New cancer treatment offers hope

A new technology that destroys cancerous tumours using focused sound waves could eventually offer another treatment choice, including for selected patients in Uganda.

The technology, known as histotripsy, can destroy targeted tumour tissue without surgical incisions, radiation or the heat used in some other treatments. It has already received authorization in the United States for treating liver tumours.

But it is not yet an established treatment option in Uganda, and researchers are still studying its long-term benefits. That distinction matters in a country facing a substantial cancer burden.

According to figures cited from the World Health Organisation’s International Agency for Research on Cancer, Uganda recorded an estimated 29,966 new cancer cases and 18,205 cancer-related deaths in 2024.

About 59,662 people were living with a cancer diagnosis made within the preceding five years. These figures underline the need for better prevention, earlier diagnosis and more effective treatment.

They also explain why advances in cancer technology attract interest, even when their introduction remains uncertain. Histotripsy works differently from conventional surgery.

Instead of cutting out a tumour, doctors use specialized equipment to direct powerful, precisely focused ultrasound pulses towards the affected tissue. The pulses create microscopic bubbles that rapidly expand and collapse.

This process mechanically breaks down the targeted tissue into tiny fragments, which the body gradually clears. Because the effects are concentrated at a selected point, the technique is designed to limit damage to surrounding healthy tissue.

Doctors can also use ultrasound imaging to monitor treatment in real time. Professor Zhen Xu, a biomedical engineer at the University of Michigan, is among the scientists who developed histotripsy over more than two decades.

In a 2024 scientific review, Xu and fellow researchers Tatyana Khokhlova, Cho and Vera Khokhlova described its potential advantages, including clearly defined treatment boundaries and the ability to preserve certain nearby structures.

These may include major blood vessels, nerves and bile ducts, which carry bile from the liver. Xu received professional recognition in 2024, including fellowships from the National Academy of Inventors and the Institute of Electrical and Electronics Engineers.

She was also named the University of Michigan’s inaugural Li Ka Shing Professor of Biomedical Engineering. Her stated ambition is to make the treatment accessible to as many patients as possible.

**WHAT THE EVIDENCE SHOWS **

In October 2023, the United States Food and Drug Administration authorized the Edison histotripsy system, developed by HistoSonics, for the non-invasive destruction of liver tumours.

The authorization followed the HOPE4LIVER clinical trials involving 44 patients with primary or secondary liver tumours at centres in the United States and Europe. Results published in Radiology in September 2024 showed technical success in 42 patients, approximately 95 per cent.

In practical terms, doctors successfully treated the targeted tumour tissue in most participants. That does not mean 95 per cent of patients were cured. Technical success measures whether the procedure achieved its immediate treatment objective, not whether cancer was permanently eliminated or survival improved.

Three patients experienced major complications. Investigators considered at least two of these related to the underlying cancer rather than the treatment system. The findings were encouraging, but the study was small.

Longer follow-up and further research are needed to establish how treatment affects survival and outcomes in different patient groups. Histotripsy is therefore not a universal replacement for surgery, chemotherapy or radiotherapy.

Whether it is suitable depends on the tumour’s type, location and stage, as well as the patient’s overall health.

**COULD IT TREAT OTHER CANCERS? **

Researchers are investigating histotripsy beyond the liver. The HOPE4KIDNEY trial continued enrolling patients in 2024 to examine its use against kidney tumours.

Scientists are also studying possible applications in pancreatic cancer and sarcomas, which affect bones and soft tissues. Another area of research concerns the immune system.

Breaking down tumour tissue may release substances that help immune cells recognize cancer. Researchers are investigating whether this could produce effects beyond the treated tumour.

However, any improvement in long-term cancer outcomes remains unproven. Scientists are also examining potential applications outside cancer, including blood clots and other abnormal tissue. These experimental uses should not be confused with treatments already authorized for clinical practice.

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