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LMC #51 | Dr. J. Louis Hinshaw on Tumor Ablation, Histotripsy, and the Future of Interventional Oncology
In this physician-to-physician conversation, Dr. Hinshaw traces two decades of progress in interventional oncology—from early radiofrequency ablation to modern microwave ablation and the dawn of histotripsy. He explains why indolent, chronic cancers (like many solitary fibrous tumors and neuroendocrine tumors) are especially well-suited to repeatable, organ-sparing treatments that preserve quality of life, and how multi-disciplinary care guides the “right tool for the right lesion” approach. He also previews what’s next: better targeting (e.g., cone-beam CT), safety learnings, and where histotripsy could realistically expand beyond the liver.
Highlights- From RF to Microwave: Why microwave ablation became a turning point—larger, faster, safer zones; shorter procedures; and better consistency compared with early RF systems.
- Histotripsy 101: Noninvasive, ultrasound-guided, FDA-cleared (liver) therapy with a strong safety profile to date; active kidney trials and future potential in other ultrasound-accessible organs.
- Patient Impact: For indolent metastatic diseases, ablation can be repeated over years, controlling disease while preserving recovery time and daily life.
- Team Sport: When radiation, intra-arterial therapies, surgery, or ablation takes the lead—and why humility and multidisciplinary planning produce the best outcomes.
- What’s Next: Better targeting (e.g., cone-beam CT), workflow refinements, and continued lab/animal/patient-level research from UW’s ablation program.
- Repeatable, organ-sparing care: Minimally invasive ablation lets clinicians control metastatic disease across years with quick recovery.
- Histotripsy is promising (and young): Early clinical use shows a favorable safety profile; efficacy and targeting workflows are rapidly evolving.
- Match the tool to the tumor: Outcomes improve when ablation, radiation, surgery, and intra-arterial options are chosen case-by-case via a collaborative team.
- For clinicians: Refer appropriate patients to centers with established ablation programs; consider multidisciplinary boards for complex cases.
- For patients/caregivers: Ask your team whether minimally invasive ablation or clinical trials (e.g., histotripsy) are options for your tumor type and location.
- For researchers/industry: Collaborate on targeting, safety, and outcomes studies to accelerate adoption and guidelines.
- About UW Radiology & Interventional Programs (faculty profiles, publications).
- About the LMC series — candid physician–patient conversations on science, decisions, and day-to-day realities of advanced disease.
J. Louis Hinshaw, MD is Professor of Radiology and Urology at the University of Wisconsin School of Medicine and Public Health, Chief of Abdominal Imaging, and Fellowship Director. His research and clinical leadership span image-guided tumor ablation (microwave, RF, cryo) and advancing minimally invasive oncology care, with numerous peer-reviewed publications and national awards.
About the Host:
Dr. Peter Crane is a board-certified physician, educator, and storyteller with a heart for service and a calling to spotlight doctors who make a difference—in their communities, in medicine, and in the lives they touch.
Through Doctors Making a Difference, he brings you into intimate conversations with physicians who have overcome challenges, redefined success, and found purpose in and beyond the clinic. His goal is simple: to help more doctors stay in medicine by showing them what's possible.
About the Show:
Doctors Making a Difference is more than a podcast—it’s a movement to highlight the good, the gritty, and the deeply human side of medicine.
In every episode, Dr. Peter Crane interviews physicians whose stories defy the script. From burnout recovery to bold career pivots, health challenges to quiet leadership, this show honors the truth that healing begins with connection—and doctors, too, deserve to be whole.
Visit: doctorsmakingadifference.com
LMC Series Note:
Living with Metastatic Cancer (LMC) explores the science, decisions, and day-to-day realities of life with advanced disease—through candid physician–patient conversations.
The Doctors Making a Difference Podcast is for informational purposes only and does not substitute for medical, legal, or professional advice. Always consult appropriate experts regarding your unique circumstances.
Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
View all episodes
By Peter M. Crane, MDIn this physician-to-physician conversation, Dr. Hinshaw traces two decades of progress in interventional oncology—from early radiofrequency ablation to modern microwave ablation and the dawn of histotripsy. He explains why indolent, chronic cancers (like many solitary fibrous tumors and neuroendocrine tumors) are especially well-suited to repeatable, organ-sparing treatments that preserve quality of life, and how multi-disciplinary care guides the “right tool for the right lesion” approach. He also previews what’s next: better targeting (e.g., cone-beam CT), safety learnings, and where histotripsy could realistically expand beyond the liver.
Highlights- From RF to Microwave: Why microwave ablation became a turning point—larger, faster, safer zones; shorter procedures; and better consistency compared with early RF systems.
- Histotripsy 101: Noninvasive, ultrasound-guided, FDA-cleared (liver) therapy with a strong safety profile to date; active kidney trials and future potential in other ultrasound-accessible organs.
- Patient Impact: For indolent metastatic diseases, ablation can be repeated over years, controlling disease while preserving recovery time and daily life.
- Team Sport: When radiation, intra-arterial therapies, surgery, or ablation takes the lead—and why humility and multidisciplinary planning produce the best outcomes.
- What’s Next: Better targeting (e.g., cone-beam CT), workflow refinements, and continued lab/animal/patient-level research from UW’s ablation program.
- Repeatable, organ-sparing care: Minimally invasive ablation lets clinicians control metastatic disease across years with quick recovery.
- Histotripsy is promising (and young): Early clinical use shows a favorable safety profile; efficacy and targeting workflows are rapidly evolving.
- Match the tool to the tumor: Outcomes improve when ablation, radiation, surgery, and intra-arterial options are chosen case-by-case via a collaborative team.
- For clinicians: Refer appropriate patients to centers with established ablation programs; consider multidisciplinary boards for complex cases.
- For patients/caregivers: Ask your team whether minimally invasive ablation or clinical trials (e.g., histotripsy) are options for your tumor type and location.
- For researchers/industry: Collaborate on targeting, safety, and outcomes studies to accelerate adoption and guidelines.
- About UW Radiology & Interventional Programs (faculty profiles, publications).
- About the LMC series — candid physician–patient conversations on science, decisions, and day-to-day realities of advanced disease.
J. Louis Hinshaw, MD is Professor of Radiology and Urology at the University of Wisconsin School of Medicine and Public Health, Chief of Abdominal Imaging, and Fellowship Director. His research and clinical leadership span image-guided tumor ablation (microwave, RF, cryo) and advancing minimally invasive oncology care, with numerous peer-reviewed publications and national awards.
About the Host:
Dr. Peter Crane is a board-certified physician, educator, and storyteller with a heart for service and a calling to spotlight doctors who make a difference—in their communities, in medicine, and in the lives they touch.
Through Doctors Making a Difference, he brings you into intimate conversations with physicians who have overcome challenges, redefined success, and found purpose in and beyond the clinic. His goal is simple: to help more doctors stay in medicine by showing them what's possible.
About the Show:
Doctors Making a Difference is more than a podcast—it’s a movement to highlight the good, the gritty, and the deeply human side of medicine.
In every episode, Dr. Peter Crane interviews physicians whose stories defy the script. From burnout recovery to bold career pivots, health challenges to quiet leadership, this show honors the truth that healing begins with connection—and doctors, too, deserve to be whole.
Visit: doctorsmakingadifference.com
LMC Series Note:
Living with Metastatic Cancer (LMC) explores the science, decisions, and day-to-day realities of life with advanced disease—through candid physician–patient conversations.
The Doctors Making a Difference Podcast is for informational purposes only and does not substitute for medical, legal, or professional advice. Always consult appropriate experts regarding your unique circumstances.
Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.