New Mission Hospital machine uses sound waves to vaporize liver tumors

After 25 rounds of chemotherapy and twice having radiation beads injected into his tumors, Michael Farris’ liver was still too cancer-filled for surgery.

Then, just a month ago, the Ladera Ranch father of three was told there might be a non-invasive way to get at one of the tumors deep in his liver that wasn’t responding to the earlier treatments.

Doctors at Providence Mission Hospital told him they had a new machine that uses sound waves to pulverize liver tumors of a certain size for which he might be a good candidate.

“I was excited and wasn’t apprehensive at being one of the first patients,” Farris said. “I had complete faith in the doctors and they were excited about it.”

The machine, an Edison Histotripsy System, was just approved by the Food and Drug Administration in October, following clinical trials, and the Mission Viejo hospital is the first in California to have the new technology – and the second on the West Coast. A hospital in Seattle was the first.

The histotripsy technique had been pioneered at the University of Michigan and was under development for several years.

The machine is seen as a huge breakthrough in treating cancer, especially as the rate of cancer is rising and showing up earlier in younger people, hospital officials said. A recent report from the American Cancer Society said rates of younger people diagnosed with cancer have started to climb, led by a rise in colorectal and breast cancers.

Presently, the technology is only being used to treat liver tumors, but is going through clinical trials to treat kidneys, and then the pancreas and prostate. Future versions could treat thyroid, breast and brain tumors.

Farris was the second patient to be treated with the technology at Mission Hospital, and three more are scheduled for April. There is a list of others waiting to see if they are candidates. Requests for treatments are coming in from across the country and even the world, doctors at Mission Hospital said.

“This will be the future of cancer therapy,” said Dr. Kevin Burns, who specializes in minimally invasive, image-guided procedures at Mission Hospital and its Leonard Cancer Institute. He treats conditions throughout the body with cancer therapies, including tumor embolization and ablation.

Burns is also the one who expertly guided the histotripsy device over Farris’ liver during his March 8 treatment, eliminating a nearly 3 centimeter tumor. To do that, Farris, 51, who a year ago was diagnosed with colon and stage 4 liver cancer after a routine colonoscopy, was put under anesthesia so that he would be perfectly still while Burns guided a robotic arm to the exact spot on the liver to target the tumor.

Within 45 minutes, the tumor and its proteins were destroyed. Once pulverized, they are absorbed by the body and go into the bloodstream, where they can become helpful to the body’s immune system in attacking other tumors that could be present or may just be popping up, Burns said.

“A lot of people with stage 4 liver cancer don’t have a lot of options,” Burns said, adding that Farris was not a candidate for liver surgery because of the amount of disease present. The tumor targeted by the machine was on one of the only healthy pieces of the remaining liver lobe.

“It explodes the cells, and the target is like a grain of rice that turns into a liquid,” Burns said. “All the cells are dead, and the body’s lymphatic system absorbs them. In some patients, it can cause a systematic response and help the body recognize the tumor cells so it can learn to kill them.”

Now, Burns and Dr. Ahmad Abbass, a liver and pancreatic surgeon at the Leonard Cancer Institute, will monitor Farris’ liver through periodic imaging and blood tests that check for tumor markers.

In the meantime, Farris will continue with chemotherapy treatments every other week, which he said he has learned to endure. He is also supported by his partner, Stefanie Schroeyens, who has a background in radiology and looked up all the literature she could on the histotripsy machine. She said this helped her process what was going on with Farris and what the machine might be able to do for him.

Both are also still shocked at how the entire journey began, they said.

Farris, an avid street cyclist who logs 100 miles a week and surfs three times a week, scheduled his colonoscopy just after turning 50 at the end of 2022. At the time, he had no symptoms, he said, but just before he went for the procedure, he said he had mild constipation and felt a little off, especially on his long bike rides.

But neither he nor Schroeyens expected the news they got after the colonoscopy.

“It knocked me to the floor,” he said of finding out about the colon tumor and the spread to the liver. “A diagnosis like that is grim. I wasn’t worried about the chemo; it was a matter of living on a time clock. Waking up and staring at a short life; it’s a lot to digest.”

But, Farris’ story is not all the uncommon now, the doctors said.

“Michael was asymptomatic,” said Dr. Abbass. “There is an increase in colon cancer, and I’m seeing this more often, and I see it in younger people. In the last few years, I’ve seen metastatic colon cancer in people as young as 30.”

Abbass pointed out that in 2021, new recommendations from the U.S. Preventive Services Task Force call for colorectal cancer screening for people at average risk starting five years sooner. The change to 45 was based on the trend of growing cases among younger adults.

“It can happen to any of us,” he said. “He was living a full, active life. We need to go out of our way to find better treatment options than what we’ve been doing. A lot of people have vague symptoms and then it gets worse. Some cancers, even small, can spread before causing symptoms. Colonoscopy saves lives.”

Since his treatment with the new machine, Farris said he’s more hopeful about his prognosis. Chemo and the two radiation treatments have already helped in reducing the size of other tumors in the liver, and healthy parts of the liver have gotten bigger. Now, he’s got to handle the remaining tumor in the colon and doctors will consider a resectioning surgery.

“My markers are way down,” Farris said. “And, I feel more optimistic mainly because most of the tumor and lesions have been beat back and killed. I’m feeling like at least my time clock has been lengthened.”

Source: Orange County Register