Radical new therapy uses microscopic air bubbles to destroy tumors

After being diagnosed with liver cancer last June, Sheila Riley, 68, braced herself for painful and exhausting rounds of treatment.

Surgery, chemotherapy, radiotherapy and even ablation – where heat is used to destroy the tumor – are some of medicine’s most effective tools against cancer, but the potential side effects hidden hard to bear.

In fact, Sheila has gotten rid of all of this thanks to a radical new form of therapy that uses microscopic air bubbles to destroy tumors within minutes and leave no trace on the body.

She is one of the first patients in the UK to undergo tissue surgery, where focused ultrasound waves are directed from outside the body to destroy tumors by creating thousands of gas bubbles that explode. . The process was so quick that her tumor was removed – painlessly – in less than seven minutes.

“It’s been amazing,” said the grandmother of eight, who was treated last August at St James’s University Hospital in Leeds.

Sheila, who lives in Bradford with her partner Frank, 70, added: ‘I didn’t need any medication – not even painkillers.

‘I was able to go shopping the next day, and two days after the treatment I went out with friends. It doesn’t even leave a mark on my skin. ‘

It is now hoped the procedure could help people with tumors in other parts of the body.

Histopathology was pioneered by researchers at the University of Michigan, USA, and relies on a process called cavitation – creating an empty space inside something solid – to remove cancer.

First, a beam of ultrasound energy is directed through the skin to the tumor site. When the beam hits the targeted site, it triggers thousands of naturally occurring air sacs in tissue throughout the body, even tumors, as a result of respiration.

These tiny air sacs are normally dormant, but when blown with sound waves, they expand, vibrate, and explode, forming a high-energy cloud of tiny particles within the tumour.

As they rapidly expand and collapse, the bubbles burst into the surrounding cancerous tissue, liquefying it into a solution that is then excreted from the body as waste.

Unlike existing treatments such as microwave ablation, where a heat-generating probe is used to ‘cook’ tumor cells, no heat can damage surrounding healthy tissue. around, making the invasive process potentially safer.

This ultrasound’s ability to destroy tissue has been known for many years but was not previously used as a cancer treatment because it was too difficult to control the bubble clouds and avoid damaging the tissues. strong.

However, the procedure has now been refined and the energy source can be better directed inside the tumor, avoiding the risk of nearby healthy tissues or organs being affected.

An international trial is currently underway to review liver cancer histopathology. Principal investigator, Professor Tze Min Wah, senior consultant in interventional radiology at St James’s University Hospital, believes that cavitation could transform cancer treatments.

“Instead of using heat, radiation, or surgery to remove a tumor, the cloud of bubbles created by histopathology is so powerful that it ruptures the tumor but doesn’t damage the tissue around it,” she said.

The scientists chose to test the cavitation procedure on liver cancer because of its poor five-year survival rate, but the technology also has the potential to treat other organs, including the kidney, pancreas, breast, prostate and brain.

The procedure is performed under general anesthesia and uses real-time ultrasound that scans the liver, allowing the radiologist to see the tumor being identified and destroyed.

A bedside machine with a robotic arm, built by the University of Michigan’s subsidiary manufacturing company, HistoSonics, is moved into position on the patient’s abdomen.

Attached to the end of this arm is a transducer, a device that, once activated, converts electrical energy into ultrasonic energy.

Prof Wah explains: ‘Once a tumor in the liver has been located, it becomes a target for the system to block.’

The machine’s software then calculates the amount of energy needed to create a cloud of bubbles powerful enough to destroy the tumour, with the ultrasound waves focusing on a focal point at its center.

Prof Wah said: “Once the tumor debris has been liquefied, it is naturally absorbed by the body before being discharged as waste.

In contrast, with conventional excision therapy (which also uses image guidance), a needle is inserted into the patient’s abdomen and into the tumor. When in place, the microwave energy heats up the water molecules in the tumor, thereby destroying it.

The debris created becomes scar tissue, and although considered a safe treatment, there is a small risk of nearby blood vessels (or in the case of liver cancer, the bile ducts). heat damage may occur.

To date, two patients have received epileptic treatment in Leeds and two at the Freeman Hospital in Newcastle. Four hospitals in Europe are also participating in this #HOPE4LIVER trial, involving 40 patients.

Professor Wah said: “Those are very early days, but for patients who have undergone histological testing, it is encouraging and exciting to be able to treat patients without the need for treatment. make an incision or even use a needle.

Professor Gail ter Haar, leader of therapeutic ultrasound at the Institute of Cancer Research, said: ‘I think the use of histopathology is very interesting. In the past, we used to say don’t use bubble operation as a treatment because it’s unpredictable.

‘But more recent research has shown that the use of the sonic flaw, which is what the HistoSonics system is using, can now be controlled. Now you can generate its energy where you want it and keep it going to continue to mechanically break down tumor tissue.

‘In the future, this treatment could be used for tumors in the prostate and kidney, and tumors where the bones or ribcage will not disrupt the highly focused beam.

‘But because ultrasound cannot travel through gas, for example, it cannot be used to treat deep-seated lung tumours.

‘The jury is still out on whether this approach is more successful than thermal ablation, but it will be interesting to see if this treatment is successful. “

Before her breakthrough diagnosis and treatment, Sheila, a retired contract manager, had been experiencing abdominal discomfort for three or four months, with ‘a constant dull ache’ in her side and neck. made worse if she lifted anything heavy and woke her up. her in the night if she turns herself.

By April 2021 it is almost unbearable; After a car ride where she winced in pain every time it passed a speed bump, Sheila’s partner Frank called an ambulance to take her to the hospital. Tests showed she had two liver tumors.

Larger tumors were treated with histological epilepsy; the smaller one is obscured by Sheila’s ribs so it won’t be visible on an ultrasound and needs to be removed instead.

Sheila said: ‘After the tissue test, I didn’t feel any pain in my abdomen.

‘But after conventional microwave heat ablation last November I was hospitalized for a week and then in pain for about five weeks. I am taking prescription pain relievers as well as paracetamol which I buy to deal with the pain.

‘At first, I couldn’t even stand long enough to be able to peel vegetables while making us dinner.’

Sheila, who is still regaining her strength after the amputation, is now looking forward to marrying Frank later this year and several more holidays. Follow-up tests showed no signs of cancer on her liver.

“I booked us one stay in Ibiza in June and another near Skegness,” says Sheila. ‘I feel so lucky to be treated like this.

‘I hope it can be used to help other cancer patients, as well as people with cancer like me. That would be really great. ‘

Under the microscope

Former Olympic and World Champion cyclist Victoria Pendleton, 41, takes our fitness quiz

Can you run up the stairs?

Former Olympic and World Champion cyclist Victoria Pendleton, 41, takes our fitness quiz

Former Olympic and World Champion cyclist Victoria Pendleton, 41, takes our fitness quiz

Former Olympic and World Champion cyclist Victoria Pendleton, 41, takes our fitness quiz

I’m always running up the stairs, usually two people at a time. It’s just the way I do things. I exercise maybe six out of seven days. I also have two horses for exercise.

Get your year a day?

Probably most days I eat more than five years apart. I love a colorful diet and I really enjoy cooking from scratch. I’ve been on a vegan or plant-based diet for almost nine years and will never go back. I feel good for it.

Ever been on a diet?

I have never been a dieter. If I could exercise all day, I would. I’m lucky I’ve never really had to cut calories so rigorously to lose weight. I’ll just go a longer way. I am 5ft 4in (1.65m) tall and weigh 13lb (57kg) for the 8th time.

Any evils?

I like a couple of glasses of red wine on the weekend and dark chocolate. I wouldn’t say they are really evils.

Worst illness or injury?

Touching wood, I was very lucky, despite playing a lot of dangerous sports. I broke my finger as a kid in gym class, crash, but it was the worst of it. I also fell off a few horses and got a little bumped, but that’s normal.

Domino’s Disease

Health conditions that are related to other diseases. This week: Gum disease and dementia

According to a study by Cornell University in the US, gum disease may increase the risk of Alzheimer’s disease. People diagnosed with Alzheimer’s disease have higher levels of antibodies against the bacteria P. gingivalis, a risk factor for gum disease, reports the Journal of Alzheimer’s. This bacteria is thought to travel to the brain and cause inflammation.

Take any medicine?

I usually take a multivitamin if I feel a bit bloated or in the winter. I don’t take one every day. I tend to avoid taking tablets if possible. If I get a headache, I’ll wait until I really need to take one.

Coping well with pain?

Very good. I have a pretty high tolerance.

Tried alternative remedies?

I like a little acupuncture. I find it really helpful for aches and pains or muscle tension. I also received chiropractic treatment.

Ever been depressed?

Yes. I was severely depressed after being deprived of oxygen [when attempting Everest in 2018]. I spent a lot of time with advisors and it was really helpful. Surfing also helps a lot. I have been prescribed medication but it is not ok for me. I felt worse, so I stopped immediately.

Cure a hangover?

I have never had a hangover.

Ever had plastic surgery?

I fully support non-invasive plastic surgery. I think there’s no reason you can’t make yourself feel better. I’ve had a bit of Botox myself.

What keeps you awake?

I actually sleep really well – about eight to ten hours a night.

Want to live forever?

Certainly not. I think that’s an absolutely terrifying idea. Why would you want to live forever and watch everyone you love and know go by around you?

Victoria is supporting the launch of SlimFast Vitality shakes –

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