On the Destruction of Cancer Cells Using Laser-Induced Shock Waves: A Review on Experiments and Multiscale Computer Simulations

Abstract

In the clinical treatment of solid tumors, besides traditional surgery and chemotherapy, the use
of High Intensity Focused Ultrasound (HIFU) has been established as a minimally non-invasive
technique for tumor treatment, which is based on coagulative necrosis of cells, induced by
conversion of mechanical energy into heat. Another, less developed technique for the destruction
or damage of tumor cells, is based on the pure mechanical effects of strong shock waves
on cells, which are generated by using laser ablation, thus avoiding the heat-related unwanted
side-effect when using HIFU (cutaneous burns of healthy tissue). Despite the general therapeutic
success of extracorporeal shock wave therapy in medicine, e.g. for disintegrating congrements,
the mechanical effects of shock waves on the cytoskeleton of cells, on the transient
permeability and rupture of cell membranes, or on tissue damage remain widely unknown. The
mechanical behavior of bio-macromolecules however, is of particular importance on the cellular
level as several basic and yet unanswered questions are raised: How are cell stresses and
energy transmitted through cells and in what way are the forces and interactions that determine
the stability of cell plasma membranes affected by a shock wave and give rise to cell deformation,
structural damage or rupture of the membrane with subsequent apoptosis? Here, we intend
to review research on the shock wave destruction of tumor cells and discuss the use of laserablation
as a new potential technique for tumor treatment. We also discuss here recent progress
in computational modeling strategies and techniques for understanding the basic physical
mechanisms that occur in the interaction of shock waves with cellular structures and show how
computer modeling and numerical simulation can contribute to a fundamental understanding
in this emerging multidisciplinary field, where physics, chemistry, biology and medicine meet.