Histotripsy: My experience
"Histotripsy uses a transducer, which converts energy into sound, to deliver pulsing ultrasound waves to a malignant mass at a precise location. When those waves hit gases inside cancerous cells, they generate clouds of millimeter-sized bubbles that repeatedly grow and collapse. The mechanical energy created breaks up the tumor cells’ structure, turning it into a harmless liquid called acellular lysate that is reabsorbed by the body."
This is copied from: https://news.engin.umich.edu/2024/12/histotripsy-tumor-treatment-moves-from-trials-to-triumphs-in-2024/
Just trying to give a description of this fairly new procedure for everyone. I've heard about it on this Mayo site a bit, and was more intrigued with the idea of getting this when my original oncologist from Hoag (Newport Beach, CA) mentioned that at the recent PANCAN Walk for Cancer that I did this year (woohoo!) that they were one of three facilities in California that had the equipment to do histotripsy.
I did targeted radiation (MRIdean) at City of Hope in October 2024 for a stubborn 0,9cm lesion (originally diagnosed as 1.5cm in December 2023) that wouldn't shrink via my chemo/abraxane chemo anymore). It seemed to have work as my cancer antigen 19-9 hovered around 11 for several months, or approximately, 5.5 months. Then CA19-9 started to rise and and it seemed a new lesion had appeared adjacent to lesion that had been "ablated", but this early guess of a new lesion appeared only as a result of a PET scan, and no image had been seen on the MRI and CT scans seen in April of this year. At this time I had only been on the gem chemo since January 2025 as a maintenance drug since my antigen CA19-9 had been normal 11 since the previous October or my last targeted radiation treatment. I took a gem chemo break at the end of March 2025 since we were moving to a new residence.
After that time I noticed pain in the liver and across my lower abdominal area (most likely those 2 peritoneal nodules that had been possibly diagnosed as a metastasis in December of 2023). I say possibly because the biopsy had been negative, but my wise UCLA pancreatic dr had told me to assume it was metastasis since that was a common pathway. Those nodules had not grown for 1 year and 3 months while I was on the gem/abraxane chemo treatment. Now the pain was increasing and I suspected they were growing, but difficult to see in scans. My city of Hope oncologist wanted me to go into the phase 3 clinical trial in 6236, but it was randomized, and not being as altruistic as others I didn't want to take the chance that I wouldn't be in that 50% group that would actually receive the 6236 trial drug. So I parted ways with my COH onc and went back to Hoag and got into the Naliri-5FU chemo treatment for the now 2-3 liver lesion(s) (each under 1.5cm) and peritoneal nodules. I haven't had any elimination of these sites (maybe this chemo is keeping them at a very slow growth pace for my very aggressive cancer mutations); but last checked my ca19-9 was 11,100!
Peritoneal carcinomatosis is critical if it gets into the intestines or stomach, or apparently the appendix. Blockage can occur and then make eating difficult; it happened to my father and my best friend; but now I have 2 spreads; the liver and the peritoneum as I have a "belt" of nodules across my peritoneum with 1 invading my appendix, and the other 2 largest ones hovering around the large intestine.
I'm back to navigating my own care at Hoag again. I tried radiation so histotripsy sounds very hopeful to keep my liver intact and functional at least for a few more months.
Histotripsy is a procedure where you go under anesthesia for a few hours and it turns your lesions (you can work on a few at one time) and let them dissolve. I had absolutely no side effects following my histotripsy procedure yesterday. I was told the airway tube would be double the size typically used so my throat would be sore and uncomfortable after my procedure, but I say MIRACULOUSLY no effect on me yesterday.
I'm not afraid to ask for prayers and I ask my very best friends and relatives to pray for me and thankful for those on this board who prayed. The procedure seemed successful and in 1 month I have a recheck with my IR dr, Dr. T. Patel, and we will see how I did! This gives me some peace of mind as I now can focus on treating my peritoneal nodules through my previous UCLA oncologist. No histotripsy on peritoneal nodules yet, but my dr said, I think, there is a trial for nodules in kidneys that they are doing in Spain.
Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.
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New lesion at 6 cm was discovered at first CT scan after SBRT, so roughly May 16th (I had SBRT the first week of March). Last CT scan showed the lesion is still at 6 cm. Doing another CT scan July 30th. Although my CA19-9 is coming down, that will tell whether Naliri is having any effect on the existing lesions.
SBRT seems to have killed the subcutaneous tumor I had in my belly, but did not seem to kill the lesion that I already had in Section 7 of my liver. The new larger lesion crosses sections 5 and 8.
I go to Mayo Clinic Jacksonville in August, my goal is to see what clinical trials or procedures I can get into there.
Appreciate all your thoughts!
Forgot to answer, I'm in Ottawa Canada.
Did you have MRI guided SBRT to two separate areas in one cycle of treatment?I have been reading more about this and I am scheduled for a planning scan of my liver this Thursday.
I did SBRT in Mar h on a small module in my lung and last scan showed it gone.
However, this spot in my liver requires MRI and is in a more “delicate” spot. A bit nervous I understand our organs do move when we breathe!
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1 ReactionHi @gamaryanne! I had MRI guided SBRT for my liver, and separate CT scan guided SBRT for my subcutaneous belly tumor since it was so close to the surface they didn't need the MRI. To control movement, they put a tight belt around me so that I could not take deep breaths. They prepped each session with the belt for over an hour to plan their target precisely, then deliver the radiation in about 10 minutes.
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3 ReactionsHow are you feeling?
Hey. Just checking in on you since the histotripsy. How are you feeling?
Hi, I'm fine. I have to wait until my next appointment which is in 2 weeks to see if the procedure was successful. I'm going back on gem-abraxane chemo as it previously worked on the peritoneal nodules which is my greatest problem now; however I'm still walking and working and doing errands and it looks like I'll make my 50th high school reunion afterall. I hope you are well.
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7 ReactionsAmazing! Good for you @mnewland99!
I have some good news to report! It's been 2.5 weeks since my histotripsy. My CA19-9 has gone down from 13,900 to 4,840. It's possible that it could down even more. My follow up appointment is in 10 days. I'm also scheduled for a CT. It should be noted that I also have several peritoneal nodules which are a contributing factor to the CA19-9 count. I just started an aggressive chemo regimen of gem-abraxane yesterday of 3 weeks on and 1 week off to address the nodules. The CA19-9 is taken before I start my chemo session.
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5 ReactionsAlso, @stageivsurvivor I was sure to wear my frozen booties and mittens during my abraxane treatment which thought to freeze those nerves deterring neuropathy, hopefully. I told my dr you swear (or something similar) by them. She didn't look impressed by I'm going to use them anyways!