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Nano Knife My Journey So Far

Posted 26 Nov 2022 at 14:57

Anyone reading this is probably on or about to start a potentially life changing path.

My own experience is I am sure typical of many of us, a raised PSA level detected at a health check,

then monitoring of a generally rising level over a prolonged period, then finally seeking more expert help, this is not a real time blog more a diary of events.

Best practice with an ever-increasing PSA level is to have an MRI scan and then a biopsy, if MRI scan shows a possible problem, my test results were left anterior choriocarcinoma Gleason 3+4.

Depending on the results there are then normally three main options:

1 Active surveillance - Watch and wait, then another scan in 12 months' time, good if advised, but usually action will eventually be required.

2 Whole Prostate removal – Good choice although longer recovery and side effects such as incontinence can be difficult in the short to medium term but usually will clear with time.

3 Radiotherapy - Can carry on working but a few concerns, NHS does not at present shield the bowl wall from radiation, may also need Hormone treatment and possible short term fatigue issues.

Although removal may well be the best treatment, if the cancer is in a suitable position there are many other less invasive options to consider if available, such as:

Cryotherapy - Freezing cancer cells.

Brachytherapy - The insertion of radioactive grains either left to decay or removed after treatment.

Hormone Treatment - Will not stop cancer but will slow it down.

Cyber Knife. - A more accurate form of Radio Therapy.

HIFU - Radio waves through Bowl wall used to kill cells.

Photo Dynamic Therapy - A Targeted drug which can then be activated by light.

Proton Therapy - Uses an external high proton beam to destroy cells

Intensity Modulated Radiation Therapy - 3D CT scans allow high does pinpoint radiotherapy.

After reading the above all have advantages and disadvantages, but the really good news is that all treatments generally have a very positive outcomes in the long term, so all is not lost.

So, what did I choose?  Well, the title gives it away, after much deliberation I decided to see if Irreversible Electroporation better known as Nano Knife was an option for me and it was. Nano Knife is the eradication of cancer cells by an electric shock delivered via inserted needles, the downsides are a general antithetic, catheter for a few days and will need a few days to recover. Only one surgeon at present offers this treatment in UK at present and has been doing so for twelve years plus with good results, providing the patients are suitable.  Due to Covid delays decided to go the private route.

No Turning Back

05/08/2022 Operation Day, an injection of a cool liquid in my arm then nothing until recovery, which was ok with me as I did not want to wake up in the operating theatre!

No issues other than having a catheter and a tap which can be fitted with a bag for longer journeys.

06/08/2022 No pain but could not sleep due to the very strong urge to pass urine, a false feeling caused by having the catheter inserted but uncomfortable nonetheless, on arrival home could not sleep due the continuing urge to pea even just after a pea, thankfully this abated after 24 hours.

Urine clear but the odd bits of debris present, which I could feel passing through.

07/08/2022 Now cannot sleep due to diarrhea, possibly unrelated not sure the prescribed laxative certainly not required!

08/08/2022 Catheter removed not painful, off for MRI scan, involving more cool liquid into my arm, then back for a urine output check after drinking 1 litre of water. To my relief there was output if a little slow, on arrival home flow rate worryingly decreased to not much more than a trickle, especially at night a little dis-concerting, found sitting down to pea helped.

09/08/2022 Flow rate a little better but not anything like normal.

10/08/2022 Coping with flow rate just about, really worried as a blockage would mean a catheter being inserted, which makes me wince just thinking about it.

11/08/2022 Much better night's sleep first pea standing up and flow rate steadily improving.

12/08/2022 I now feel that I am in control of my bladder rather than it being in control of me.

19/08/2022 MRI scan results show good volume of necrosis (cell death) surrounding tumor and my surgeon says that he is happy with results.

23/08/2022 Urine has changed from champagne to red wine especially at the start of flow

28/08/2022 Still passing red wine, a little concerned.

30/08/2022 Emailed Hospital about my concerns told if running a temperature, urine has a strange smell or stinging sensation could be a urine infection, only symptom I have is a change in smell.

02/09/2022 Still worried had urine Test with GP. This showed both old and new blood in urine and suggests infection, so prescribed antibiotics.

11/09/2002 Blood and clots in urine are now reducing.

18/09/2022 Urine looks clear today no visible blood or clots.

24/09/2022 Urine still looks clear with just the odd small bit of debris now and again.

01/10/2022 Urine clear flow rate good

18/11/2022 PSA results are back from GP from the Blood test I had a week ago, PSA is 0.82, down from just over 8 a year ago.


Posted 26 Nov 2022 at 23:32

Interesting.  As you've still got a prostate 0.8 seems pretty low presumably, and it's expected to stabilise around that?

Posted 28 Nov 2022 at 19:38
With Focal Therapy, of which Nanoknife is an example, nearly always nowadays only significant tumours are treated so as you would expect PSA is higher than from a good Prostatectomy. However, although there may well be some fluctuations, hopefully this will not be consistently upward. However, should PSA increase significantly, it should be possible to have further Focal Treatment or if this is not sufficient more radical treatment.

You never know whether you have gone for the best option but can feel you have done well regardless if the outcome is good.

Posted 03 Oct 2023 at 09:32

i am facing a similar decision ,either nanoknife or cryotherapy .my gut says nanoknife  , do you mind me asking where you were treated , and who was the doctor who did your nanoknife procedure?

Posted 03 Oct 2023 at 18:59
Assuming your MRI scans show Knano Knife could be a suitable treatment I would certainly consider it, still not that much done on NHS , my treatment was in London only one hospital and consultant doing then.
Posted 03 Oct 2023 at 23:01

With Focal Therapy you don't have long term results like with Prostatectomy or Radiation and Nano Knife results are even more lacking in long term analysis. The widely acknowledged top Focal Expert in the UK said they had had some nice results with Nanoknife but that Focal treatment Urologist tend to use the form of treatment they are most comfortable with and it can depend on individual patient circumstances. I haven't seen much about it but a comparable Focal Treatment to HIFU is now being delivered through the Urethra rather than the rectum. It's called Tulsa Pro, so yet another option for some men. https://www.google.com/search?q=tulsa+pro&sca_esv=570352775&sxsrf=AM9HkKmHXUQmeLPqYZJPYijdcl5hjh_SVg%3A1696369451218&ei=K4scZbTxDJCN9u8Ps5y9mAg&oq=tulsa+&gs_lp=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&sclient=gws-wiz-serp#fpstate=ive&vld=cid:e1362f05,vid:gPyiiVZKmJc,st:



Edited by member 03 Oct 2023 at 23:02  | Reason: Not specified

Posted 04 Oct 2023 at 12:03

Thanks Dave ,

i have been offered cryotherapy but i would prefer nanoknife ,

just waiting on a return tel call

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