UAMS announced Wednesday that it is the first provider in Arkansas to use NanoKnife technology, a new form of focal therapy for localized prostate cancer.
Focal therapy is a minimally invasive outpatient procedure that uses different forms of energy to target only the area of the prostate where cancerous cells are located and destroy them while sparing damage to surrounding tissue. It carries a lower risk of side effects than radiation and surgery, which are the other treatments for prostate cancer.
The specific NanoKnife form of focal therapy uses irreversible electroporation (IRE), which consists of short, high-voltage electrical pulses, to isolate the tumor without overtreating the entire prostate gland.
According to AngioDynamics, the medical technology company that designs and manufactures the technology, the NanoKnife System is the only function-preserving, minimally invasive therapy that uses electricity to destroy prostate tumors. Other types of focal therapy destroy the tumor with cold gases, heat from a laser or heat from high-frequency sound waves.
“This is a more advanced version of focal therapy,” Dr. Tim Langford, a urologist and chair of the UAMS Department of Urology, said in a press release from UAMS. “It treats the tumor only and will virtually eliminate the risks of incontinence and erectile dysfunction.”
The release stated that Dr. A. Murat Aydin, a urologic oncologist at UAMS who has “extensively trained” on the use of NanoKnife technology, performed the state’s first procedure using the technology on March 21. The patient went home the same day and was doing well when he returned to UAMS for a follow-up visit 10 days later.
“Prostate cancer is the most common cancer in men, and there is a very wide disease spectrum in terms of stage and survival,” Aydin said in the release. “Overtreatment of low-risk and early stage prostate cancer by surgery or radiation is a major issue, and this leads to increased frequency of quality-of-life issues without any survival benefit.”
Patients with low-risk prostate cancers have a “very good prognosis and can be managed with active surveillance and stringent follow-up,” according to Aydin. But he said in the release that about 10% of men on active surveillance still receive radical treatment due to disease progression, a blood test showing increased levels of PSA marker, patient choice or patient anxiety.
He said focal therapy emerged as a novel treatment option to destroy the cancer while minimizing the adverse effects of radiation and surgery, but that the thermal therapies using ultrasound waves or freezing have had “variable results.” NanoKnife Technology is a nonthermal therapy.
“With IRE, we place thin needles in the perineum to deliver electrical pulses to destroy the cancerous cells,” Aydin said in the release. “This technique has been shown to be very effective, avoiding energy spread beyond the needles to protect essential organs and structures related to functionality such as the rectum, the sphincter muscles responsible for urinary continence and the nerves around the capsule of prostate that are responsible for erection.”
Langford said in the press release that “this is kind of the Holy Grail for prostate cancer.”
Aydin and another urologic oncologist, Dr. Marcelo Bigarella, perform the NanoKnife procedure at the UAMS Health Urology Center at Premier Plaza in Little Rock. It takes about 45 minutes while the patient is under general anesthesia, and the patient is discharged the same day with a urinary catheter that will be removed in two to five days.
“The follow-up for patients after the procedure consists of a prostate-specific antigen test, MRI and biopsies at regular intervals,” Aydin said in the release.
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