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Ultrasound Cancer Treatment: Sound Waves Fight Tumors

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Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#81

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 th…

Metastasis is not just random tumor cell going for a hike, they are seeded with extracellular vesicles carrying particular mix of microRNAs, growth factors, vimentin and other stuff.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#83

Earlier quoted context omitted.

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.

>>> ... the study found that removing the parachute prior to jumping led to a shocking increase in mortality among skydivers. When there's a clear causal mechanism, additional research that doesn't propose a clear resolution to the underlying problem doesn't negate the clear causal mechanism. Releasing a bunch of loose cancer into the body is a clear causal mechanism, so unless you're filtering it or killing the loos…

The surface of cancer that protects it from the bodies defenses breaking up + parallel chemo or clonal antibody treatments should take care of that. But the principle critical view is correct.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#84

Earlier quoted context omitted.

>>> ... the study found that removing the parachute prior to jumping led to a shocking increase in mortality among skydivers. When there's a clear causal mechanism, additional research that doesn't propose a clear resolution to the underlying problem doesn't negate the clear causal mechanism. Releasing a bunch of loose cancer into the body is a clear causal mechanism, so unless you're filtering it or killing the loos…

The evidence seems to be that the cells are destroyed, not just split up: https://pmc.ncbi.nlm.nih.gov/articles/PMC9404673/

How do they prevent good cells from being destroyed on the way? Shaped sound waves adding up locally?

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#85
post #11
post #7

Earlier quoted context omitted.

Ok, but this might stimulate migration further.

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.

> trust the body to clean up the mess

This is what I'd like to understand better, rather than operate on trust. A couple of other commenters have shared good context.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#86

Earlier quoted context omitted.

The evidence seems to be that the cells are destroyed, not just split up: https://pmc.ncbi.nlm.nih.gov/articles/PMC9404673/

How do they prevent good cells from being destroyed on the way? Shaped sound waves adding up locally?

Yes exactly - focus at a point. You don't reach threshold pressures until you have sufficient summed waves.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#87

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 th…

What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body? Welp I put it to you like this - if you DON'T use this then you have a gorillion cancer cells among which very likely one genetically predisposed to adventure throughout the body as turbocancer. If you use this, or radiotherapy, or whatever, presumably there is just a lump of dead tissue where the cancer was, signifying at best…

Cancers aren't perfectly optimized to metastasize, and metasteses (rather than, e.g., bulk pressure from the original tumor) are usually what kills you. It's perfectly possible that the procedure kills 90% or 99% of the cells in the original tumor but increases migration of the remaining cells such that the net effect reduces patient survival.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#88

Earlier quoted context omitted.

What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body? Welp I put it to you like this - if you DON'T use this then you have a gorillion cancer cells among which very likely one genetically predisposed to adventure throughout the body as turbocancer. If you use this, or radiotherapy, or whatever, presumably there is just a lump of dead tissue where the cancer was, signifying at best…

Cancers aren't perfectly optimized to metastasize, and metasteses (rather than, e.g., bulk pressure from the original tumor) are usually what kills you. It's perfectly possible that the procedure kills 90% or 99% of the cells in the original tumor but increases migration of the remaining cells such that the net effect reduces patient survival.

Don't cancer metastases have more to do with cancer mutations allowing the cancer cells to form new tumors? Some cancer types tend do not develop the ability to colonize new tumors while others do regularly.

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#89
post #35

Earlier quoted context omitted.

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 align…

I'm not sure how they do it exactly. I know just the nature of the machine is that it has a massive array of ultrasound emitters and sensors.

Ideally it'd just be software driven. Take an ultrasound scan, adjust, blast. In theory this could be done in milliseconds to counter patient movements. Pretty nifty really!

Re: Ultrasound Cancer Treatment: Sound Waves Fight Tumors

#90
We are more than a decade away from knowing if Histosonics technology will actually be a meaningful treatment modality. It definitely is 'cool' in that there is no incision. However, whenever you deliver ultrasound energy from outside of the body, accuracy goes down; you are also limited by anatomy in the path of the ultrasound (e.g. going through the rib cage with ultrasound is not trivial). Folks I have spoken to who have bought these units say they are only allowed to use them if the tumor is superficial (i.e. near the skin). On top of that patient motion due to breathing definitely causes inaccuracies and complications. One doctor said it's an expensive paperweight (but it does bring patients in who ask for it).

Also, the clinical efficacy is not fully understood. Researchers are most excited by an enhanced abscopal effect (i.e. natural immune response), but that's not a proven phenomenon. Finally, it is really expensive (~$1.5M) so it will be difficult to scale outside of research hospitals and cancer centers. Of course, I don't want to be too negative. It's a win for patients when they have more options.

Full disclosure: I am co-founder of Current Surgical, where we are developing a minimally invasive system based on miniaturized focused ultrasound to achieve precise thermal ablation (not cavitation). Our device can both see and destroy tissue from the same sensors, we can achieve millimeter accuracy. And because the technology can be integrated into any number of surgical tools (needle, catheter, etc) we can potentially reach any anatomy.

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