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Focal Therapy Irreversible Electroporation (IRE or Nanoknife)

User
Posted 12 Feb 2025 at 17:00

Hi,

Back in May 24 I was diagnosed with localised intermediate (Gleason 3+4) prostate cancer. In a nutshell, I considered the two options offered to me here in Kent, Radiotherapy or Prostatectomy. I have to say that neither seemed great (side effects likely), so my wife and I researched like mad, and found articles on Focal Therapy Irreversible Electroporation (IRE or Nanoknife). This is much less invasive and expected to have little to no adverse side effects.

So, I signed up to the PART clinical trial, and on the 8th January, I underwent the surgery. General anaesthetic, but back home without an overnight stay in hospital. It was performed at the Kent and Canterbury Hospital, under the NHS, and I was the first person in this hospital/area, so a surgeon from UCLH visited to mentor the local consultant urologist.

Moving forward 4 weeks. Everything has settled well. No incontinence and good signs with regard to the erectile function. I will now be monitored with MRI scans and PSA tests for the next 5 years, as the PART trial requirements, but this provides me with a measure of confidence that any changes will be detected quickly.

From my point of view, this is currently a very good news story, and if of interest to anyone, I am happy to share more details.

Best wishes to all, Ross

 

User
Posted 03 Mar 2025 at 18:33
I think Nanoknife is becoming accepted contender for treatment for suitable men in the UK. In the USA there is even more choice with FLA (Focal Laser Ablation) and Telsa Pro. Both of these can be done 'in bore' but the latter is sometimes done outside the Scanner as it ties up the Scanner for a long time. Interestingly, whereas Nanoknife and HIFU cannot reach all parts of the Prostate, Tulsa Pro can, because the entry of the probe is via the ureter and where required can ablate the entire Prostate from inside to out. Tulsa Pro has also been available in Continental Europe for a couple of years or so but I am unaware that it is available in the UK yet. So it is highly likely that this will be available before very long and men will have yet another option.
Barry
User
Posted 12 Feb 2025 at 17:00

Hi,

Back in May 24 I was diagnosed with localised intermediate (Gleason 3+4) prostate cancer. In a nutshell, I considered the two options offered to me here in Kent, Radiotherapy or Prostatectomy. I have to say that neither seemed great (side effects likely), so my wife and I researched like mad, and found articles on Focal Therapy Irreversible Electroporation (IRE or Nanoknife). This is much less invasive and expected to have little to no adverse side effects.

So, I signed up to the PART clinical trial, and on the 8th January, I underwent the surgery. General anaesthetic, but back home without an overnight stay in hospital. It was performed at the Kent and Canterbury Hospital, under the NHS, and I was the first person in this hospital/area, so a surgeon from UCLH visited to mentor the local consultant urologist.

Moving forward 4 weeks. Everything has settled well. No incontinence and good signs with regard to the erectile function. I will now be monitored with MRI scans and PSA tests for the next 5 years, as the PART trial requirements, but this provides me with a measure of confidence that any changes will be detected quickly.

From my point of view, this is currently a very good news story, and if of interest to anyone, I am happy to share more details.

Best wishes to all, Ross

 

User
Posted 12 Feb 2025 at 17:23
Hi Ross,

I am also on the PA-RT trial. I've been hoping some other guys who are on the trial would post on here! I was diagnosed last May (52 yrs. old) and I had Nanoknife last October and I am very pleased with the outcome so far. My first PSA showed a drop from 3.3 to 0.65 which is better than I could have hoped for. My journey on here is updated after each stage.

Wishing you the best outcome and continued recovery at your next PSA!

Seb

User
Posted 12 Feb 2025 at 19:05

Seb,

Fantastic answers - I wish I had found you earlier. My Clinical Nurses, who are lovely, just say "Nanoknife - we dont know". I know someone who has had the IRE procedure today, so I will make sure he sees the answers as well.

Thanks

Ross

User
Posted 13 Feb 2025 at 12:52

Hi, I am expecting a 75% chance of cure, therefore 25% chance of repeat IRE required in 2 or 3 years. I also noted at time of making my decision, that those rates are also applicable to both of the radical treatments (prostatectomy and radiotherapy). I am on the PA-RT clinical trial that is trying to prove the effectiveness of the Focal Therapy (HIFU or IRE) vs the radical treatments. I am 63 YO, and did not want the impact of the side effects at this age (ED or incontinance), so it is an interesting one to weigh up what is best for each person. After 5 weeks, I do not suffer from either traditional side effect experienced in the radical treatments. 

BW Ross

User
Posted 13 Feb 2025 at 13:06
Hi Adam

Even if your cancer is initially treated with surgery or radiation, there is always a possibility that the cancer will reoccur. About 20 to-30% of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark. I was told this is similar across all treatments, including focal therapy. The likelihood of recurrence depends on the extent and aggressiveness of the cancer.

I hope I don't need to have further treatment, but I'm fully aware it is a possibility. The No.1 factor for me, was the longterm quality of life after treatment. Each treatment, has its own positives and negatives, short and long term.

Best

Seb

User
Posted 23 Feb 2025 at 16:44

SHARING: I met Jim P on the 8th January, with us both scheduled for our Nanoknife procedure in sequence on the same day. Sadly for Jim, the UTI caused a delay, but we managed to share phone numbers, and have kept in touch since. SEB, your input has been really helpful to me personally, as I was rushing my recovery based on a lack of information, so your real life story really helped me.

 

My point here: Anyone else approaching this innovative treatment, or post-op, do reach out to the 3 of us, because it is hard when you suffer in silence. Immediately after reading SEBs first reply to me about recovery times, my wife said "she just saw the weight of the world fall away from my shoulders".

 

Thanks guys.

Ross

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User
Posted 12 Feb 2025 at 17:23
Hi Ross,

I am also on the PA-RT trial. I've been hoping some other guys who are on the trial would post on here! I was diagnosed last May (52 yrs. old) and I had Nanoknife last October and I am very pleased with the outcome so far. My first PSA showed a drop from 3.3 to 0.65 which is better than I could have hoped for. My journey on here is updated after each stage.

Wishing you the best outcome and continued recovery at your next PSA!

Seb

User
Posted 12 Feb 2025 at 18:11

Seb,

My PSA was 4.2 and the tumour was considered bilateral, but only intermediate on one side. Actually 5 weeks since procedure. Still some clots and very light bleeding (Rose wine I am told), which I thought would have gone by now, but being told, no issue. How did you experience this please? Did it clear up quickly?

Thanks

Ross

User
Posted 12 Feb 2025 at 18:43
Hey Ross

Blood in my pee seemed to finally stop by week 9. It could have been a week earlier if I hadn't been lugging suitcases. Anything particularly heavy can cause a strain and a light flush of blood in the first 12 weeks.

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 and I'd say, back to normal now.

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.

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

Best

Seb

User
Posted 12 Feb 2025 at 19:05

Seb,

Fantastic answers - I wish I had found you earlier. My Clinical Nurses, who are lovely, just say "Nanoknife - we dont know". I know someone who has had the IRE procedure today, so I will make sure he sees the answers as well.

Thanks

Ross

User
Posted 13 Feb 2025 at 12:35

Hi Ross & all

I'm also low/intermediate Gleason 3+4 diagnosed last month and have decided against AS. Seen a surgeon and this week seen an oncologist. She spoke well of focal therapies although they happen not to provide them at The Royal Marsden, she did however say that reoccurrence can be about 30% because unlike RARP or RT by its nature it doesn't treat the whole gland.

Were you or others on this feed told the same or have any other info??

Many thanks

Adam

User
Posted 13 Feb 2025 at 12:52

Hi, I am expecting a 75% chance of cure, therefore 25% chance of repeat IRE required in 2 or 3 years. I also noted at time of making my decision, that those rates are also applicable to both of the radical treatments (prostatectomy and radiotherapy). I am on the PA-RT clinical trial that is trying to prove the effectiveness of the Focal Therapy (HIFU or IRE) vs the radical treatments. I am 63 YO, and did not want the impact of the side effects at this age (ED or incontinance), so it is an interesting one to weigh up what is best for each person. After 5 weeks, I do not suffer from either traditional side effect experienced in the radical treatments. 

BW Ross

User
Posted 13 Feb 2025 at 13:06
Hi Adam

Even if your cancer is initially treated with surgery or radiation, there is always a possibility that the cancer will reoccur. About 20 to-30% of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark. I was told this is similar across all treatments, including focal therapy. The likelihood of recurrence depends on the extent and aggressiveness of the cancer.

I hope I don't need to have further treatment, but I'm fully aware it is a possibility. The No.1 factor for me, was the longterm quality of life after treatment. Each treatment, has its own positives and negatives, short and long term.

Best

Seb

User
Posted 14 Feb 2025 at 15:16
Hi Ross

I hope all's well!

Quick update:

Just had my 2nd PSA test post Nanoknife / IRE treatment and it has dropped to 0.567 which is brilliant. I'm sure it would have been slightly lower if I hadn't had this head cold which causes inflammation and can raise a PSA test.

Prior to treatment: 3.3

6 weeks post treatment: 0.650

3 months: 0.567 (with a common cold)

Very happy here.

Happy Valentine's to all and have a great weekend!

Best

Seb

User
Posted 14 Feb 2025 at 17:04

Hi Seb,

Well that is such a result. I have just been to give a blood sample, so I will hear the 6 weeks progress next week one day. Fingers crossed it goes down, although the Urologist did say it could go either way at 6 weeks, once again, due to inflammation from the surgery. We will see.

You must be so pleased. 

BTW, which hospital did your treatment? 

 

Cheers

Ross

User
Posted 15 Feb 2025 at 15:55

Hi Ross

The entire team at the hospital were and are incredible. I can't praise my consultant and his team highly enough. The trial nurses are wonderful and have been there every step of the way and continue to offer valuable support. My Macmillan nurses are angels in uniform.

Have a great weekend.

Best

Seb

Edited by moderator 15 Feb 2025 at 16:03  | Reason: Hospital named

User
Posted 19 Feb 2025 at 14:36

I just received my first post-op PSA test, with an amazing result of "0.4". So, fantastic result from this revolutionary treatment option. 

Ross

User
Posted 19 Feb 2025 at 15:12
Ross this is fantastic news, you must be thrilled!

Seb

User
Posted 21 Feb 2025 at 12:09

Hi

Following on from the postings by Ross,  I thought it may be helpful to others for me to share my Nanoknife experiences. I am currently 72 and was 70 when first diagnosed in 2023. Back in late 2023 my GP suggested I had a PSA test as part of a routine examination, I had no symptoms.  Two days after the consultation, I was advised that my PSA  was 6.2 and I was referred Kent & Canterbury Hospital Urology Department, where I had an MRI scan and a biopsy. It was confirmed that  8 out of 20 biopsies contained cancer cells and my Gleason score was 3+4.

I had a briefing with a McMillan Nurse who outlined my options and at this stage. After considering the options,  I decided I did not want a radical prostatectomy, due to the well publicised side effects associated with incontinence and ED. I then saw my Urology Consultant who said I was suitable for the PART study and that if I was happy he would put my name forward. He also mentioned Nanoknife as a new procedure which attracted my interest. I was accepted on the PART study but unfortunately, I was randomised to another therapy “Brachytherapy”. I followed this course of treatment with Oncology but eventually I was advised that this treatment was not suitable for me and my only option was to be referred back to Urology,  for a prostatectomy, which was my least favoured option.

My Urology consultant advised me that he felt I could still go back into the PART study and have Nanoknife as part of a trial treatment starting at Canterbury in January 2025. I was once again accepted back on the trial with a planned date for the procedure early in January 2025. Disappointingly, my pre-op assessment identified a urinary infection and at the very last minute my procedure was cancelled on the day. A new date was arranged for the 12th February and this time everything went to plan and I was discharged in the late afternoon with a catheter and anti biotics.

After around 24hrs I felt pretty good with some soreness and swelling. I personally found the catheter uncomfortable. The catheter was removed on the 18th February and I had an MRI scan on the 19th. So far I feel pretty good, I get tired easily, so taking things one step at a time. Urine flows seems ok but can become urgent at times, so using a pad just in case of accidents. It is planned for my consultant to ring me next week with the MRI results and hopefully some good news. I will update once I have some news.

Everyone I have engaged with in the NHS at Kent & Canterbury Hospital during my cancer pathway have been absolutely brilliant and their support has been much appreciated.

Jim

User
Posted 21 Feb 2025 at 12:54
Hi Jim

All sounds very promising so far! The catheter was the worst bit for me as it really aggravated my bladder. My urine flow was ok but took around 9 weeks to be at full flow again and now it seems better than it was pre treatment. Urgency will diminish week on week, but give it time. Mine decreased weekly and took around 12 weeks to go back to normal. How is your bruising and swelling down below? I went from port wine to black but eventually this subsided. I also used a donut cushion for around 8 weeks because I couldn't sit on any hard chairs. I had fatigue for approximately 12 weeks which seems to have gone now. Tiredness would suddenly hit me and I had to close my eyes for a bit which was totally out of the norm for me.

All the best for your ongoing recovery.

Seb

User
Posted 22 Feb 2025 at 08:53

Hi Seb

Hated the catheter, it was painful, everytime I moved for some reason. Bruising was a bit of a shocker, but I have been lucky as although swollen and very bruised  it has not been painful.

Jim

User
Posted 23 Feb 2025 at 16:44

SHARING: I met Jim P on the 8th January, with us both scheduled for our Nanoknife procedure in sequence on the same day. Sadly for Jim, the UTI caused a delay, but we managed to share phone numbers, and have kept in touch since. SEB, your input has been really helpful to me personally, as I was rushing my recovery based on a lack of information, so your real life story really helped me.

 

My point here: Anyone else approaching this innovative treatment, or post-op, do reach out to the 3 of us, because it is hard when you suffer in silence. Immediately after reading SEBs first reply to me about recovery times, my wife said "she just saw the weight of the world fall away from my shoulders".

 

Thanks guys.

Ross

User
Posted 01 Mar 2025 at 10:12

Hi All

Got a phone call yesterday from my consultant regarding my post op MRI scan and all looks look. Such a relief. Just concentrate on getting fit again over the next few weeks.

Jim

User
Posted 03 Mar 2025 at 14:18
Jim

That's brilliant news, wishing you all the best in your recovery!

Seb

User
Posted 03 Mar 2025 at 18:33
I think Nanoknife is becoming accepted contender for treatment for suitable men in the UK. In the USA there is even more choice with FLA (Focal Laser Ablation) and Telsa Pro. Both of these can be done 'in bore' but the latter is sometimes done outside the Scanner as it ties up the Scanner for a long time. Interestingly, whereas Nanoknife and HIFU cannot reach all parts of the Prostate, Tulsa Pro can, because the entry of the probe is via the ureter and where required can ablate the entire Prostate from inside to out. Tulsa Pro has also been available in Continental Europe for a couple of years or so but I am unaware that it is available in the UK yet. So it is highly likely that this will be available before very long and men will have yet another option.
Barry
User
Posted 31 Mar 2025 at 17:50

Hi Seb/Jim/Everyone,

I am now 3 months post IRE procedure, and I would say 95% back to normal. Some results of this procedure at this stage...

a) my second PSA test, results in today, 0.2 !! Amazing or as my Clinical Research Nurse says, "Awesome".

b) pee flow is unlike anything I can remember for years. Probably twice as good. What a great side benefit from this procedure. 

c) I know this is a bit personal, but in the spirit of sharing information for everyones benefit, no problem on the Erectile side of things, but fairly well "dry orgasm". I was warned this could occur, especially whilst the healthy cells reproduce, but not a big problem.

 

So, I vote IRE as an incredible procedure, and feel so glad I stumbled upon it.

Hope all well with everyone else. Feel free to ask questions.

Thanks

Ross

 
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