Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants

Brachytherapy places a radioactive source directly inside or next to the tumour.

Hyperthermia heats tumours to 40-43 °C to make radiation and chemotherapy work better.

An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.

Aminolevulinic acid is painted on sun-damaged skin and then activated with a lamp, destroying actinic keratoses before they can become skin cancer; in Europe the gel is also approved for superficial basal cell carcinoma.

Biofrontera is a German dermatology company whose photodynamic therapy product Ameluz (aminolevulinic acid gel) with its RhodoLED lamp treats actinic keratosis and, in Europe, superficial basal cell carcinoma.

biolitec is a German medical laser company that holds the EU authorisation for temoporfin (Foscan), a photosensitiser for palliative photodynamic therapy of advanced head and neck cancer.

Thermal ablation kills a tumour with heat or cold delivered through a needle, with no incision required.

Irreversible electroporation uses short high-voltage pulses that punch permanent holes in tumour cells while sparing nearby vessels and ducts.

Laser interstitial thermal therapy guides a laser fibre through a small skull hole, monitored by real-time MRI, to heat and destroy deep brain tumours a surgeon could not safely reach.

Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.

Most small kidney tumours found on scans grow slowly. Options range from watching them, to freezing or heating them, to removing just the tumour and keeping the kidney.

Wearable electrodes that deliver alternating electric fields disrupting cancer cell division.

Optune is a wearable device delivering electric fields that disrupt cell division. It is approved for glioblastoma and, in 2026, pancreatic cancer.

The trial that made a wearable electric-field device part of glioblastoma care, extending median survival by about five months.

STELLAR is the small single-arm study behind the device approval of tumour treating fields in mesothelioma.

PANOVA-3 is the trial behind the 2026 approval of a wearable electric-field device for pancreatic cancer, the first new approval in locally advanced disease in decades.

Novocure makes Optune tumour treating fields, approved in glioblastoma, lung, mesothelioma, and (2026) pancreatic cancer.

Cetuximab sarotalocan is an EGFR antibody carrying a light-activated dye: after infusion, a red laser is shone on the tumour and the cells burst. It has been approved in Japan since 2020.

An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.

Bursting tumour cells with light releases their contents to the immune system; adding immunotherapy might turn a local treatment into a body-wide one.

TAR-200 is a small pretzel-shaped device placed in the bladder that releases gemcitabine for three weeks at a time. It was approved in 2025 for early bladder cancer that no longer responds to BCG.

A tiny pretzel-shaped device that slowly releases chemotherapy inside the bladder cleared carcinoma in situ in over 80% of patients whose BCG had failed.

Treating early bladder cancer by putting the drug straight into the bladder through a catheter, so the whole body is spared.

Nadofaragene firadenovec is the first gene therapy for bladder cancer: a virus that makes bladder cells produce interferon for weeks, given once every three months.

Brief electric pulses applied to a tumour open pores in cell membranes so that a tiny dose of bleomycin or cisplatin floods in; used for skin metastases and, increasingly, for deep tumours.

Injecting the gene for a powerful immune cytokine into a tumour and using an electric pulse to push it into the cells, so the cytokine is made locally rather than flooding the body.

Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.

Inventor of histotripsy, non-invasive tumour destruction with focused ultrasound bubbles; acquired for $2.25B in 2025.

Destroying a tumour mechanically with sound, rather than heat, leaves the debris intact enough for the immune system to learn from it.

Sound waves plus microbubbles briefly open the brain's protective barrier so chemotherapy or antibodies can get to the tumour.

MR-guided focused ultrasound company, with oncology use in blood-brain-barrier opening for brain tumours.

One of Canada's largest cancer centres, where focused ultrasound first opened the blood-brain barrier in a patient and Canada's first MR-linac was installed.

A drug that does nothing until ultrasound hits it, then kills the cells that took it up. Being tested in brain tumours because sound reaches where light cannot.

SonALAsense is testing sonodynamic therapy, in which patients receive a drug that cancer cells turn into a light-sensitive chemical and then focused ultrasound is beamed through the skull to activate it, killing brain tumour cells without surgery.

Most drugs cannot cross into the brain, so brain tumours and brain metastases lag every other site.

A tightly fitted cap chilled to a few degrees above freezing, worn before, during and after each chemotherapy infusion, narrows the blood vessels of the scalp so less drug reaches the hair roots. In a randomised trial about half of women on taxane-based chemotherapy kept most of their hair, compared with none who went without.

Luminate makes a wearable device that presses gently on the scalp during chemotherapy to stop the drug reaching the hair follicles, so patients keep their hair.

Shining low-power red or near-infrared light on the inside of the mouth before and during treatment prevents severe mouth ulcers in people having head and neck radiotherapy or high-dose chemotherapy for transplant. Mucositis guidelines recommend it, though few centres yet have the equipment.

iSono Health makes a wearable ultrasound scanner that images the whole breast automatically in about two minutes, with software to flag suspicious masses, for use outside specialist imaging centres.

Destroying precancerous cervical cells with a heated or frozen probe in under a minute, the tool that makes screen-and-treat possible where there are no surgeons.

Ananya Health makes a portable freezing device that lets a nurse in any clinic treat abnormal cervical cells before they turn into cancer, at a tenth of the usual cost.

Women can collect their own sample for the virus that causes cervical cancer; those who test positive can be treated the same day with a simple heat device. Done nationally, this could eliminate a disease that still kills hundreds of thousands of women a year.

Infusion devices are the implanted ports, smart pumps, and take-home pumps that deliver chemotherapy safely, including 46-hour infusions patients carry home.

Robots and closed systems that prepare chemotherapy doses safely, protecting pharmacists from hazardous drugs and patients from errors.

Magnetic nanoparticle hyperthermia injects iron-oxide nanoparticles into a tumour and heats them from outside with an alternating magnetic field.

Gold nanoshells that accumulate in a tumour and cook it when a near-infrared laser is shone on them.

Nanoparticles that turn ordinary radiotherapy X-rays into a much bigger dose exactly where they sit.

Alpha Tau Medical places tiny radioactive seeds directly inside tumours so that short-range alpha radiation destroys the cancer from within. It is testing the approach in pancreatic, skin, head and neck, brain and prostate cancers.

Folded DNA machines that open only when they touch a tumour, releasing a payload or clotting the tumour's blood supply.

Radical oncology is a horizon map of the wilder ideas in cancer, sorted by how close they are to mattering, with the reason each one might never arrive.

Surgery and radiotherapy cure more people than drugs do, but attract a fraction of the research investment.

A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.

New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.

Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.