What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body? 2024 meta analysis of seeding I didn't see ultrasound in there: https://pubmed.ncbi.nlm.nih.gov/39605885/
We simply won’t know until they do the inevitable phase2/3 RCTs. They will need to show that this method helps people survive longer or with better quality of life than the current standard of care.
HistoSonics has studies published with 50 patients. Their upcoming study with 5000 liver patients obviously will give more information, but we already have some.
And with that said, these studies are more relevant than the top of thread linking to a review from 2011 looking at papers from 2005-2006 for ultrasound cavitation causing metastases.
Chemo post-histrophy would remove any lingering cancer cells effectively. Cancer cells need lots of fuel or they stop replicating, and this is what traditional chemo is great at stopping.
For sure. Goes without saying in any cancer treatment that cost/benefit is a prime consideration. Still, that will not stop me from asking the question. You can't do that analysis without the answers after all.
> The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood
If it was true, couldn't you get the same effect by taking a biopsy, fragmenting the cells, and injecting them back in? Like a vaccination, in fact. Somebody must have studied that approach already.
I had the opportunity to meet with folks from Histosonics at a Canopy Cancer Collective (pancreas cancer focused group - https://canopycancer.org/) annual meeting a couple of years ago. They had shown very promising results (and approval) with liver cancer, and the applicability to any soft-tissue openly-addressable masses (e.g., not brains in skulls, not lungs full of air) seemed very likely, based on the physics. (Note: I'm a consumer electronics and ML engineer, not a medical devices engineer).
I'm excited to see this option become more broadly available. The ability to precisely target and illicit an inflammatory response is impressive, and Whipples are no joke.
Per the article, this seems even better than the headline would suggest:
> Histotripsy generally seems to stimulate an immune response, helping the body attack cancer cells that weren’t targeted directly by ultrasound. The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood. Researchers are now exploring ways to pair histotripsy with immunotherapy to amplify that effect.
As someone who was recently diagnosed and treated for Uveal Melanoma (get your annual eye exam and retinal scans!), and occasionally struggling with some intrusive thoughts about the potential for liver mets, reading about this treatment brought me so much joy. Bless Zhen Xu!
no symptoms. first identified the lesion a few years back and it hadn't changed over a few subsequent appointments. exam this year, it had grown a small amount 5mmx5mm to 6mmx8mm - still considered small, but the change was enough for the Drs to recommend treatment. I have been treated by Dr. Dan Gombos[1] at MD Anderson and received excellent care.
Due to some family stuff, this is something I've been investigating. My oncologist has said "this will probably be standard care in a few years". The results and studies around this have been excellent.
What this does better than pretty much anything else is it isolates the destruction of cells to just the target. The liver is a VERY "bleedy" organ. It has a ton of blood that flows through it which makes surgery extra hard. In fact, the not this surgery that's next best for our circumstances laparoscopic through the arteries to drop a radioactive pellet in the center of the cancer.
The non-invasive nature of this is going to be very good for the future of cancer treatment. Minimizing scaring and damage to tissue is the number 1 factor to better results.
The only reason my local oncologist does not have this machine is they are still pretty pricey.
When I first learned about this, I thought it was pseudo-science BS. It's crazy what can be done with just sound.
I finished treatment for prostate cancer this summer. Most of my time in the x-ray machine was spent getting the alignment right. They'd take a CT scan, do some image analysis and other computations, then adjust the table some small amount before turning the beam on.
I'm curious how they do the alignment with the histotripsy machine. I would think that they could obviously do an ultrasound scan to get the gross alignment correct. But perhaps there is a CT scan afterwards that lets them make the fine alignment. It probably also helps that the liver is a much larger gland so aiming is less critical?
Histotripsy means "cell pulverizing". We know disruption (pulverization or otherwise) of a tumor bed tends to incite a local inflammatory reaction, and a brisk inflammatory reaction seems to correlate with survival. So the idea here seems to be an extension of high energy ultrasound methods developed for lithotripsy (breaking up kidney stones) to disrupt tumor beds. Not something I'd want for a pre-cancerous lesion, but if it's stage 4 liver mets ... sure. Have at it.
The machine has been available for a couple years to treat liver tumors. It’s available in several US cities but not widely available. It uses cavitation to destroy the tumor.
The advancements in imaging, cheap intelligence and non-invasive (mostly) tools like this are amazing. I can easily see a future where we can scan, and analyze, every cell in a body and then selectively manipulate them to achieve the desired effect. I doubt we are actually that far away actually.
> Histotripsy generally seems to stimulate an immune response, helping the body attack cancer cells that weren’t targeted directly by ultrasound. The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood. Researchers are now exploring ways to pair histotripsy with immunotherapy to amplify that effect.
Cancer isn't caused by proteins in the way you might think. Its definitely not infectious at the protein level. You could ask if this disruption spreads out cancer cells themselves and that would be fair to ask. But then the cancer cells were already in your body and were likely trying to migrate to other sites anyway.
The success of surgery to remove solid tumors usually hinges on whether there are "clean margins," meaning they were able to remove all the bad tissue and a little good surrounding tissue just to be sure. It's likely that the same principle applies using this new procedure: if you blast the whole thing and trust the body to clean up the mess, hopefully there won't be anything left to worry about.
the article talks about this, the (too vaguely explained) tldr is that pulverization allows neoantigens to be exposed to the immune system rather than hidden within a tumor. i saw elsewhere (weeks ago) an article that this worked excellently, but this article seems to not reference it.
Here is a study on AEs specifically from this type of ultrasound: https://journals.plos.org/plosone/article?id=10.1371/journal...
Quote: "Cavitation detaches cancer cells/emboli from the primary site and thereby releases them into the circulation, leading to metastasis"
And with that said, these studies are more relevant than the top of thread linking to a review from 2011 looking at papers from 2005-2006 for ultrasound cavitation causing metastases.
In theory, this may mean that metastisizing this tumour could destroy it in the pancreas, but allow the cells to spread to more treatable locations?
1 - https://www.canceraustralia.gov.au/cancer-types/pancreatic-c...
that's discussed in the article
If any medical professional could give answers that would be neat.
Seems a little too speculatively worded, IMO.
I'm excited to see this option become more broadly available. The ability to precisely target and illicit an inflammatory response is impressive, and Whipples are no joke.
> Histotripsy generally seems to stimulate an immune response, helping the body attack cancer cells that weren’t targeted directly by ultrasound. The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood. Researchers are now exploring ways to pair histotripsy with immunotherapy to amplify that effect.
https://www.nature.com/articles/s41467-025-65080-9
which could imaginably lead to wireheading or something like Niven's "tasp".
[1] https://faculty.mdanderson.org/profiles/dan_gombos.html
Best wishes!
What this does better than pretty much anything else is it isolates the destruction of cells to just the target. The liver is a VERY "bleedy" organ. It has a ton of blood that flows through it which makes surgery extra hard. In fact, the not this surgery that's next best for our circumstances laparoscopic through the arteries to drop a radioactive pellet in the center of the cancer.
The non-invasive nature of this is going to be very good for the future of cancer treatment. Minimizing scaring and damage to tissue is the number 1 factor to better results.
The only reason my local oncologist does not have this machine is they are still pretty pricey.
When I first learned about this, I thought it was pseudo-science BS. It's crazy what can be done with just sound.
I'm curious how they do the alignment with the histotripsy machine. I would think that they could obviously do an ultrasound scan to get the gross alignment correct. But perhaps there is a CT scan afterwards that lets them make the fine alignment. It probably also helps that the liver is a much larger gland so aiming is less critical?
https://www.mdanderson.org/cancerwise/histotripsy-for-liver-...
this is one such article:
https://viterbischool.usc.edu/news/2025/11/tricking-tumors-i...