Ultrasound Cancer Treatment: Sound Waves Fight Tumors
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The medical world is abuzz with a novel cancer treatment that harnesses sound waves to pulverize tumors, sparking a lively debate about its potential risks and benefits. Some commenters worry that disrupting tumors could spread cancer cells or proteins, but others counter that the treatment might actually stimulate an immune response, exposing neoantigens and helping the body attack cancer cells. As one commenter noted, histotripsy - or "cell pulverizing" - has been shown to incite a local inflammatory reaction, which could be a crucial factor in its effectiveness. With this technology already available in some US cities for treating liver tumors, the discussion is not just speculative, but also tantalizingly close to real-world application.
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This is what I'd like to understand better, rather than operate on trust. A couple of other commenters have shared good context.
[1] https://faculty.mdanderson.org/profiles/dan_gombos.html
If any medical professional could give answers that would be neat.
that's discussed in the article
Seems a little too speculatively worded, IMO.
[1] - https://news.engin.umich.edu/2023/10/these-bubbles-kill-canc...
Part of the freak-out about the Trump admin's attacking of scientific research (including, especially, of mRNA research) earlier in the year is that it threatened these trials.
In theory, this may mean that metastisizing this tumour could destroy it in the pancreas, but allow the cells to spread to more treatable locations?
1 - https://www.canceraustralia.gov.au/cancer-types/pancreatic-c...
A number of studies show that, in humans, the keto diet (the medical keto diet[1] and not the meat heavy Internet version) causes metabolic stress in breast cancer cells and in several other types of cancer, due to their significantly increased metabolic needs. It's like the difference between a normal human and Michael Phelps during Olympic competition. The cancer cells can process ketones, but not efficiently enough to fuel their activity so they starve.
In humans this eventually results in the death or deactivation of the cancerous cells (deactivation being the primary way that tumors "adapt" to a starvation diet). There have been few, if any, reported cases of metastasis in the types of cancers studied in humans. This outcome is statistically significant enough that multiple cancer treatment centers recommend the medical keto diet to human patients as part of a treatment regime.
As mentioned, the recent study from 2024 shows that this type of metabolic stress can, in mice cause the cancerous cells to metastasize in a last-ditch attempt to survive. However, very little of the cancer research conducted on mice has applications to human cancers. For example, chemotherapy has also been shown to cause metastasis in mice, and a number of earlier studies attempting to replicate the keto research in humans shows that the keto diet in mice increases tumor growth, which is the opposite effect it has in humans.
[1] The medical keto diet is basically just fat and vitamins. No carbs, and minimal to no protein because protein can get converted into glucose by gluconeogenesis. It is not a diet anyone would want to be on longer than strictly necessary. One of my friends had stage 4 metastatic lung cancer, which she discovered during a company-sponsored mud run. Surgery was not an option and chemotherapy was not working. With less than 4 months to live, she went on the medical keto diet and the two-punch combo of keto and chemo put the cancer into remission for almost three years. (Note: She only maintained the diet for a few months after ending chemo treatment. Unfortunately not all of the cancer cells had died, some had merely deactivated. Four years after remission the cancer cells reactivated with a vengeance and she died the day after she started showing symptoms.)
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.
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 loose cancer somehow, I'm not sure what those studies could tell you that overcomes the underlying problem. And until they address that problem, it's going to be limited to a quality of life type application - stopping the tumor from killing you now with the certainty of metastasis killing you later.
And so humans evolve to enforce better cooperation among the cells.
So, no, cancer cells did not evolve to kill you. They do evolve for short term gain, however.
It's an endless struggle.
It's not unlike the struggle between civilized people and criminals.
I'm not in cancer field, but I'm not sure it is. AFAIK the cells that metastasize need to undergo EMT. Simply releasing them from the tumor doesn't mean the cells can attach and survive in the distal site.
https://www.fusfoundation.org/posts/transformational-milesto...
https://www.mddionline.com/business/jeff-bezos-others-comple...
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 you cured it but at worst, knocked it down - specifically if you knocked it down from a gorillion to a million cells, genereally speaking if the body has been seeded or the tumor persists - the tumor will take longer to rebuild back up where it was. The latter is manifested as another such and such months of life, making the therapy "life extending"
"The risk of tumor seeding after liver biopsy is 2.7%"
https://easl.eu/wp-content/uploads/2018/10/Hepatocellular-Ca...
Tissue containment systems for uterine morcellation
https://www.fda.gov/medical-devices/safety-communications/up...
i'd never heard of that counter before so i googled it:
> The word "gorillion" is often used by white supremacists and Holocaust deniers in the form of "six gorillion", which mocks the figure of six million Jews that died during the Holocaust.
may want to look at using different verbiage.
You may want to look at using a different dictionary for reference.
Of course, one should ask themselves why so much of that culture is fed from and feeds into outright hateful people like nazis and Eugenicists and vague wife haters, and conspiracy theorists who "aren't nazis" but sure seem to believe everything is the fault of the jews.
"Gorillion" as I saw it was about the "Ape" context of wallstreetbets discourse. The Ape framing is actually non-hateful, referencing the new Planet of the Apes movies where someone makes a dumb analogy to a bundle of sticks: "Ape together strong"
They are similarly fans of calling people and things retarded, but that was getting reddit itself to nag them. So they switched to "regarded", because they aren't very clever.
Other gems of this community include frequent references to making "wife changing money" and an insistence that after GME totally turns out to not have been a scam and they bring down the entire american economy through literal shenanigans, that they will all collectively be crowned king, and totally won't oppress anyone, but also they relish the expectation that they will be able to smugly say "I told you so" to all the people suffering in their new regime.
They also adore doing the kind of "theory crafting" that is usually done by the most crazy person you know trying to "prove" bill gates did 9/11 because of that wingdings thing from 20 years ago.
But culture leaks, so this person might have just picked it up somewhere.
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 pricy.
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 alignment correct. But perhaps there is a CT scan afterwards that lets them make the fine alignment. It probably also helps that the liver is a much larger gland so aiming is less critical?
I think we were all thinking that. Acoustic Cavitation has also been proposed as a mechanism for enabling cold fusion. https://www.science.org/doi/10.1126/science.1067589
https://www.nature.com/articles/s41467-025-65080-9
which could imaginably lead to wireheading or something like Niven's "tasp".
https://news.ycombinator.com/item?id=46008332
Are these guys losers,clueless, or born psychopaths?
I hope for another category :)
https://news.ycombinator.com/item?id=45955649
(By way of an "explanation" of the "3 boxes")
https://news.ycombinator.com/item?id=23475069
It seems that "third-person first" encapsulates the ALARM theory perfectly..
In
Bottom box as primordial "third person" would go along with egolessness in various traditions (including 李小龙's "be water, my friend")?
Note that solidarity from roman law was directly taken up by civil codes, but HN's home country is a common law jurisdiction: https://en.wikipedia.org/wiki/List_of_national_legal_systems...
("joint and several liability" seems to cover passive, but not active, solidarity?)
Note that narcissism is what PH/Kohut is trying to analyse here. I'm struggle to put egolessness at its foundation, because that smells too much like nihilism. seem s increasingly less healthy to scale nihilistic therapy to a handful, 37, 1000s..
Why not an alternative life-force that could legitimise the "ri" in shu-ha-ri, "acting-out", "disruption" (& still make it both personal and ... solidarital?)
Disruption is after all the unspoken (meta?)ideology on HN..
Fully hypothetically, its how "weaponized curiosity" gets bootstrapped into a full alarm (as "we" model the minds running an institution (PH), the spiessig (you?), HN moderators (I) :)
Right, I just think Kohut's third box (we are talking about the bottom one, right?) may be just as profitably looked at through the "egolessness" prism as through the "integrated" prism.
Looking through the shu-ha-ri prism, I could see the top two boxes as being symptomatic of the "ha" stage: breaking the rules with grandiose intentions usually leads to worthless results? In this model, there are two paths out: a retreat from frustration, back into "shu", or a tunnelling through frustration, onwards into "ri"?
(to what degree might tunnelling relate to LLM "double descent"?)
Speaking of "weaponized curiosity", I once ran across a recommendation for determining which puppies to bother attempting to train as hunting dogs: https://news.ycombinator.com/item?id=41488445
Will merge these streams into a more recent stub--
Not like water?
* is it intuition, or is it following a geodesic on (your foliation of) the Lagrangian?
I'm still trying to internalize+merge the other sense of Lagrangian (as in "L submanifold")
If you want to dig a little bit, the team of Mathias Fink in Paris explored "time reversal" techniques to get through the skull: one have to emmit from the tumor location, listen with a huge array, reverse the signature and blast. I don't know if this ended with a medical device.
Take care.
The key thing is, one of the things most tumors need to do to get past a certain point is avoid getting caught being tumors.
If you can very selectively cause precise tissue death, from any method, then your body will suddenly start looking askance at any tissue that looks like the secretly-full-of-tumor-markers corpse it just found.
And ultrasonic cavitation means you can, in theory, cause very precise tissue death with even less surrounding effect than radiation.
The former is somewhat effective but based on early research shares the same problems as other active fat loss treatments: lysing the fat cells causes all the relevant hormones to get released into the bloodstream, causing reabsorption by other fat cells. It’s a very gradual process and quite expensive.
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.
Is this because of: - the efficiency is going down massivly (maybe into useless)
or
- using it "below superficial" might cause other/new problems?
1. There is a wavelength and penetration depth trade off. For better accuracy you need smaller wavelengths (i.e. higher frequencies) but at higher frequencies ultrasound pressure gets absorbed at a higher rate, making it challenging to get the required pressure levels deeper into tissue.
2. Ultrasound focus can deflect as it travels in tissue (tissue is a non-linear material and multiple tissue types impacts wave propagation). The deeper you try to focus, the more likely that there is a deflection; thus your focus point won’t be exactly where you were planning.
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 network (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.
Click bait is click bait but reliably reels in the gullible.
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.
https://www.mdanderson.org/cancerwise/histotripsy-for-liver-...
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.
> 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.