Ultrasound is transforming cancer treatment by offering a non-invasive option to destroy tumours without surgery.
Histotripsy, developed in the early 2000s by biomedical engineer Zhen Xu at the University of Michigan, uses focused ultrasound pulses to create microbubbles that rapidly expand and collapse, mechanically breaking down cancer cells. Xu recalls being astonished when she first saw the effect on pig heart tissue, marking the start of a novel cancer therapy.
In October 2023, the U.S. FDA approved histotripsy for liver tumour treatment. Clinical trials have shown a 95% success rate with minimal side effects such as abdominal pain or minor bleeding, and patients typically leave hospital the same day. The UK became the first European country to adopt this treatment in June 2025, making it available on the NHS through a special approval route designed to speed access to innovative medical devices.
Histotripsy employs robotic guidance to focus ultrasound waves into a precise target zone, producing microbubbles that shatter tumour tissue. The debris is then cleared by the body’s immune system. This method avoids damage to nearby healthy structures, such as blood vessels and bile ducts, which often suffer in conventional cancer treatments.
The treatment typically lasts 30 to 90 minutes and usually requires only one session, though larger or multiple tumours may need more.
Beyond liver cancer, researchers are exploring histotripsy for tumours in the kidney and pancreas, with promising early results. Another ultrasound-based treatment, High-Intensity Focused Ultrasound (HIFU), uses heat generated by sound waves to “cook” cancer tissue and is already used for prostate cancer, offering outcomes similar to surgery but with faster recovery.
Ultrasound is also being combined with other therapies. Injected microbubbles stimulated by ultrasound can temporarily open the blood-brain barrier, allowing chemotherapy drugs to reach brain tumours more effectively. Ultrasound may also enhance radiotherapy and immunotherapy by amplifying tumour vulnerability and immune response, though these applications remain under study.
Health officials see ultrasound treatments as a way to improve patient outcomes while reducing hospital stays and side effects. As Xu puts it, “Cancer is awful. What’s making it even worse is cancer treatment.” While not a cure-all, ultrasound-driven therapies hold the promise of gentler, effective cancer care with fewer long-term complications.