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Okay, you sold me. Where can I get an ultrasonic massage?

An eye opener for me was when a friend of my was dying of cancer there was a period where he got sepsis, ultimately because of the effects of chemotherapy not directly because of the cancer. But had he passed from sepsis (he survived that incident), the cause of death would ultimately be attributed to cancer and not chemotherapy.

I looked into it deeper at the time and it's very difficult to untangle the true cause of death in many of these situations. While certainly these treatments are ultimately beneficial statistically, it is concerning that there's not as much discussion around their harm and the real risk rewards behind various treatments. I know from my own (non-cancer) experience that there is a very strong bias towards treatment even in cases where, once you break down all the risk and rewards, there is a strong argument for non-intervention.

Proton therapy offers incremental, if any advantage, over standard IMRT for non-pediatric cases. In the case of the prostate, recent evidence shows no benefit at all. It suffers from near hyperbolic marketing from debt-ridden therapy centers pushing dubious claims that are now being exposed by high quality phase III comparison trials.

HIFU for prostate also is a ripe area for grifters as it is advertised and marketed towards low risk cases that would probably benefit from active surveillance.

> Tech folks pivoting to medical always throws off some alarm bells to me, but she was fairly compelling on the podcast and the basic idea seemed to make sense.

The best way to evaluate biotech startups from the outside is to look at their investors. If they’re full of VCs specializing in biotech, chances are someone did the bare minimum due diligence on the science.

Theranos for example didn’t have a single one because biotech VCs steered clear of that mess entirely.

> Tech folks pivoting to medical always throws off some alarm bells to me

Same for me. I've been in the medical device industry for 15+ years now and came from "tech". What a lot of techies under/don't appreciate is that the medical device industry is heavily regulated and moves at a muuuch slower pace than other technologies.

There are lots of regulatory and quality/testing hurdles that you must clear (namely verification and validation testing, in addition to your 510(k) clearance or approval, if PMA) before you can market and sell your device.

I tell customers, on average, a Class II medical device project can take 18-24 months and cost $3M to 4M, minimum.

She has a couple of TED talks on this tech from several years ago.

I was aware of her from the OLPC project and the cool Pixel Qi screen tech from that, but haven't watched the talks.

The article mentions that this is a different type of ultrasound treatment than the one that has been in use for prostate cancer treatment for some time.

>But you cannot use this anywhere where the ultrasound would be blocked by other organs.

Yes you can. If you had an array of ultrasonic transducers around the body you could have each of them in phase targeting a single spot. Beamforming is a thing we've been doing for years with RF. It's even more trivial with sound.

Can’t the surgery be then with a small probe just to get the ultra sound tip near the cancer? I don’t know the size of the ultrasound tip but seems to me it can be smaller then a hand or tweezers.

> Fun fact: using this ultrasound for prostate cancer treatment reduces the risk of erectile disfunction

I’m not aware of strong evidence in this area (not saying you’re incorrect).

For the liver indications, several elite radiology departments have had very poor outcomes with their patients, despite the strong public data. I would not, with my own prostate, try a new technology until at least a decade out, at least.

I just spoke to a oncologist surgeon about this. Even though their facially doesn't have one (they are expensive machines) he said it's looking like it'll be standard care in the future.

He did an evaluation about getting one for my local hospital.

It looks like this can be used to burst and liquify body fat, near to the surface of the skin! Wild.

“Lithotripsy” is the name of the kidney stone treatment. My understanding is it’s based on vibration, not ultrasound (I know, vibration is sound - my understanding is the method on the linked article uses higher frequency + intensity + shorter pulses than the kidney stone method - so sorta like microwaving tumors vs using a massage gun on kidney stones?)

AFIKR two facilities do this kind of treatment. One in Canada and one in China. There already was a HN threads with some reporting to have been treated in Canada.

https://news.ycombinator.com/item?id=31630679

Apparently, only some tumors have a distinct and unique shape / size. The “trick” is to calibrate the resonance exactly to the size of the cancer cell. So that resonance would “hurt” only that kind of shape / size cell. Which was much harder to do than it sounds. Sadly not all cancer cells are unique and not that “easily” distinguishable by size

But I am not in the medical field and just repeating what I’ve read.

https://www.statnews.com/2024/06/22/hank-green-pissing-out-c...

Watching Hank Green's YouTube video where he found out that his cloudy pee was cancer leaving his body, he was surprised that doctors don't tell you to expect it. It can be such a morale boost.

The recycling of dead cells is a normal biological process the same thing happens when they use radiation to kill cancer cells

If I interpret the article correctly, the ultrasound energy does two things: it effectively destroys the cancer cells by overheating them, and it physically breaks apart the tumour. Your immune system can further break up and get rid of dead cells the way it deals with normal dead cells.

Usually, it suffices to initiate apoptosis, the self-destruction mechanisms of the cells.

There was a startup in Shanghai in the early 2000. Their device used multiple transducers. The probe was at least 40 cm in diameter. They did trials on uterine fibroids, among other diseases. One of the difficulties was while it looks good in theory, but the path ultrasound travels in the body is more complicated than, say x-ray or gamma ray. They expected a fine focal zone, but sometimes the focal zone was much larger than expected. This new wave of ultrasound equipment may have discovered better ways to control the sound beam.

Don't know about mRNA but individualized remedies based on CAR-T technology have been making significant strides in this area, with major commercialisation expected in the next 1-2 years