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By Yen Duong
Radio waves can entertain and inform you when driving around, but tweak the frequency and amplitude just right and it could save lives, according to a new study by researchers from Wake Forest Baptist Health.
Researchers are working on getting FDA approval for a treatment device that kills tumor cells of hepatocellular carcinoma, a kind of liver cancer, by using amplitude-modulated (AM) radio waves–the same type of varying-height waves that transmit to car radios.
The team recently published a paper demonstrating how the device, called Therabionic, works.
“It’s almost magical that you can use very benign radio waves and you can cure cancer with it,” said Dr. Bhadrasain Vikram, chief of radiation oncology at the National Cancer Institute, who was not involved with the study. “If we had a simple treatment [for HCC] that works without side effects, that would be amazing.”
Liver transplants at an early stage are the only current cure for HCC, but liver cancer is hard to detect at early stages and donor livers are hard to obtain, Vikram said. Left untreated, the median survival for HCC is four months. Though liver cancers are the 13th most common cancer diagnosed in the U.S., they are the fifth leading cause of cancer-related deaths.
“Treatment [for HCC] is almost never curative,” Vikram said. “A couple of drugs have been approved by the FDA in recent years, but they’re not terribly effective: they prolong life by a few weeks or a couple of months.”
How the device works
The Therabionic device transmits AM radio waves at a tumor-specific frequency through the patient, treating the body as an antenna. When the waves hit a liver cancer tumor, they start a chemical reaction that shrinks the cancer cells. Most importantly, the waves have shown no effect on other cells.
“During the shrinkage, the cancer cells transform into scar cells,” said chair of cancer biology at Wake Forest Baptist, Dr. Boris Pasche, who led the study. “And then are removed by the natural body process, which deletes the cells that are, in a sense, dead.”
For the treatment, patients stick the spoon-like device into their mouths for three one-hour sessions per day, which they can do at home. While that may seem onerous, it’s far easier than a similar device called Novocure used in the U.S. to treat specific types of brain cancer, in which patients wear electrodes glued to their heads for 18- to 0 hours per day.
“Patients can do pretty much everything except for drinking, eating and speaking,” Pasche said. “They can watch TV, they can be reading a book; it’s minimally invasive.”
Pasche said one benefit of the treatment is that it’s “systemic,” which means it goes through the entire body and can affect all cancer cells instead of just one area. That’s especially important for liver cancer, which can pop up in different places.
“Cutting out one part of the liver generally is not curative in the long term, although it may benefit the patient on the short term,” Vikram said. “This is reminiscent of what we used to see in lung cancer, which is smoking related: you’d cut out one cancer, but the practice [of] smoking that produced the first cancer can produce a second and a third and a fourth cancer.”
Preventative measures for a deadly cancer
Although HCC is the third leading cause of cancer-related deaths around the world, it gets less publicity than breast, lung or prostate cancer in the U.S. Liver cancer death rates are rising faster than any other cancer, and diagnoses of liver cancer are increasing along with the rise of its risk factors of hepatitis C, obesity and diabetes.
Liver cancer was once primarily associated with alcohol overuse, but over the past few decades, it’s been increasingly linked to chronic hepatitis infections and obesity. With the widespread hepatitis B vaccine and effective though costly hepatitis C treatment, Vikram anticipates that hepatitis-linked cancers will decrease, but warns that liver cancers caused by obesity and non-alcoholic liver disease have been increasing “at an alarming rate”.
This year, the American Cancer Society estimates that over 42,000 American adults will be diagnosed with liver cancer, of which three-fourths will be HCC. It also estimates that over 31,000 people will die from liver cancer this year. Since 1980, liver cancer diagnoses have more than tripled, and the death rate from liver cancer has more than doubled.
“Your liver is your internal chemical power plant,” said Thelma King Thiel, founder of the Liver Health Initiative, a nonprofit educational organization. “Everything you eat, breathe and absorb through your skin has to be processed through the liver… When you’re participating in unhealthy behaviors, [such as] eating too many fatty foods [and] exposing it to viruses, you’re killing those employees in your power plant.”
To prevent liver cancer and other liver diseases, Thiel is on a mission to educate children and adults about how to care for the largest organ in their bodies through healthy eating and drinking.
“Ignorance is the liver’s worst enemy,” Thiel said. “Unfortunately, it has no mechanism for giving pain. It’s a silent organ. It can be severely damaged without any indication to get tested or screened.”
Potential for more than just liver cancer
Two months ago, the treatment received FDA “breakthrough” status, which means that it will be sped through clinical trials and could be available to HCC patients as soon as next year, Pasche said. The trials as listed on clinicaltrials.gov have been small: a 2007 Therabionic trial lists 40 cancer patients in Brazil, while a 2012-2015 study listed 60 Brazilian hepatitis B patients with and without HCC.
Six of the 40 Brazilian patients who had very advanced liver cancer survived for more than two years, while one of those patients who used Therabionic daily survived for six and a half years.
“The main question in my mind is why has there not been another clinical trial in the last eight years,” Vikram said. “It seems it’s safe, at least in the short term. But in the long term, if the effect on the tumors is real or not: I think that needs better clinical trials.”
The device was approved in 33 countries in Europe last July, where it has the same safety classification as hearing aids and dental implants, Pasche said.
“The level of electromagnetic field delivered to the body with the spoon placed in the patient’s mouth is about 100 times less than when you have a cell phone next to your ear or cell phone next to your waist,” Pasche said.
The researchers have a 2011 paper which lists specific radio frequencies for different types of cancers. It includes 28 “compassionate care” patients who used Therabionic, in the best case extending a patient’s life by almost five years. Pasche said European patients have successfully used Therabionic to treat prostate and pancreatic cancer, and he hopes that gallbladder cancer and breast cancer will be next.