In a major clinical trial, scientists at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust — a specialist cancer treatment hospital in London — are testing the potential for using high-frequency sound waves to relieve bone cancer pain. The technique being employed uses focused ultrasound beams to produce heat in bone tissue — similarly to the way a magnifying glass can concentrate the sun’s rays on a surface and creating heat — in order to burn away the pain source.
An ICR release notes that an initial five patients have been treated in the clinical trial, and have experienced encouraging reductions in the amount of bone tumor pain they’d been suffering.
Called “high-intensity focused ultrasound (HIFU),” the technique involves concentrating precise ultrasound energy on a target in the body to thermally destroy tissue. HIFU is used in conjunction with magnetic resonance imaging (MRI) guidance in order to identify, target and track the treatment’s progress in real time. The treatment produces heat that destroys nerve tissue in the bone directly surrounding the tumor that has been causing the pain, while leaving adjacent areas unharmed.
While Ultrasound is commonly used in medical body imaging, researchers believe that when used at higher power it also offers promise as an exciting, new way to treat cancer symptoms.
Many patients with metastatic cancers affecting the bone experience intense bone pain, severely diminishing their quality of life. The hope is that HIFU can provide a non-invasive, non-drug technique for controlling pain in patients for whom radiotherapy is no longer a viable option, or where other treatments have been unable to control the disease.
If the HIFU technique can be proven successful for pain control, it is expected to be followed by further studies at ICR and the Royal Marsden with thermally destruction of local tumors at earlier stages of the disease, possibly helping to extend life.
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The release cites Royal Marsden patient Moira Rogers, the first patient to participate in the clinical trial, commenting that, “Being on this trial has meant a great deal to me. It has helped get the pain I was in under control and given me my quality of life back. Trials like these are extremely important and I am so glad I have been given the opportunity by my doctors at The Royal Marsden to be part of this ground breaking study.”
Study co-leader Gail ter Haar, a Professor of Therapeutic Ultrasound at The Institute of Cancer Research, London, observes that: “Focused ultrasound is an exciting potential cancer treatment because of its ability to target tumours very precisely. The point onto which the ultrasound beam is focused gets very hot, but the surrounding tissue is left unharmed. Its like using a magnifying glass in the sun to start a fire, where you need to form a sharp focal spot on the dry tinder.”
Professor ter Haar’s Therapeutic Ultrasound Team is undertaking research designed to improve our understanding of high intensity focused ultrasound (HIFU) for the treatment of cancers of the liver and kidney, and she also sits as chair on both the British and European committees for medical ultrasound safety.
Prof. ter Haar’s study co-leader Professor Nandita deSouza, a Professor of Translational Imaging and lead academic radiologist at The Institute of Cancer Research, London and Honorary Consultant at The Royal Marsden NHS Foundation Trust, comments: “We’re still learning how best to use focused ultrasound, but we believe it has real potential for improving the quality of life of patients with advanced cancer. Cancers that have spread to the bone can cause intense pain, and further radiotherapy may not be an option. It is early days in our trial, but we hope ultrasound therapy will prove effective at reducing the pain caused by bone metastases, and offer the chance for patients to live the final stages of their lives much more comfortably.”
Dr. deSouza also co-ordinates multi-disciplinary research projects involving clinical medicine, physics, biochemistry and engineering aimed at improving patient care. Her research has primarily focused on using MRI to identify biological indicators of a patient’s prognosis and likely response to treatment, and to improve techniques for diagnosing cancer, including using robotic devices to better target biopsies. She has pioneered the use of endocavitary probes — imaging devices can be inserted into the body to provide high-quality pictures of cancer tissue and track chemical changes within tumors using — MRI. Diagnostic information obtained with these techniques is unrivaled by other imaging methods, she maintains.
The ultrasound clinical trial is part of a wider joint initiative among the ICR, The Royal Marsden, the Focused Ultrasound Foundation and Philips which is the corporate developer of the HIFU system a collaboration dedicated to creating a state-of-the-art resource for clinicians and scientists that can establish global standards for medical application of focused ultrasound and to accelerate the technology’s development the treatment of cancer.
Founder and Chairman of the Focused Ultrasound Foundation Neal F. Kassell, M.D., says: “We are delighted to work with the clinical and technical teams at The Royal Marsden and ICR. We look forward to this collaboration advancing the science and helping to develop the best clinical practices needed for widespread adoption to ultimately help extend the lives of patients with a range of cancers.”
“MR imaging is emerging in oncology applications, because of its excellent real-time 3D visualization of both soft tissue anatomy and physiological processes,” says Christopher Busch, General Manager MR Therapy at Philips. “Combining focused ultrasound thermal therapies with real-time MR imaging and monitoring is a powerful concept that has the potential to become a new precision treatment tool in oncology.”
Sources:
The Institute of Cancer Research
The Royal Marsden NHS Foundation Trust
The Focused Ultrasound Foundation
Image Credits:
The Institute of Cancer Research
The Royal Marsden NHS Foundation Trust
The Focused Ultrasound Foundation
Philips Healthcare
