Histotripsy for OM that has spread to the liver
Developed by HistoSonics, Histotripsy is a new, non-invasive and non-thermal treatment for liver tumours, including those caused by ocular melanoma that has spread to the liver.
You can learn more about treatment below.
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- What is Histotripsy?
- How does Histotripsy work?
- Who can have histotripsy?
- Where is treatment offered?
- Can I be considered for Histotripsy?
- How can I be referred for treatment?
- What happens before treatment?
- What happens during histotripsy?
- How long will treatment last?
- Will I need follow up after treatment?
- What are the side effects of treatment?
- How effective is Histotripsy for uveal melanoma?
- How can I find out more?
What is Histotripsy?
Histotripsy, delivered using the Edison System, is being researched to treat solid tumours in the liver.
This treatment may be an option for individuals with liver tumours secondary to uveal melanoma. It is most effective for clearly defined lesions that are smaller than 3 cm in diameter.
Some people with uveal melanoma may have tumours that appear as very small, widely scattered deposits. This is sometimes called miliary disease. If you have miliary disease patterns, histotripsy may not be a suitable treatment option. This is because it is difficult to target multiple small lesions safely.
How does Histotripsy work?
Histotripsy uses focused ultrasound waves to create tiny bubbles in tumour cells, which disrupts them.
Like traditional ablation treatments that use heat, the bubbles formed during Histotripsy destroy cancer cells. You can learn more about traditional ablation techniques on our treatments webpage.
Histotripsy is delivered from outside your body, and does not require incisions or needles entering the liver. Because of this, recovery time is much shorter than traditional surgery, and it has potentially fewer side effects.
Who can have histotripsy?
Currently, Histotripsy is available for people with primary liver cancer and secondary cancers that have spread to the liver.
The treatment is available through MHRA approval under a special Unmet Clinical Need Authorisation (UCNA).
It is not yet commissioned by NHS England, so places are limited. There is currently a waiting list.
Where is treatment offered?
Currently, the treatment is only available at Cambridge University Hospitals NHS Foundation Trust.
Can I be considered for Histotripsy?
To be considered for histotripsy, you must fit the eligibility criteria.
We’ve included a list of important eligibility criteria below, but please note, this is not an exhaustive list:
- A confirmed diagnosis of primary or secondary liver cancer
- Being medically suitable for general anaesthesia or deep sedation
- Tumours less than 3 cm in their longest diameter
- Up to 3 tumours that could be treated during the same procedure
- Cases where surgery or heat-based ablation might be possible, but your multidisciplinary team feels histotripsy is appropriate
- Where other standard therapies are not suitable or have not been effective
This is not an exhaustive list. If you want to know more about whether or not you might be considered for this treatment, talk to your oncologist. Your case will be discussed with a multidisciplinary team of specialists to see if histotripsy is right for you.
How can I be referred for treatment?
Your medical team must refer you to your local multi-disciplinary team (MDT), who then refers you to the team in Cambridge.
On referral, your case will be reviewed by the Cambridge University Hospital’s MDT, who will decide if you are eligible for Histotripsy.
You are currently unable to refer yourself for this treatment.
What happens before treatment?
If your doctors decide you are a suitable candidate for histotripsy, you may have blood tests to ensure you are well enough for treatment. You may also have scans to plan your treatment.
Depending on your overall health, you may also be given other medications and tests.
What happens during histotripsy?
Three main things happen during your procedure:
- The target area is identified using ultrasound. This is to ensure that this procedure is right for you. It also helps your medical team visualise and target the cancer cells.
- You will be placed under general anaesthesia, which means you will be asleep for the procedure.
- Your doctors will focus the high-intensity ultrasound waves on the cancerous tumour. They will use a live ultrasound to guide the treatment in real time.
How long will treatment last?
Treatment usually takes around 30 minutes, with some additional time needed for setup and anaesthesia.
Most patients will be able to return home on the same day.
Will I need follow up after treatment?
You will require appointments to review your recovery and any side effects that you might have from treatment.
Your doctors will tell you more about what to expect.
What are the side effects of treatment?
Histotripsy is still a fairly new treatment, so not all side effects from treatment are known.
So far, we know that treatment is generally safe. You may have temporary pain or discomfort in the treated area. You may also notice some mild bleeding or bruising on the skin where your treatment was delivered.
Your care team will be able to tell you more about what to expect.
How effective is Histotripsy for uveal melanoma?
Histotripsy is not an established treatment for uveal melanomas that have spread to the liver.
Evidence is therefore currently limited, but research is ongoing.
How can I find out more?
If you want to find out more about this treatment, please speak to your care team.
You may also find more information on the Cambridge University Hospital website.