Histotripsy is an innovative, non-invasive treatment that uses focused ultrasound waves to destroy liver tumors without the need for incisions or needles. This procedure offers hope to patients seeking alternatives to traditional cancer treatments. But who exactly is eligible for histotripsy? Let’s explore the criteria, benefits and considerations to determine candidacy.
Understanding histotripsy
Histotripsy employs high-intensity ultrasound pulses to create microbubbles within the targeted tumor tissue. As these bubbles form and collapse, they mechanically break down the tumor cells, effectively liquefying them. The body’s immune system then naturally clears away the destroyed tissue. This method allows for precise targeting of cancerous cells while sparing surrounding healthy structures like blood vessels and bile ducts.
Who is eligible for histotripsy?
Histotripsy is currently approved for treating liver tumors. There are currently many standards of care therapies available to patients with the below listed diseases. However, histotripsy may be an option for patients who are otherwise not candidates for liver directed therapies. Histotripsy is being studied at Northeast Georgia Medical Center (NGMC) to identify its efficacy and benefits in managing a variety of diseases, including:
- Primary liver cancer: Such as hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
- Metastatic liver tumors: Cancers that have spread to the liver from other organs, including:
- Colorectal cancer
- Breast cancer
- Neuroendocrine tumors
- Sarcoma/gastrointestinal stromal tumors
Eligibility depends on several factors, including:
- Number of tumors: Patients with up to three tumors are considered ideal candidates. If there are numerous lesions, more than one histotripsy session may be required to treat the patient.
- Tumor size: Tumors should typically be smaller than four centimeters.
- Tumor location: Accessible locations within the liver are preferable, as the procedure requires a clear ultrasound view.
- Overall health: Patients should have relatively normal liver function and be healthy enough to undergo general anesthesia.
Who might not be suitable for histotripsy?
While histotripsy offers a promising treatment option, it may not be suitable for everyone.Factors that might exclude patients include:
- Advanced liver disease: Patients approaching liver failure may not be ideal candidates.
- Multiple or large tumors: Those with more than three tumors, or tumors larger than five centimeters, may require more than one session to treat with histotripsy.
- Tumors near critical structures: If tumors are located near vital structures, histotripsy might not be advisable. Their candidacy is identified after the pre-procedure MRI.
- Presence of extrahepatic disease: Patients with uncontrolled cancer outside the liver may need to address those areas before considering histotripsy.
Benefits of histotripsy
Histotripsy presents several advantages over traditional treatments:
- Non-invasive: No incisions or needles are required, reducing the risk of infection and complications.
- Precision: Targets only tumor tissue, preserving healthy liver structures.
- Minimal recovery time: Patients often return to normal activities quickly, with many going home the same day.
- Compatibility with other treatments: Histotripsy can be performed without disrupting ongoing chemotherapy or other therapies.
Preparing for histotripsy
At NGMC, there is a process to determine whether a patient is eligible for histotripsy. Based on the information the patient provides, they may be asked to continue with the following next steps.
- Consultation: We request in-office consultations to discuss your medical history and treatment options with one of our providers.
- Additional imaging tests: Undergo imaging studies like CT or MRI scans to assess tumor size and location.
- Evaluation: A multidisciplinary team will review your case to determine eligibility.
- Procedure scheduling: If approved, the procedure will be scheduled, and you’ll receive instructions on preparation.
What to expect during the histotripsy procedure
Understanding the procedure can alleviate concerns:
- Anesthesia: General anesthesia is administered to keep you comfortable and still.
- Procedure duration: The treatment typically lasts between 1 to 3 hours, depending on tumor size and number.
- Post-procedure: After monitoring in a recovery area for 1 to 3 hours, most patients can go home the same day.
Histotripsy with NGMC
NGMC is the first, and only, hospital in the state to offer histotripsy as a form of liver cancer treatment.
If you or your loved one is facing a cancer diagnosis, discussing treatment options with your healthcare team is the first step. When navigating cancer, you can turn to NGMC for the expertise you need. Our team can review your previous treatments, including imaging and other tests to see if you could benefit from histotripsy for liver cancer.
At NGMC, you can find the advanced treatment options needed for liver cancer, including histotripsy. For more information about NGMC’s cancer program, click here.