Dumb question, but isn't there a risk of spreading cancer causing proteins throughout the body with this approach?

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.

https://www.mdanderson.org/cancerwise/histotripsy-for-liver-...

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.

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!

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/

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"

Previously: https://news.ycombinator.com/item?id=45514378

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.

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.

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.