Recently, founder and chairman of the Foundation Neal F. Kassell, MD, spoke with Melanie Crandall, head of content at tech communications firm Red Lorry Yellow Lorry, to discuss why CES 2018 was such a great venue to showcase focused ultrasound technology and where he thinks the field is headed, particularly in regards to the treatment of essential tremor.

You were recently at CES with John Grisham. Was this your first time at the show and how was the technology received?
Yes, it was our first time. We were somewhat anxious going into this, as we are definitely not consumer electronics. But our expectations of a positive reception were wildly exceeded. The response from show attendees was nothing short of astonishing. People came by the booth eager for more information and expressing enthusiasm about the potential of the technology. Attention from the senior leadership of CES was amazing. The panels we were part of and participating in Gary’s Book Club with John Grisham were incredible experiences. On a scale of 0 to 10, I would rate it a 16.

What exposure did your attendance bring, and what is the impact of having John writing a book about focused ultrasound?
A number of thought leaders were present at the show: president of the Consumer Technology Association Gary Shapiro, president of Fortune Magazine Alan Murray, senior VP of LG Electronics USA John Taylor, and countless others. Thought leaders across industries were convinced of the virtue of focused ultrasound. The demographics of the show were perfect. We were in front of intellectually curious people from around the globe – people who will go out and tell the world about the merits of the technology. We also received tremendous media attention. One of the major objectives of the Foundation is awareness. I can’t think of any single activity that could have increased our exposure more than CES was able to.

  garys book club
 

Gary Shapiro of CTA interviews John Grisham and
Neal Kassell for Gary's Book Club at CES.

John’s book, The Tumor, was not written to raise money for the Foundation. It’s free. It was written as an instrument to increase the awareness among all stakeholders in this very complex focused ultrasound ecosystem. John calls it the most important book he’s ever written. Using his brand and his storytelling ability has really worked very effectively. Gary Shapiro was very excited to interview John for Gary’s Book Club.

Can you share your thoughts about the power of technology to transform medicine and patients' lives?
Focused ultrasound is a technology that can improve quality of life, increase longevity, and decrease the cost of care for millions of people. Focused ultrasound has the potential to revolutionize therapy, just like MR scanning did for diagnosis some years ago. It’s a really, really big deal.

Can you share a recent patient story that’s really moved you or affirmed your belief in focused ultrasound as a life-changing technology?
The patient stories that I see every day, and those most move me, are the patients that we can’t currently treat. When we know that one, two, or three years from now we’ll have a solution – but we don’t now – and unfortunately those patients may not be here when we do. Those are the patients that most move and motivate me.

  Jack sm 180
  After his focused ultrasound treatment, Jack was back on the field in a matter of days.

But there are lots of positive stories. Take the woman who was treated for essential tremor here at University of Virginia as part of the clinical trial. She had been disabled by essential tremor for 20 years – unable to button her shirt, tie her shoes, or hold a cup of coffee. She went into treatment and came out a few hours later symptom-free, calling her treatment by Dr. Jeffrey Elias a "blessing." Or Jack, a 16-year-old athlete disabled by intractable pain from a benign tumor of his femur. The afternoon after his treatment he was home, pain-free, and he was back on the field in a matter of days. Or the surgeon in Milan, Italy, with pancreatic cancer. After two courses of aggressive chemotherapy failed, he was given three months to live. He received focused ultrasound therapy in an attempt to alleviate pain, and now more than two years later, he's still alive. Or the woman with uterine fibroids, unable to get pregnant. She was told she needed a hysterectomy, but instead chose to have focused ultrasound treatment. Her symptoms went away, but more importantly, she got pregnant and had a baby. These are all anecdotal accounts of successful treatments of patients, but the evidence is mounting.

Focused ultrasound technology is still considered early-stage but has shown efficacy for essential tremor as well as other conditions. What do you think is the most significant hurdle to greater adoption in the United States?
For essential tremor, the greatest hurdle is insurance reimbursement, both for Medicare and commercial insurance companies. The second largest hurdle is awareness among patients and physicians of the therapy’s potential benefits.

How can we overcome these challenges?
In terms of reimbursement, it’s about informing the decision-makers – the insurance companies, both public and private – about the existing evidence, which will be bolstered in the not-too-distant by further publication of data. The body of knowledge about the safety, the efficacy, and the cost benefits of focused ultrasound is coming in the form of additional publications that demonstrate rigorous scientific evidence. This will help tremendously. In reality, there is plenty of information and knowledge. It’s a matter of convincing stakeholders that this is enough. Sharing this information is at the core of the work that the Foundation team is doing.

Can you tell us about the mission and role of the Focused Ultrasound Foundation?
We believe that focused ultrasound is a revolutionary technology that has the potential to improve the lives of millions of people around the world with life-threatening or disabling medical conditions. Our vision is for focused ultrasound to be a mainstream standard of care that improves the lives of millions with serious medical disorders.

Our mission is to accelerate the development and adoption of focused ultrasound. Every month that we shave off the time it takes for the technology to be widely adopted translates into a reduction in cost of care, unnecessary suffering, disability, and death for countless patients. We are concerned with saving time and saving lives. The Foundation engages in a variety of programs and activities to shorten the time for laboratory research to pave the way for widespread utilization of the technology. We regularly study the process, identify the choke points, and direct our energy and resources to overcome the barriers and take advantage of opportunities.

To what extent do you think focused ultrasound technology will continue to figure in the treatment of tremors? Are there advancements on the horizon?
Focused ultrasound is not a panacea or a silver bullet. It is not for every patient with essential tremor. But a significant number of patients will benefit from this treatment, and it will transform their lives. Today's technology is very sound. In the future we will gather additional evidence of how it can be used to repeat the treatment in that subset of patients whose tremors come back. Currently, patients are treated on one side of the brain. Studies are ongoing to treat both sides of the brain. Finally, there are some technical limitations that cause some patients to be excluded from receiving the treatment. Those technical barriers will be overcome in the next year or so. It’s just engineering; nothing new has to be discovered. So the pool of patients will increase, and the efficacy of the therapy will become even better in the future.

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