Japan applies advanced technologies in cancer treatment

In early 2024, the World Health Organization (WHO) predicted that by 2050, the number of new cancer cases worldwide would exceed 35 million, up 77% from 20 million cases in 2022.

This increase is largely due to aging populations, population growth, and lifestyle factors. The cancer burden is expected to have far-reaching effects across countries.

In Japan, doctors and engineers are leveraging artificial intelligence (AI) and other cutting-edge technologies to develop tools to effectively diagnose and treat cancer.

Using AI technology to detect early signs of cancer

Early and accurate diagnosis is key in the fight against diseases like cancer. However, a recent study found that nearly 800,000 people in the United States die or suffer permanent damage each year due to misdiagnosis or failure to detect cancer early.

In particular, gastrointestinal (GI) cancers are the leading cause of cancer deaths in Japan and globally, largely due to late detection. Although endoscopy is considered an effective tool for detecting early-stage GI cancers, it is worrying that approximately 20% of cases are still missed by physicians when examining a patient’s upper GI tract.

But what if AI technology could review the endoscopy images and detect any abnormalities that the doctor might have missed? This is exactly the goal of the advanced AI system gastroAI model-G developed by medical technology company AI Medical Service Inc.

The system is designed to assist physicians during gastroscopy by analyzing images in real time and detecting abnormalities that may be missed during examination.

Notably, the system works in tandem with the endoscopist, continuously reviewing the images obtained from the endoscopy. If it detects a potentially risky area, such as an abnormal lesion or sign of cancer, gastroAI model-G will highlight that area and issue a warning such as: "Consider biopsy."

This helps doctors focus more on problem areas, improving diagnostic accuracy and reducing the rate of missing serious diseases, especially gastrointestinal cancers.

“Endoscopy is essentially an image recognition process,” said Tada Tomohiro, CEO of AI Medical Service. “Doctors look at the stomach or colon to detect lesions, and the AI ​​system acts as a powerful assistant, helping them re-examine areas that show signs of abnormalities. Even though the doctor’s concentration may decrease from morning to evening, the AI ​​system maintains constant performance without getting tired.”

Tada Tomohiro found that AI can outperform humans in image recognition, a key factor in detecting gastrointestinal cancers.

In 2016, Mr. Tada Tomohiro began applying AI to endoscopic medicine. He built a deep learning AI system, trained with about 200,000 high-quality gastrointestinal medical videos, and successfully developed the world's first AI system capable of detecting early-stage gastric cancer and esophageal cancer.

In 2017, he founded AI Medical Service, expanding operations by launching subsidiaries in the US and Singapore.

The company quickly became a pioneer thanks to two outstanding advantages: a strong research network with access to data from more than 100 major medical centers in Japan, including the University of Tokyo Hospital, Keio University Hospital, and Osaka International Cancer Institute; along with close cooperation with device manufacturers.

AI Medical Service focuses on developing flexible software that can integrate and operate with most existing endoscopy systems, expanding global applicability.

“Japan is currently the world leader in the production of endoscopes,” Mr. Tada emphasized. “Collaborating with manufacturers is not only an important strategy but also a step towards making Japan a global leader in medical technology.”

AI Medical Service's diagnostic support system has been approved by regulatory authorities in Japan, Brazil and Singapore, confirming the technology's effectiveness and reliability.

The company has also successfully raised about 14.5 billion yen ($93.4 million) from venture capital funds and government subsidy programs, laying a solid foundation for expansion.

In 2024, AI Medical Service was honored by Forbes Asia magazine in the list of 100 outstanding small companies and startups, attracting strong interest from the investment community.

Currently, Mr. Tada Tomohiro is focusing on expanding his presence in Singapore, while continuously updating and improving the system based on the advancement of AI technology.

The company is also working to gain regulatory approval in the US and expand its AI applications to diagnose other types of cancer. Despite his busy technological mission, Mr. Tada maintains clinical work, demonstrating a strong commitment to improving public health.

Using high intensity focused ultrasound technology to treat cancer

At Tokyo Medical University Hospital, a cancer patient lies on a treatment table as a cone-shaped device attached to a robotic arm is gently placed on his abdomen.

The device uses ultrasound waves to deliver energy to the patient's pancreas, creating local temperatures of up to 100°C, to destroy cancer cells in the organ.

Additional ultrasound waves help the doctor track the exact location of the heated area, ensuring effective treatment. The procedure is extremely minimally invasive, requiring no surgery or anesthesia, and takes only about half an hour to complete.

This technique uses high-intensity focused ultrasound (HIFU) for treatment. Unlike traditional radiotherapy, where radiation can damage not only cancer cells but also surrounding healthy cells, HIFU waves can be precisely focused on a small area inside the body without affecting healthy tissue.

Although the focal energy decreases as it goes deeper under the skin, HIFU can still be applied repeatedly to treat recurrent cancers, providing effective disease control.

In international studies, focused ultrasound has been applied to treat many types of cancer, including brain, breast, prostate and other organs. In Japan, HIFU technology has been used to treat prostate enlargement, Parkinson's disease and essential tremor.

Clinicians in Japan now expect HIFU to become the standard treatment for pancreatic cancer, one of the most deadly cancers and one that tends to recur frequently.

In fact, about 70% of pancreatic cancers are diagnosed when the disease is too advanced to be surgically removed, resulting in a 3-year survival rate of just 3.2%. Furthermore, even after surgery, pancreatic cancer recurs in about 80% of patients.

Pancreatic cancer is difficult to treat in part because the organ moves with the patient's breathing, complicating the delivery of radiation therapy. This movement can cause radiation to affect not only the pancreas but also surrounding organs, especially the digestive system.

“The pancreas is resistant to radiation, so high doses of radiation therapy are needed, which can be delivered in daily sessions over six weeks,” said Satoh Tohru, CEO of SONIRE Therapeutics Inc., a Tokyo-based startup developing next-generation HIFU technology for cancer treatment. “With SONIRE’s HIFU technology, patients only need to undergo two outpatient treatment sessions, shortening the treatment time and minimizing the impact of the treatment.”

The unique feature of HIFU technology is the application of the cavitation effect, a phenomenon commonly seen around underwater propellers. This effect occurs when pressure changes, creating air bubbles in the liquid.

By taking advantage of the cavitation effect, SONIRE's technology helps the doctor visualize the exact area to be treated, ensuring high efficiency and optimizing the heating process. This not only improves the treatment efficiency but also shortens the intervention time, bringing great benefits to the patient.

Research results show that HIFU can improve effectiveness when combined with traditional treatment methods. The median survival time of patients with inoperable pancreatic cancer is only 288 days after treatment with chemotherapy alone.

However, according to a study published in the cancer scientific journal Current Oncology, published in Canada in 2021, when combined with the HIFU method, the patient's survival time increased significantly, reaching 648 days.

SONIRE's innovation has earned the company widespread recognition both domestically and internationally. In 2023, the company was selected by the Japanese Ministry of Economy, Trade and Industry to participate in the J-Startup support program for startups.

In 2024, SONIRE's HIFU therapy system was designated as a breakthrough device in the treatment of pancreatic cancer by the US Food and Drug Administration (FDA). These achievements have opened up many opportunities and helped the company reach new heights.

Together with research and clinical partners, SONIRE is currently conducting the world's first randomized, controlled trial of HIFU therapy for pancreatic cancer.

The study, conducted at six hospitals across Japan, aims to provide new hope to patients, their families, and medical professionals. The study will track the survival outcomes of 90 patients with inoperable pancreatic cancer, including 30 patients treated with chemotherapy alone and 60 patients treated with chemotherapy combined with HIFU therapy.

“We want to bring safer and more effective cancer treatment to as many patients as possible, and to do it as soon as possible,” said Satoh. “Our goal is to cross the boundary between pharmaceuticals and medical devices, and one way to do this is through HIFU therapy for cancer patients.”