The NHS is set to become the first health system in Europe to offer histotripsy, a groundbreaking ultrasound technology that destroys liver tumors using focused sound waves without the need for surgery, radiation, or chemotherapy. The treatment will begin trials this summer at Addenbrooke's Hospital in Cambridge, marking a significant milestone in non-invasive cancer therapy.
Revolutionary Sound Wave Technology
Histotripsy works by firing pulsed ultrasound waves to create "bubble clouds" from gases naturally present within tumor tissue. These microscopic bubbles expand and contract within microseconds, generating shockwaves that break apart cancerous masses at the cellular and sub-cellular level while leaving surrounding healthy tissue largely unharmed.
"This technology kills tumours without even touching you," explained Dr. Jennifer Linehan of St John's Cancer Institute. "Sometimes when I'm talking to patients I tell them this is 'Star Wars technology' because there are no cuts, there's no poking, there's nothing that's going inside you from outside. It's all happening with a focused beam of ultrasound to destroy the tumours."
The treatment destroys cancer cells and leaves debris to be eliminated naturally by the immune system, avoiding the ionizing damage of radiation or heat damage from thermal treatments.
Clinical Outcomes and Patient Benefits
Clinical trial data from HistoSonics demonstrates promising survival outcomes. According to 12-month follow-up data published in the Annals of Surgery journal in April, overall survival rates after one year were 73.3% for primary liver cancer patients and 48.6% for those with secondary tumors. The study noted that both tumor control and survival rates were similar to those achieved with current standard treatments.
More than 1,500 patients worldwide have received histotripsy treatment, primarily in the United States following FDA approval in October 2023. The technology offers significant advantages over traditional surgical approaches, with treatments potentially completed in just 30 minutes as day cases with limited or no pain and quick recovery times.
Addressing Critical Medical Need
Liver cancer represents a growing health challenge in the UK, ranking as the 17th most common cancer and 8th most frequent cause of cancer death according to Cancer Research UK. More than 8,000 people received new liver cancer diagnoses in 2022, with incidence rates surging 42% over the past decade according to the British Liver Trust.
The histotripsy system, manufactured by HistoSonics and called the Edison System, will initially treat patients with primary and secondary liver tumors. Research is underway to evaluate its potential application for pancreatic and kidney cancers.
Regulatory Innovation and Implementation
Health Secretary Wes Streeting personally intervened to authorize controlled early access to the device through the new Innovative Devices Access Pathway (ADIP) programme, designed to accelerate approval of safe and effective medical technologies that address unmet clinical needs.
"I've slashed red tape, so NHS patients will be the first in Europe to benefit from a revolutionary and non-invasive liver cancer treatment that uses ultrasound technology to destroy tumours - years earlier than planned," Streeting stated. "Patients stand to see faster recovery times, fewer dangerous complications, and shorter hospital stays."
James Pound, innovation director at the Medicines and Healthcare products Regulatory Agency (MHRA), described the approval as "a strong example of smart, agile regulation in action" and "a major step forward for patients with liver cancer."
Hospital Implementation and Future Prospects
The histotripsy device, donated by the Li Ka Shing Foundation, is expected to be fully installed at Addenbrooke's Hospital later this year. Roland Sinker, Chief Executive of Cambridge University Hospitals, emphasized the technology's potential to transform patient care.
"By offering this non-invasive, more targeted treatment we can care for more people as outpatients and free up time for surgeons to treat more complex cases," Sinker explained. "The faster recovery times mean patients will be able to return to their normal lives more quickly, which will also reduce pressure on hospital beds."
Fiona Carey, a kidney cancer patient who co-chairs Cambridge's patient advisory group, welcomed the development: "This is seriously good news. A new, non-invasive option to treat these cancers is very welcome indeed. For patients for whom ordinary surgery is no longer an option, this could make all the difference."
The Department of Health and Social Care plans to publish an evaluation of the NHS pilot later this year, which will inform broader implementation decisions and potential expansion to other cancer types.
