“The future of medicine is the medicine of frequencies.” – Albert Einstein

Imagine a future where cancerous tumors inside the body could be destroyed using only sound waves. Well… the future is now. And it’s called histotripsy.

Histotripsy is a non-invasive process that uses sound waves to completely eliminate cancer tumors. Like radiation therapy, doctors point an ultrasound device at your tumor and “zap it.” But unlike radiotherapy, there is no cancer-causing radiation or heat involved, tumors can be destroyed in one treatment, there is minimal damage to surrounding tissue, a low rate of complications, faster recovery time, and it has been shown to activate immune cells to identify and target any remaining cancer cells in the body.

The term “histotripsy” is derived from two Greek root words. “Histo” means soft tissue and “tripsy” means break down.

The Science: Histotripsy uses short ultrasound bursts (microseconds in length) with a low duty cycle (≤1%) to minimize heating, and higher peak pressure amplitudes to generate acoustic cavitation from endogenous gas in tissues. Acoustic cavitation is the generation, oscillation, and collapse of microbubbles activated by ultrasound. Very high ultrasound pressure causes inertial expansion and collapse of cavitation bubbles that impart localized intense strain that can fracture cells into an acellular debris. (source)

Translation: Histotripsy uses targeted high-intensity ultrasound, which causes tiny bubbles of gas inside cells to rapidly expand and collapse causing the cell to rupture, essentially blowing up cancer cells from the inside. The cellular debris is then metabolized and eliminated by the body.

This process is similar to lithotripsy, which uses ultrasonic shockwaves to break up large kidney stones, except histotripsy is highly targeted, much more precise and able to destroy cells.

Histotripsy was first discovered by Zhen Xu PhD and colleagues at the University of Michigan in 2001 and has be in development for over twenty years, spearheaded by a company called HistoSonics, which manufactures the Edison Histotripsy System.

Histotripsy may help your immune system fight cancer

Two studies in rodents suggest that after a tumor is destroyed (liquified) by histotripsy, the immune system learns how to identify cancer cells as threats and activates a natural immune response to the remaining cancer.

In one study, only 50% to 75% of liver tumor volume was destroyed by histotripsy, but afterward, the rats’ immune systems eliminated the rest of the tumors. 80% of those rats had no evidence of recurrence or metastases after treatment. (source)

Another rat study shed more light on this phenomenon revealing that that histotripsy exposes cancer cell antigens to the immune system, which the immune system identifies as threats, thus empowering immune cells to recognize and kill previously “invisible” cancer cells. (source)

The implications of this are huge. Treating one tumor with histotripsy could potentially activate the immune system to kill remaining cancer cells in the body, thus eliminating the need for traditional surgery, radiation or drug therapies.

Histotripsy treatment options

In 2023, histotripsy therapy received FDA approval for treating liver tumors, including liver tumors that originated in other organs, but there are some eligibility restrictions and that’s the only cancer it’s approved for so far. There are ongoing clinical trials for liver, kidney and pancreatic tumors. Typically patients in clinical trials don’t have to pay for treatment. You can learn more about enrolling in one of these trials here.

Eli Vlaisavljevich PhD, associate professor in the Department of Biomedical Engineering and Mechanics at Virginia Tech and his team are currently leading large projects to advance histotripsy for the treatment of other cancers, including pancreatic, breast, bone (osteosarcoma), soft tissue sarcoma, brain, and oral, as well as in other applications.

“This is an exciting milestone and hopefully the first of many applications that will be approved for histotripsy in the future,” said Vlaisavljevich. “Now, we are going after all the cancers.” (source)

There are no long-term human studies on histotripsy yet, so we don’t know what impact this procedure has on metastasis or long-term survival–only time will tell–but I am encouraged to see the early trial results showing a much lower risk of harm than surgery, chemo and radiation and potential whole body anticancer immune system activation.

Where to get histotripsy

As of the writing of this article (December 2024), there are currently 27 histotripsy providers in the United States and one in the United Arab Emirates. If the research continues to show benefits, I can forsee a not-too-distant future where histotripsy is available in every city and approved for most solid-tumor cancers.

Find a histotripsy provider here.

HistoSonics patient information site

Histotripsy: the first noninvasive, non-ionizing, non-thermal ablation technique based on ultrasound

Article written by Chris Wark

Chris Wark
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