First Patient Undergoes Histotripsy Treatment for Cancer at LVHN

Denise Walsh, from Wilkes-Barre, Pa., was a happy-go-lucky, 30-something optimist three years ago. Miraculously, she still is today. Even though she’s had as many as eight cancerous tumors, multiple surgeries, biopsies, chemotherapy, immunotherapy, radiation and countless nights when she didn’t know what the next day would bring.

At only 36, Walsh held the distinction of having stage 4 leiomyosarcoma of the inferior vena cava, an extremely rare cancer with less than 400 cases ever reported in medical literature. The chances of surviving five years or more is somewhere around 20 percent depending on whether it has spread. 

Fortunately, Lehigh Valley Health Network (LVHN) recently introduced histotripsy, a noninvasive procedure that uses computed tomography and ultrasound guidance to deliver hyper-focused sound waves to liver lesions. The sound waves mechanically destroy the tumor while sparing normal tissue.

Histotripsy technology – which has turned out to offer Denise new hope – allows physicians to treat liver cancer without surgery, pain, incisions or radiation.  

Back in 2021, while working on her house, Walsh felt an odd pain. The clinician at an urgent care clinic told her it was her gall bladder. But an ultrasound showed a mass in her abdomen. They did a biopsy and results confirmed the tumor – attached to the smooth muscle lining the walls of the large vein that carries blood from the lower body to her heart – was cancer.

While this cancer is attached to a vein, more than half the time, it spreads to the liver because it is so close to it. This was the case with Walsh.

She underwent surgery to remove the tumor in July 2021 at a hospital in northeastern Pennsylvania, but by May 2022, the cancer had come back. She wanted a second opinion and came to Lehigh Valley Topper Cancer Institute for a consultation with hematologist oncologist Suresh Nair, MD, Physician in Chief.

“There aren’t a lot of guidelines with a rare cancer,” Dr. Nair says. “Denise had done her research, but there wasn’t a single blueprint that was promising. Standard chemotherapy may have provided one year of survival. I told her that we’d have to think outside the box.”

The Cancer Institute’s multidisciplinary tumor board was a huge advantage. Cancer experts from across the network, including radiation oncologist Alyson McIntosh, MD, and Errin Hoffman, MD, Chief, Section of Cardiovascular and Interventional Radiology, along with Dr. Nair and others, got together to discuss her treatment. Because her cancer was so rare, it called for an informed yet explorative approach.

The months in 2022 and into 2023 were a loaded calendar for Walsh, as she and her Cancer Institute team worked to find a treatment that would help her. It seemed with everything they applied – from chemotherapy combined with immunotherapy to oral chemotherapy and radiation – the results were not optimal, although a miracle for Walsh.  

“Immunotherapy got us to the two-year mark,” Dr. Nair says. “That made Denise the longest living survivor with this type of cancer.”

The team paused treatment during 2024 so Walsh could regain her strength. During this break, her team began looking into histotripsy, which offered a new avenue of hope. It was the answer they needed after Walsh’s first CT scan in 2025 showed eight tumors in her liver; two had decreased in size but there were five new ones.

“Additional oral chemotherapy was administered; however, a follow-up MRI showed tumor progression with interval growth of existing tumors and new lesions in the liver and right thigh,” Dr. Hoffman says. “At this point, Denise was scheduled for histotripsy.”

Walsh started histotripsy treatment, targeting three areas, in early March 2025. In late March, the team targeted three more liver tumors and Walsh’s thigh. Drs. Nair, Hoffman and McIntosh report that Walsh is tolerating histotripsy well and that the signs are “good.” The team will continue with additional treatment options as well to control the cancer as long as possible.

“We’re shooting for quantity and quality of life. Being the longest living survivor isn’t enough,” Dr. McIntosh says.   

Meanwhile, despite everything, Walsh continues to inspire those she meets. She kept on with her life throughout her treatment – going to work and running 3 miles a day except when recovery from surgery or side effects slowed her down. “Running got me through this,” Walsh says. “That and a positive attitude. Once you start the negativity, it beats you up,” she says. “I’m living life, not living cancer. That’s the difference.”