Histotripsy: My experience

Posted by marienewland @mnewland99, Jul 22 9:26am

"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.

Profile picture for marienewland @mnewland99

I'm sorry to hear the news. Naliri didn't work for me either and was very tough on me. I'll be praying for you.
My reunion was a blast and reignited some really good friendships from the old days who have been a good source of support for me.

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@mnewland99
Hi Marie! An update:
Just a quick update: my current chemo (capecitabine) seems to be working, it's brought my CA19-9 down from 795 to 23! Last CT scan showed no new progression, maybe a little bit of shrinkage.

BUT I seem to have developed either ascites, or an infection. My upper belly has blown up like a balloon, I look like I'm about 7 months pregnant. Very uncomfortable, and some shooting pains. I went to see my GP on Monday, she actually got my oncologist on the phone (a miracle), and they ordered pee and blood tests for me which I had right away on Monday, and a CT scan which I had yesterday. They really need the radiologist's CT scan report to know what's going on, so they can treat it. So, I wait.

I also spoke to the clinical trials doc on Monday as well, my turn will likely be January-February. That's ok as long as my current chemo continues to keep me stable until then. Just gotta get my tummy deflated somehow so I can just live a tiny bit normally.

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Profile picture for dalegantous @dalegantous

@mnewland99
Hi Marie! An update:
Just a quick update: my current chemo (capecitabine) seems to be working, it's brought my CA19-9 down from 795 to 23! Last CT scan showed no new progression, maybe a little bit of shrinkage.

BUT I seem to have developed either ascites, or an infection. My upper belly has blown up like a balloon, I look like I'm about 7 months pregnant. Very uncomfortable, and some shooting pains. I went to see my GP on Monday, she actually got my oncologist on the phone (a miracle), and they ordered pee and blood tests for me which I had right away on Monday, and a CT scan which I had yesterday. They really need the radiologist's CT scan report to know what's going on, so they can treat it. So, I wait.

I also spoke to the clinical trials doc on Monday as well, my turn will likely be January-February. That's ok as long as my current chemo continues to keep me stable until then. Just gotta get my tummy deflated somehow so I can just live a tiny bit normally.

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@dalegantous I had ascites. It can be unpleasant. How long will it take to get the results from the scan? I have been living on capecitabine for three years. The last two years, I only took capecitabine. It has kept things stable for me.

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Profile picture for Turkey, Volunteer Mentor @tomrennie

@dalegantous I had ascites. It can be unpleasant. How long will it take to get the results from the scan? I have been living on capecitabine for three years. The last two years, I only took capecitabine. It has kept things stable for me.

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@tomrennie Well that gives me hope, thank you Tom. I'd love to make it another 3 years on capecitabine, that would let me get into my 70s! CT results came back, ascites confirmed but also some progression(boo). I hope to get the ascites under control this week if they can fit me in for paracentesis.
Ascites is making it harder and harder to eat, not great when I'm down to 89 pounds (pre-cancer weight was 107 - I'm not a big girl).

Thanks for all comments!

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I had the same procedure at Mayo Jacksonville and had no ill effects. It took care of the two tumors targeted. Unfortunately My next MRI showed a small cluster of tumors too small to be targeted by this procedure. I started reluctantly on Kemtrek, a chemotherapy drugs. Taking it once a week with no problem except for being tired the day of the infusion. I still do my normal activities. I have no nausea, weight loss, pain or hair loss. I am 76 and hoping to see 80 . Or more

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@mnewland99

How are you doing Marie? I don’t see posts since this one in July.

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Hi gamaryanne, thanks for checking in! I hope you are doing well. I'm on abraxanxe-gem right now and my CA19-9 is trending downward. 2 weeks ago it was 360 and it was drawn again today, but too early to get the results. However, I've been wrestling with another issue as of late that has been beating me down - possible a primary cancer of the bladder. Getting more testing with biopsy next week to rule out so got my hands full / being very tired lately.

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Profile picture for dalegantous @dalegantous

@tomrennie Well that gives me hope, thank you Tom. I'd love to make it another 3 years on capecitabine, that would let me get into my 70s! CT results came back, ascites confirmed but also some progression(boo). I hope to get the ascites under control this week if they can fit me in for paracentesis.
Ascites is making it harder and harder to eat, not great when I'm down to 89 pounds (pre-cancer weight was 107 - I'm not a big girl).

Thanks for all comments!

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@dalegantous
Well it turns out my problem is not ascites, it's a partial bowel obstruction. One thing after another, as we all experience. They're going to try to get it to resolve on its own through liquid diet, meanwhile my stomach is like a big beachball. I sure hope it does because I don't want surgery.

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Profile picture for marienewland @mnewland99

Hi gamaryanne, thanks for checking in! I hope you are doing well. I'm on abraxanxe-gem right now and my CA19-9 is trending downward. 2 weeks ago it was 360 and it was drawn again today, but too early to get the results. However, I've been wrestling with another issue as of late that has been beating me down - possible a primary cancer of the bladder. Getting more testing with biopsy next week to rule out so got my hands full / being very tired lately.

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@mnewland99
Oh my. This is a roller coaster isn’t it? I will specifically pray over your biopsy. We always want to know so we can do something! But it does get exhausting doesn’t it?
Your tumor marker is positive! That is great news!!! Stay strong💪

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Profile picture for dalegantous @dalegantous

@dalegantous
Well it turns out my problem is not ascites, it's a partial bowel obstruction. One thing after another, as we all experience. They're going to try to get it to resolve on its own through liquid diet, meanwhile my stomach is like a big beachball. I sure hope it does because I don't want surgery.

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@dalegantous Though I never had a partial bowel obstruction before, I am happy for you that it isn't ascites. Ascites is typically the result of a body organ or organs not functioning properly. Immediate action is usually necessary. I am crossing my fingers that the liquid diet works for you. Beachball be GONE!

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Profile picture for gamaryanne @gamaryanne

@mnewland99
Oh my. This is a roller coaster isn’t it? I will specifically pray over your biopsy. We always want to know so we can do something! But it does get exhausting doesn’t it?
Your tumor marker is positive! That is great news!!! Stay strong💪

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Thank you @gamaryanne!

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