In addition to the therapies applied in our center established forms of therapy with reliable long-term results from international studies, treatments are also used in other clinics whose efficacy is not or not yet sufficiently proven or whose long-term side effects are unknown.

Irreversible electroporation (IRE) is a novel method of destroying tumor cells in the prostate using an electric current. Strong, localized electric fields cause tiny pores in the cell walls, resulting in the death of tumor cells in the treatment area. IRE is a focal therapy of the prostate in which only tumor-suspected areas are treated rather than the entire organ.

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Disadvantages of irreversible electroporation with the NanoKnife:

Experimental procedure
Irreversible electroporation with the NanoKnife is an experimental treatment procedure for prostate cancer. Randomized multi-center studies as well as long-term experience are missing so far. Currently, two clinical studies are available on a total of 20 and 34 patients, respectively, who were examined over a period of 6 and 12 months.(1/2) Due to the small number of patients and the short follow-up period, valid statements on the efficacy of the procedure cannot be made at this time.

Does focal therapy of the prostate make sense?
If therapy is necessary due to tumor size, aggressiveness and/or extension, it is advisable to treat not only individual tumor sites but the entire prostate. Especially in the case of intermediate- and high-risk prostate carcinomas, it is important to destroy all tumor cells in order to minimize recurrence of the disease (relapse).

Wait and see instead of NanoKnife
IRE is therefore currently mainly used in patients with low-risk prostate cancer who can be subjected to "active surveillance" according to the recommendations of the current guidelines. In case of a "hasty" therapy with the NanoKnife, there is a risk of "overtherapy".

Cost-intensive
Due to the lack of proof of effectiveness of irreversible electroporation, the method is not covered by private and statutory health insurance. The costs to be borne are between 15,000 -20,000 euros.

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1. Valerio M et al: A prospective development study investigating focal irreversible electroporation in men with localised prostate cancer: Nanoknife Electroporation Ablation Trial (NEAT). Contemp Clin Trials. 2014 Sep;39(1):57-65. doi: 10.1016/j.cct.2014.07.006. Epub 2014 Jul 26.
2. Valerio M, et al: Initial assessment of safety and clinical feasibility of irreversible electroporation in the focal treatment of prostate cancer. Prostate Cancer Prostatic Dis. 2014 Sep 2. doi: 10.1038/pcan.2014.33.