New surgical technique preserves continence in men after prostate removal
20 November 2024
Publish date: 04 January 2022
If you are a patient and you are interested in exploring whether this treatment is suitable for you, please speak to your treating consultant and they can refer you to UCLH or another centre if appropriate.
A minimally invasive technique for treating prostate cancer has been used for the first time in the NHS at University College London Hospitals NHS Foundation Trust (UCLH).
Irreversible electroporation (also known as Nanoknife) can be used with precision to treat the area of the prostate affected by cancer. As a result, side effects such as problems with urination, incontinence and loss of sexual function are much less frequent than when the whole prostate is treated.
UCLH consultant urologist Alistair Grey, who led the procedure on the first patients, said: “This technology has the potential to benefit cancer patients with rapid recovery and low side effects. It causes minimal discomfort, and we can use it for tumours that were previously difficult to treat.
“What is very exciting about this treatment is its precision in targeting and attacking the cancerous cells without damaging healthy tissue and maintaining the prostate’s important functions.”
Nanoknife, as the technology is trademarked by its manufacturer AngioDynamics, works by administering quick electrical pulses, using electrodes, around the tumour to kill the cancerous cells. These electrical pulses effectively cut open the cells’ membrane, hence the name.
Guided by MRI scanning, the electrical pulses can be targeted to exactly the right area, posing fewer risks. The pulses used are short and do not generate any heat, leaving the surrounding healthy cells untouched and preserved.
The disruption of the cell’s membrane induces the process of apoptosis, the death of cells. The healthy cells will continue to grow without any issues and will replace the dead cells resulting from the treatment.
Nanoknife is also a short procedure carried out as a day case, which reduces pressure on hospital beds and operating theatre space. It is also a procedure which can be repeated if necessary.
UCLH consultant urologist Mark Emberton said: “We are delighted to have been the first hospital in the NHS to use irreversible electroporation for patients with prostate cancer. And at times like this, when the NHS is under great pressure, day surgery avoids the need for overnight stays in hospital and means that we can use our operating theatres more efficiently.”
One of first patients treated at UCLH was Neil Gershon, 70, who had the procedure in early November. He was diagnosed with prostate cancer earlier this year and was offered several treatment options including radiotherapy, surgery to remove the prostate, cryotherapy, or brachytherapy. Neil opted for cryotherapy in Autumn 2021.
But, shortly afterwards, he received a call from the UCLH team explaining that Nanoknife had just become available to NHS patients and he could also consider this new option.
Neil said: “I was very happy to go ahead and try this new treatment. What appealed to me about the electroporation treatment was that it was minimally invasive and very precise, also that the likelihood of side effects was very low compared to other treatments.”
“It was all done in a day which was great. When the general anaesthetic wore off, I felt absolutely fine, no pain at all. It couldn’t have gone better. I would like to add my thanks to the superb team who looked after me during the procedure.”
Neil had the catheter removed at his local hospital one week later.
The team (which also included urologists Caroline Moore and Clement Orczyk, anaesthetist Alan Fayaz, planning radiologist Shonit Punwani and nursing team Edfelyn Birung, Boyan Bonchin, and Sandra Paguyo) has carried out six procedures.
