Podcast Summary: The goop Podcast

Episode Title: Histotripsy: Changing How We Treat Cancer
Host: Gwyneth Paltrow
Guest: Mike Blue, CEO of Histosonics
Release Date: February 17, 2026

Episode Overview

This episode explores a groundbreaking, non-invasive cancer treatment called histotripsy, developed by Histosonics. Gwyneth Paltrow interviews CEO Mike Blue about this ultrasound technology’s impact on cancer care and beyond. They discuss the psychological toll of cancer, the limitations of current therapies, and how histotripsy’s approach could redefine not only tumor management, but also treatment for various benign and malignant conditions.

Key Discussion Points & Insights

1. What Is Histotripsy?

• Definition: Histotripsy uses focused, high-powered ultrasound energy to destroy unwanted tissue (e.g., tumors) non-invasively, creating a liquefied area the body naturally removes ([03:40]).
• Scope: While being developed for cancer, it can target any undesirable tissue, like benign prostate hyperplasia or uterine fibroids ([05:06]).
• Regulatory Status: Currently FDA-cleared for liver tumors, with data being submitted for kidney and pancreatic tumors. Future goals include treating brain tumors, fibroids, and more ([08:47], [20:57]).

2. Clinical Applications and Safety Profile

• Current Indications: Primarily used for liver tumors, especially those metastatic from breast or pancreatic cancer.
• Patient Eligibility: Due to the non-invasive nature, most candidates are late-stage patients with limited options or ineligible for surgery and radiation ([06:12], [09:04]).
• Safety: Almost no side effects, non-toxic, repeatable, and minimal discomfort. Described as "more forgiving than any of those therapies" ([11:50]).

3. Paradigm Shift in Cancer Care

• Contrast to Other Therapies: Unlike chemotherapy and radiation, histotripsy is less taxing and does not preclude other treatments. Many patients are self-referred after exhausting standard options ([12:55]).
• Palliative Impact: Offers immediate relief from pain caused by tumor pressure, especially valuable for advanced-stage patients ([12:55], [23:34]).
• Potential for Early Use: As imaging and early detection improve, histotripsy could intervene at early stages, avoiding “watch and wait” scenarios ([18:05]).

4. Real-Life Patient Stories & Outcomes

• Advanced Cancer Patients: Many testimonials feature patients given few options, often young parents desperate for more time ([17:32], [32:49]).
• Notable Outcomes: For instance, a nurse named Joy with advanced cancer found new hope with histotripsy. Another patient after multiple treatments was able to run a marathon again after recurrent tumors. Emma, diagnosed as terminal with 22 tumors, saw all tumors necrosed after treating only three ([32:49], [35:27]).
• Immune Response: Some cases show immune-mediated clearance of untreated tumors, with histotripsy releasing antigens that “awaken the immune system” ([35:33]).

5. Technical and Clinical Limitations

• Physical Target Required: Works best on localized tissue/tumors, stones, or blood clots. Less effective for diseases dispersed in the blood or blocked by airways, such as some lung conditions ([20:57]).
• Minimal Discomfort: Some report transient soreness, especially from unusual positioning, but almost always resolve within 1-2 days. Compared to chemo/radiation, side effects are minimal ([22:50]).

6. Regulatory, Clinical, and Financial Roadmap

• Data Requirements: Medical devices have lighter FDA demands than drugs, so critics note shorter-term data. Ongoing trials for other organs are proceeding in parallel, enabled by recent capital influx ([27:13], [41:28]).
• Off-Label Use: Physicians can use devices at their discretion, especially for patients with no options, though insurance often won’t cover unapproved indications ([30:46]).
• Platform Approach: The Edison system is designed as a modular platform to treat almost all solid tissue types ([27:32]).

7. Industry Impact and Resistance to Change

• Medical Economy: While less costly and less invasive than current treatments, histotripsy is unlikely to be opposed by surgeons or pharmaceutical companies, since it complements systemic therapies and enables previously ineligible surgeries ([46:26], [47:01]).
• Adoption Barriers: The main hurdle for early-line use is the medical community’s need for long-term, robust data ([33:21]).

8. Women's Health, Fibroids, and Future Applications

• Benign Condition Treatments: Plans are underway to target uterine fibroids, with clinical trials beginning soon. Breast cancer is also a prime target; primary tumors and metastases are thought to be easily accessible ([43:14]).
• Timeline: Timelines vary by condition, but progress is accelerating considerably due to increased funding ([46:00]).

Notable Quotes & Memorable Moments

• "We use non-invasive, therapeutic focused ultrasound … to liquefy targeted tissue. … Removing unwanted disease tissue from your body and doing that completely non-invasive."
  — Mike Blue ([03:40])

• "The thing about liver tumors is that they almost always eventually recur. … There's nothing that restricts a patient from having another histotripsy treatment down the road."
  — Mike Blue ([06:12])

• "What makes it incredibly unique is its safety profile… non-invasive, non-toxic, and usually with almost no side effects."
  — Mike Blue ([11:50])

• "A lot of these patients… are self-referred. They're finding about histotripsy on a Facebook page… have been told they don't have options left."
  — Mike Blue ([12:55])

• "If all we ever did was put a patient who doesn't have a lot of options in a better place in terms of their quality of life… he would have signed up for that every day of the week."
  — Mike Blue, on his father's cancer ([12:55])

• "Why would you be on active surveillance or watch and wait? … Why wouldn't you just treat it and be done with it?"
  — Mike Blue ([18:05])

• "I really believe that there will be a day when we look back and say, I just can't believe we did those types of surgeries. … The side effects are just so extreme. I really believe that we can eliminate a lot of that."
  — Mike Blue ([24:34])

• "I can't even get my mind around… having to tell your kids that you have six months to live. So that wasn't acceptable. … And she [Emma] still alive today and doing incredibly well."
  — Mike Blue ([35:33])

• "We learned through those experiments… even when we only partially treated a tumor with histotripsy, at 30 days, the tumor was completely necrosed or dead… it was almost like we were delivering a systemic drug therapy."
  — Mike Blue ([33:21])

• "Within an hour of announcing FDA clearance, the Cleveland Clinic placed our first order… I think it is one of the most successful stories in the history of medical device."
  — Mike Blue ([41:28])

Timestamps for Important Segments

• Histotripsy Basics & Origins: [03:40]–[05:56]
• Current Clinical Use & FDA Status: [05:56]–[08:47]
• Why Haven’t You Heard Of It?: [09:04]–[11:35]
• Safety, Efficacy, and Patient Experience: [11:50]–[12:55]
• Impact on Quality of Life, Patient Stories: [12:55]–[17:32]
• Potential for Early-Stage Disease: [17:32]–[19:10]
• Technical Limitations & Broad Applications: [20:57]–[22:50]
• Pain & Patient Recovery: [22:50]–[24:12]
• Personal Motivation & Responsibility: [24:53]–[27:13]
• Roadmap and Clinical Trials: [27:13]–[30:46]
• Testimonials & the Immune Response: [32:49]–[35:27]
• Immunotherapy Synergies: [35:27]–[38:41]
• Systemic Treatment Effects (Distant Tumor Response): [38:41]–[40:39]
• Investment & Market Adoption: [40:50]–[43:14]
• Women's Health Applications: [43:14]–[46:00]
• Medical Industry & Adoption Barriers: [46:26]–[49:14]
• How Patients Can Access Histotripsy: [49:31]–[50:10]
• Hope for the Future: [50:10]–[50:43]

Resources & How to Learn More

• Find a Treatment Center:
  https://histosonics.com – use the physician finder for locations
• Patient Stories:
  "If you have 5, 10, 15 minutes, go to the website for … find the patient testimonials and just start watching. … It's just unbelievably compelling and gives me such hope for the future." — Mike Blue ([50:10])

Overall Tone and Feel

The conversation is intimate, hopeful, and profoundly empathetic, shaped by both Gwyneth Paltrow’s personal experience and Mike Blue’s deep sense of mission. The tone is candid and accessible, blending technical rigor with palpable emotion and a vision for a gentler, more effective approach to cancer care.