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Hong Kong cancer therapy

US brain surgeon says more awareness needed of ultrasound technology that could treat cancer, Hong Kong’s No 1 killer

Dr Neal Kassell, founder of the Focused Ultrasound Foundation, calls for more research on non-invasive procedure used for benign breast tumours that may hold potential for wider treatments

PUBLISHED : Sunday, 10 June, 2018, 10:02am
UPDATED : Monday, 11 June, 2018, 10:34am

With cancer being the No 1 killer in Hong Kong, an American neurosurgeon devoted to fast-tracking global research on an ultrasound cancer treatment wants the technology to be more accessible in the city.

The procedure, called focused ultrasound, uses high-intensity sound waves to treat tumours that are hard to detect.

“Focused ultrasound is the most powerful sound you will never hear but it can someday save your life,” Dr Neal Kassell, founder and chairman of the Virginia-based Focused Ultrasound Foundation, said on a recent visit to Hong Kong to promote the technology.

A former co-chair of neurosurgery at the University of Virginia, Kassell said trials that applied the treatment to more than 100 diseases – including 23 cancers – were being conducted at 550 sites worldwide.

The sites include 200 facilities in China with Chongqing University at the forefront of research efforts in Asia.

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Official statistics show there was a historic high of 30,318 new cases of cancer in 2015, up 2.4 per cent from the previous year. Last year, an estimated 14,610 people died of cancer and in the year before, the figure was 14,209.

Kassell said focused ultrasound was not a magic bullet but it could enhance the delivery and effectiveness of standard treatment methods, chemotherapy, radiation therapy and immunotherapy.

He said he held high hopes it could help treat brain cancer in cases where tumours were inaccessible.

“Radiation affects tissues [in only one way] and destroys DNA and cells. Focused ultrasound is a non-invasive technology and it has 18 ways to interact with tissue.

“It can destroy tissue, deliver drugs in very high concentration to the point where it’s needed, or stimulate the body’s immune response to malignant tumours and augment the effectiveness of oncology drugs,” Kassell said.

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The ultrasound “strips away” the camouflage of tumours, allowing the body’s immune system to “see the tumour and start killing it” while also enhancing the effectiveness of cancer drugs, according to him.

“Pivotal trials” are being conducted for use of the technology in treating breast cancer, with regulatory approvals worldwide for 23 cancer types. The United States’ Food and Drug Administration has also given the green light for its use in the treatment of prostate cancer, essential tremor (a nerve disorder), benign prostatic hyperplasia, uterine fibroids and bone metastases.

Dr Ava Kwong, a clinical associate professor of the University of Hong Kong’s department of surgery said at least 20 women who have fibroadenoma – a non-cancerous breast lump – have undergone focused ultrasound using a machine bought two years ago from a German manufacturer.

“There are not that many [patients] because the technology has limitations, where if the type of breast lump is too close to the skin, the worry is it could cause a skin burn,” Kwong, who is not involved with the foundation, said.

“We finished the fibroadenoma study and [are considering] the results,” she said, referring to whether further research on applying the technology to breast cancer would be carried out.

Kwong added that based on preliminary data from a study in Britain, the ultrasound could reduce tumour volumes by half on average, but not 100 per cent.

She said she believed focused ultrasound could be used in the future for lower grade breast cancer in which surgery was impossible or for patients who were not fit enough to go under the knife.

An oncologist at the private Hong Kong Sanatorium and Hospital, who spoke on condition of anonymity, confirmed a similar machine was bought 12 years ago, and that it was used to treat benign breast tumours. The doctor did not reveal whether the hospital still had the device.

An Israeli company, Insightec, of which Kassell is a shareholder, made the first machine 12 years ago.

From five makers, there are now 60 manufacturers of the device, with 10 in China, and one each in Taiwan and South Korea, according to Kassell.

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The Department of Health said there was no specific legislation on the manufacture, import, export, sale and use of medical devices in Hong Kong. A system is in place for voluntary listings of medium-risk and high-risk devices “to facilitate the transition to long-term statutory control,” a spokesman said.

In the foundation’s latest 2018 Spring Report released on Friday, Kassell said it was funding a “first-of-its-kind” pilot trial at the University of Virginia combining focused ultrasound with a cancer immunotherapy drug to treat stage four metastatic breast cancer in 15 women.

Immunotherapy treatments involve stimulating the body’s immune system to fight or prevent a particular disease.

The foundation counts among its board of directors, bestselling legal thriller novelist John Grisham, who wrote a 44-page book titled The Tu mor, available online for free to help raise awareness for the treatment.