(MENAFN- The Conversation) For anyone facing cancer, the treatment options can feel brutally familiar: surgery, radiotherapy, chemotherapy, or a combination of them all. But a new approach is beginning to offer something very different. By using nothing more than precisely controlled sound waves, histotripsy can destroy tumours without cutting the skin or burning healthy tissue.

Histotripsy uses technology similar to medical ultrasound scans but delivers far more powerful and focused energy. Instead of creating an image, it produces controlled bursts of energy that form microscopic bubbles inside the targeted tissue.

As these bubbles rapidly expand and collapse, they break the tissue apart into tiny particles. The body then absorbs and clears away this debris over a few weeks, leaving behind little to no scar tissue and protecting the surrounding structures.

One of the biggest advantages of histotripsy is that it is non-invasive. For patients, this means no incisions, less pain, a lower risk of infection, and a quicker recovery than surgery or treatments that rely on heat to destroy tissue.

Crucially, histotripsy does not use ionising radiation or heat, both of which can harm healthy cells. Instead, the procedure is guided in real time using imaging, so clinicians can see exactly where the therapy is being delivered and adjust instantly. This level of precision is central to its safety.

Research into histotripsy has grown rapidly. Laboratory and animal studies have shown that it can effectively destroy tumours in the liver, kidney, pancreas, and other organs. Its ability to clearly define the treatment area while sparing nearby vital structures makes it especially useful for cancers that sit close to blood vessels, ducts, or other sensitive tissues.

Clinical trials have recently brought histotripsy closer to routine patient care. The US Food and Drug Administration has approved it for selected liver treatments after promising results in patients with primary and secondary liver cancers.

In the multi-centre Hope4Liver trial, histotripsy successfully removed targeted liver tumours with fewer complications than many standard treatments. These early results suggest the technology could be valuable not only for cancer but also for benign conditions.

Histotripsy does more than mechanically break down tumours. When tumour cells are fragmented, they release cellular debris and chemical signals that alert the immune system. Laboratory research shows this can help the body recognise and attack cancer cells.

Some studies have even demonstrated abscopal effects, meaning immune responses are triggered in tumour sites far from the treatment area. This immune activation raises the possibility of combining histotripsy with modern immunotherapies to make cancer cells more vulnerable to the body's defences.

Read more: Unlocking the body's defences: understanding immunotherapy

Another strength of histotripsy is that it works hand-in-hand with real-time imaging. This gives doctors the ability to adjust the treatment to a patient's movement, such as breathing, and to work around anatomical variations.

Researchers are exploring histotripsy for a wide range of health problems. Trials have investigated its use for benign prostate enlargement, softening calcified heart valves, and potentially treating certain neurological conditions. Its ability to target tissue gently and precisely, without harming surrounding areas, makes it appealing for patients who are poor candidates for surgery.

In early studies of valve disease, histotripsy has been shown to soften calcified valve cusps and improve leaflet motion, thereby reducing pressure gradients and improving valve opening. It is not yet a technique that reliably removes all calcification or replaces the valve, and most of the evidence so far comes from pre-clinical research.

Looking ahead, histotripsy may become a powerful addition to medicine's toolkit. Researchers are still studying its long-term benefits in larger patient groups, but its safety record, minimal damage to surrounding tissues, and compatibility with immune-based treatments set it apart.

As further trials are completed, doctors expect to better understand which patients will gain the most. Technological advances are also likely to produce devices designed specifically for different organs, along with improved imaging guidance and motion correction.

For patients, the potential impact is significant. If widely adopted, histotripsy could reduce the need for invasive surgery, improve tumour control and offer new options when other treatments are too risky or have failed.

The transition from laboratory research to clinical practice is still underway, but the momentum is strong. Each study adds to the evidence that histotripsy can provide precise, effective treatment with fewer risks

Current limitations

But challenges remain. Differences in tissue density, patient anatomy and movement can make targeting harder. The phenomenon known as acoustic aberration, where sound waves are distorted by bone or other tissues, can also reduce accuracy.

Engineers and clinicians are continually improving equipment and navigation algorithms to achieve even greater precision and to broaden its use.

It is also important to remember that cancer is often more widespread than imaging can detect. Histotripsy works on specific, localised lesions and cannot identify or treat hidden microscopic cancer cells. For many patients, though, it can play a valuable role in a broader treatment plan.

Histotripsy's ability to break cancer with sound reflects a major shift in medical innovation. By transforming sound waves into a potent and precise therapy, scientists and clinicians are redefining how conditions such as cancer can be treated: less invasively, more safely and with greater potential for cure. As research continues, histotripsy stands poised to reshape patient care for years to come.

MENAFN27112025000199003603ID1110406224