NanoKnife for prostate cancer

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  NanoKnife is an innovative, targeted treatment for prostate cancer that uses a technology called irreversible electroporation (IRE) to precisely destroy cancerous tissue within the prostate.

Through my experience with advanced diagnostic techniques—particularly MRI-guided biopsy—I became interested in NanoKnife as a highly controlled method for treating prostate cancer while minimizing side effects. Its ability to target specific areas of concern, rather than the entire prostate, represents a meaningful shift in how we approach treatment.

The procedure is performed under general anesthesia and typically takes about one hour. It is minimally invasive and involves placing small needles into the prostate around the cancerous area. This is done using a combination of ultrasound and MRI guidance, similar to the process of a prostate biopsy.

In most cases, a temporary urinary catheter is placed prior to treatment and remains in place for a few days afterward. Patients are given clear instructions, and catheter management is generally straightforward.

NanoKnife works by delivering short bursts of electrical energy between the needles, creating controlled cell disruption within the targeted area. Because this energy does not rely on heat or freezing, it helps preserve critical surrounding structures such as the urethra, bladder, sphincter, and neurovascular bundles responsible for erectile function.

NanoKnife is typically best suited for men with:

• Intermediate-risk prostate cancer
• A clearly defined lesion on MRI or PSMA PET imaging
• Cancer located in areas that are more difficult to treat with other focal therapies (especially the anterior prostate)
• A desire to avoid or delay surgery or radiation
• A preference for preserving urinary and sexual function when possible

It can also be an effective option for recurrent prostate cancer, particularly in men who have previously undergone radiation therapy and want to avoid more aggressive treatments.

In appropriately selected patients, long-term cancer control rates are strong, with studies reporting approximately 85–90% cancer-free outcomes at 10 years.

• Urinary incontinence is rare
• Erectile function is preserved in many patients, depending on the treatment area
• Recovery is typically faster than with more invasive treatments

Ongoing follow-up is essential and includes periodic PSA testing and MRI imaging. If needed, the procedure can be repeated to treat new or previously untreated areas of the prostate.

My training in NanoKnife was guided by internationally recognized leaders in the field, including Dr. Philip Stricker. This experience, combined with advanced imaging and careful patient selection, is critical to achieving optimal outcomes.

• What are the characteristics of the cancer (Gleason score, size, and location)?
• Is preserving urinary control and erectile function a priority?
• Is the tumor clearly visible on MRI or PSMA PET imaging?
• Is there a desire to avoid surgery or radiation?
• Where is the cancer located within the prostate (particularly anterior vs. posterior)?