NanoKnife: IRE focal therapy treatment
- Minimally-invasive treatment
- Targets and destroys cancerous prostate tissue with precision
- Can also destroy tumours that can't be reached with HIFU
NICE Approved
2,186
Focal Therapy
Treatments Completed
Treatments Completed
Avoid Incontinence
and Erectile problems
and Erectile problems
Fast recovery
Outpatient procedure with quick recovery time (2-3 days)
Little to no side effects
Low risk of incontinence and impotence
Minimally invasive
No hormones, radiation or incisions
NanoKnife Irreversible Electroporation (IRE) is an advanced, minimally invasive treatment for prostate cancer that uses electrical pulses to destroy cancerous cells while preserving surrounding healthy tissue. NanoKnife IRE works at a cellular level without causing thermal damage, making it an excellent option for men with tumours at the front of their prostate gland.
NanoKnife has been used in the treatment for cancer tumours since 2008 and has been approved by NICE for use with Prostate Cancer tumours since 2022.
Which Consultants Perform the Procedure?
At The Focal Therapy Clinic, all of our expert consultant urologists have extensive experience in NanoKnife IRE treatments, ensuring optimal patient outcomes.
Our consultant Uro-Radiologist team prepare precise treatment plans for each patient based upon a detailed review of their MRI and Biopsy results. The use of these treatment plans in theater ensures enhanced cancer control and reduced risk of urinary or erectile function side effects.
Learn more about how NanoKnife works
Mr Tim Dudderidge How does NanoKnife work
00:00:35
Playlist
Learn more about how NanoKnife Works
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): NanoKnife destroys prostate cancer cells using electrical pulses while preserving surrounding healthy tissue. This minimally invasive approach offers effective treatment with fewer side effects, making it a valuable option for selected patients.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado Who is NanoKnife suitable for
00:00:59
Playlist
Learn more about how NanoKnife Works
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Focal therapy for prostate cancer at the front has even fewer side effects. It avoids nerves affecting erections and reduces rectal risks, making it an excellent minimally invasive treatment option that preserves quality of life while effectively treating cancer.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam Is NanoKnife better than HIFU
00:01:00
Playlist
Learn more about how NanoKnife Works
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): HIFU and NanoKnife are chosen based on tumor location. HIFU treats the posterior prostate, while NanoKnife targets anterior tumors. Comparative data between them is still evolving, and the choice depends on tumor characteristics and patient preference.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
| Feature | NanoKnife IRE |
|---|---|
| Treatment Type | Minimally invasive focal therapy |
| Temporary swelling | Common |
| Energy Used | Electrical pulses (non-thermal) |
| Hospital Stay | Outpatient (same day) |
| Cancer cure rate at 3 years | 95% + |
| Urinary Incontinence Risk | Very low (<1%) |
| Erectile Problems | <3% |
| Repeatable Treatment? | Yes |
| Best for Tumour Location | Tumours located at the front (anterior) of the prostate |
| Suitability | Men eligible for focal therapy where tumour location is in the front of the prostate rather than the base of the prostate gland |
| Follow-Up Care | Regular PSA testing and occasional MRI scans |
“If you’re deemed suitable for [NanoKnife], it really is a no brainer. I think to go down this line first is the only way if you want to minimise your possible after effects.”
Brian Bishop
The Focal Therapy Clinic patient
Is NanoKnife right for me?
NanoKnife for Prostate Cancer is a minimally-invasive treatment for men with localised prostate cancer in parts of the prostate that are too hard for HIFU to reach. NanoKnife could be right for you if your prostate cancer is:
Early or intermediate stage
In the anterior or lateral parts of the prostate
Localised
Recurrent
It could also be the right choice if you are keen to avoid long-time side effects from prostate cancer treatment.
Check your suitability
Success rates
NanoKnife has been shown to be extremely effective for controlling cancer, potency and fertility.
Book your consultation today
Cancer control at 3 years
85% needed no further treatment after NanoKnife
Sexual potency
95%+ had normal sexual function after NanoKnife
Urinary continence
98% had no problems with urinary continence after NanoKnife
Mr Marc Laniado MRI US Fusion technology and focal therapy success rates
00:01:00
Playlist
NanoKnife (IRE) Focal Therapy for Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): MRI fusion improves focal therapy accuracy, ensuring over 90% of men are cancer-free at one year. Globally, 7580% of men avoid radical treatment for 610 years post-focal therapy, making it an effective and minimally invasive option for prostate cancer.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
NanoKnife: Advantages and Disadvantages
Advantages
- Minimally invasive - No incisions, no radiation, no hormones
- Preserves sexual function & continence - spares nerves and urinary structures
- Outpatient procedure - Go home the same day. Rapid recovery
- Repeatable if needed - Can be combined with other treatments
- Effective cancer control - equivalent to radiotherapy or surgery at 8 years
Disadvantages
- Minimally invasive - No incisions, no radiation, no hormones
- Follow-up monitoring required - Regular PSA testing and MRI scans needed
- Limited long-term data - NanoKnife is newer than traditional treatments.
What to Expect Before, During, and After Treatment
What to Expect Before, During, and After Treatment
- MRI and biopsy to confirm eligibility
- Pre-Procedure instructions (e.g. fasting)
Mr Tim Dudderidge How should I prepare for focal therapy
00:00:25
Playlist
Care: Before Treatment
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Before focal therapy, youll receive fasting instructions and arrival details. Avoid a heavy meal the night before, and if you have any questions, check with the ward nurses to ensure youre fully prepared for your procedure.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge What happens on the day of a focal therapy treatment
00:01:37
Playlist
Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy is a day-case procedure performed under general anesthesia, typically lasting 6090 minutes. A catheter is required for 57 days, and most patients resume normal activities soon after, making it a minimally invasive and efficient treatment option.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
05 Mr Tim Dudderidge Do I need a general anaesthetic for focal therapy
00:00:46
Playlist
Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): **Most patients can safely undergo general anesthesia for HIFU, NanoKnife, and cryotherapy**. **Spinal anesthesia is not suitable for HIFU or NanoKnife but may be an option for cryotherapy**.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge What happens during focal therapy
00:01:38
Playlist
Care: On the Day
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Focal therapy procedures last 6090 minutes under anesthesia, using MRI-ultrasound fusion to precisely target cancer. HIFU, cryotherapy, and NanoKnife effectively destroy cancer cells while preserving healthy tissue, offering a minimally invasive alternative to surgery or radiotherapy.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Recovery after focal therapy
00:01:04
Playlist
Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Pain after focal therapy is uncommon, but bladder spasms are the most frequent discomfort, typically lasting 2448 hours. Antispasmodic drugs and simple painkillers help manage symptoms, ensuring a smoother recovery.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge How long does it take to recover from focal therapy
00:01:25
Playlist
Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Recovery after focal therapy is quick. Most patients resume light activities within a week and return to normal physical activity soon after. Some may experience temporary urgency or fatigue, but side effects are typically mild compared to traditional treatments.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Will I need to wear a pad after focal therapy
00:00:32
Playlist
Care: Recovery
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Post-surgery pad use is usually due to sphincter damage, leading to long-term incontinence risks. In contrast, focal therapy may cause only temporary urgency-related leakage, with most patients regaining full bladder control quickly. Website: https://www.thefocaltherapyclinic.co.uk LinkedIn: linkedin.com/company/the-focal-therapy-clinic/ Facebook: facebook.com/TheFocalTC Telephone: +44 (0) 207 036 8870 #FocalTherapy #ProstateHealth #MinimallyInvasive #MensHealth #ProstateCancerTreatment #Urology
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge When can I go home after focal therapy
00:00:40
Playlist
Care: After your treatment
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Most patients go home within a few hours after focal therapy, once theyve eaten, had fluids, and been shown how to use the catheter. Those traveling far may choose to stay in a nearby hotel overnight for added convenience and comfort.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado Will I need help getting or maintaining an erection after focal therapy
00:00:41
Playlist
Care: After your treatment
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Most men regain normal erections within a few months after focal therapy, though medications can help. By one year, function is usually restored, with rare cases needing further treatment or additional support.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Raj Nigam After focal therapy what tests are done to see if it was effective
00:01:38
Playlist
Care: After your treatment
SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): We closely monitor all focal therapy patients with regular PSA tests and MRI scans to track treatment success. If recurrence occurs (510%), further focal therapy or traditional treatments like surgery or radiotherapy remain viable options, ensuring flexible and effective cancer management.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Side effects & Risks
| Symptom | Frequency | Duration |
|---|---|---|
| Urinary Catheter required | Always | 3-5 Days |
| Mild discomfort in perineum area | Common | 2-3 Days |
| Temporary swelling and bruising | Common | 2-3 Weeks |
| Blood in urine or semen | Common | Up to 8 weeks |
| Erectile dysfunction | Rate (<5%) | Usually temporary |
| Return to normal | Common | 3 - 7 days |
Questions to ask your doctor
Am I a good candidate for NanoKnife prostate cancer treatment?
You might be, especially if your cancer is localised, in one area, and Gleason 3+4 or 4+3. NanoKnife works best for small, clearly seen tumours. Your doctor will check PSA level, MRI, and biopsy results to decide.
“NanoKnife was more accurate for the awkward position of my cancer.” — Brian Bishop
“NanoKnife was more accurate for the awkward position of my cancer.” — Brian Bishop
Is NanoKnife available at your clinic, and how experienced is the team?
Yes, the Focal Therapy Clinic offers NanoKnife. It's one of the few centres in the UK with expertise. Consultants like Mr. Marc Laniado and Mr. Alan Doherty are experienced in using it for suitable cases.
“NanoKnife gives us a high level of control around the ablation area.” — Mr. Alan Doherty
“NanoKnife gives us a high level of control around the ablation area.” — Mr. Alan Doherty
How does NanoKnife compare to other treatments like HIFU, surgery or radiotherapy?
NanoKnife is precise and less invasive. Compared to surgery or radiotherapy, it has fewer side effects like incontinence or erection issues. It also avoids heating the tissue like HIFU, which may help preserve nerves.
“NanoKnife's precision reduces side effects like incontinence.” — Mr. Tim Dudderidge
“NanoKnife's precision reduces side effects like incontinence.” — Mr. Tim Dudderidge
What are the success rate and potential side effects for my specific case?
Success depends on your cancer’s grade and location. In one study, NanoKnife cleared cancer in 84-97% of treated areas, with no serious side effects. Most men stayed continent, and around half kept full erections.
“I've had no lasting after-effects whatsoever—less discomfort than a filling.” — Brian Bishop
“I've had no lasting after-effects whatsoever—less discomfort than a filling.” — Brian Bishop
What follow-up schedule should I expect?
After NanoKnife, expect PSA tests every 3 months in the first year, then every 6 months. MRI scans usually happen at 6 and 18 months. A biopsy is often done around 12 months.
“MRI quality is key; poor scans undermine focal therapy decisions.” — Mr. Tim Dudderidge
“MRI quality is key; poor scans undermine focal therapy decisions.” — Mr. Tim Dudderidge
Choosing Between NanoKnife & HIFU: Key Factors
Both NanoKnife IRE and HIFU are focal therapy options that treat localized prostate cancer while preserving quality of life. The choice between them depends on tumor location, treatment goals, and patient preferences.
| Benefit | NanoKnife | Hifu |
|---|---|---|
| Best for Tumour Location | Irregularly shaped or near critical structures (nerves, urethra) | Well-defined tumors in specific prostate zones |
| Preservation of Nerves | No heat damage; excellent for preserving erectile function | Low risk, but heat may affect nearby structures |
| Suitability for Recurrent Cancer | Ideal for post-radiation recurrence | For tumors near the base of the prostate |
| Side Effects | Minimal impact on urinary function and sexual health | Low risk of incontinence and erectile dysfunction |
| Treatment risk | Risk of rectal injury at base of prostate | Risk of under treatment at front of prostatetd> |
The Role of MR-US Fusion Technology in Treatment Accuracy
MRI-Ultrasound (MR-US) Fusion Technology combines high-resolution MRI imaging with real-time ultrasound guidance, allowing for precise targeting of cancerous tissue.
Benefits of MR-US Fusion Technology
- Improved Tumour Detection - More accurate than ultrasound alone
- Greater Targeting Precision - Helps specialists precisely pinpoint tumours
- Reduces Risk of Missing Cancerous Tissue - Ensures comprehensive tumour destruction
Mr Marc Laniado MRI US Fusion technology and focal therapy success rates
00:01:00
Playlist
NanoKnife (IRE) Focal Therapy for Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): MRI fusion improves focal therapy accuracy, ensuring over 90% of men are cancer-free at one year. Globally, 7580% of men avoid radical treatment for 610 years post-focal therapy, making it an effective and minimally invasive option for prostate cancer.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Frequently asked questions
There are many factors to consider when choosing a treatment for your prostate cancer. Medical factors, such as your cancer stage and tumour location are important. However, your current and future quality of life is also very important.
Reference List
Blazevski, A., Scheltema, M. J., Amin, A., Thompson, J. E., Lawrentschuk, N., & Stricker, P. D. (2020). "Irreversible electroporation (IRE): A narrative review of the development of IRE from the laboratory to a prostate cancer treatment." BJU International, 125(3), 369–378. https://pubmed.ncbi.nlm.nih.gov/31725935/
Valerio, M., Dickinson, L., Ali, A., Ramachandran, N., Donaldson, I., McCartan, N., Freeman, A., Ahmed, H. U., & Emberton, M. (2017). "Nanoknife Electroporation Ablation Trial: A prospective development study investigating focal irreversible electroporation for localized prostate cancer." The Journal of Urology, 197(3 Pt 1), 647–654. https://pubmed.ncbi.nlm.nih.gov/27697580/
lazevski, A., Scheltema, M. J., Yuen, B., Masand, N., Nguyen, T. V., Delprado, W., Shnier, R., Haynes, A. M., Cusick, T., Thompson, J., & Stricker, P. (2020). "Oncological and quality-of-life outcomes following focal irreversible electroporation as primary treatment for localized prostate cancer: A biopsy-monitored prospective cohort." European Urology Oncology, 3(3), 283–290. https://pubmed.ncbi.nlm.nih.gov/31103721/
The Focal Therapy Clinic Resources: www.thefocaltherapyclinic.co.uk