Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with bladder tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling bladder tumors to be treated without surgery.
One preclinical study in the 1990s found that focused ultrasound could be used to destroy bladder tissue. There has been some recent work looking at the concept of using focused ultrasound to provide organ sparing surgery for patients with bladder cancer at UCLA. This preclinical work showed that one can use focused ultrasound in a transmural, full thickness ablation of an intact bladder wall. Further work needs to be done to demonstrate the impact of these approaches in patient care.
The primary options for treatment of bladder cancer include medication and invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
A clinical trial for urothelial cancer with metastatic lesions (and other tumors) has begun at the University of Virginia. Urothelial cancer is the most common type of bladder cancer.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for bladder tumors is not yet approved by regulatory bodies or covered by medical insurance companies.
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de Castro Abreu AL, Ukimura O, Shoji S, Leslie S, Chopra S, Marien A, Matsugasumi T, Dharmaraja A, Wong K, Zaba N, Ma Y, Desai MM, Gill IS. Robotic transmural ablation of bladder tumors using high-intensity focused ultrasound: Experimental study. Int J Urol. 2016 Jun;23(6):501-8. doi: 10.1111/iju.13083.
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