Experimental NanoKnife treatment offers new, less radical way of keeping prostate cancer at bay

The treatment of prostate cancer is now following the successful path of breast cancer, by offering new conservative surgeries to remove tumours without removing the prostate.

The treatment of prostate cancer is now following the successful path of breast cancer by offering conservative surgery to cut out tumours without removing the prostate.

Victorian men with prostate cancer now have a surgical option to remove tumours in a less invasive way, just as lumpectomies replaced radical mastectomies in breast cancer treatment.

Experimental NanoKnife technology at Epworth Healthcare is a day surgery that uses tiny bursts of electrical fields to create small holes in the cancer cells, causing them to die.

The EJ Whitten Foundation has partnered with the hospital — which treats two-thirds of Victoria’s prostate cancer patients — to open a new prostate cancer research centre that is already recruiting for its first clinical trials.

The prostate cancer blood test — the single prostate-specific antigen (PSA) test — had been controversial, given that in some men it will diagnose cancers that will never cause them problems and lead to unnecessary and invasive treatment.

But Epworth urologist surgeon and oncologist Associate Professor Nathan Lawrentschuk said advances in imaging techniques and new methods meant the chance of over-treatment had reduced.

Associate Prof Lawrentschuk said advances in imaging techniques meant the chance of over-treatment had reduced.

“Instead of going from a PSA test to biopsy to radical treatment, you’re much more likely to have a PSA test, a repeat test and an MRI,” Associate Prof Lawrentschuk said.

“Only a small number of those men will actually have a biopsy, and an even smaller number of men will end up having radical treatment.

“Most cancers that are detected are low grade and can be watched.”

As part of this watch-and-wait thinking, the first 20 patients have had the Nano­Knife treatment. The clinic is also treating men whose cancer returns after radiation, using focal therapy instead of removing the entire prostate.

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These men are joining an international register to measure their quality of life.

“Rather than being a big hammer and everything is the nail, maybe we can be very precise, reducing that hammer to a very small tap,” Associate Prof Lawrentschuk said.

“We want to cure as many men as possible, but in those men we can’t cure we want to turn this into a chronic disease that they don’t die of.”

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