Nanoknife / IRE Focal Therapy Clinical PA-RT Trial

Hi All,

I had (partial ablation) Nanoknife, (IRE) on Friday mid afternoon as a day case, (as a participant on the PA-RT Trial). I was kept overnight because my BP was up and they needed to get it under control. The procedure apparently went very well. I was on pain relief for a couple of days and now almost nothing.

The hardest bit, (as anyone knows who has experienced a catheter), is exactly that. Tomorrow can't come soon enough for it to be removed. 5 days, the longest of my life! Unfortunately, I seem to have a very sensitive bladder and initially I was having intense regular spasms. This is now under control due to 2 different medications, one in the morning and one in the evening.

Having a shower has become a military operation, connecting / disconnecting tubes, emptying bags etc. My TWOC (trial without catheter is tomorrow morning!) In the afternoon, I will be having my week 1 MRI. I've had a few teary days, but that's a combination of the anaesthetic leaving your body, mixed with a rollercoaster of emotions.

However, today is a good day! I took a picture to see what had gone on below deck. Very heavy bruising, scrotum almost black and that runs into my perineum and bottom. It looks worse than it is. I'm not in pain but it's uncomfortable to sit bolt upright, so I'm at a recline on the sofa, in between walking around regularly. Just waiting for a donut cushion to arrive to ease pressure when sitting on a chair, which I currently cannot do.

6 weeks post surgery, I will have a PSA and discuss all results of surgery, MRI and tests with my consultant.

After that, a PSA test will be done every 3 months for the first year and annually thereafter for 5 years minimum.

1 year post surgery, MRI scan further prostate biopsies and up to 3 years after that.

Barry, in answer to your question, there are clear plans in place, should the first treatment not be successful. I would have further Nanoknife (IRE) treatment if appropriate or it could be surgery, radiotherapy, hormone therapy or chemotherapy - depending on test results. Radical prostatectomy after partial ablation, (Nanoknife IRE / HIFU) or radiotherapy can be more difficult and could have worse outcomes than having radical prostatectomy as a first option.

If I can answer any further questions, I will do so to the best of my ability.

Best,

Seb

Good luck mate! 🤞

I assume you know the focal therapy options available, depend on whereabouts your cancer is. HIFU wasn't an option for me due to the position of the tumour, so it could only be NanoKnife.

UPDATE:

2 weeks post op, my research nurse called. She'd left a multidisciplinary team meeting with my consultant plus others. He told her to ring me as the preliminary scans showed that surgery went even better than expected and it looked like the tumour had been destroyed and my consultant was very pleased. I still needed to have my PSA blood test which should show a drop and would hopefully be even more promising. Huge relief! Wasn’t expecting to hear anything until my follow up with him @ 6 weeks.

6 weeks post op - consultant hoping for a drop of 50% - before treatment PSA 3.3

I couldn't be happier - PSA is now 0.65. Absolutely thrilled.

Blood in my pee seemed to finally stop by week 9.

I still do daily pelvic floor exercises. I can't stress how important this is and has helped with controlling the sense of urgency to pee. This has greatly improved.

Erections are almost back to normal. This was a big worry for me initially, but my consultant said this would improve and it has considerably. I'd say I'm at 95% and some days 100%. At week 6 I was retrograde ejaculation but this also massively improved and I am more than happy.

Peeing at full strength again at 12 weeks post op. This took longer to return to normal than I would have imagined.

I definitely underestimated my recovery post surgery. It was a lot slower than I expected. I didn't drive for almost 3 weeks due to it being too uncomfortable. Best purchase was a Benazcap Donut Cushion to sit on - it was a game changer. I used it for 8 weeks.

My next follow up and PSA is in February and I will update further then. I am so pleased that I had NanoKnife and with my results to date.

If there is anything else I can help answer, please don't hesitate to ask or private message me. I wish you all the best.

Best regards,

Seb