Ablation technologies in cancer

Cancer represents a major target of the clinical applications of ablation technologies, as illustrated by the share of each modality’s 2011 revenues that are used in cancer:

Source: Report #A145, “Ablation Technologies Worldwide Market 2009-2019″, MedMarket Diligence, LLC.

Considering the utility of the different ablation types for treatment of cancer, it’s not surprising that radiation is the dominant source of ablation technology revenues for cancer in 2011.

Share of All Ablation Revenues in Cancer, by Modality, 2011

Source: Report #A145, “Ablation Technologies Worldwide Market 2009-2019″, MedMarket Diligence, LLC.

Ablation technologies global growth (electrical, radiation, light, RF, ultrasound, cryo, thermal, microwave, hydro)

The global market for ablation is in steady growth, but also is shifting in the balance of technologies employed.

The global market for energy-based ablation Devices in 2011 was estimated at almost $11.5 billion. For purposes of definition, ablation is considered to be a therapeutic destruction and sealing of tissue. The technologies that fall into this segment to nine different types based on the energy modality employed:

  • Electrical
  • Radiation
  • Light
  • Radiofrequency
  • Ultrasound
  • Cryotherapy
  • Thermal (other than cryotherapy)
  • Microwave
  • Hydromechanical

Below is illustrated, first, the 2009 and 2019 revenues ($millions) for ablation by energy type and, second, the 2009 and 2019 revenues by energy type as a percent of total.

 

Source: MedMarket Diligence, LLC, Report #A145, "Ablation Technologies Worldwide Market, 2009-2019".

 

Although the applications of ablation devices include a number of aesthetic treatments, the majority of applications remain chronic disorders in areas which include cancer, cardiovascular, urology, gynecology and orthopedics. Many of these disorders are age-related, and the related device segments are driven by the aging of the global populations.  Other market drivers include the Chinese government’s push to modernize its healthcare facilities by building 400 hospitals per year, and developed country populations which are demanding anti-aging treatments, to which physicians are responding by purchasing equipment

Clinical trends and market growth in ablation technologies

The number and type of clinical applications for tissue ablation are proliferating almost as fast as the number and type of technologies and manufacturers.  These versatile technologies have clinically demonstrated ability to provide therapeutic destruction of tissue, excision of tissue, formation of therapeutic lesions and other therapeutic benefits across a wide range of clinical specialties.

Over the past decade, the application of ablation technologies has been propelled by clinical evidence, indeed.  The ability to precisely target malignant tissue (e.g., tumors, errant pathways in arrhythmia, fibroids, etc.) while producing minimal "collateral" tissue damage has validated many specific ablation modalities (e.g., laser, radiofrequency, microwave, cryo, etc.) for specific clinical applications. Those benefits notwithstanding, the growth of ablation technology in the medical device industry has been even further propelled by innovative manufacturers who have aligned their product development with the specific needs of clinicians and healthcare systems to produce instrumentation and equipment that facilitates the effective management of large patient caseload at reasonable cost and attractive clinical outcomes.

The future of ablation technology markets will be dictated by recent trends and the continued development of products that offer clinicians with effective tools in their armamentaria to manage growing patient populations in cost effective and clinically advantageous ways.

Below is illustrated the 2011 worldwide ablation technologies market and its forecast growth by modality type.

Source: MedMarket Diligence, LLC; Report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

Growth and uptake of ablation technologies in clinical practice

Technologies for the therapeutic ablation of tissues are diverse — from ultrasound to electrical, light to radiation — but their common function is to cause the controlled destruction of tissue, either for its excision or simply to remove its aberrant function (as in arrhythmia).

The uptake of the different ablation technologies in clinical practice is driven by the relevance of specific energy types for specific tissue types, the ability to avoid collateral tissue damage, clinician acceptance of manufacturers' equipment and devices and a variety of other factors.

The resulting size of the different ablation market segments, and their growth, is a result of both the historical success each has had in clinical practice and the degree to which these are trending toward continued uptake in therapeutic ablation.

Source: MedMarket Diligence, LLC; Report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

Ablation technologies are driven by cancer therapy, general surgery and cardiovascular disease treatments

Technologies used for medical and surgical ablation are used in virtually all clinical practices.  Ablation is the therapeutic destruction or excision of tissue for purposes ranging from the destruction and excision of cancerous or otherwise diseased tissue, the cauterizing of wounds, the formation of therapeutic lesions as in ablation of abnormally conducting cardiac tissue in atrial fibrillation and others.

Ablation technology types are differentiated, for the most part, on the kind of energy employed.  These include light/laser, radiation, radiofrequency, microwave, ultrasound, cryo, electrical, thermal and hydromechanical.

While the number and type of ablation technologies makes them versatile tools for use in a wide range of general surgical procedures, the predominant use of ablation technologies is in cancer therapy for the excision and destruction of cancerous tissue, followed by general surgery applications, then cardiovascular disease applications. Below is the share of the global medical technology product revenues in ablation by major clinical area of application.

Share of Global Medical Product Revenues in Ablation, by Clinical Area

Source:  "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities", MedMarket Diligence, LLC, Report #A145.

The current aggregate market for ablation technologies worldwide stands at over $11 billion, with most technology types growing at double-digit rates as these technologies are made more and more routine in clinical practice and as physicians increase the patient caseload (and indications) targeted by these technologies.

Growth of modalities in tissue ablation

An examination of the future markets for technologies used in therapeutic ablation has support for a general and sustained growth in ablation technology revenues:

Ablation-modality-growth-revenues

Source: Report #A145

However, when considering the relative growth of each of the modalities in tissue ablation, it is clear that some modalities are growing more aggressively than others:

Ablation-modality-growth-shares

Source: Report #A145

The “traditional” types of tissue ablation — electrosurgery and radiation therapy — are losing relative share as new modalities are able to penetrate caseload of other modalities, or even tap previously untreated patients and increase the aggregate caseload. In particular, radiofrequency and cryotherapy will demonstrate the highest growth over the 2011 to 2019 period.

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Tissue ablation is predominantly cancer therapy

Tissue ablation is defined as the “removal of a body part or the destruction of its function, as by surgery, disease, or a noxious substance.” Put more simply, ablation is considered to be a therapeutic destruction and sealing of tissue.

The technologies representing the majority of physical (rather than chemical) ablation are comprised of the following:

  • Electrical
  • Radiation
  • Light
  • Radiofrequency
  • Ultrasound
  • Cryotherapy
  • Thermal (other than cryotherapy)
  • Microwave
  • Hydromechanical

Source: Report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

The largest share of the market for energy-based ablation devices is used in cancer therapy, primarily using the radiation therapy modality. Following that is general surgery with its use of electrocautery and electrosurgical devices, RF ablation, cryotherapy, etc. Cardiovascular is thought to be third, even though cardiovascular is making the most noise in the medical press with RF and cryoablation of atrial fibrillation, this segment is thought to be third in share order. The remaining applications are relatively small and fall in line behind the three leading sectors.