Last
week, more than 400 people from around the world gathered in Washington to talk
about an evolving medical technology promoted by a Virginia foundation.
It’s called Focused Ultrasound, and it shows promise for the treatment of
everything from cancer and Parkinson’s disease to arthritis and high
blood pressure.
High
frequency sound waves have long been used to help doctors and their patients
look inside the body. It’s this technology that allows prospective
parents to see a fetus in the mother’s womb. Sound waves can also be used to
destroy human tissue when they’re focused – like a laser beam – on a single
part of the body.
At the
Focused Ultrasound Foundation in Charlottesville Dr. Neal Kassell and his
colleagues have fine-tuned their techniques to eliminate the tremors suffered
by an estimated ten million Americans.
“For
essential tremor, the treatment is destroying the abnormal nerve cells deep in
the brain that are causing the shaking.”
This
painless and bloodless procedure is guided by magnetic resonance imaging and
takes from one to three hours.
“And at
the end of that treatment you know whether it’s been effective or not, because
you’re monitoring the patients. The patients are wide awake throughout
the entire procedure. They receive no drugs, and that’s it. Then
they go home.”
Now,
Kassell says, this therapy faces its next big hurdle.
“The
next step is to get it approved by insurance companies – both Medicare and the
commercial insurance companies.”
Patients
in Switzerland and Israel pay more than $30,000 for the procedure, and Kassell
says reimbursement rates in this country will have to be high enough to
encourage commercial development of an industry. Already, the federal
government and private insurers reimburse for elimination of fibroid tumors,
and Kassell says studies are underway for patients with various psychological
and neurological conditions.
“There
are clinical trials on-going for obsessive-compulsive disorder, for depression,
dystonia, for Parkinson’s Disease. We hope the first pilot trial,
the first baby step for Alzheimer’s Disease will start in the next weeks to
months the first patients with epilepsy will be treated.”
This
technology could also be used to zap nerves cells that cause pain in patients
with arthritis or back trouble, and doctors are also looking at ways to use
ultrasound in the treatment of various cancers.
“Liver,
pancreas, breast, prostate. Today there are more than 60 indications,
clinical indications that are at various stages of research and development,
from hypertension to arthritis to all the brain things that we talked about,
and most importantly, cancer immunotherapy. Focused ultrasound may have a big
role in stimulating the body’s immune response to help it fight cancer as well
as to augment the effectiveness of the new cancer immunotherapy drugs.”
But how
would sound waves do that?
“Cancer
cells are very smart. They have a way of camouflaging themselves from the
body’s immune response, and they can send out signals that block the immune
response as well. Focused ultrasound can disrupt the cell membranes and
expose the antigens that allows the body’s immune response to see them.”
If
studies show focused ultrasound is effective in treating any of these
conditions, Kassell says we’ll have to wait for FDA approval and sign-off from
insurers willing to cover the cost. He hopes Medicare will start that
ball rolling in November, when it’s expected to decide whether and how much to
pay for focused ultrasound treatment of essential tremor.
“That
will be the lynchpin that allows the floodgates to open and the field to take
off.”
The
technology is approved for treating uterine fibroids, prostate cancer, benign
prostatic hyperplasia and metastatic bone cancer. Other countries have
approved the use of focused ultrasound to treat essential tremor, Parkinson’s disease, back pain, cancers of the breast, kidney, liver and
pancreas.
http://wvtf.org/post/charlottesville-foundation-forefront-groundbreaking-medical-procedure#stream/0
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