NANOKNIFE - Novel minimally invasive therapy for Prostate Cancer
Nanoknife or irreversible electroporation was developed in 2007 by a team of biomedical engineers at Virginia Technikon and the University of California in Berkeley. It was FDA approved in 2008 and has been used around the world to treat liver, lung, kidney and more recently prostate cancer. It is especially useful in tumours which are deemed ‘inoperable’ and in prostate cancer for tumours which can not be reached by other minimally invasive techniques (such as HIFU) or in certain salvage cases (where previous treatment has taken place).
The Nanoknife uses an electric field that be precisely targeted to create tiny holes in tumour cells while not affecting adjacent organs. Ultraprecision allows treatment of particular areas within the prostate that are difficult to reach by other minimally invasive techniques. Better treatment appears to be produced in small tumours.
Delivery of quick bursts of energy through a set of electrodes which are inserted into and around the tumour create pulses that can last 100 microseconds and create an electric field of up to 3000 volts per centimetre. A cell within range of the electric field will form pores in its fatty membrane, allowing ions to rush through. Exposure to higher voltages and longer pulse duration causes the pores in the cell membrane to remain open and a process of induced apoptosis (natural cell death) occurs.
After treatment, adjacent non-cancerous cells migrate in and replace the dead cancer cells. There is some evidence that healthy cells grow back and regenerate instead of leaving a hole in the organ allowing the organ to continue to function and minimising side effects.
Professor Mark Emberton has performed five cases of Nanoknife for prostate cancer, one of which was a salvage treatment following radiotherapy, at the Princess Grace Hospital in London, over the last 4 months. Candidates are carefully chosen to suit a particular range of criteria and are fully aware of the lack of long term data related to this form of treatment. Over the short term the results look promising.
- Daycase, painless procedure with minimal to no side effects
- Able to treat tumours previously difficult to treat with minimally invasive procedures or in salvage cases
- No long term data available on the outcomes or long term effects