HYPERTHERMIC TREATMENT FOR THE BLADDER TUMOR

III. Ultrastructural Study

Abstract

From the clinical experiences heat has been known to induce tumor regression without causing significant changes to normal surrounding tissues. Heat has also been shown to enhance the radiosensitivity or effect of anticancer drug to the cancer cells. However, little is known about the mechanism of the cancerocidal effect of heat in spite of large number of clinical and experimental investigations. We have achieved hyperthermic treatment of the bladder cancer for the past 3 years. This report is aimed to describe 1) ultrastrucure of normal and malignant cells of the bladder 2) ultrastructural changes of the bladder cancer cells following hyperthermic treatment and combined therapy with hyperthermia and radiation.
Normal epithelium of the bladder is composed of three layers, superficial cell, intermediate cell and basal cell. The luminal plasma membrane of the superficial cell consists of asymmetric unit membrane. Overall appearance of well differentiated carcinoma shows regular arrangement tumor cells with moderate numbers of cytoplasmic organelles.
Poorly differentiated carcinoma develops disorderly with large and irregular shaped nucleus. Ultrastructural changes of tumor cells were appreciated not only immediately after the single treatment but also after ten times treatment of hyperthermia. The most prominent change was the degeneration of the cytoplamsmic matrix like burned appearance. Cytoplasmic organelles, such as mitochondria and Golgi apparatus showed moderate changes in number and form. Some of the nucleus appeared slightly clear nucleoplasm after the hyperthermic irrigation. But plasma membrane and nuclear membrane were almost preserved and seemed to be the most resistant to the heat. After the combination therapy alteration occurred more intense than hyperthermia alone.
From the present study it was demonstrated that high temperature affected the cytoplasm and nucleus of the cancer cell and might induce a cancer cell death. Further studies must be performed in regard to the ultrastructural changes of normal bladder cells after the hyperthermic treatment.