CES 2018: Chairman Neal Kassell Featured in CTA Blog

Written by Neal F. Kassell, MD

Dr. Kassell recently advised on John Grisham’s The Tumor, a book about how medical tech changes a man’s outcome with a brain tumor. We had a chance to speak with Dr. Kassell about his background, technology in healthcare and The Tumor.

CTA: Tell us a little about your background and the field you are currently working in now.
Dr. Kassell: I’m the founder and chairman of the Focused Ultrasound Foundation, based in Charlottesville, Virginia, and while I’ve had a lifelong interest in technology, my background is in neurosurgery. I was co-chair of neurosurgery at the University of Virginia, and I had a large and active clinical practice related abnormalities of blood vessels in the brain and benign brain tumors. I also had a laboratory and clinical research program that resulted in more than 500 contributions to the literature, such as publications in medical journals and book chapters. Then I came across focused ultrasound, and I immediately understood that it had the potential to be a game-changing technology that could impact the lives of millions of people with serious medical disorders. That’s been my focus ever since.

How did you first hear about focused ultrasound and why did you get involved so quickly?
About 12 years ago I was operating on a patient with an aneurysm, and a cardiac anesthesiologist was substituting for the neuroanesthesiologist. He told me how he was using ultrasound and microbubbles to measure blood flow in the heart muscle, and suggested that it would probably work to measure blood flow in the brain as well. So we soon started a laboratory project to try that, and it worked. Additionally, at the same time I’d been searching for a minimally or noninvasive approach for helping patients with tumors in areas of the brain that were not readily accessed surgically, or whose tumors had maxed out on conventional therapies, including surgery, radiation and drug therapy.

So one day I was driving home from the hospital and the light bulb went off in my head, it was a true epiphany, that perhaps there was a way to use ultrasound plus or minus microbubbles to treat these challenging tumors. After decades of research I thought I finally had a Nobel Prize-winning idea! Turns out others had also already had this idea, so I wasn’t the first. But this concept is what launched our Foundation. In 2006, the nonprofit Focused Ultrasound Foundation was founded as a unique medical research, education and advocacy organization to shorten the time that it would take to get focused ultrasound widely utilized throughout the world. It often takes decades for a technology like focused ultrasound to evolve from an idea or concept to widespread utilization as a standard of care, and I wanted to find a way to shorten that process. Because every month we can shave off that process translates into a decrease in death, disability and suffering, and reduced cost of care for countless people.

You recently advised John Grisham on content for his e-book, The Tumor. How did you start working with Grisham?
John has been a neighbor and a friend for many years. I told him about focused ultrasound and he became enthusiastic about it, and joined our Board of Directors for the Foundation. Then one day at a Board meeting we noticed that he was scribbling away on his notepad, and it turned out he was outlining this book called The Tumor, about how focused ultrasound rewrites a man’s outcome with a brain tumor.

The idea was entirely his, to use his brand and his storytelling ability to write something that could help increase awareness among our target audiences. So I provided him with medical and technical content about the technology, and he wove that into this fairly dramatic story that he now calls “the most important book he’s ever written.” It’s an e-book that is available for free and has received nearly one million downloads to date.

Tell us a little about the medical innovation described in The Tumor.
The technology is called focused ultrasound. It is the most powerful sound you will never hear, but a sound that could someday save your life. It is an early-stage, revolutionary, non-invasive therapeutic technology with the potential to transform the treatment of many medical disorders by serving as an alternative or complement to surgery, radiation therapy, drug delivery, and cancer immunotherapy. It works by using ultrasonic energy to target tissue deep in the body without incisions or radiation.

The fundamental principle is analogous to using a magnifying glass to focus beams of sunlight on a single point to burn a hole in a leaf. Where each of the individual beams passes through the tissue, there is no effect. But, at the focal point, the convergence of the multiple beams of focused ultrasound energy results in many important biological effects, creating the possibility of treating a variety of medical disorders, including: tumors of the brain, breast, prostate, liver and pancreas; Parkinson’s and Alzheimer’s disease and epilepsy; depression and obsessive-compulsive disorder; and, arthritis and hypertension. Currently there are more than 100 indications for focused ultrasound in various (mostly early) stages of development, with five U.S. FDA approvals and 23 worldwide regulatory approvals.

What emerging health or medical technologies are you most excited about as a medical professional?
I’m fascinated by this burgeoning field of the biological effects of physical energy, whether that be electrical current, radiation or light, cold/cryotherapy, heat/thermotherapy, magnetism, and of course, ultrasound. Focused ultrasound is a prime example of harnessing the biological effect of physical energy to treat patients noninvasively. On the other side, I’m also very excited about geonomics and proteomics, the new “CRISPR” technology for editing genomes, regenerative medicine, the application of artificial intelligence or machine learning as it applies to diagnosis and treatment planning and evaluation, etc. I’m also interested in other noninvasive technologies that will decrease cost and improve outcomes and accessibility for patients.

But my focus is on driving the field of focused ultrasound forward, as this technology is a great example of intersecting science, technology and the humanities in a way that will create alternatives to traditional therapy that will improve the quality of life for millions of people. So there’s a moral imperative to focus on this, and to make progress quickly, as saving time equals saving lives.

Dr. Kassell and John Grisham discussed The Tumor at Gary’s Book Club at CES 2018. Watch the video.

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