NanoKnife

NanoKnife—the most up to date prostate cancer therapy

A new type of treatment method for prostate cancer, IRE (Irreversible Electroporation) is opening up new options for prostate cancer therapy—with a minimum of side effects. Here at Vitus, we use the NanoKnife IRE Soft Tissue Ablation System to give the best results for treating prostate cancer.

Current treatment methods, such as surgery and radiation therapy, lead to impotence (loss of erection ability) and incontinence (loss of bladder control) in the majority of men, but these side effects can usually be avoided by treatment with Irreversible Electroporation using NanoKnife. The significance of this paradigm shift in prostate cancer therapy becomes clear in light of the fact that one in five men develops prostate cancer in his lifetime. Besides, prostate cancer used to be primarily an old man's illness, but younger men are now contracting it in increasing numbers, and older men are now more active and live longer.

NanoKnife is the first surgical ablation system based on Irreversible Electroporation technology,

In NanoKnife treatment, strong electric fields cause cells to die without exposing the tissue to radiation or heating it. This so-called Irreversible Electroporation (IRE) reliably destroys tumor and parenchyma cells. But important anatomical structures in and around the prostate such as nerves, the intestinal wall, the sphincter, veins and arteries are spared. Erection and bladder control are thus spared.

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NanoKnife technology—perfect for treating prostate cancer

NanoKnife is based on ultrashort (100 µsec) pulses of extremely strong electrical fields. Compared to all standard procedures, this new technology has unique characteristics that make it perfect for use in the prostate:

  • Tissue selectivity: Only cells, which have a cell membrane—such as cancer cells—are reliably destroyed, while all other structures (nerves, arteries, connective tissue structures, etc.) remain unharmed.
  • Ultrasharp edges: With NanoKnife, the line between “completely removed” and “undamaged” is measured in micrometers. This contrasts favorably with other treatments, such as radiation, heat-based therapies and even surgery, where the central treatment field is always surrounded by an area of unintended tissue damage—often many centimeters in diameter.
  • Induced cell death: NanoKnife induces cell death, or apoptosis, but not radiation damage or burning and consequently no scarring. With current standard procedures such as radiation (protontherapy, brachytherapy, etc.) or heat therapies (HIFU, etc.), a large “toxic” area occurs because the burned tissue is a toxin for the body. The result is inflammation and pain, followed by scarring, all of which prevent or hamper any subsequent treatment that may become necessary in case of a recurrence.
  • No limit on repeated treatment: Because IRE therapy does not cause lasting tissue damage, treatment using all other techniques (radiation, heat, surgery) is still possible without limitation after NanoKnife treatment. NanoKnife treatment can also be repeated as often as necessary.
  • Painless and minimally-invasive: For the reasons mentioned above and because thin needles are the only invasive instrument used, patients usually do not even feel the therapy at all.
  • Quick and in one session: In one single session under general anesthesia, even extensive areas can be treated.
  • Broad spectrum of uses: Although small, early detected prostate cancer tumors definitely represent the simplest use, NanoKnife therapy is also a potential treatment method for inoperable carcinomas that have penetrated the prostate capsule as well as recurrences after radiation therapy, radical removal of the prostate, HIFU or brachytherapy.
  • Immune system: The tumor proteins released during NanoKnife treatment help the patient's immune system to fight any other tumors.

IRE as a technique has been certified by the FDA in the USA and CE in Europe since 2006. It received certification because it was possible in all studies to demonstrate the reliable killing of all cells in a defined area in soft tissue. Nevertheless, two factors are critical for the success of any IRE therapy:

The first is the absolutely correct and precise knowledge of the location of the tumor before treatment.

The second is placement of the electric field in the right position.

The first is achieved using multiparametric MRI examinations, 3D biopsies and other procedures as necessary at the Institut für Bildgebende Diagnostik (Institute for Imaging Diagnostics) in Offenbach, Germany, which has specialized in this procedure for ten years.

The second is achieved by minimally-invasive surgery under general anesthesia in which sterile needles with variable exposition length are introduced. “Exposition length” refers to the length of the part of the needle that touches tissue with electric current. With over three years’ experience and the largest number of prostate treatments worldwide, we are world leaders, other clinics are just starting.

What are the steps in the treatment of prostate cancer with NanoKnife?