A medical technology that could replace surgery and make drugs more effective in many cases
Five years ago, John Dutton was diagnosed with Parkinson’s Disease. He knew something was wrong when his right hand started shaking.
“You can’t get away from it! It’s on you all the time, and it got worse and worse and worse," he recalls.
Dutton couldn’t write or drink from a cup -- even getting dressed was difficult, and the drugs his doctor prescribed did nothing, so he turned to a relatively new treatment – focused ultrasound. Using magnetic resonance imaging to guide them, doctors propel sound waves through the skin and skull, bypassing healthy tissue, to generate heat at a precise spot in the brain. It’s painless, requires no incision and delivers rapid results.
"In that first blast of 20 seconds you can tell right away – they got the right spot, because your tremors stop immediately, and the feeling of joy you have is like – Oh my life has changed in 20 seconds!”
The extraordinary promise of this technology inspired Charlottesville neurosurgeon Neal Kassell to establish the Focused Ultrasound Foundation in 2006.
"The mission is very simple – to shorten the time from laboratory research to widespread utilization," he says.
In the last ten years the number of potential uses for this therapy has grown from three to more than 180 with nine approved for use in this country and 32 in other parts of the world. It has, for example, eliminated tumors in the prostate gland, bladder, liver, kidney, bone and breast, has treated glaucoma, varicose veins and uterine fibroids. Even more intriguing, Kassell says, are the ways in which focused ultrasound works.
Take, for example, making medications more effective. By injecting drugs into tiny bubbles, Kassell explains, doctors can more effectively target treatment.
"You can fill those micro-bubbles up with chemotherapy agents for cancer, growth factors for Alzheimer's or Parkinson's -- and you inject millions of these micro-bubbles into the bloodstream, and the micro-bubbles circulate throughout the body, but the drug is totally inactive, because it's trapped in the micro-bubble except at the point where the ultrasound is focused, and at that point only, the micro-bubbles burst and release their pharmacological payload."
The technology has also made cancer cells more vulnerable.
"They have a way of camouflaging themselves from the body’s immune system," Kassell says. Focused ultrasound can strip away that camouflage and allows the body’s immune system to recognize these tumors as bad actors and augment the effectiveness of cancer immunotherapy drugs."
He adds that focused ultrasound techniques are relatively easy for physicians to master.
"It's a lot easier than learning surgery, particularly if somebody is young and has grown up playing video games."
And he notes Virginia is a leader in the field, with support coming from the state.
"There's been considerable research that's being done at the University of Virginia and now Virginia Tech, so we are positioning Virginia on the leading edge of high-tech development in focused ultrasound."
Last year, he says, about 100,000 patients were treated with focused ultrasound. Five years from now he predicts the number will grow to a million as costs come down, insurance companies cover its use for more conditions, awareness increases, and public access improves.