Researchers at The Institute of Cancer Research (ICR) are investigating a new treatment that could destroy cancer cells in the abdomen by zapping them with intense soundwaves.
The technique, High Intensity Focused Ultrasound (HIFU), uses a machine to direct energy in the form of sound waves very accurately at tumours deep inside the body. The cancerous cells are killed by raising their temperature above 60oC, in less than a second.
Just as a magnifying glass can be used to focus the sun’s rays and set fire to a dry leaf, the energy from HIFU can be targeted precisely at a small area of tumour tissue. This means the soundwaves – which are 10,000 times stronger than those used for diagnostic ultrasound - can pass through healthy tissue without causing damage, and can destroy the diseased tumour precisely.
The technique is being particularly investigated as an alternative treatment for abdominal cancers, as for these tumours chemotherapy and surgery are often either not possible or offer poor outcomes. More than 20,000 people are diagnosed with upper abdominal cancers a year in the UK, of which more than half die.
The therapy is especially promising because serious complications rarely occur and patients are usually discharged from hospital within 24 hours. However, there are several obstacles that will need to be overcome before the use of this technique can become widespread.
The treatment needs to be introduced through the rib cage, which could increase the risk of skin burns and damage to the rib surface. There is a risk that microscopic bubbles - also known as “microbubbles” or acoustic cavitation - may form, which can damage tissue in an unpredictable way. The effects of movement, as the patient breathes, on the accuracy of the treatment also needs to explored.
A team from the ICR has therefore joined with other UK researchers in a collaboration designed to overcome these problems. The different partners are bringing their own expertise to identify practical solutions to these problems. Dr Gail ter Haar, leader of the therapeutic ultrasound team at the ICR, will work alongside Professor Constantin Coussios of the University of Oxford to develop methods for real-time monitoring of the procedure. The ICR team have particular expertise in developing and testing HIFU systems and conducting clinical trials.
The ICR team and Nader Saffari from UCL Mechanical Engineering are developing patient-specific treatment planning software, while David Hawkes and Dean Barratt from UCL Centre for Medical Image Computing are working on analysing and correcting for organ motion.
Dr Gail ter Haar comments: “HIFU is still in its infancy and our initial aim is to develop this technique for tumours in the abdomen, such as those of the kidney and liver, but the procedure is already showing promise for treating prostate, breast and brain cancers.”
“We hope this dedicated collaboration will help us overcome some of the issues that currently stop this technique being used widely, as it has a lot of promise as a cancer treatment.”
In recognition of the progress she has already made in advancing this promising technique, Dr ter Haar in June 2012 was honoured with the William and Francis Fry Award, the most prestigious prize from the International Society of Therapeutic Ultrasound.