma and unnecessary as a partial pressure of oxygen of 100 mm Hg in the trachea approximates normal ventilation [14]. The stomach would most likely be irrigated with chilled water to prevent systemic dehydration and to prevent boiling of stomach contents remembering that ebullism in the abdomen resulted in projectile vomiting in the animal experiments (sometimes metaphorically referred to as “exploding” in vacuum). There remains much to be determined about this possible therapeutic approach. In particular, whether the caloric output of even a fast-growing tumor would be enough to cause useful ebullism in a reasonable time. Also, whether repeated treatments would have cumulative effect. Nonetheless, the approach seems to merit further study.
319
References [1] Bancroft RW. Physiological responses to near vacuum. AFSAM TR-66-301, USAF School of Aerospace Medicine, Brooks AFB; 1996. [2] Bancroft RW, Dunn II JE. Experimental animal decompressions to a near vacuum environment. AF-SAM-TR65-48, USAF School of Aerospace Medicine, Brooks AFB; 1965. [3] Burch BH, Kemph JP, Vail EG, et al. Some effects of explosive ecompression and subsequent exposure to 30 mm Hg upon the hearts of dogs. J Aviation Med 1952;23: 157–9. [4] Bancroft RW, Dunn II JE. Experimental animal decompressions to a near vacuum environment. Aerospace Med 1965;36:720–5. [5] Dunn II JE, Bancroft RW, Haymaker W, Foft JW. Experimental animal decompressiens to less than 2 mm hg absolute (pathological effects). AF-SAM-TR-65*48, USAF School of Aerospace Medicine, Brooks AFB; 1965. [6] Dunn II JE, Bancroft RW, Haymaker W, Foft JW. Experimental animal decompressions to less than 2 mm Hg Absolute (pathological effects). Aerospace Med 1965;36: 725–32. [7] Edelmann A, Hitchcock FA. Observation on dogs exposed to an ambient pressure of 30 mm Hg. J Appl Physiol 1952;4:807–12. [8] Hitchcock FA. Studies in explosive decompression, physiological an pathological effects. WADC-TR-53-191, Wright Air Development Center, Wright-patterson AFB; 1953. [9] Hitchcock FA, Kemph JP. The boiling of body liquids at extremely high altitudes. J Aviation Med 1955;26:289–97. [10] Kemph JP, Burch BH, Beman FM, Hitchcock FA. Further observations of dogs explosively decompressed. to an ambient pressure of 30 mm Hg. J Aviation Med 1954;25: 107–12. [11] Koestle AG. The effect on the chimpanzee of rapid decompression to a near vacuum. NASA-CR-329, National Aeronautics and Space Administration; 1965. [12] Ward JE. The true nature of the boiling of body fluids in space. J Aviation Med 1956;27:429–39. [13] Robert C. West, editor. CRC handbook of chemistry and physics. Cleveland: Chemical Rubber Company. [14] Luft JC. Aviation physiology – the effect of altitude. Handbook of physiology, Section, 3, vol. II. Washington: American Physiological Society; 1965.