Providence Swedish makes history with histotripsy

Dr. Marc Horton, at left, and Dr. Evan Ong, at right, with the Edison histotripsy platform.   

[4 MIN READ] 

In this article: 

  • Swedish First Hill is the first hospital on the West Coast to offer a new treatment called histotripsy to people with liver cancer.  
  • The FDA-approved process uses sound waves to create sonic beams that destroy cancer cells with bubble clouds. 
  • Histotripsy does not require an incision, has no side effects and minimal recovery time.
  • Histotripsy is a safe, effective option for people who may not be good candidates for surgery or who have tried other treatments without success. 

A device using sound waves that creates sonic beams to produce bubble clouds that eliminate tumors may seem like something you’d see in a science fiction film but starting in 2024, patients with liver cancer may be able to choose it as a treatment option at Swedish. 

It’s called histotripsy. And experts say the revolutionary treatment could change everything in how physicians are able to treat patients with liver tumors. 

“Thanks to Nils Johanson's visionary founding of Swedish, the institution has been a pioneering force in treatment for patients with cancer for the past century. Histotripsy is now poised to carry forward that legacy, potentially propelling us light years into the future," states M. Trevor Bennett, MBA, associate vice president of acute care operations and executive director of surgical and interventional services at Providence Swedish, Central Puget Sound. 

Histotripsy uses focused sonic beams created by ultrasound waves to target cancer cells. The process creates tiny bubble clouds that expand and collapse rapidly, dissolving the tumor and destroying its cells. The patient’s lymphatic system cleans up any remaining debris. 

“I’ve been doing this for 35 years, and I’m not sure I’ve ever been as excited about a new technology as I am about this. I foresee that when we are all old and gray and look back on what new technology changed everything for us, this therapy will be on top of everybody’s mind,” says Marc Horton, M.D., FACS, executive medical director of surgical services, surgical chair, attending surgeon at Swedish Surgical Specialists. “People will tell you - I don’t get excited about every new thing on the block, but this is going to be a game changer.” Dr. Horton is an integral part of the team responsible for bringing histotripsy to Swedish. 

Making history with histotripsy 

Swedish First Hill, part of the Providence family of organizations, is the first site on the West Coast to offer histotripsy as a potential treatment option for people with liver cancer.  

“Histotripsy creates areas of microbubbles that cause extreme, rapid pressure changes. These pressure changes take cells, stretches and shrinks them so quickly that they rupture. The process is purely mechanical. It doesn’t do anything else. There’s no heat that’s generated. There’s no radiation that’s induced. It really is going to be very different from any other sort of modality that we have currently available,” says Cliff Cho, M.D., a histotripsy researcher and surgical oncologist at the University of Michigan. 

Engineers and physicians from the University of Michigan have been working since 2009 to develop histotripsy and formed HistoSonics, producer of the Edison delivery platform. Edison was approved in 2023 by the U.S. Food and Drug Administration and is the first and only histotripsy platform currently available in the United States.

“The Edison System and histotripsy are significant advances for both our patients and dedicated caregivers. It’s a tool that will put Providence Swedish in the vanguard of care and bolster our mission of delivering the highest level of quality and safety for our patients."

Safe, effective care 

Studies have shown that histotripsy is a safe and effective addition to treatments currently available for cancer and liver tumors, which include radiation, chemotherapy and surgery.  

“The benefit of histotripsy is that it can create a very distinct area of treatment. That makes the treatment highly controllable, highly predictable and more precise. It can achieve the same results as surgery but with less side effects and fewer complications. And when treatments are done in that environment, it makes them safer,” says Evan Ong, M.D., MS, FACS. Dr. Ong is a surgical oncologist at Swedish who will be among the first physicians nationwide who will offer histotripsy to his patients. 

“Since there's no radiation, no freezing and no heat used, there’s no collateral damage for healthy cells around the target area,” adds Dr. Horton. “On the cellular level, the sound waves cause the cell to squish, collapse and squish back and forth in different axes until it pops and dies. If we could pick out a cell with a pair of tweezers, put it on the table, and squash it—that’s what the Edison platform does.” 

What makes a good candidate? 

Early clinical trials show a histotripsy success rate of 95.5%, indicating that physicians can precisely target and destroy liver tissue and tumors that cannot be completely removed through surgery. It also brings new hope to patients who cannot tolerate surgery or for whom radiation or chemotherapy is not a viable option. 

“We have an array of things we can do to treat tumors in the liver and elsewhere. However, sometimes those things are contraindicated because of the proximity to vital structures such as blood vessels or bile ducts. Our present-day treatments using radiation or ablation can cause such collateral damage” says Dr. Horton. “This isn’t true for histotripsy. Time will tell but it is possible that the sky’s the limit regarding patients that would qualify for this therapy.” 

Unlimited potential 

Surgeons at Swedish First Hill received extensive training on Edison after the platform arrived in December 2023. 

“We're excited about the integration of this innovative modality. The Edison System and histotripsy are significant advances for both our patients and dedicated caregivers. It’s a tool that will put Providence Swedish in the vanguard of care and bolster our mission of delivering the highest level of quality and safety for our patients,” says Bennett. 

“This gives us an even better, more precise tool in our toolkit. It gives us more and more opportunities and more and more patients we can help that we couldn’t help before. This new technology at Swedish could make it possible for people who weren’t treatable previously to be treatable now,” affirms Dr. Horton. 

“Histotripsy has minimal side effects. It’s more precise than some of the noninvasive treatments that we have, and it reduces the recovery time. Those three things together provide a drastic improvement in therapy,” says Dr. Ong. “Once again, Swedish is on the cusp of doing things that are very progressive. We have always been that way.”  

Learn more and find a practitioner

Swedish continues to bring innovative, advanced treatment through clinical research and the expertise of the entire team. For more information about histotripsy, call Swedish Surgical Specialists at 206-386-6700. 

If you or a loved one have questions about cancer diagnosis, treatment or care, the experts at Swedish Cancer Institute are here for you. We can accommodate both in-person and virtual visits. To speak with someone or make an appointment, call 1-855-XCANCER. 

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you. 

Information for patients and visitors 

Related resources 

Swedish is the first Washington State hospital to offer groundbreaking ALS treatment

Upcoming studies give hope to people with lupus and MS 

Newly approved drug is a major advancement for patients with ulcerative colitis 

Swedish is a destination for innovative, world-class care 

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions. 

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