HN

Comments (89)

• Menu

  amashal
  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.
• Menu

  CGMthrowaway
  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"
• chaboud
  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.
• YossarianFrPrez
  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.
• Menu

  jtbaker
  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!
• melling
  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-...
• Menu

  snowless
  Could this be applicable and available to the public within a reasonable time horizon? My mother is dealing with a brain tumor located in the pons, and no surgeons will operate because of its location, as the risk is too high. Radiation treatments have also been exhausted and have already caused some necrosis. There was another form of light-based therapy, but it is experimental and carries an incredibly high risk as well. The prognosis has never been good, but we’ve been holding out hope. At this point, treatment consists of nonstop chemotherapy.
• darubedarob
  I wish there was a way todo chemo locally only. Like a body part has cancer, you add a bypass to that part and put that bodypart on a eccmo chemo poisoning only the affected system part. After that flush out and reconnect.
• Menu

  cogman10
  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.
• 0xWTF
  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.
• jmward01
  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.
• Nevermark
  Being non-invasive and incredibly precise, this could be a fantastic therapy for brain cancer treatment.Assuming the costs of the precise powerful machines needed are not too high (this isn't anything like MRI), it could be a therapy for almost any kind of cancer tumor, and even small potential/pre-cancer tumors that are safe to remove without bothering to do a diagnosis.
• Menu

  aitchnyu
  Will this be applicable to belly/visceral fat? It could be wildly popular.
• lostsock
  The awesome "What's your problem" postcast had an episode with the CEO of this company recently which I really enjoyed: https://www.pushkin.fm/podcasts/whats-your-problem/using-sou...
• mcbain
  Previously: https://news.ycombinator.com/item?id=45514378
• Menu

  PaulHoule
  In general there is a lot of work on ultrasound stimulation now, some of it is scary in other ways:https://www.nature.com/articles/s41467-025-65080-9which could imaginably lead to wireheading or something like Niven's "tasp".
• KnuthIsGod
  A random popular article on ieee.org is not a Phase 3 RCT published in the NEJM.Click bait is click bait but reliably reels in the gullible.
• buu700
  Thanks for posting this. Sounds super promising, and the explanation of histotripsy's mechanism of action is compelling.Given the 2023 approval (for liver tumors) and oversubscribed $250m funding round announced in October, it seems like there's a ton of momentum behind this. I also see that the treatment is available at my local hospital system (Inova), which is an encouraging sign of its general availability.Anyone who's commenting to ask whether it's an option for you or a loved one, check your state's right-to-try laws. Virginia and various other states do apparently have right-to-try laws that cover medical devices: https://triagecancer.org/state-laws/righttotry.Fuck cancer.
• anon
  undefined
• Menu

  maxdo
  from purely physics , how is cancer cell different from regular cell to react with ultra/infra? is it so different?
• Menu

  jbverschoor
  Does this work with lung cancer?
• Menu

  darkerside
  Dumb question, but isn't there a risk of spreading cancer causing proteins throughout the body with this approach?
• anon
  undefined
• pointbob
  Heavy metal has entered the chat.