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NanoKnife

NanoKnife

A pioneering new cancer treatment for inoperable tumours in the lungs, kidney, liver, breast, prostate and pancreas is now available at The Princess Grace Hospital. The NanoKnife technique destroys soft tissue tumours with an electric current, minimising the risk of damage to nearby organs or blood vessels. Over the last 20 years, patients with inoperable cancers have been given radiofrequency ablation therapy, which heats up the tumour and ‘cooks’ it until the cancer cells die but is less effective/ and or risky if the tumour is adjacent to a main vessel. NanoKnife circumvents this problem very effectively by using a 3,000-volt electric current rather than heat to destroy the cancer.

More recently there has been great interest in using NanoKnife to ablation unresectable Pancreas Carcinoma which is usually involving adjacent major blood vessels. Preliminary results from USA and UK suggest the median time it takes for the disease to progress and the median survival is almost doubled with integration of NanoKnife to ablate the pancreatic carcinoma compared with conventional systemic chemotherapy. 

Requiring no cuts or incisions, two fine needles are guided through the skin by ultrasound or CT scans to the tumour, after which a strong electric current is passed through it for two minutes. The entire procedure takes around 45 minutes and is performed under general anaesthetic. Patients are monitored overnight and usually go home the next day.

Treatment for prostate cancer is changing now that we are able to locate the tumour by means of MRI scanning.  This means that the target for treatment is changing. For about 100 years the target has been the prostate, whether the treatment be radiotherapy or surgery. Today's target is the cancer plus a 5mm margin. Given that few prostate cancers at the time of diagnosis measure more that 2mls in volume it is now possible to treat the cancer by exposing relatively small volumes of prostate tissue to an energy source. It is worth remembering that most prostates measure between 35 and 45mls in volume, so the majority of the tissue can be preserved in most cases. This leads to better outcomes. Studies conducted by Professor Emberton from LUA and his team have been published in top cancer journals and have demonstrated that men can have their cancer treated with a 99% chance of preserving continence and a 90% chance of preserving erectile function sufficient for penetration. Many men also kept their ejaculate. 

NanoKnife(™) (or irreversible electroporation) offers a very precise way of administering energy to prostate tissue. It works by passing a very high voltage current between a set of needles that surround the tumour – usually 3 or 4 needles, depending on the location of the tumour. The current changes the membrane potential of the cell wall (a delicate balance of positive and negative charge) and as a result creates holes in the membrane wall of the cell. These holes (porations) force the cell to commit suicide (a process known as apoptosis). The treatment therefore is not thermal, in that it does not require an extreme of temperature to destroy cells – and therefore is unique amongst ablation technologies. 

Because the energy passes between the needles the energy is concentrated within the space between the needles. It is this that confers the precision.  

The treatment is quick. The passage of energy between the needles takes about 10 minutes and moreover is painless. This means that men can be treated as a day case procedure, with few men requiring pain killers afterwards. Administering NanoKnife does cause the prostate tissue to swell. This means that men will need a catheter (a tube that drains the bladder) for 3-4 days afterwards. 

Success is measured by an MRI that is scheduled 7-10 days after the procedure. This is the ideal time to see the amount of tissue that has been destroyed and to make sure that the original tumour plus a margin has been encompassed by the treatment. 

The Princess Grace Hospital has the largest series of prostate cancer NanoKnife procedures in the world. The early results are the subject of a preliminary paper that has been submitted to a urological journal for publication.

If you have NanoKnife treatment at The Princess Grace Hospital, you will benefit from:

  • Targeted treatment in the only private hospital in the UK to offer the ground-breaking new NanoKnife System
  • Treatment in a comfortable and friendly environment
  • The best quality of personalised care
  • quicker recovery time and relatively pain-free experience compared to alternative cancer treatments

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