What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body? 2024 meta analysis of seeding I didn't see ultrasound in there: https://pubmed.ncbi.nlm.nih.gov/39605885/
What are the chances that breaking up a tumor this way seeds cancer elsewhere in the body?
Welp I put it to you like this - if you DON'T use this then you have a gorillion cancer cells among which very likely one genetically predisposed to adventure throughout the body as turbocancer.
If you use this, or radiotherapy, or whatever, presumably there is just a lump of dead tissue where the cancer was, signifying at best you cured it but at worst, knocked it down - specifically if you knocked it down from a gorillion to a million cells, genereally speaking if the body has been seeded or the tumor persists - the tumor will take longer to rebuild back up where it was. The latter is manifested as another such and such months of life, making the therapy "life extending"
Cancers aren't perfectly optimized to metastasize, and metasteses (rather than, e.g., bulk pressure from the original tumor) are usually what kills you. It's perfectly possible that the procedure kills 90% or 99% of the cells in the original tumor but increases migration of the remaining cells such that the net effect reduces patient survival.
Don't cancer metastases have more to do with cancer mutations allowing the cancer cells to form new tumors? Some cancer types tend do not develop the ability to colonize new tumors while others do regularly.
i'd never heard of that counter before so i googled it:
> The word "gorillion" is often used by white supremacists and Holocaust deniers in the form of "six gorillion", which mocks the figure of six million Jews that died during the Holocaust.
Most non-shitty people probably picked it up from Meme stock sub cultures and wallstreetbets
Of course, one should ask themselves why so much of that culture is fed from and feeds into outright hateful people like nazis and Eugenicists and vague wife haters, and conspiracy theorists who "aren't nazis" but sure seem to believe everything is the fault of the jews.
"Gorillion" as I saw it was about the "Ape" context of wallstreetbets discourse. The Ape framing is actually non-hateful, referencing the new Planet of the Apes movies where someone makes a dumb analogy to a bundle of sticks: "Ape together strong"
They are similarly fans of calling people and things retarded, but that was getting reddit itself to nag them. So they switched to "regarded", because they aren't very clever.
Other gems of this community include frequent references to making "wife changing money" and an insistence that after GME totally turns out to not have been a scam and they bring down the entire american economy through literal shenanigans, that they will all collectively be crowned king, and totally won't oppress anyone, but also they relish the expectation that they will be able to smugly say "I told you so" to all the people suffering in their new regime.
They also adore doing the kind of "theory crafting" that is usually done by the most crazy person you know trying to "prove" bill gates did 9/11 because of that wingdings thing from 20 years ago.
But culture leaks, so this person might have just picked it up somewhere.
We simply won’t know until they do the inevitable phase2/3 RCTs. They will need to show that this method helps people survive longer or with better quality of life than the current standard of care.
HistoSonics has studies published with 50 patients. Their upcoming study with 5000 liver patients obviously will give more information, but we already have some.
And with that said, these studies are more relevant than the top of thread linking to a review from 2011 looking at papers from 2005-2006 for ultrasound cavitation causing metastases.
>>> ... the study found that removing the parachute prior to jumping led to a shocking increase in mortality among skydivers.
When there's a clear causal mechanism, additional research that doesn't propose a clear resolution to the underlying problem doesn't negate the clear causal mechanism. Releasing a bunch of loose cancer into the body is a clear causal mechanism, so unless you're filtering it or killing the loose cancer somehow, I'm not sure what those studies could tell you that overcomes the underlying problem. And until they address that problem, it's going to be limited to a quality of life type application - stopping the tumor from killing you now with the certainty of metastasis killing you later.
The thing about this kind of 'just so' story causal mechanism is that we still have to actually do the science to find out. Your body does filter and kill potentially cancerous cells all the time already. And cancer cells aren't like, some super thing that evolved to kill you specifically. My just-so story goes like this: 'the cancer cells die because they're suddenly outside of the specific bodypart that they were exploiting'. And we're probably both right, depending on the location of the cancer, the type of cancer, etc.
All life, from humans to cells to chromosomes, has only one purpose - to survive. It turns out that reproduction is an effective way to survive. Also, cooperation is an effective way to survive. The cells in our bodies cooperate for survival. Sometimes cells survive better by no longer cooperating, and reproducing as fast as possible. This winds up killing the host, but the cancer cells don't know that.
And so humans evolve to enforce better cooperation among the cells.
So, no, cancer cells did not evolve to kill you. They do evolve for short term gain, however.
It's an endless struggle.
It's not unlike the struggle between civilized people and criminals.
So what's the problem? The vast majority of cancer treatments seek only to put the condition into remission for a while. Realistically that's often all that can be done.
Some tumor types metastasize well, others not so much. But the article doesn't say anything about metastasis, or leaving any cells behind from the target. Rather, it talks about destroying the targeted cells entirely, leaving behind only proteins.
> Releasing a bunch of loose cancer into the body is a clear causal mechanism
I'm not in cancer field, but I'm not sure it is. AFAIK the cells that metastasize need to undergo EMT. Simply releasing them from the tumor doesn't mean the cells can attach and survive in the distal site.
The surface of cancer that protects it from the bodies defenses breaking up + parallel chemo or clonal antibody treatments should take care of that. But the principle critical view is correct.
Chemo post-histrophy would remove any lingering cancer cells effectively. Cancer cells need lots of fuel or they stop replicating, and this is what traditional chemo is great at stopping.
Is the idea that you would need less chemo after the tumor is broken up to remove any remaining cancer cells versus just starting out with chemo to remove the tumor?
Chemotherapy isn't always successful, and depends on the tumor's characteristics, but the idea is yes, less chemo. Histrophy is similar to resection, physically removing a tumor. I've seen chemo options for both scenarios with resectable cancers. For example, hormonal therapy is usually prescribed after resectable breast cancer, regardless of outcome. Or, chemo first to shrink the tumor, and have better surgical margins.
The keto diet is also very good for this because many (but not all) cancer cells can't metabolize ketones. However recent research from Columbia Medical School suggests that it can promote metastasis.
It's a good thing you edited for politeness because you seemed to be basing your understanding of what I said based on stuff you read on Reddit.
A number of studies show that, in humans, the keto diet (the medical keto diet[1] and not the meat heavy Internet version) causes metabolic stress in breast cancer cells and in several other types of cancer, due to their significantly increased metabolic needs. It's like the difference between a normal human and Michael Phelps during Olympic competition. The cancer cells can process ketones, but not efficiently enough to fuel their activity so they starve.
In humans this eventually results in the death or deactivation of the cancerous cells (deactivation being the primary way that tumors "adapt" to a starvation diet). There have been few, if any, reported cases of metastasis in the types of cancers studied in humans. This outcome is statistically significant enough that multiple cancer treatment centers recommend the medical keto diet to human patients as part of a treatment regime.
As mentioned, the recent study from 2024 shows that this type of metabolic stress can, in mice cause the cancerous cells to metastasize in a last-ditch attempt to survive. However, very little of the cancer research conducted on mice has applications to human cancers. For example, chemotherapy has also been shown to cause metastasis in mice, and a number of earlier studies attempting to replicate the keto research in humans shows that the keto diet in mice increases tumor growth, which is the opposite effect it has in humans.
[1] The medical keto diet is basically just fat and vitamins. No carbs, and minimal to no protein because protein can get converted into glucose by gluconeogenesis. It is not a diet anyone would want to be on longer than strictly necessary. One of my friends had stage 4 metastatic lung cancer, which she discovered during a company-sponsored mud run. Surgery was not an option and chemotherapy was not working. With less than 4 months to live, she went on the medical keto diet and the two-punch combo of keto and chemo put the cancer into remission for almost three years. (Note: She only maintained the diet for a few months after ending chemo treatment. Unfortunately not all of the cancer cells had died, some had merely deactivated. Four years after remission the cancer cells reactivated with a vengeance and she died the day after she started showing symptoms.)
they mention at the end that the destruction of tissue exposes proteins normal and abnormal to the immune system, with the abnormal ones no longer hidden by tumor structures. if you then search (kagi, google, etc) for this there are results where this worked fantastically.
Metastasis is not just random tumor cell going for a hike, they are seeded with extracellular vesicles carrying particular mix of microRNAs, growth factors, vimentin and other stuff.
> The mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells elsewhere in the body, explains Wood
Yes, we were doing a clinical trial where the primary tumor was irradiated which causes antigen release. The patients were given immune checkpoint inhibitors at the same time to activate immune cells. It's promising but tricky.
If it was true, couldn't you get the same effect by taking a biopsy, fragmenting the cells, and injecting them back in? Like a vaccination, in fact. Somebody must have studied that approach already.
First issue is that tumors don't necessarily have to be highly immunogenic, e.g. there're tumors that don't present many neoantigens on the surface. This means immune cells can't easily recognize them. Second issue is that tumor microenvironment evolves to be immunosuppressive. There're many different signals that regulate immune cells activation and simply having antigen-specific cells isn't enough. But as someone said in a sister thread, what you're describing is a basis for multiple clinical trials that combine antigen release with immune activation.
There were reports that if you inject the goo from melting the tumor into another mouse, that mouse became much more resistant to that class of tumor[1], so...
I assume the immune system probably already reacts to this in a specific way. For example, a major bruise has a lot of broken up cells, but doesn't warrant a big immune response.
Major damage tends to cause a much larger immune response than a vaccination. That said, they do have therapeutic cancer vaccines that present proteins from cancer (sometimes patient-specific) with adjuvants to help stimulate the immune response.
Interested layman here: IIUC, immunotherapy is currently the holy grail for difficult-to-treat cancers like pancreatic. There are designer mRNA vaccines available that have ridiculous efficacy, but they must be tailored to each individual and so are extremely expensive (and are currently undergoing trials). mRNA COVID vaccines have been shown in some studies to increase the lifespan of pancreatic cancer patients. So, it's not hard for me to imagine that a treatment that gives the immune system a crack at learning to identify and destroy pancreatic cancer cells will boost survivability.
Part of the freak-out about the Trump admin's attacking of scientific research (including, especially, of mRNA research) earlier in the year is that it threatened these trials.
For sure. Goes without saying in any cancer treatment that cost/benefit is a prime consideration. Still, that will not stop me from asking the question. You can't do that analysis without the answers after all.
Here is a study on AEs specifically from this type of ultrasound: https://journals.plos.org/plosone/article?id=10.1371/journal...
Quote: "Cavitation detaches cancer cells/emboli from the primary site and thereby releases them into the circulation, leading to metastasis"