Histotripsy

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Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Histotripsy

Postby Dennyp » Tue Jan 23, 2024 5:24 am

Hey all,

I’m eligible for liver surgery to remove a single liver lesion. It’s located in an area that increases the risk of liver failure but the risk is still pretty low about 5%. I’ve been reading about histotripsy and seems really promising. I’d love to avoid surgery but I think this technology is too new. I’m not sure if I’m even eligible for histotripsy. I called a center that does it and started the ball rolling on getting a consultation. I’m curious about what others are thinking about it?
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

User avatar
beach sunrise
Posts: 1041
Joined: Thu Mar 05, 2020 7:14 pm

Re: Histotripsy

Postby beach sunrise » Tue Jan 23, 2024 2:41 pm

I have been following their progress updates and seems very good. Hopefully they say they can take CRC patients now.
Keep us in the loop. I find this very interesting for sure.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Histotripsy

Postby Dennyp » Thu Jan 25, 2024 8:43 am

beach sunrise wrote:I have been following their progress updates and seems very good. Hopefully they say they can take CRC patients now.
Keep us in the loop. I find this very interesting for sure.


Will do, started the ball rolling, I’ve asked my care team to contact them and send them whatever they need to evaluate my case. I’ll keep you posted.
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

User avatar
beach sunrise
Posts: 1041
Joined: Thu Mar 05, 2020 7:14 pm

Re: Histotripsy

Postby beach sunrise » Fri Mar 01, 2024 7:49 pm

Hey Dennyp, any updates?
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Histotripsy

Postby Dennyp » Sat Mar 02, 2024 4:45 am

beach sunrise wrote:Hey Dennyp, any updates?

Yes, after talking to my oncologist I decided to do radiation. She is interested in the technology but thinks more data is needed. Also I was having a very difficult time getting access to the technology. More machines have been placed near me in the NYC area. Hopefully I won’t need it, but if I do I will definitely consider it.
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

skimom
Posts: 78
Joined: Fri Mar 17, 2023 12:24 pm
Location: Oregon USA

Re: Histotripsy

Postby skimom » Sat Mar 02, 2024 9:31 pm

I just got approved and scheduled for histotripsy and will be having it done on the 20th at Swedish Hospital in Seattle. I’ll let you all know how it goes!
47yo F at DX
DX 12/11/22 Stage IV (liver & lung mets) KRAS PIK3CA
12/15/22 Primary tumor removed from Transverse Colon (4.3x4.0x0.6cm G2 3/15 lymph nodes. Clear margins)
01/06/23 started Folfox (10 cycles)
Initial CEA 5608
CEA after 4 rounds 1319
CEA after 6 rounds 427
CEA after 9 rounds 95
HAI pump installed 06/20/23
Start FOLFIRI and FUDR 07/05/23
CEA down to 37
31
21
18
9/2023 Switch back to FOLFOX due to new lung nodules
11/23 FOLFOX fail CEA up to 62

Dennyp
Posts: 84
Joined: Thu Oct 29, 2020 9:28 pm

Re: Histotripsy

Postby Dennyp » Mon Mar 04, 2024 12:06 pm

skimom wrote:I just got approved and scheduled for histotripsy and will be having it done on the 20th at Swedish Hospital in Seattle. I’ll let you all know how it goes!

Please do! Best of luck!!
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/21 CT NED
2/22 CT NED
5/22 CT NED
8/22 PET NED
11/22 CT NED
3/23 PET lesion on liver
3/23 MRI confirmed lesion
4/23 liver surgery aborted lesion found on diaphragm
5/23 chemo started
7/23 CT shows shrinkage of lesion, consult scheduled with surgeon

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: Histotripsy

Postby roadrunner » Thu Mar 07, 2024 1:49 am

Skimom: This approach looks very interesting. As I am sure you know, it’s shown very good results in terms of local control but seems to have significantly enhanced abscopal effects as well, at least according to some studies. Are they using a checkpoint inhibitor with it? This looks really promising in general, and I wish you the best of luck with it!
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

skimom
Posts: 78
Joined: Fri Mar 17, 2023 12:24 pm
Location: Oregon USA

Re: Histotripsy

Postby skimom » Thu Mar 07, 2024 7:15 am

Thanks Dennyp & roadrunner for the encouragement.
roadrunner wrote:Skimom: This approach looks very interesting. As I am sure you know, it’s shown very good results in terms of local control but seems to have significantly enhanced abscopal effects as well, at least according to some studies. Are they using a checkpoint inhibitor with it? This looks really promising in general, and I wish you the best of luck with it!

I have read some promising studies as well. Honestly didn’t think I would qualify with the spread to other areas that I have and having a HAI pump but they say I do! And I’m waiting for a TIL therapy trial to open and it doesn’t disqualify or delay that either which was so nice to hear. I don’t believe they are using a checkpoint inhibitor. I have my consultation on the 18th. If I find out anything new I’ll post it. And I’ll surely let you all know how it goes on the 20th
47yo F at DX
DX 12/11/22 Stage IV (liver & lung mets) KRAS PIK3CA
12/15/22 Primary tumor removed from Transverse Colon (4.3x4.0x0.6cm G2 3/15 lymph nodes. Clear margins)
01/06/23 started Folfox (10 cycles)
Initial CEA 5608
CEA after 4 rounds 1319
CEA after 6 rounds 427
CEA after 9 rounds 95
HAI pump installed 06/20/23
Start FOLFIRI and FUDR 07/05/23
CEA down to 37
31
21
18
9/2023 Switch back to FOLFOX due to new lung nodules
11/23 FOLFOX fail CEA up to 62

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: Histotripsy

Postby roadrunner » Thu Mar 07, 2024 10:45 am

Well, the checkpoint inhibitor wouldn’t likely matter to you anyway, since you are KRAS. I assume you know this, but the success of this kind of therapy, at least when it comes to the potential abscopal effect, is optimized when your immune function is good. IMO that doesn’t necessarily mean “supplementation” (IMO there’s little evidence for most such approaches, particularly at achieving the kind of *balance* that’s really needed), but good sleep, diet, no alcohol, no smoking, exercise, low stress (easy, I know!), and avoidance of infection (not political, but masking might be a good idea in your circumstance to avoid any “distracting” respiratory infections, not just COVID) may make a big difference, particularly as your system is already occupied with fighting cancer. Your age (young) and gender are already pluses for immune function.

Again, you’ve probably already thought of this stuff, but just thought I’d give you my 2 cents in case you hadn’t. Of course, the best move is to check with your team(s), particularly if you do supplement, as some supplements may be contraindicated or skew blood panels, etc.

I really hope you get at least some meaningful abscopal benefit here. It is a promising strategy. Good luck!
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

skimom
Posts: 78
Joined: Fri Mar 17, 2023 12:24 pm
Location: Oregon USA

Re: Histotripsy

Postby skimom » Thu Mar 07, 2024 11:02 am

Thanks roadrunner! Greatly appreciate the advice. I have never smoked and haven’t had alcohol in years so that part is easy. The sleep not so much but I do my best. My wonderful husband and the rest of my family have done their best to eliminate stress from my life and I’m convinced it has a lot to do with how good I feel. I did have a good workout routine going but been slacking a bit lately. I will get back on it for sure! I feel my immune system is as good as it can be for my circumstances. Sick kids and grandson around and somehow I’m the only one to not get it! I do IVC twice a week and do take supplements as well. Oncologist knows and is good with it all.

Thanks again for the advice and I’ll be sure to let you know how it goes :)
47yo F at DX
DX 12/11/22 Stage IV (liver & lung mets) KRAS PIK3CA
12/15/22 Primary tumor removed from Transverse Colon (4.3x4.0x0.6cm G2 3/15 lymph nodes. Clear margins)
01/06/23 started Folfox (10 cycles)
Initial CEA 5608
CEA after 4 rounds 1319
CEA after 6 rounds 427
CEA after 9 rounds 95
HAI pump installed 06/20/23
Start FOLFIRI and FUDR 07/05/23
CEA down to 37
31
21
18
9/2023 Switch back to FOLFOX due to new lung nodules
11/23 FOLFOX fail CEA up to 62

roadrunner
Posts: 465
Joined: Sun Jan 12, 2020 8:46 pm

Re: Histotripsy

Postby roadrunner » Thu Mar 07, 2024 12:31 pm

Sounds good! As far as the immune system goes, it’s def good to be female. Us men weren’t built to last like you are!
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23


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