[HN Gopher] Ultrasound is ushering a new era of surgery-free can...
       ___________________________________________________________________
        
       Ultrasound is ushering a new era of surgery-free cancer treatment
        
       Author : 1659447091
       Score  : 349 points
       Date   : 2025-10-08 10:18 UTC (6 days ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | sho_hn wrote:
       | How's progress on individualized cancer remedies based on mRNA?
        
         | michaeljx wrote:
         | Don't know about mRNA but individualized remedies based on
         | CAR-T technology have been making significant strides in this
         | area, with major commercialisation expected in the next 1-2
         | years
        
       | RedShift1 wrote:
       | Once you've destroyed the tumor, how do you get it out of the
       | body?
        
         | Timsky wrote:
         | Usually, it suffices to initiate apoptosis, the self-
         | destruction mechanisms of the cells.
        
           | elric wrote:
           | I doubt ultrasound would trigger apoptosis in cancer cells,
           | one of the reasons they're cancerous is that they refuse to
           | commit suicide when they should.
        
             | snovv_crash wrote:
             | It heats them until enough damage is done that they die
             | regardless.
        
               | patall wrote:
               | So more like necrosis, not apoptosis. Maybe non-
               | biologists are not aware, but apoptosis is not just cell
               | death.
        
               | hgomersall wrote:
               | Or just tears them apart in the case of Histosonics.
        
         | xbmcuser wrote:
         | The recycling of dead cells is a normal biological process the
         | same thing happens when they use radiation to kill cancer cells
        
         | elric wrote:
         | If I interpret the article correctly, the ultrasound energy
         | does two things: it effectively destroys the cancer cells by
         | overheating them, and it physically breaks apart the tumour.
         | Your immune system can further break up and get rid of dead
         | cells the way it deals with normal dead cells.
        
           | polishdude20 wrote:
           | Won't there still be some broken up live cells that can now
           | migrate around the body and cause cancer in other areas?
        
             | ceejayoz wrote:
             | This was an issue with uterine morcellation;
             | https://en.wikipedia.org/wiki/Morcellator. Per the article,
             | though:
             | 
             | > Some researchers have raised concerns about histotripsy
             | potentially seeding new cancer growths as tumours are
             | broken up inside the body, meaning they can be transported
             | to other areas. That fear, however, hasn't borne out in
             | animal studies so far.
        
         | colmmacc wrote:
         | https://www.statnews.com/2024/06/22/hank-green-pissing-out-c...
         | 
         | Watching Hank Green's YouTube video where he found out that his
         | cloudy pee was cancer leaving his body, he was surprised that
         | doctors don't tell you to expect it. It can be such a morale
         | boost.
        
       | isoprophlex wrote:
       | I remember seeing a demo from people who could slap a raw steak
       | into one of these machines, and with ultrasound, sear their logo
       | into the meat at sub mm precision. But that was long ago & not
       | ready for medical usage yet. Cool that it seems to be used for
       | actually treating people now.
        
         | cogman10 wrote:
         | I just spoke to a oncologist surgeon about this. Even though
         | their facially doesn't have one (they are expensive machines)
         | he said it's looking like it'll be standard care in the future.
         | 
         | He did an evaluation about getting one for my local hospital.
        
       | owenthejumper wrote:
       | This can also be used for prostate, it's nothing new. But you
       | cannot use this anywhere where the ultrasound would be blocked by
       | other organs.
       | 
       | Fun fact: using this ultrasound for prostate cancer treatment
       | reduces the risk of erectile disfunction
        
         | ptsneves wrote:
         | Can't the surgery be then with a small probe just to get the
         | ultra sound tip near the cancer? I don't know the size of the
         | ultrasound tip but seems to me it can be smaller then a hand or
         | tweezers.
        
           | timschmidt wrote:
           | Often constructive and destructive interference of waves can
           | be used to focus the ultrasound through tissue without any
           | incisions at all. Kidney stones are sometimes broken up this
           | way.
        
           | mattkrisiloff wrote:
           | See currentsurgical.com
        
         | bonsai_spool wrote:
         | > Fun fact: using this ultrasound for prostate cancer treatment
         | reduces the risk of erectile disfunction
         | 
         | I'm not aware of strong evidence in this area (not saying
         | you're incorrect).
         | 
         | For the liver indications, several elite radiology departments
         | have had very poor outcomes with their patients, despite the
         | strong public data. I would not, with my own prostate, try a
         | new technology until at least a decade out, at least.
        
           | owenthejumper wrote:
           | Here is a trial (2022):
           | https://pubmed.ncbi.nlm.nih.gov/35714666/
           | 
           | And a review: https://pubmed.ncbi.nlm.nih.gov/36686753/
        
           | wlaw15 wrote:
           | Urinary and erectile function are a major issue with partial
           | and radical prostatectomy. These ultrasound treatments are
           | showing significant improvements in both areas.
           | 
           | This technology is also now used to treat non-cancerous
           | prostate enlargement (BPH).
        
             | bonsai_spool wrote:
             | > Urinary and erectile function are a major issue with
             | partial and radical prostatectomy
             | 
             | There are other options besides prostatectomy or the
             | untested histotripsy.
        
               | wlaw15 wrote:
               | True, but currently prostatectomy is the most common
               | intervention and second is radiotherapy which as
               | mentioned in a comment above is a very expensive
               | alternative with known side effects.
               | 
               | Histotripsy is early in its clinical life but I wouldn't
               | say untested.
        
               | bonsai_spool wrote:
               | I'm not sure why we're plugging a brand new entity when
               | PAE is already in guidelines.
               | 
               | People who aren't in medicine are very susceptible to
               | advertising - this is why I'm writing so stridently
        
         | sarchertech wrote:
         | The article mentions that this is a different type of
         | ultrasound treatment than the one that has been in use for
         | prostate cancer treatment for some time.
        
         | Veliladon wrote:
         | >But you cannot use this anywhere where the ultrasound would be
         | blocked by other organs.
         | 
         | Yes you can. If you had an array of ultrasonic transducers
         | around the body you could have each of them in phase targeting
         | a single spot. Beamforming is a thing we've been doing for
         | years with RF. It's even more trivial with sound.
        
           | thechao wrote:
           | We were privy to a lab that accidentally cooked mice with
           | gold nanoparticles in the late 90s with multiple IR lasers.
           | After they figured the power side, it turns out that gold
           | nanoparticles are wildly cytotoxic on a number of axes.
        
             | a11r wrote:
             | https://house.fandom.com/wiki/Clueless
        
           | fortran77 wrote:
           | IN fact, they do this today to break up kidney stones.
           | Multiple beams.
        
           | dylan604 wrote:
           | How is it more trivial with sound? Sound is just a wave just
           | like ultrasound. In fact, ultrasound has the word sound in it
           | making it sound. So your conclusion is not sound.
        
             | BurningFrog wrote:
             | Reread, and you'll realize it means more trivial than RF.
        
               | dylan604 wrote:
               | Ugh, yes. Not sure how the wires got crossed like that.
               | However, sound is just a wave while RF is also waves even
               | if at higher frequencies. Just as ultrasound is higher
               | frequency that audible sound (which I guess is how
               | "sound" was being used). If you continue increasing the
               | frequencies past the RF range you will eventually get
               | into light.
               | 
               | You just gotta catch the right wave
        
       | hans_castorp wrote:
       | Don't they break up kidney stones using ultrasound as well? Or is
       | that a different type of "ultrasound"?
        
         | herval wrote:
         | "Lithotripsy" is the name of the kidney stone treatment. My
         | understanding is it's based on vibration, not ultrasound (I
         | know, vibration _is_ sound - my understanding is the method on
         | the linked article uses higher frequency + intensity + shorter
         | pulses than the kidney stone method - so sorta like microwaving
         | tumors vs using a massage gun on kidney stones?)
        
           | CaptainOfCoit wrote:
           | I think parent is thinking of "Ultrasonic lithotripsy" which
           | does use ultrasound.
        
           | bamboozled wrote:
           | I've had it, it's ultrasound but it's not always effective
           | against hard stones.
        
           | gosub100 wrote:
           | I think that's traditionally done with lasers.
        
             | bamboozled wrote:
             | That's transurethral lithotripsy.
        
             | psunavy03 wrote:
             | Having had kidney stones, they're both used. I think for
             | the sonic one they put you in a water bath because it
             | conducts better. But as I understand it, the docs can pick
             | whichever one is more optimal, be it shattering the stone
             | sonically or zapping it with a laser.
        
             | billforsternz wrote:
             | My surgeon told me my previous kidney cancer surgery
             | (partial nephrectomy) meant my 7/8 size kidney wouldn't
             | handle ultrasound treatment for the big kidney stone I'd
             | developed 10 years after the cancer. So laser instead!
             | Worked well but not much fun at the time.
        
         | molszanski wrote:
         | AFIKR two facilities do this kind of treatment. One in Canada
         | and one in China. There already was a HN threads with some
         | reporting to have been treated in Canada.
         | 
         | https://news.ycombinator.com/item?id=31630679
         | 
         | Apparently, only some tumors have a distinct and unique shape /
         | size. The "trick" is to calibrate the resonance exactly to the
         | size of the cancer cell. So that resonance would "hurt" only
         | that kind of shape / size cell. Which was much harder to do
         | than it sounds. Sadly not all cancer cells are unique and not
         | that "easily" distinguishable by size
         | 
         | But I am not in the medical field and just repeating what I've
         | read.
        
       | Tade0 wrote:
       | > "Cancer is awful," Xu says. "What's making it even worse is
       | cancer treatment."
       | 
       | Well said. And it's either terrible or expensive (and sometimes
       | also terrible as well).
       | 
       | Proton therapy for instance is amazing at targeting hard to reach
       | tumors like those in the eye, but costs close to fix figures as
       | it requires a team of people to design the treatment.
       | 
       | For comparison, a liver histotripsy costs $17.5k:
       | 
       | https://histosonics.com/news/histosonics-notches-significant...
       | 
       | Not a bad deal for a non-invasive life-saving surgery.
        
         | roadside_picnic wrote:
         | An eye opener for me was when a friend of my was dying of
         | cancer there was a period where he got sepsis, ultimately
         | because of the effects of _chemotherapy_ not directly because
         | of the cancer. But had he passed from sepsis (he survived that
         | incident), the cause of death would ultimately be attributed to
         | _cancer_ and not _chemotherapy_.
         | 
         | I looked into it deeper at the time and it's very difficult to
         | untangle the true cause of death in many of these situations.
         | While certainly these treatments are ultimately beneficial
         | statistically, it is concerning that there's not as much
         | discussion around their harm and the real risk rewards behind
         | various treatments. I know from my own (non-cancer) experience
         | that there is a very strong bias towards _treatment_ even in
         | cases where, once you break down all the risk and rewards,
         | there is a strong argument for non-intervention.
        
           | BurningFrog wrote:
           | No one gets paid for non-intervention.
        
           | hylaride wrote:
           | I suspect the medical industry is so heavily regulated that
           | it is very difficult for doctors to recommend non-treatment
           | or risk being sued into oblivion, though maybe it depends on
           | the country.
           | 
           | Here in Canada, before assisted suicide was legalized, my
           | grandfather (in his late 80s) refused any treatment for his
           | kidney failure. He was ready to die and could barely walk or
           | eat on his own anymore. There was a _wink wink_ situation
           | where as the kidney failure worsened, his morphine was
           | increased to the point where it was fatal. The death
           | certificate still said renal failure, though.
           | 
           | For me, if I ever got terminal cancer, I'd weigh the quality
           | of life of treatment versus non-treatment. I've seen people
           | go both ways and I've seen the results being right and wrong
           | both ways. I don't want to spend my final months semi-alive
           | on a bed or constantly messed up, though.
        
             | cogman10 wrote:
             | > it is very difficult for doctors to recommend non-
             | treatment or risk being sued into oblivion
             | 
             | Not my experience. I have a loved one going through cancer
             | treatment right now and they've been very up front about
             | risks, side effects, and even talked about DNRs with them
             | what they mean and how they can be applied.
             | 
             | People and their loved ones don't want to experience death.
             | It's often as simple as that.
             | 
             | > There was a wink wink situation where as the kidney
             | failure worsened, his morphine was increased to the point
             | where it was fatal.
             | 
             | In the US, exactly because of situations like this, that
             | sort of thing is a lot harder today to pull off.
             | 
             | > I'd weigh the quality of life of treatment versus non-
             | treatment.
             | 
             | Something to consider, it's not a binary and treatment can
             | look entirely different depending on the cancer.
             | 
             | You can, for example, do a lower than effective dose of
             | chemo which will still be effective at slowing the growth
             | of cancer.
             | 
             | Some therapies, such as immunotherapy, can be practically a
             | walk in the park.
             | 
             | I'd suggest strongly in any case that you have a discussion
             | with an oncologist if you ever get to that point. Things in
             | medicine aren't nearly as black and white as people
             | sometimes assume.
        
               | hylaride wrote:
               | > People and their loved ones don't want to experience
               | death. It's often as simple as that.
               | 
               | People also don't want (their loved ones) to suffer,
               | especially needlessly. (I want to also stress that I'm
               | not advocating terminating life, though I do think it
               | should be an option - just that this is what my
               | grandfather wanted).
               | 
               | > In the US, exactly because of situations like this,
               | that sort of thing is a lot harder today to pull off.
               | 
               | I've anecdotally heard that a huge percentage of US
               | medicare costs is desperately saving elderly people at
               | the end-stages of life instead of a more palliative (and
               | some would argue dignified) end. This was made worse
               | during the Terri Schiavo case when the very idea was put
               | up as anti-life and we were warned that "death panels"
               | would be inevitably setup. DNRs are allowed, but
               | alleviating the suffering leading up to the end is, for
               | both better and worse, heavily restricted.
               | 
               | > I'd suggest strongly in any case that you have a
               | discussion with an oncologist if you ever get to that
               | point. Things in medicine aren't nearly as black and
               | white as people sometimes assume.
               | 
               | I've been extremely lucky that cancer hasn't been much of
               | an experience I've had to deal with in my circles. I'm
               | mostly pro-modern medicine and I know a lot of progress
               | is also being made. I hope that it never happens, but if
               | it did I'd want to be informed as possible to make my own
               | decisions. The decisions I'd make depend so much on where
               | I'm at. I'd be likely more willing to risk it now as I
               | have a 7 year old to live for, than I would be in my 90s
               | where the odds are a lot less for a comfortable
               | experience.
        
           | 6SixTy wrote:
           | Chemotherapy is essentially a bet that the drugs will kill
           | the cancer faster than you. Because ultimately, cancer isn't
           | a virus, bacteria, fungus, parasite, nor even a prion (this
           | one is nightmare fuel) -- it's your own cells acting as a
           | parasite. This reason alone makes cancer horrific to treat as
           | it is.
        
             | cogman10 wrote:
             | There are multiple types of chemo. There's not just 1 chemo
             | drug and how it looks can be all over the board.
        
           | hinkley wrote:
           | Sort of at the opposite end, I knew a PT who harped on
           | balance exercises and pointed out that a lot of old people
           | have pneumonia as cause of death on their death certificate.
           | The pneumonia was often acquired while immobilized by a
           | broken hip. The broken hip was caused by falling (+ lower
           | body atrophy), so really these people died from falling. It
           | just took a while.
           | 
           | I don't know what the right answer is for coding death
           | certificates. Maybe the correct answer is to record several
           | so we can see comorbidities and contributing factors more
           | easily when deciding what science to fund, charities to
           | endow, and which treatments to disfavor.
           | 
           | Died of complications of cancer, reaction to chemo. Died of
           | complications of hip fracture, pneumonia.
        
         | theglocksaint wrote:
         | Proton therapy offers incremental, if any advantage, over
         | standard IMRT for non-pediatric cases. In the case of the
         | prostate, recent evidence shows no benefit at all. It suffers
         | from near hyperbolic marketing from debt-ridden therapy centers
         | pushing dubious claims that are now being exposed by high
         | quality phase III comparison trials.
         | 
         | HIFU for prostate also is a ripe area for grifters as it is
         | advertised and marketed towards low risk cases that would
         | probably benefit from active surveillance.
        
           | seesthruya wrote:
           | > HIFU for prostate also is a ripe area for grifters as it is
           | advertised and marketed towards low risk cases that would
           | probably benefit from active surveillance.
           | 
           | Unfortunately, I have extensive first hand experience with
           | practices that do this, and you are 100% correct.
           | 
           | The grift is very insidious. If you scan people over a
           | certain age with prostate MRI, you will find suspicious
           | lesions in a large percentage. And using fusion MRI/US guided
           | biopsies, you will inevitable get cancer cells in the sample.
           | 
           | Many (most?) of these people being treated will die WITH
           | prostate cancer, not FROM prostate cancer.
        
         | dyauspitr wrote:
         | Don't the out of pocket maximums make the costs of the
         | treatment irrelevant for most people if you have insurance. For
         | both of those the patient would probably end up paying the same
         | $15,000 out of pocket maximums.
        
           | laterium wrote:
           | The real cost will matter at least from an allocation
           | perspective. You can't keep relying on a treatment that costs
           | $100m even if the patient pays nothing. Someone needs to pay
           | that cost.
        
       | deep_signal wrote:
       | It's amazing how we're turning sound waves into healing tools.
        
       | jijji wrote:
       | The only thing the article fails to mention is the use of more
       | than one transducer used to focus multiple ultrasound beams to an
       | intersection point in the body, increasing the heating power of
       | all beams
        
         | infinet wrote:
         | There was a startup in Shanghai in the early 2000. Their device
         | used multiple transducers. The probe was at least 40 cm in
         | diameter. They did trials on uterine fibroids, among other
         | diseases. One of the difficulties was while it looks good in
         | theory, but the path ultrasound travels in the body is more
         | complicated than, say x-ray or gamma ray. They expected a fine
         | focal zone, but sometimes the focal zone was much larger than
         | expected. This new wave of ultrasound equipment may have
         | discovered better ways to control the sound beam.
        
           | jijji wrote:
           | it seems like the intesection point can be smaller than a
           | grain of rice, and moved at 0.1mm three dimensionally [0]
           | 
           | [0] https://youtu.be/3Bwq2YxD9eU
        
             | infinet wrote:
             | This is amazing! That HIFU 20 years ago used phase array to
             | steer beam. Don't know the size of transducer. One of the
             | tests I heard of was on a pig leg. The damage was bigger
             | than expected, could be in the range of few centimeters,
             | probably due to the leg has skin, subcutaneous fat, muscle
             | and bone. All have different sound characteristic.
        
       | breppp wrote:
       | It's a highly promising direction for many diseases, I
       | specifically remember Alzheimer's as one
       | 
       | https://www.fusfoundation.org/diseases-and-conditions/
        
       | bee_rider wrote:
       | At the intersection of ultrasound and startups (since this is
       | HN), does anyone have any thoughts about that Openwater project?
       | They are apparently working on open source ultrasonic medical
       | devices.
       | 
       | I don't actually know much about them, I just heard of them
       | because their CEO (Mary Lou Jepsen, she's quite famous, right?)
       | was on the AMC podcast (months ago, actually, I was just going
       | randomly though the back catalogue).
       | 
       | Tech folks pivoting to medical always throws off some alarm bells
       | to me, but she was fairly compelling on the podcast and the basic
       | idea seemed to make sense. Ultrasonic treatments, using
       | diagnostic-level energies, using focusing and resonance based
       | tricks, I guess. (It is way outside my wheelhouse, sorry if the
       | description is inaccurate).
        
         | ZeroGravitas wrote:
         | She has a couple of TED talks on this tech from several years
         | ago.
         | 
         | I was aware of her from the OLPC project and the cool Pixel Qi
         | screen tech from that, but haven't watched the talks.
        
         | throwup238 wrote:
         | _> Tech folks pivoting to medical always throws off some alarm
         | bells to me, but she was fairly compelling on the podcast and
         | the basic idea seemed to make sense._
         | 
         | The best way to evaluate biotech startups from the outside is
         | to look at their investors. If they're full of VCs specializing
         | in biotech, chances are someone did the bare minimum due
         | diligence on the science.
         | 
         | Theranos for example didn't have a single one because biotech
         | VCs steered clear of that mess entirely.
        
         | zomg wrote:
         | > Tech folks pivoting to medical always throws off some alarm
         | bells to me
         | 
         | Same for me. I've been in the medical device industry for 15+
         | years now and came from "tech". What a lot of techies
         | under/don't appreciate is that the medical device industry is
         | heavily regulated and moves at a muuuch slower pace than other
         | technologies.
         | 
         | There are lots of regulatory and quality/testing hurdles that
         | you must clear (namely verification and validation testing, in
         | addition to your 510(k) clearance or approval, if PMA) before
         | you can market and sell your device.
         | 
         | I tell customers, on average, a Class II medical device project
         | can take 18-24 months and cost $3M to 4M, minimum.
        
           | bee_rider wrote:
           | Yeah, it seems that their pitch is that they want to move at
           | consumer electronics speed, I mean, their website explicitly
           | says
           | 
           | "Our tech-driven approach leverages software, hardware and AI
           | [...]
           | 
           | That means we can iterate at the speed of consumer
           | electronics"
           | 
           | Which is kind of scary but also a bit interesting.
           | 
           | How would you go about regulating an open source medical
           | device? The user can just plop whatever software on there
           | that they want, and ultrasound themselves wherever... play
           | with resonance and focusing, right?
        
             | throwup238 wrote:
             | _> How would you go about regulating an open source medical
             | device? The user can just plop whatever software on there
             | that they want, and ultrasound themselves wherever... play
             | with resonance and focusing, right?_
             | 
             | The manufacturer will still need to validate their own
             | firmware and subsequent updates. Whether it's open source
             | or not doesn't matter because a huge part of the approval
             | process is quality control tied to a specific manufacturer.
             | 
             | Anyone who plops their own software will be liable for the
             | consequences and I doubt malpractice insurance would allow
             | it in the vast majority of cases.
        
       | fortran77 wrote:
       | I really hope she didn't damage her (or her colleague's) hearing
       | while doing these experiments!
        
       | backwardsmoo wrote:
       | I had the absolute pleasure during my engineering undergraduate
       | (Oxford) to take a biomedical module. One of my 'labs' was on
       | nonlinear acoustics, specifically ultrasound applied for
       | therapeutic uses. It was very captivating seeing a very focused
       | point within a block of gel become ablated. A part I found
       | particularly exciting was realising that it was a phased array of
       | ultrasonic emitters, so that the point where the ablation
       | occurred could in fact be placed anywhere you desired in the gel.
       | 
       | They showed us results of HIFU applied to real patients to non-
       | invasively ablate tumours and treat prostate issues. As far as I
       | can tell the probe creating the ultrasonic waves needs to be
       | relatively close.
       | 
       | A thought I had at the time was if you knew all of the material
       | properties of all of the tissues inside someone and their
       | locations (say with an MRI) you could in theory apply this even
       | deeper in someone than is currently possible - with a larger
       | stick-on patch of actuators as a phased array.
       | 
       | Finally, another memorable thing that was discussed was what
       | another researcher was doing with ultrasonics. Stride (who I am
       | delighted to say was a fantastic lecturer) was very interested in
       | bubbles. She would construct tiny bubbles where the surface (or
       | interior?) was made of a chemotherapy drug. These bubbles could
       | then be injected into someone's blood stream and would be
       | ruptured using ultrasound to allow for extremely targeted
       | application of chemotherapy (the jet formed from rupture would be
       | so strong it would inject the drug into nearby tissue).
       | 
       | Fascinating, fascinating stuff but of course developed over many
       | years of hard work.
        
         | bikeshaving wrote:
         | Okay, you sold me. Where can I get an ultrasonic massage?
        
           | walrusted wrote:
           | a high percentage of physical therapists have an ultrasound
           | massage device.
        
         | JumpCrisscross wrote:
         | > _Stride...was very interested in bubbles_
         | 
         | This reminds me of Feynman s spinning plates.
         | 
         | It also drives home the serendipity of science. One can easily
         | pander a researcher spending their days thinking about bubbles
         | from a place of ignorance. Yet this is what basic research
         | often looks like--play.
        
           | sndean wrote:
           | As someone who has worked on bubbles from a
           | bioengineering/synthetic biology perspective, it is
           | definitely play at some level. Like "what happens if we
           | freeze dry them?" And of course determining which extremely
           | specific kind works best for whatever application, etc.
        
         | BurningFrog wrote:
         | "Ablation (Latin: ablatio - removal) is the removal or
         | destruction of something from an object by vaporization,
         | chipping, erosive processes, or by other means."
        
         | aantix wrote:
         | > treat prostate issues
         | 
         | Is prostate size reduction possible?
        
           | backwardsmoo wrote:
           | The example that I saw was of a patient whose prostate had
           | swollen closing up the urethra. HIFU was applied to ablate
           | the urethra which "opened it back up" so that fluids could
           | pass through again un-impeded. As a consequence the patient
           | could then live a normal life.
        
       | nilslindemann wrote:
       | I hope for a great future of this therapy.
        
       | 716dpl wrote:
       | There was a game in the early '80s called Microsurgeon where you
       | piloted a robot probe into a body to cure it of diseases. It was
       | armed with an array of tools, one of which was ultrasound that
       | you could use to destroy cancer. I wonder how long this idea has
       | been around for.
       | 
       | https://en.wikipedia.org/wiki/Microsurgeon_(video_game)
        
       | siliconc0w wrote:
       | You can get a ultrasonic fat cavitation machine off Ali Express
       | for a few hundred bucks. The technology has gotten surprisingly
       | cheap.
        
         | ncr100 wrote:
         | It looks like this can be used to burst and liquify body fat,
         | near to the surface of the skin! Wild.
        
           | spockz wrote:
           | Okay... and is that something that is beneficial? How? Will
           | it flow out from an incision? Will it just target white or
           | brown fat? Any other effects like also liquifying muscle
           | tissue?
        
       | mountainriver wrote:
       | Also very very interesting for brain modulation!
        
       | michael1999 wrote:
       | My mother received ultrasound ablation as brain surgery to treat
       | idiopathic tremors. It was wild.
        
       | zzzeek wrote:
       | I've got a node in my thyroid that can reasonably only be removed
       | chemically, which has risks of blowing out my whole thyroid.
       | ultrasound treatment is now available for it, however have been
       | going to my endocrinologist every four months for a bloodwork
       | checkup (because I need to take thyroid-suppressing drugs until
       | the node can be removed) and am still waiting for him to have
       | heard about this treatment outside of my own telling him so (even
       | though his larger medical organization, NYU, offers it, it still
       | seems to not be routine within his practice).
        
         | BurningFrog wrote:
         | There has to be a way to find a practice that uses this tech?
        
           | zzzeek wrote:
           | absoultely but I am in no hurry and I would like it to be
           | Very Boring and Ordinary For My Particular Condition before I
           | go anywhere near it
        
       | verisimi wrote:
       | If it can target and kill cancer, how can it also be safe for
       | foetuses?
        
         | f1shy wrote:
         | You can vary the frequency, power, energy, focus... is not the
         | SAME ultrasound.
        
           | verisimi wrote:
           | But surely it could cause some damage at a lower frequency,
           | power, etc anyway?
        
         | BobaFloutist wrote:
         | That's like asking how if a laser can cut through steel how
         | lamps can be safe to have indoors.
        
           | verisimi wrote:
           | Do you have a link or something that compares the power in
           | both? I can't find one.
           | 
           | This is the summary I get from chatgpt - comparing
           | Histotripsy and ultrasound imaging
           | 
           | | Property | Strongest Diagnostic / Imaging Ultrasound |
           | Histotripsy (Therapeutic Ultrasound |
           | 
           | | Frequency | 2 - 10 MHz (obstetric: 2-5 MHz; high-res
           | imaging up to 15 MHz) | 0.25 - 3 MHz (sometimes up to 6 MHz)
           | |
           | 
           | | Pressure (Peak Negative) | Up to ~5-6 MPa (mechanical index
           | limit [?] 1.9) | 10 - 100 MPa (depending on type: intrinsic
           | vs. boiling histotripsy) |
           | 
           | | Intensity (Spatial Peak, Temporal Average) | Typically <
           | 0.1 W/cm2; upper safe limit [?] 0.72 W/cm2 (FDA/AIUM) | 100 -
           | 10,000 W/cm2 (very high peak intensities) |
           | 
           | | Pulse Duration | Microseconds (~1-5 us typical) |
           | Microseconds to milliseconds (short bursts for mechanical
           | disruption) |
           | 
           | Its kind of hard to know what this means - some of the
           | numbers seem pretty close/crossover - but I don't think
           | saying the difference is akin to a laser and a light.
        
             | an-honest-moose wrote:
             | There are 2 to 5 orders of magnitude difference in
             | intensity. That alone is a pretty big difference.
        
         | fragmede wrote:
         | Shit, you figured it out. It's not! That's whats been causing
         | all the autism! Big ultrasound has been managing to keep this
         | under wraps for _decades_!
        
       | themantalope wrote:
       | A few points based on comments I'm seeing about the article.
       | 
       | This method of ultrasound treatment is called histotripsy. The
       | underlying mechanism it uses to treat tumors is by focused
       | ultrasound beams that mechanically disrupt cell membranes . It
       | basically turns the lesion into soup. It does not treat the
       | lesion by heating, although there are other techniques that do
       | use ultrasound to ablate tissue with thermal energy.
       | 
       | Where I have seen it used and discussed is in the liver, whether
       | that be metastatic disease to the liver or primary liver tumors.
       | 
       | One challenge is that in the liver you can't use it for lesions
       | that are near the capsule of the liver. It can also be difficult
       | to keep the ultrasound beam focused on the lesion with
       | respiration, especially if the tumor is small.
       | 
       | It's an interesting technique and I think more people will use it
       | over time. Whether it will be better than other established
       | techniques like microwave ablation or radioembolization (for
       | liver tumors) remains to be seen. I'm an interventional
       | radiologist.
        
       | esafak wrote:
       | How does it compare with stereotactic radiosurgery (Gamma Knife)?
       | 
       | https://en.wikipedia.org/wiki/Stereotactic_surgery
        
         | theglocksaint wrote:
         | Gamma Knife is used in brain lesions where focused ultrasound
         | is not a viable treatment option or likely to ever be.
        
           | esafak wrote:
           | Is ultrasound preferable where it is viable?
        
       | hn_throwaway_99 wrote:
       | There are already lots and lots of treatments for localized
       | tumors in the liver - radiofrequency oblation, cryo oblation,
       | microwaves, etc. These kinds of articles often tout new
       | treatments as a bold new thing, but they don't really change the
       | state of medicine, and it's not like they would be a replacement
       | for chemo, for example. I'd be very curious how histotripsy
       | compares to these other localized tumor treatments.
        
       ___________________________________________________________________
       (page generated 2025-10-14 23:00 UTC)