What Types Of Cancer Is Nanoknife More Commonly Used To Treat
NanoKnife is an ablation procedure that may be a viable option for patients with inoperable tumours or those that are difficult to access. Some patients may have already had a range of therapies to treat their tumours before their doctors consider IRE a relevant option.
While NanoKnife is an effective cancer treatment, this may not be the best choice for your particular circumstances. Your oncologist will be able to give you information on the best treatment pathways for your individual situation. Why not get a second opinion to make sure that your treatment choice is the right one for you?
Irreversible electroporation or NanoKnife may be suitable for patients with locally advanced pancreatic cancer. This type of cancer is one which has spread to either the blood vessels or the lymph nodes next to the pancreas. As a result, these tumours cannot usually be removed through traditional surgery.
Some patients with borderline resectable pancreatic cancer could be offered this treatment. This is where the cancer has grown very close to the blood vessels surrounding the pancreas. Your doctor will let you know if this is a viable option for you.
No one treatment may be suitable for every individual and every type of cancer. You should discuss with your care team on the most appropriate treatment option for you.
Who Are Suitable Candidates For Nanoknife Therapy
NanoKnife Therapy is not suitable for all types of prostate cancer. Men suitable for Nanoknife treatment are carefully selected following MRI and prostate mapping biopsies.
Patients with Prostate tumours which are localised to one part of the prostate may be suitable.
Your surgeon will discuss your suitability for this type of Prostate Cancer treatment. Where NanoKnife surgery is offered as an option, you will be made aware that no long-term data is available.
How Does Ire Work
Treating prostate cancer using IRE involves inserting thin electrodes into the cancerous areas via the perineum. Voltages of several thousand volts are built up between each set of two electrodes. These strong electrical fields create pores in the cell membranes of the cancer cells found within the treatment area. These pores can no longer close, which is why the procedure is referred to as irreversible electroporation. The cancer cells are killed due to the formation of these pores.
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Why We Treat Some Prostate Cancer With Focal Ire Nanoknife
Whilst most prostate cancers occupy large areas of the prostate, there are some that occupy less than half and often less than a quarter of the prostate gland. These more focal prostate cancers probably constitute about 20% of all prostate cancers. With high quality3T multiparametric MRI combined with template 3D transperineal biopsies and sometimes combined with PSMA PET scanning, it is now much more possible to identify this select group of patients. The advantage of focal treatments of the prostate with energy sources such as the NanoKnife allow eradication of the cancer with minimal side effects.
Whole-gland therapies such as surgery, radiotherapy and brachytherapy have a long and established track record in the treatment of multifocal and high grade prostate cancer. However, their use in more focal cancers may be regarded as overtreatment based on recent data from a large randomised trial . Furthermore, radical prostatectomy, radiotherapy and brachytherapy have a significant side effect profile including urinary incontinence, impotence and rectal damage which are largely avoided by focal NanoKnife therapy.
Why This Treatment Is So Effective
NanoKnife is a way of destroying tumors that may be in close proximity to important structures. For example, NanoKnife can be an effective technique for treating areas close to blood vessels that you may not want to treat with radiation therapy. NanoKnife involves the placement of long, thin needles under image guidance to deliver targeted therapy, sending electrical pulses directly into the tumor that cause cancer cells to die while preserving important structures such as ducts, veins and nerves around the treatment site.
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Treatment Costs In Germany
The treatment of prostate cancer varies from patient to patient, thus it is impossible to say which costs will occur. It is possible that only a small tumor has to be removed from the prostate and no further measures are necessary afterwards. In this case, the expenses remain comparably low. If the tumor has spread, more complex and costlier therapies have to be applied.
In principle, foreign patients pay the same prices as German patients, because the bill complies to statutory cost catalogues. If individual services like treatment by a head physician or single room are added, prices increase. For patients from abroad explicitly, travel expenses, costs for translation and accommodation accrue.
Suppose that a patient has been diagnosed with local prostate cancer that has not spread yet. The patient is 65 years old and physically fit for his age. A doctor advises him to have surgery, because there is a high chance that he will recover well. The patient agrees. In this case, his treatment in a clinic would cost approximately 8,694 euros and he would spend 8 days in the hospital. He would be charged according to the flat-rate payment M01B which is the flat-rate that is most frequently used for prostate cancer in Germany. These costs and the days of stay are average values.
Most Accurate Imaging Technique For Prostate Cancer Detection
Contrary to other imaging techniques MRI provides multiple mutually independent parameters for the assessment of the prostate:
- T1- and T2-relaxation time
- Tissue perfusion and
- Spectroscopic information about metabolism.
Due to this, MRI is superior to other imaging techniques such as ultrasound and also when compared to elastography.
The four pillars of multi-modal MRI diagnostics of prostate cancer: Imaging, diffusion, perfusion and spectroscopy.
Also the analysis of the chemical composition of prostatic tissue makes the diagnostic with MSR so precise and valuable.
Prostate spectroscopy depicts the chemical make-up of prostatic cells. Healthy cells contain large amounts of citrate and little cholin. Cancer cells contain less citrate, which is metabolised for the generation of energy, and more cholin, which is needed for the assembly of the cell membranes in the tumour cells.
Our Treatment of Prostate Cancer
Specifying the Target with Transperineal 3D-Biopsy of the Prostate: Pain-free Safe Precise
Pain-Free and Safe
Transperineal biopsy is carried out pain-free in full anaesthesia, and steril under operation room conditions such that the risk of a post biopsy infection of the prostate is negligible.
The highest accuracy is achieved with transperineal 3D-biopsy, which affords a detection rate for prostate cancer between 75 and 100 %.
A 3D biopsy is carried out ultrasound-guided with the aid of a stepper and grid.
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Risks And Complications With Nanoknife Procedure
Based on the published data, the NanoKnife procedure is very safe and has a very low complication rate. Patients can expect to experience minimal to no side effects at all.
Some men may be infertile due to decreased/absent ejaculatory fluid.
No long-term data are available on side-effects and outcomes.
The Irreversible Electroporation Procedure
Duration of the procedure
Cussenot and Stricker agreed that the NanoKnife prostate treatment typically takes 1 hour, from the time patients are sedated until they regain consciousness. Within that timeframe, the passage of energy takes 2030 minutes. Skills are required in transperineal biopsy, transrectal ultrasound, and interpretation of imaging, including MRI/ultrasound fusion imaging. Most urologists worldwide now have those skill sets, said Stricker. The procedure takes 23 hours initially and the learning curve is around 1020 patients unless you pick tricky cases, which I dont recommend in the first 50 cases.
IRE as a salvage technique
IRE can be used as a salvage technique for intraprostatic recurrence, after histological confirmation of the recurrence, said Cussenot. Selection criteria should be localised recurrence and preferably PSA < 4, noted Stricker. The lower the PSA, the greater the success in eradicating the cancer, so monitoring after radiotherapy, radical prostatectomy, or NanoKnife therapy is equally important to preserve the opportunity for a second cure.
Nature of the tissue following irreversible electroporation and the impact on subsequent treatments
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Nanoknife Certified In Usa & Europe Since 2007
Every week we get emails from cancer patients living in the UK, USA, Canada, South Africa, and Europe interested in Nanoknife therapy. They all look pretty much the same, so you are not alone:
I have prostate carcinoma. I had major surgery in 2017 but unfortunately it came back. My PSA level is 20 ng/ml. I heard about Nanoknife for prostate cancer but not sure if itâll help. Iâm afraid.
My husband has prostate cancer stage 3 but has not started chemotherapy yet. Does not want to do radiation either. Gleason score 4+3=7, no perineural invasion or extraprostatic extension identified, ISUP grade 3. We are interested in getting the treatment for his prostate cancer.
We bet youve already taken a look at conventional ways of fighting cancer:
- Combined therapy, that includes both radiation and surgery.
The significant drawback of the first one in the list lies in affecting all the body, especially healthy cells, while surgery leads to impotence in 70% of cases and incontinence in 2050% of cases. And here comes NanoKnifeÂ® for prostate cancer. Technique has been certified by the FDA in 2007 in the USA and by CE since 2006 in Europe.
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The Ire Treatment In Videos
Depending on the size of the tumour, between two and six needles are required. Larger tumours can also be treated. When the needles are positioned around the tumour, high-voltage impulses of 70 microseconds in length are emitted, which are repeated every 100 to 1,000 milliseconds . They create short currents of around 50 amperes. The electrical impulses open the cell membranes by creating tiny holes, known as nanopores. The cell then dies. The field strength and impulse length are set so that no heat is generated – therefore the cells are not destroyed by heat, but by the electrical field of the NanoKnife which opens the cell membrane.
The procedure enables the healthy tissue in the treatment area to completely regenerate after a short time, whilst the cancerous tissue is completely destroyed. In this way, important functions of the prostate are maintained. Depending on the location of the prostate tumour, it is possible to protect the potency nerves so that impotence can be avoided. Following treatment, many patients feel a fleeting muscle ache as the electrical impulses have activated the leg and pelvis muscles. In most cases, the catheter can be removed just a few days after treatment and the patient can leave the clinic after just one nightâs stay under medical supervision.
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Nanoknife For Prostate Cancer To Affect Malignant Cells Only: How This Is Achieved
In general, NanoKnife® for prostate cancer uses electric current to affect malignant cells. Before it starts, a patient is given general anaesthesia. The surgery itself implies placing thin needles around the tumour, and they create electric field in-between. When it happens, cancer cells membranes are affected, so that theyll reduce and die.If its hard for you to imagine this process, you can watch this short video-explainer:
Mri And Nanoknife/ire Treatment For Prostate Cancer In San Diego
Living better in San Diego interviewed Dr. Ross Schwartzberg on the topic of Prostate Cancer. You can listen the to the interview by clicking on the attached link.
The main points of the interview are:
Dr. Schwartzberg and Dr. Cooper are radiologists that have established a new clinic in San Diego for the treatment of prostate cancer. The clinic was originally called the Prostate Center of San Diego and is now called Vitus Prostate Center. Dr. Schwartzberg set up the clinic in conjunction with Dr. Michael Stehling who is based in Offenbach in Germany. Dr Stehling is an interventional radiologist and is the worlds leading expert in a new form of prostate cancer treatment known as NanoKnife or IRE
The development of the new clinic grew of out of Dr. Schwartzbergs interest and work in the area of imaging for prostate cancer or MRI.
So, what is the prostate? He explains that the prostate is a reproductive organ that sits between the rectum and the bladder. As men get older the prostate gets larger in 60-70% of men and about 17% or 1 in 6 men will be diagnosed with prostate cancer.
The second and equally important news for prostate cancer patients is a new treatment called NanoKnife or IRE which builds on the accurate identification of the cancer cells by MRI.
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Hta Of Cyberknife Proton Beam Therapy And Nanoknife For Prostate Cancer In Austria
In mid-August 2018, the Austrian HTA body, the Ludwig-Boltzmann Institute , has published a health technology assessment in which they have assessed the efficacy and safety of stereotactic radiotherapy , proton beam therapy and irreversible electroporation for localized prostate cancer .
Prostate cancer is the leading cause of cancer in men in Austria accounting for 23% of all new cancer incidence cases. The primary objective of treating clinically confined localized PCa is to target males most likely to need intervention to prevent disability or death while minimizing intervention-related complications. There are many possible treatment options, but this report of the LBI focuses on assessing the relative effectiveness and safety of the following three methods:
The authors goal was to assess whether the abovementioned methods are more effective and safer than alternative prostate cancer-specific treatment options for localized prostate cancer.
The authors have performed a systematic review of the literature obtained from the following databases: Cochrane library, Centre for Research and Dissemination , Clinical Trial Registries, Embase, Medline via Ovid. The authors searched for publications published after 2010, only in German and English. Eventually, eight publications with five Controlled interventional studies, 14 publications with 12 Non-controlled prospective studies with 50 patients, two systematic reviews and one HTA report were included in this report.
Preparation For Nanoknife Therapy
Your surgeon will explain the procedure and answer any questions you may have.
Preparation will include information on:
- How long you should avoid eating and drinking beforehand,
- Whether MRI or PET scans are required to determine the size, shape and location of your tumour,
- What medications would need to stop prior to the procedure, and
- Any other post operative planning information that is required.
Like all procedures, there are risks or side effects involved. Your surgeon will explain these to you.
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What Symptoms Does Electroporation Treatment Address
NanoKnife surgery for prostate cancer is relatively new treatement and is currently only available privately at King Edward VIIs Hospital. Your surgical team will be able to discuss your suitability for the procedure with you.
Electroporation can treat newly diagnosed or a returning prostate cancer that hasnt spread to any other part of your body.
The symptoms of prostate cancer can include:
- The need to pass urine more often, especially during the night
- An urgent need to pass urine
- Difficulty in starting to pass urine
- A weak flow or trickling when you pass urine
- A feeling that you havent emptied your bladder even though youve just been to the toilet
- Blood in your urine or semen
However, the majority of men who have treatment for localised prostate cancer havent had any symptoms. They are likely to have had a blood test for prostate cancer that was high for their age.
Quality Of Life With The Nanoknife System
The quality-of-life outcomes with NanoKnife are one of the major reasons to choose the technology for suitable patients, while accepting the need for follow-up, said Stricker. This was further demonstrated in a study evaluating the effect of robot-assisted radical prostatectomy versus focal IRE with the NanoKnife system on patient-reported quality of life and early oncological control.6 A total of 50 IRE patients were matched to 50 RARP patients by propensity score. IRE patients experienced more early oncological failure than RARP patients. But IRE was significantly superior to RARP in preserving pad-free continence and erections sufficient for intercourse up to 12 months after treatment.
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Videos On Nanoknife For Prostate Cancer
Prof. Dr. Michael Stehling talks about the rationale and the advantages of using NanoKnife for the treatment of prostate cancer.
NanoKnife is the latest technology to treat prostate cancer. This short video demonstrates the out patient treatment of prostate cancer with NanoKnife .
Dr. Israel Barken independently reviewed our data and comments on the treatment of prostate cancer with NanoKnife .
Alternatives To Nanoknife Surgery
Your care team will discuss all options for your treatment plan with you so that you can make an informed decision about the best route forward. Every person is different, and treatment should be personalised to suit each patient. There are positive and negative aspects to all procedures and not every treatment may be right for you, so it is good to consider all potential pathways with your oncologist.
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Nanoknife Approval Throughout The World
Since its advent, NanoKnife® has been approved on the official level in 45 countries, including the European Union, Asia, North America, and Australia. The latest countries that adopted NanoKnife® are South Korea, China, Malaysia, Vietnam and Thailand.Moreover, the Food and Drug Administration of the USA provided NanoKnife® with 510 clearance for soft tissue surgical removal. It means that cancer patients in the USA can legally benefit from NanoKnife® therapy.
If you or your beloved one have stage III or more cancer case, dont lose hope. Contact us via form on the right or click the button below.
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