Nanoknife my journey

Mcesario
Mcesario Member Posts: 16 Member
edited January 15 in Prostate Cancer #1

Hello everyone!

I had my Nanoknife procedure performed on August 29, 2023 and I am reporting back my experience. To make it easy to follow I will use sequential numbers below. For detailed background check previous postings. On another note, using this site is not an easy task for me.

  1. Procedure time about one hour under anesthesia
  2. Discharged with a catheter the same day
  3. Catheter came off after five days
  4. Discomfort lasted about a week
  5. No dripping or bowel issues
  6. Some minor blood discharge at the beginning of urination
  7. Resumed normal activities one week after the procedure
  8. There was a brief period of occasional involuntary dripping corrected with pelvic exercises
  9. ED was present during the first sixty days, followed by brief weak erections
  10. Took Viagra with partial success but still not at the before procedure level
  11. The doctor prescribed Cialis 20mg to use as required but need more time for full recovery.
  12. Urine flow test shows a significant improvement compared with before procedure
  13. PSA test result after 90 days shows a significant drop: was 9.4 current value is 0.9
  14. MRI after four months indicates that the lesion is no longer present
  15. Follow up with PSA test in three months and MRI in one year

Conclusion:

I am personally very satisfied with the outcome, the cancer is gone and no additional treatment is required other than continuous monitoring using PSA tests every three months and MRI yearly. Unfortunately Nanoknife is not covered by public health care because the procedure is considered experimental and is expensive.

If you are a candidate for this procedure is worth to consider in my view, of course there are many other options available and ultimately you will make that decision.

Best wishes to the people suffering with prostate cancer, hopefully my journey may help in your decision.

Comments

  • centralPA
    centralPA Member Posts: 322 Member

    Thanks for the update!

    An ongoing clinical trial should report out early results in July 2024. Obviously not long term results…


  • swl1956
    swl1956 Member Posts: 123 Member

    Thank you for your detailed post! Sounds a little more intrusive than I was thinking it would be, but Very helpful! I've been advised at Fox Chase that I am likely a good candidate for Nanoknife. It will require me having another biopsy. At age 67 and considering the less side effects than either surgery or radiation, I'm seriously considering it. Even if the cancer returns in a few years, I could then opt for radiation when the long term side effects of radiation would be less worrisome. I'm hoping you'll give us an update perhaps monthly going forward?

    Of the many radiation treatments, I like what I've heard about Cyberknife. After a couple of months of researching and stressing, I've ruled out the prostatectomy and am narrowing my options. I'm sure you are glad to be on the other side of all this decision stuff?

  • swl1956
    swl1956 Member Posts: 123 Member

    I'm curious if you were part of a clinical trial? Was the Nanoknife procedure done at a major cancer center?

  • Mcesario
    Mcesario Member Posts: 16 Member

    Nanoknife is no more intrusive than a biopsy with the difference being that you will be under anesthesia during the procedure. I was not given pain killers to take home, they just told me take an Advil if you experience pain and didn't use it. I am seventy six years old and the PSA is 0.9 the MRI indicates that the cancer was removed successfully, of course there is a need to monitor the condition to ensure there is no recurrence and that's very easy to do. I recommend you talk to your Urologist for a decision on what treatment is best for your condition, I wish you well.

  • Mcesario
    Mcesario Member Posts: 16 Member

    I live in Ontario, Canada just north of Toronto in Vaughan, In November of 2022 a team of urologists teamed up with Nanoknife specialists and received all the necessary clearance from the Government as well as the necessary training and approvals to perform the procedure in specialized clinics or as part of local Hospitals. My Urologist was part of that team initially however; due to geographic location he decided to acquire his own equipment with the continuous support from Nanoknife specialists. I am probably the 26th patient undergoing treatment. Not part of a clinical trial per say, I am sure that they will use my case for statistical purposes, it was done in a specialized clinic as in a Hospital setting with all the necessary equipment, nurses and other doctors familiar with the procedure to assist, they use the MRI and ultrasound equipment to position the needles in the exact location surrounding the cancer cells and finally the electrical pulses are sent in short cycles to kill the cancerous cells sparing other healthy surrounding tissue and vessels. I hope this helps with your case. Just to clarify; all the statements and information given above pertains to my personal situation and is not intended to encourage the use of the Nanoknife procedure. You should consult with your medical team to select a procedure that best fit your particular situation.

    Best wishes and I hope you will come up on top soon.

  • Mcesario
    Mcesario Member Posts: 16 Member

    Thank you for the input, hopefully all participants benefited from their experience.

  • swl1956
    swl1956 Member Posts: 123 Member

    The Fox Chase clinical trial is also called "Preserve" same as in the above Urology Times article. I'm uncertain if this study is still recruiting candidates? The doctor I spoke with said that Nanoknife was available to me, but I would need to get a transperenial biopsy done there first to be certain I was a good candidate. Even though this is a major cancer research hospital, it's a little unnerving that this procedure is still in beta mode. I'm going to ask at my next appointment how many of the nanoknife procedures they have done.

    https://www.foxchase.org/news/2023-02-22-fox-chase-cancer-center-researchers-open-clinical-trial-that-could-help-men-avoid-surgery-to-remove-prostate

  • swl1956
    swl1956 Member Posts: 123 Member

    From what I've been reading, the Fox Chase clinical trial (Preserve) is closed for new subjects, but the procedure is available to those who are good candidates and want it. I will be asking more detailed questions at my next appointment. Being a mechanically minded person, I'm wondering how they can stick those probes through the perianal area and position them accurately around the tumors? Seems to me that would be a challenge. Can any of you guys explain this? Obviously they are able to insert needles for biopsies accurately. Must be a similar technique? Fascinating!

    Perhaps I am naive?, but to my logic the IRE Nanoknife seems like a no brainer for those with low to medium risk tumors that are not widespread throughout the prostate? IF it's as safe as they claim, when comparing the minimal or no side effects to standard treatments, why not try it. You may be able to have a second round of nanoknife and / or surgery or radiation. Likely not as simple as I would hope, but am I making any sense?

  • centralPA
    centralPA Member Posts: 322 Member

    As I read it, they do the insertion while using ultrasound to position the probes, fusing in MRI results. Basically, like how they target lesions in a biopsy or brachytherapy.

    Seems like it has real potential. I know one thing is because it provides electric shocks, to keep your body from moving and goofing up the probe placement they put you way under. Full general anesthesia. They’re trying to make it so that is not necessary, by fiddling with how they do the pulses.

  • swl1956
    swl1956 Member Posts: 123 Member

    Just read this article at their website. John Hopkins, a renowned leader in cancer research is studying focal techniques.

    https://www.hopkinsmedicine.org/news/articles/2023/12/focal-therapy-killing-the-cancer-not-the-prostate

  • oldspice
    oldspice Member Posts: 58 Member

    That’s really positive news thanks for that update and best of luck moving forward.

  • Rikx
    Rikx Member Posts: 3 *

    I had the procedure in March ‘24 Chicago. Very pleased so far. @ 6 month PSA 1.96 and MRI indications seem very good. I hope you will continue to report your progress. Did you have a biopsy at one year? How did that go?

    New to this site. I provided more detail in my introduction comments. Longer term results will be useful. I try to follow some of that info from Europe. best wishes to all

  • Mcesario
    Mcesario Member Posts: 16 Member

    Hello Rick,

    Hope you are doing well

    Exactly one year after my Nanoknife procedure the PSA value is 0.64 and the MRI shows no lesions present. I feel great and my urologist told me that everything is good. He asked if I would agree to a biopsy which I declined because I don’t see any value in it. We will continue monitoring with PSA test every three months and follow up in six months. MRI will be repeated yearly.

    Best wishes

  • Rikx
    Rikx Member Posts: 3 *

    Glad to hear you are also doing well. I plan to do the biopsy (even tho I don’t like doing it ) at the year point since it is part of the protocol they want to use to expand the research database. A biopsy seems to be the best way they can medically confirm the one year outcomes since PSA/MRI are only indicative of the outcomes…best

  • Mcesario
    Mcesario Member Posts: 16 Member

    Thank you for your insight. I may consider the biopsy if I notice any physical changes or if the PSA values increase drastically. At the end of year two I will reassess together with my urologist.

  • swl1956
    swl1956 Member Posts: 123 Member

    Had nanoknife procedure May 2024. PSA was 5.6 prior to the procedure and dropped to only 4.6 at 3 months later. Was hoping for a bigger drop. Surgeon didn't seemed concerned. PSA will be checked again at 6 months and also an MRI. I'm keeping my fingers crossed.

  • Rikx
    Rikx Member Posts: 3 *

    PSA can be affected by lots of stuff. I assume you were told no orgasm of any sort 4-5 days prior to test.

    Let us know how it goes at 6 months….best

  • Old Salt
    Old Salt Member Posts: 1,505 Member

    I still have to learn a lot more about this procedure but since it was targeted/focal, most of your prostate is still producing PSA. Hence, I wouldn’t expect a big drop in PSA.

    Does that make sense?

  • swl1956
    swl1956 Member Posts: 123 Member

    Yes, the IRE nanoknife focal procedure only destroys the tumor and a margin around it. In my case I should have over half of my prostate still intact. Urinary function is the same as before procedure. Sexual function is also as before procedure with only difference being there is no longer any ejaculate fluid. Still having a prostate makes the PSA not as reliable of an indicator as it would be with a prostatectomy. I would think however that having less prostate volume and if tumor was destroyed would equate to much lower PSA level? I was hoping to see a more drastic drop at 3 months. It did drop by one point from 5.6 to 4.6. My surgeon did not seem concerned.