High Intensity Focused Ultrasound (HIFU)Site Visit - HIFU in BeijingIn China, there are two major programs that use High Intensity Focused Ultrasound (HIFU) to non-surgically destroy cancerous tumors. We reported on the first program, located in Chongqing, in our spring 2003 newsletter and have since made a site visit to the competing HIFU program at the People's Hospital in Beijing. Pine Street's visit in August 2003 helped resolve the hospital's various legal, medical, and administrative concerns and now this program is much more accessible to Western patients. This development is significant because it 1) gives prospective patients more HIFU options, 2) Beijing is easier to reach than Chongqing (there are direct flights from major US cities), and 3) the Beijing program is less expensive than its Chongqing counterpart. For both programs, however, it is necessary to fully research and understand the procedures and risks involved, to bring along a friend or family member, and to have a Chinese speaking guide familiar with the area and culture. An Interview with Dr. James KennedyDr. James Kennedy is a surgeon at England's Oxford University who is currently conducting a clinical trial studying the safety and efficacy of High Intensity Focused Ultrasound (HIFU). This new cancer treatment strategy uses sound waves to treat solid tumors. Following a visit to his trial site in October 2002, we spoke with Dr. Kennedy for our Spring 2003 newsletter. That conversation is reproduced below. Pine Street Foundation: Dr. Kennedy, could you begin by defining HIFU and explaining the technology? Dr. James Kennedy: Certainly. HIFU is a developing technique involving high-energy focused sound waves (focused ultrasound), and it allows us to destroy a precise volume of tissue within the body without harming surrounding structures. The energy carried in the ultrasound beam is thousands of times higher than the energy in conventional diagnostic ultrasound, and at the focal point of the beam, the temperature rise is sufficient to kill the target cancer cells instantaneously. Outside the focal region, the energy levels are not high enough to cause damage to the tissues. PSF: You recently published a scientific review paper on HIFU. What were the chief findings of your study? JK: For the last ten years, small devices have been developed and sued for the treatment of organ-confined prostate cancer and over 2000 patients have now been treated with that disease. It will be a few years more before the medical community at large accepts it as a mainstream treatment for prostate cancer, but these early results are extremely encouraging. PSF: The Chinese seem to have a considerable amount of clinical experience with HIFU. In what conditions have they found it to be most helpful? JK: They have used it most extensively for the treatment of primary tumors in the liver, breast, and bone. Of a total of over 1,400 patients, over half have had liver cancer, but over 200 patients have been treated with breast tumors, and over 200 with primary bone tumors. In most cases, they are treating advance stage disease, and so are using HIFU as an alternative to surgery, and often combining HIFU with other treatments such as chemotherapy in order to improve the likelihood of cure in any given case. They have also used it to treat tumors in the kidney, pancreas, and for benign uterine fibroids. PSF: Do you see HIFU someday replacing certain types of surgeries? JK: HIFU will not be able to treat everything, but if it can be shown to be as effective as I hope it will, there is a possibility that HIFU will significantly reduce the number of patients who have to undergo major liver resections, kidney operations, and perhaps even breast surgery. There will always be tumors that are inaccessible to HIFU, because of their position relative to other sensitive structures or their being shielded by bone or gas (which ultrasound cannot easily penetrate). PSF: Regarding your clinical trial currently in progress, what motivate you to initiate it? JK: Our trials are not the first in the Western World to use HIFU, but the first to use this specific device. The device that we are investigating is the JC Tumor Therapy System, designed and built by the Chongqing HAIFU Technology Company in China. In Oxford, England, we have been fortunate to be able to use the first such device to leave China. Until very recently, nobody even knew of this Chinese work and a UK-based company (Ultrasound Therapeutics Limited) felt that it was extremely important to try to bring it to the West so that we too might benefit from the technology. Obviously, for such a novel technique to be introduced, it must first be validated thoroughly and that has been our prime motivation and objective. We have designed three parallel trials, which should go some way towards demonstrating the safety and efficacy of HIFU in the treatment of soft tissue cancers. PSF: What types of patients are eligible for the trial? PSF: Is the Chinese HIFU technology you are using at the Oxford trial site also accessible to patients who can travel to China? JK: Certainly patients can travel to China for the treatment and in that way they would not be bound by the constraints of our trials. The center is located in Chongqing, in south-central China approximately three hours by plane from Shanghai. The clinical team in Chongqing, China has significant experience with HIFU. In addition, treatment costs may be lower than in the UK. PSF: How is the Chinese hospital experience different for a patient from what they would encounter in England or the United States? JK: In China, the hospitals have access to most of the same high-tech facilities that we are used to in the West and all patients could be confident that they would be treated expertly and courteously. Single-use disposable equipment would be used in all cases. The difference comes in the 'hotel facilities' within the hospital. In China, a patient's family or friends are usually expected to provide food and sustenance. Sheets and blankets would be made available, although this would be an exception to their normal practice. Patients would be able to stay in a private room, which would have two beds in it and access to a toilet and washing facilities. I would have no reserve about expressing my own confidence in their medical expertise, however. PSF: Is it advisable to have a travel companion? JK: Absolutely. The feedback that we have received from previous visitors is that Chongqing can seem a very alien environment, particularly when one is having to contend with a cancer treatment. The food is very different and cultural differences can lead to misunderstanding. A translator can be arranged locally through the Chongqing HAIFU company, but if I was able to take my own guide or translator, I probably would. Dr. James Kennedy can be reached via email at hifus.oxford@utlltd.com. ....................................................................................................................Donate Now | Home | Programs | Avenues Newsletter | Becoming Your Own Advocate | Events | Search | Site Map Pine Street Foundation · 124 Pine Street · San Anselmo · California · 94960-2674 Copyright © 1989-2007 Pine Street Foundation, a 501(c)(3) non-profit public charity. All rights reserved. Legal. |
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