Histotripsy
"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.
I am so happy for you. Thanks for the update and please keep us posted.
I'm happy too, and hope you decide if you can also get that treatment.
If my chemo stops working, it is definitely an option. Thanks for allowing us the opportunity to learn from your experience. I really appreciate it.
@mnewland99
I anxiously jumped on the board today to see if you would post.
Thankyou! You inspire us to stay on top of this stuff, even when we are told we are NED or our CA19-9 is low. Thrilled to hear you came out of the procedure feeling well and we are all hopeful for the one month follow up! I am waiting for pre-cert for SBRT but also getting my name in for histotripsy . It all takes so long, sort of like standing in line. You are vey fortunate to live amidst so many treatment options.
Prayer works. I am on your prayer team. Know that you are doing God’s work on this board. Thank you. Rest today!
Great news to hear @mnewland99! Always great when someone you are rooting for wins, even if it's just a battle in the war. 🙂
Thank you so much @mnewland99! I am visiting Mayo Jacksonville in August to discuss options. I've been on Naliri for 4 infusions, CA19-9 has come down from 307 to 118 so far. Treatment is harder than Gem/Abrax but hoping it works better. My liver lesion is large, 6.2 cm, and another smaller one that SBRT didn't kill. We'll see what they tell me in Jacksonville. Best of luck to you, yes please do keep us posted!
Oh you are in good hands, Dale! I'm glad your numbers are going down! Thst didn't happen with me - numbers co tinted to climb, but I'm pretty sure it's the peritoneal nodules that are causing that. How long ago was the last scan before they realized lesion was at 6?
Thank you, will do! The 1 month follow up will let me know if the procedure worked.
@dalegantous
Where are you located? There is a high volume center doing histotripsy also in Gainesville, Ga. Just fyi
Naliri seems not to be working for me as numbers are climbing. Scan Friday and set up for SBRT unless scan shows more lesions elsewhere. Will be interested to know what exclusions may be for histotripsy. Size?Location? Etc
I read online 4cm is the max, but I didn't get thst information from my IR Dr. I can ask my oncologist today. From what I understand from IR Dr speaking with his staff, my 2 lesions were in a row, so they measured about 3-6cm together; I'll ask my oncologist today and post.