High-intensity focused ultrasound (HIFU) may potentially replace drug treatment for pain in cancer patients when combined with surgery, radiation therapy or chemotherapy, according to new research published online in the March-April 2018 issue of Radiographics.  

Cancer related pain may directly stem from tumors, injury to nociceptors or result from surgery or radiation therapy and is commonly treated with prescribed opioid analgesics. The noninvasive technique of HIFU however, which is approved for uterine fibroids, bone metastases, essential tremors and encouraged to treat pancreatic cancers, may be more effective than drugs and spare patients serious side effects and toxicity, according to researchers.  

At the forefront of HIPU treatment is precision: MRI technology localizes high-intensity ultrasound waves on a targeted region of the body without damaging surrounding tissues or organs. 

Noninvasive in nature and able to be safely repeated and combined with chemotherapy or radiation therapy, HIPU alleviates cancer related pain through tissue denervation, tumor mass reduction and neuromodulation, the researchers wrote, ultimately offering a multimodality approach to treating malignant diseases.   

"Currently, MRI guided HIFU is recommended as a second-line treatment after unsuccessful radiation therapy for palliation of pain related to non-spinal and non-skull bone metastases," wrote lead author Susan Dababou, MD, from the department of radiological sciences at Sapienza University of Rome. "It can be used as a first-line treatment when radiation therapy is contraindicated, or the patient refuses to receive it." 

The main benefits of HIFU treating cancer related pain includes decreasing painful stimuli, locally controlling tumors, enhancing local drug delivery and stimulating the host antineoplastic immune response, among others, Dababou and colleagues wrote. Further research is suggested to investigate whether patients will benefit from HIFU in the long term and could be a primary, secondary or complementary treatment for cancer pain management.