Histotripsy: Delivering New Hope
What is histotripsy?
Histotripsy is an FDA-approved ultrasound machine that utilizes pulsed sound waves to create “bubble clouds” from gases naturally found in targeted tissue. These tiny bubble clouds form and collapse in microseconds, producing powerful mechanical forces that can effectively break down tissue at the cellular and sub-cellular levels.
-
Non Invasive
The procedure does not require any incisions, needles, or other insertions through the skin, which can help reduce the risk of infection, bleeding, long recovery times and other complications.
-
Single Treatment
Most tumors can be effectively destroyed in a single treatment session. Depending on your condition and treatment plan, multiple treatment sessions may be necessary.
-
Targeted
Histotripsy can be used to precisely target and destroy unwanted tissue, such as tumors, while minimizing damage to surrounding tissue.
About the procedure
No incisions or cuts are made during the procedure. Instead, a soft, flexible membrane filled with degassed water is positioned over the area where the treatment is needed, and ultrasound imaging is then used to locate the tissue and monitor the histotripsy treatment in real-time.
Patients typically go home the same day or day after the procedure and can resume regular activities quickly.
Who is Suitable for Histotripsy Treatment?
Histotripsy treatment is suitable for stage 1 to 4 liver cancer patients, including those with primary and metastatic liver cancer.
-
Stage 1-3
- Curative Intent: Histotripsy is used to completely destroy the primary tumor with the intent of achieving a cure.
- Non-Surgical Alternative: It is often the preferred option for patients with small, localized tumors who are not candidates for surgery due to other health issues (like severe liver cirrhosis in liver cancer patients) or who simply wish to avoid a highly invasive procedure.
- Organ Preservation: Because it is non-thermal and precise, it is excellent for tumors located near major blood vessels or bile ducts, where heat-based ablation (like RFA or MWA) or surgery would risk collateral damage.
-
Stage 4:
- In Stage 4, the cancer has spread (M1). The goal of treatment is typically not cure, but rather disease control, prolonged survival, and symptom relief (palliation).
- Ablation of Oligometastases: This refers to a situation where a patient has a small, limited number of metastases (e.g., one or two spots in the liver). Destroying these limited spots can significantly prolong survival and may even lead to long-term disease remission in some cases.
- Local Tumor Control (Debulking): For patients with more widespread Stage 4 disease, destroying large, symptomatic tumors can reduce the overall tumor burden ("debulking"). This can alleviate pain, improve organ function, or make systemic therapies (like chemotherapy) more effective.
- Bridging Therapy: It can be used as a "bridge" to keep the cancer under control while a patient is waiting for a major procedure, such as a liver transplant.
- Immune System Stimulation: This is the most exciting potential. Pre-clinical research suggests that the mechanical destruction by Histotripsy releases specific cellular debris that can "prime" the patient's immune system to attack the cancer cells elsewhere in the body (this is called the abscopal effect). If proven clinically, this would make it a valuable partner to immunotherapy in advanced cancer.
How Histotripsy Compares to Other Liver Cancer Treatments
Understand which treatment may be most suitable for you, based on cancer stage, recovery time, effectiveness, and cost.
| Treatment | Types | Cancer Phase | Recovery & Effectiveness | Price |
|---|---|---|---|---|
| Histotripsy | Non-invasive focused ultrasound that mechanically destroys tumor tissue | Early to medium sized localized tumors | 3 - 7 days; very effective because destroying tumour tissues directly while protecting the healthy surrounding tissues. | HK$260,000 - 310,000 / US$33,000 - 39,500 |
| Radiofrequency Ablation (RFA) | Heat-based destruction of tumor with needle probe | Early small tumors | 3 - 10 days; good for less than 3 cm tumors, bigger tumors/with metastases will need treatment alternatives that can preserve healthy body tissues. | HK$270,000 - 540,000 / US$35,000 - 70.000 |
| Targeted Therapy | Drugs targeting specific cancer pathways | Medium to advanced cancer stage | Months to years; recovery and effectiveness depend on the mutations | Varies per treatment, usually min. HK$30,000 - 50,000/treatment / US$3,800 - $7,000/treatment |
| Immunotherapy | Immune-modulating cancer drugs | Medium to advanced cancer stage | Months to years: highly effective for responsive patients | Varies per treatment, HK$40,000 - 70,000/treatment / US$4,200 - $7,000/treatment |
| Surgical resection | Removal of tumor, part of or the whole liver (half or full transplantation) | Early to medium cancer stage (with very strict criteria) | 6 months - 2 year; potential to full recovery and long-term survival | HK$50,000 - $150,000 / US$80,000 - $1 million, can be very expensive due to donation scarcity |
Helping Patients Understand Clinical Trials and Their Options
A simple guide to clinical trials, the differences between each phase, and how they may offer additional treatment options for eligible patients.
