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Quick, painless, noninvasive, and relatively inexpensive, focused ultrasound may soon be used to destroy tumors without the need for surgery, chemotherapy, or radiation.

Certain kinds of cancer are an especially devastating diagnosis. One of them is glioma, the most common form of brain cancer.An all-too-typical case of glioma happens something like this. I'll use the fictional story of a 40-year-old man named Ivan.

Early Symptoms of Cancer Can Be Subtle

Ivan is an active, happy, husband and father of three with a responsible position in a growing company. He finds time to spend with family and friends, and he loves sports and nature. What Ivan doesn't know is that he has a tumor about the size of a golf ball growing in the frontal lobe of his brain.

The first time Ivan suspected something was wrong was when he started forgetting to put meetings on his calendar. He attributed it to too much holiday fun. Then he simply lost interest in doing things with his family. His son and daughter had been the joy of his life, and they still were, but somehow he wasn't motivated to do things with them. He became irritable over silly things, and then he actually got into a fight at work, which resulted in a suspension from his job. Finally, one morning Katya, Ivan's wife, hears a thump in the toilet. Ivan has collapsed He's having a gran mal seizure.

Finding Cancer Results in Drastic Treatment

At the hospital, Ivan and Katya are informed that the real problem is that Ivan has a brain tumor. He's immediately put on an anti-seizure medication, and a steroid to stop swelling in the part of his brain around the tumor. Since they are at the finest hospital in the city, a neurosurgeon offers to perform a three-hour surgery to remove the tumor, which, she assures them, might even be benign. The risk of death and paralysis is low, and it's possible that whole problem will be solved with the surgery.

Ivan has the surgery the same week. The surgeon removes a flap of skull about the size of the lid on a jar, localizes the tumor with the help of an operating microscope, makes an incision into the brain, and removes the mass. The tumor is sent to the pathology lab. Ivan pulls through the surgery but the news isn't good. The tumor is malignant. The surgeon was able to remove every visible trace of the tumor, but this turns out to be a cause for false hope.

Treatment of Cancer Can Be Worse Than the Disease

Immediately after surgery, Ivan wants to talk about what's on his mind: how his family will survive when he's gone. Katya, however, will hear nothing of it. She wants to hold on to the possibility everything will be OK. Unfortunately, it's not. The pathologist finds that Ivan's brain tumor was not a glioma, a brain cancer in its early stages, but a glioblastoma, a brain cancer that has expanded in microscopic traces through the brain. Ivan will have to have chemotherapy, which will devastate his immune system, and cause digestive upset and mouth sores, along with radiation, which will damage the parts of the brain which are currently unaffected by the cancer. His young family will spend all their savings and more fighting the disease, but he will get sicker and sicker and die, leaving behind a widow and children exhausted from the struggle over 10 long months.

There has to be a better way. Perhaps in about 10 years there will be, high-intensity focused ultrasound for treatment of cancer.

Continue reading after recommendations

  • Merckel LG, Knuttel FM, Deckers R, van Dalen T, Schubert G, Peters NH, Weits T, van Diest PJ, Mali WP, Vaessen PH, van Gorp JM, Moonen CT, Bartels LW, van den Bosch MA. First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation. Eur Radiol. 2016 Feb 6. [Epub ahead of print] PMID: 26852219.
  • Sivaraman A, Barret E. Focal Therapy for Prostate Cancer: An "À la Carte" Approach. Eur Urol. 2016 Jan 5. pii: S0302-2838(15)01223-3. doi: 10.1016/j.eururo.2015.12.015. [Epub ahead of print] PMID: 26778462.
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