Nanoknife

Mcesario

I am 76 years old diagnosed with prostate cancer a few months ago. According to my urologist I am a candidate for this procedure consisting in zapping the cancer by applying electrical pulses at high voltage to kill the cancer cells.

I looked at all the other methods and I am considering this procedure which I believe to be less invasive.

Anyone with advise or information post Nanoknife please comment.

thank you for taking the time to reply.

Clevelandguy

Hi,

Nanoknife under general anesthesia sticks 4-5 probes inside your Prostate then kills the cancer with electric current. Sounds kinda like a deep biopsy. Recover is a few days in the hospital. Another source which I have included below said you can go home the same day. If it was me I think for less invasiveness I would go with something like proven Cyberknife or Proton radiation which does not use any type of physical invasion into the prostate and requires no overnight hospital stay. You need to do whats best for you to get the best results. Your course of treatment should also take into account your age, other medical conditions, and your Gleason score(cancer aggressiveness). If your Gleason score is 3+3 with low volume, active surveillance might be a good solution. I have included a link about Nanoknife for you to study.

https://www.troygianduzzo.com.au/blog/nanoknife-treatment-for-prostate-cancer-17612.html#:~:text=What%20is%20a%20NanoKnife%20Procedure,cancer%20cells%20within%20the%20body.

https://www.rush.edu/news/new-treatment-prostate-cancer-patients

Dave 3+4

Mcesario

Thank you for your reply Clevelandguy

The link you sent is very useful but is not current (2019). I am looking for more recent stats and/or information about people who had the procedure done.

My Gleason is 4+4 but my Urologist confirmed that the size and location of the tumour makes me a good candidate. Unfortunately there are no current statistics available in Ontario, Canada.

Active surveillance it’s too risky due to the aggressiveness of Gleason 8. Sometimes I wonder if I should wait but due to my age, waiting is not considered wise.

Both: the CT scan and Bone scans are negative which is a good thing and that’s why I am considering Nanoknife as an option.

It would appreciate any further information and /or advice on this subject.

Thanks

parsaver56

I just had FLA with the Prostate Center in Houston. I'm 4+3 and was a candidate. Catheter for 3 days then flew home. Played golf today and feel great. Dr K was the person that conducted the ablation. It's worth a look.

Mcesario

Hi parsaver56,

Happy to hear that the FLA treatment worked for you. Very interesting focal ablation, I am still looking at different ideas, I will definitely search for this procedure near where I live, I am in Ontario, Canada.

Both procedures FLA and Nanoknife are performed using similar technologies I don’t know what is better: Laser or electricity.

Thank you for your input.

parsaver56

Hey Mcesario,

I would recommend highly that you call the Prostate Laser Center in Houston and talk to Dr K. He is a compassionate, thoughtful and humble Dr that will at least give you the up and downs of FLA. Read his bio and patient testimonials on You Tube. I am eternally grateful to him and his staff the way my wife and I were treated. The way medicine should be!

Mcesario

Hello parsaver56,

Thanks again for your comments and advice, I wish you all the best, enjoy life to the fullest extent. Good to know that FLA gave you a new perspective and an opportunity to be happy again.

Best regards

Old Salt

I would be VERY reluctant to go this route (Nanoknife) because there are few papers with long(er) term outcomes. In fact, there is an ongoing clinical trial that is addressing this very important issue, but it's in the UK.

Study Record | ClinicalTrials.gov

More importantly, there are several therapeutic options available for prostate cancer such as yours (confined to the prostate). These include 'classical' radiation (IMRT), brachytherapy and Stereotactic Body Radiation Therapy (SBRT).

PS: You appear to live in Canada and considering the Canadian medical system I am surprised that Nanoknife would be approved. Yes, I am speculating here.

Mcesario

In Canada It is still considered an experimental treatment and is not covered under the public health system or private insurance. My urologist is suggesting Nanoknife because of the size and location of the tumour within the gland.

I believe that the procedure is safe and it has been used in many other countries with similar side effects than current traditional treatments but with better results on ED and incontinence however; there is not sufficient data to back those claims.

I am seeking advice from people who had this treatment done, so far no one came forward.

Thank you

Old Salt

Would this urologist do this treatment himself? If so, a conflict of interest.

Mcesario

Yes, I thought about it, but before I jump into it I will make sure that the urologist training and the equipment is in good order. Sometimes we need to trust our medical system and make the right decision when the time comes. My urologist told me that he performed the procedure on 10 patients.

Unfortunately when I compare Nanoknife with other focal treatments it is the only one that offers better surrounding tissue preservation and better ED and continency issues.

The FLA (Focal Laser Ablation) is similar in nature but uses Laser instead of Electrical pulses, in my humble opinion Laser burns surrounding tissue as well as the tumour. Nanoknife claims to protect surrounding tissue and vessels which makes it more attractive.

Thank you for your honest input.

Old Salt

You mentioned in the first post that Nanoknife is less invasive than other focal treatments. That may be true, but radiotherapy (like SBRT and EBRT) is considered non-invasive.

Perhaps more importantly, I would really get a second opinion to see what is best for you. I could be wrong, but I doubt that you will get enthusiastic support for the proposed Nanoknife procedure.

Mcesario

I consulted with other professionals who are very familiar with the different types of radiation treatments and the so-called non-invasive procedures, they all claim that side effects have improved over the years; however, I am not convinced... there are countless horror stories of people who cannot go back in time, they are left without hope to reverse permanent side effects.

I researched Nanoknife treatment extensively and asked very hard questions from the pioneers in North Toronto Prostate Centre and my Urologist who is part of the group of professionals who started this treatment in Toronto last year. I am satisfied that this is the best solution for my condition, therefore I am moving forward, I will be getting this done at the end of this month, wish me luck!!

Thank you

parsaver56

Mcesario,

At the end of the day it's your decision. I felt like that when I walked into FLA. I did the research and work to make a decision that when I walked into that room I would have no regrets. To this day 5 weeks later I'm comfortable with my choice of treatment and facility. God bless you and the world of luck! Keep us informed.

Old Salt

Yes; your decision. I hope it works out great.

A report (at an appropriate time) would be great. Thanks!

Mcesario

Thank you, gentlemen,

I am scheduled to have the Nanoknife procedure done August 29, 2023, I will report back in a few weeks.

Regards

sgodwin

https://csn.cancer.org/discussion/326880/nanoknife

Hi there just wanted to know how you made out with the Nano Knife procedure. Thanks Steve

centralPA

I’m also interested in how the Nanoknife worked out. Done extensive reading on it, and understand the benefits. Big ones:

• it doesn't disrupt the cells by freezing or burning them, creating a bunch of immediate inflammation. It almost just tells them to die by opening up those micropores and setting up their eventual death
• Surprisingly sharp boundaries on the treatment zones.
• Since it doesn't involve heat, it is not messed up by large heat sinks like the ureter or large blood vessels, which distort the local heat profile.
• The vessels have collagen materials in them that survive the eletroporesis event, keeping the vessels intact
• This tends to preserve continence and prevent ED. All the papers I read had great results regarding continence particularly

Hope you're doing well, @Mcesario !

sgodwin

https://csn.cancer.org/discussion/comment/1712119#Comment_1712119

Hi just coming up on 3 weeks since I had it done so far so good. I was in and out for the day and had a catheter in for 3 days. After 10 days I drove to Florida for the winter. I had three cancer areas Gleason score 6, 7, 7 located left side mid position. Had 5 needles twice to flood the area so was sore a little longer than normal and at the moment still passing a little blood at the beginning of the urine stream. No other issues at this time😎

centralPA

https://csn.cancer.org/discussion/comment/1712120#Comment_1712120

Very nice.

Will they give you another MRI or a PSMA PET to see if they zapped it all?

They are doing it at Fox Chase in Philadelphia, which is a Cancer Center of Excellence. Participating in a trial for it too. That's why it caught my eye.

sgodwin

I will have a PSA test end of March and then an MRI end of June. My doctor was very encouraged that he got it all so will know if he is correct by June.