Reading the forum, Nanoknife experiences are less discussed, as it is a relatively recent approach to treating localised cancer, and I thought it might be useful to share mine. The primary advantages of Nanoknife are its ability to reach tumours anywhere in the prostate, and the relatively low level of long-term side effects. It's worth saying my experience was on the more challenging end of recoveries, but I know it would have been useful for me to read this.
With a family history of prostate cancer, I started getting PSA tests when I was 50. I'm now 55 years old, and have just had treatment.
My PSA when first measured in early 2021 was a suspicious 3.5, but rectal biopsy showed nothing. This rose to 5.5 at diagnosis in early 2024, when transperineal biopsy indicated a Gleason 6 tumour (with 4 positive cores out of 16). Given the localised nature of the tumour, low Gleason score, and my age, I was offered a referral to London for potential focal therapy (I'm based in Yorkshire). I went for active surveillance with a potential view to focal therapy later on.
By late 2025, my PSA had risen to 7.2 and there was also some evidence of minor tumour growth by contrast MRI, which led to a little suspicion of some Gleason 7 character. The tumour was largish at 12mm in size, and therefore even as a diagnosed Gleason 6 met the threshold for focal therapy. As the tumour was in the anterior region, Nanoknife was offered, and I decided to go ahead.
The procedure took place in early 2026 and was straightforward clinically, requiring a day visit to the hospital, general anesthetic and then discharge with a catheter.
I hated having the catheter in, and was pleased when after 6 days, it was removed. However, unfortunately, I was completely unable to pee. I was offered the opportunity to self catheterise rather than replace the in-dwelling one. This sounds awful, but it was not as hard as I thought and gave me much more freedom. Still, I was totally freaked out by the complete urinary retention as I hadn't expected it. Reading around, it turns out it happens in about 5-10% of nanoknife cases. In my case, the tumour had been close to the urethra, and the irreversible electroporation treatment went all around it, so perhaps it was not so surprising - it would have been nice to feel more warned.
In honesty, I was so stressed and upset at my trial without catheter that I cried - my reason for choosing Nanoknife was to avoid urinary problems, and I thought something could be seriously wrong. The nurses were lovely all though!
The 1 week MRI confirmed there was a lot of prostate swelling and oedema, probably explaining the retention. More pleasingly, it also confirmed that the tumour had been successfully targeted with good margins.
After another week, urination started a little, presumably as the swelling went down. During the next week it improved, I had a bladder scan to check I was voiding fully, which I was, and by the end of 3 weeks post-surgery, I felt more confident with urination. By 5 weeks, I was feeling good with it!
I did have quite a lot of urgency associated with urination over these weeks - but this was something I fully expected after the procedure, and has gradually become more manageable over time. I have also been able to hold onto increasing volumes in my bladder before having to go.
Through all of these unexpected urinary issues, the rest of my recovery was good. I was able to return to work within 2 weeks and have felt very well in myself. Pleasingly, my erections are also really good and that side of things seems good overall.
In summary, I am really pleased Nanoknife was an option for me. I have fingers crossed for continued cancer remission (although of course that is a journey with ongoing screening - and lots of options if it does recur). I am pleased to have retained full continency and potency. I just wish I had known the possibility that recovery could be a little bit slower than expected, but that this was not necessarily the end of the world. That's why I'm writing this, for anyone going through Nanoknife, as it would have been helpful for me to read.