Last week, more than 400 people from around the world gathered in Washington to talk about an evolving medical technology promoted by a Virginia foundation. It’s called Focused Ultrasound, and it shows promise for the treatment of everything from cancer and Parkinson’s disease to arthritis and high blood pressure.
High frequency sound waves have long been used to help doctors and their patients look inside the body. It’s this technology that allows prospective parents to see a fetus in the mother’s womb. Sound waves can also be used to destroy human tissue when they’re focused – like a laser beam – on a single part of the body.
At the Focused Ultrasound Foundation in Charlottesville Dr. Neal Kassell and his colleagues have fine-tuned their techniques to eliminate the tremors suffered by an estimated ten million Americans.
“For essential tremor, the treatment is destroying the abnormal nerve cells deep in the brain that are causing the shaking.”
This painless and bloodless procedure is guided by magnetic resonance imaging and takes from one to three hours.
“And at the end of that treatment you know whether it’s been effective or not, because you’re monitoring the patients. The patients are wide awake throughout the entire procedure. They receive no drugs, and that’s it. Then they go home.”
Now, Kassell says, this therapy faces its next big hurdle.
“The next step is to get it approved by insurance companies – both Medicare and the commercial insurance companies.”
Patients in Switzerland and Israel pay more than $30,000 for the procedure, and Kassell says reimbursement rates in this country will have to be high enough to encourage commercial development of an industry. Already, the federal government and private insurers reimburse for elimination of fibroid tumors, and Kassell says studies are underway for patients with various psychological and neurological conditions.
“There are clinical trials on-going for obsessive-compulsive disorder, for depression, dystonia, for Parkinson’s Disease. We hope the first pilot trial, the first baby step for Alzheimer’s Disease will start in the next weeks to months the first patients with epilepsy will be treated.”
This technology could also be used to zap nerves cells that cause pain in patients with arthritis or back trouble, and doctors are also looking at ways to use ultrasound in the treatment of various cancers.
“Liver, pancreas, breast, prostate. Today there are more than 60 indications, clinical indications that are at various stages of research and development, from hypertension to arthritis to all the brain things that we talked about, and most importantly, cancer immunotherapy. Focused ultrasound may have a big role in stimulating the body’s immune response to help it fight cancer as well as to augment the effectiveness of the new cancer immunotherapy drugs.”
But how would sound waves do that?
“Cancer cells are very smart. They have a way of camouflaging themselves from the body’s immune response, and they can send out signals that block the immune response as well. Focused ultrasound can disrupt the cell membranes and expose the antigens that allows the body’s immune response to see them.”
If studies show focused ultrasound is effective in treating any of these conditions, Kassell says we’ll have to wait for FDA approval and sign-off from insurers willing to cover the cost. He hopes Medicare will start that ball rolling in November, when it’s expected to decide whether and how much to pay for focused ultrasound treatment of essential tremor.
“That will be the lynchpin that allows the floodgates to open and the field to take off.”
The technology is approved for treating uterine fibroids, prostate cancer, benign prostatic hyperplasia and metastatic bone cancer. Other countries have approved the use of focused ultrasound to treat essential tremor, Parkinson’s disease, back pain, cancers of the breast, kidney, liver and pancreas.