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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Thank you @tomrennie!
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1 ReactionI had Histotripsy in May of 2024, was under for 7.5 hrs. This was in Seattle, Wa. and so new they told me that they could only work on small tumors and on the liver. They eradicated a few very small tumors and manage to destroy a larger one, but I have many more.
So far, the tumors are being kept at bay while taking Lanreotide and Everolimus. I had previously taken Lenvima, but (as I had no heart issues), and suffered a massive heart attack, I suspect that the Lenvima triggered it.
Waiting for the holy grail of Alpha PRRT trial I am set to take.
You should feel confident in your assigned doctor as we are all different (zebras). We become our own story, but hopefully learn (through sites like this Mayo Clinic connect) and ask a lot of questions.
Good health going forward until they come up with the right anti-cancer injection.
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3 Reactions@gamaryanne
What is the name of the center in Gainesville thst does histotripsy? I'm having some severe abdominal inflammation issues and want to determine if any of it is from my histotripsy procedure.
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1 ReactionNortheast Georgia Medical Center (Gainesville, GA) became one of the few U.S. centers offering histotripsy and enrolling in the BOOMBOX clinical trial.
I don’t see UF-Shanda Medical Center in Gainesville, FL on the Angiodynamics web site as offering Histotripsy yet.
@stageivsurvivor
Thank you. Can you explain to me immune wise as histotripsy works? I seem to have inflammation in the entire torso but I don't think it's seen on the entire CT; just in the bladder which is severely inflamed. No more UTIs, so it's not due to that. I can't stand up anymore without intense pressure filling me up and pushing in my rib cage and lungs. Difficult to breathe. Drs have no idea what's wrong with me.
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1 Reaction@mnewland99
Can ascites be picked up on the recent scan you have had?
Could it be gas?
I spoke to someone recently that did histotripsy in Gainesville. She lives in Florida i believe. Would you like to call her? I can get her contact to you.
If you are having breathing issues perhaps head to ER?
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1 Reaction@gamaryanne
Not gas, that was the first guess by my team. Inflammation it seems but who knows?
Yesterday my urologist told me one of the tests he ran via my cystoscopy last week was positive for cancer. It was actually positive for high grade BK virus which I'm learning after reading, through help of my brother-in-law's research tjst it Csn torn into bladder cancer - oh what fun!! Might also be related to Lynch Syndrome which I haven't been tested for yet.
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4 Reactions@mnewland99
One of the tests your doctors have run should say if you ate MSI high. I know you have excellent doctors; both of the Lynch patients i know have found Keytruda to be a wonderful life changing drug for them.
Is there any way you could get to Dr Boranzanci in Scottsdale? He has seen and worked with so many anomalies with pcan.
Praying deliberately for pain relief and a doctor to dig in to all of this and help you find answers. It is so hard to be your own advocate when you are in pain.
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4 Reactions@gamaryanne
Thank you, gamaryanne! I'm more in discomfort right now than pain. Mostly I have just shooting pains rather than constant pain. Unfortunately, I'm not the jet setter as you as I'm afraid of flying in my old age and driving through the desert to get to Scottsdale (though my late father in law's wife still lives there) does not appear attractive to me as I see all my conditions as potentially fragile driving through the desolate desert from California to Arizona. I'm trying to get a 2nd opinion from a urologist at City of Hope in Irvine. I still need to be tested for Lynch Syndrome; it's just something my brother-in-law (retired dr) sent me.
How's it going with you? What regimen are you on now?
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