I am scheduled for whole pelvic radiation in August. I have two positive pelvic lymph nodes and one abdominal lymph node below the aortic bifurcation. As the time gets nearer I am getting more stressed about possible side effects. RO is recomending 45gy to whole pelvis with an additional 23gy to the prostate bed(I had RP with positive margines and seminal vesicle involvement).
I just came across some info on NanoKnife on the CANCERactive site and wonder if this might be an option for my case. I read that the treatment may take care of micrometasticies.
“When using Irreversible Electroporation, the cytoplasm of cancer cells flows out through the small holes created. One huge beneficial side-effect has now been shown. As the tumour disintegrates, large numbers of tumour proteins are released into the body into the lymph system. In prostate cancer, these have been shown to arrive at the lymph nodes causing a massive immune response. All tumours cause micro-metastases in the body. The immune response then knocks these out, giving the Nanoknife IRE a second crucial benefit. “
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I had a Nanoknife therapy. It did destroy the tumor cells in the prostate. My lymph node mets where not affected. I think there is no real proof for this immune response they describe on the web site.
You can't treat a wide area like that with IRE. There is no advantage for you because you can't use it for focal treatment. They have to stop your heart and put you on a heart/lung machine with full anesthesia. It's a major operation, with no better outcomes or toxicity:
If you can get one of those new MRI-guided linacs (MRIdian or Elekta Unity) I suspect there is an advantage in treating the pelvic lymph node area because it moves separately from the prostate.
I had NanoKnife procedure and while it eliminated cancer in the prostate for awhile, cancer returned. From scans prior to procedure there was a chance of cancer outside prostate. Post treatment there was clear local lymph node involvement 18 months later. At least from current evidence, it would seem best used as a focal therapy on well defined tumors within the prostate. That said, it doesn't have the permanent negative effect that radiation has on treated tissues, perhaps in the future claims such as that in the web site will be supported by convincing evidence.
Micro-metastasis are those unseen cancer cells traveling the lymphatic and vascular system (some research is that they use nerve bundles. But that is new and not in the definition taught to me) looking for a place to land and grow. The resulting colony is seen and called metastasis or metastatic lesions; most commonly in lymph nodes and bones.
I fail to see how any radiation technique can kill areas in these vast networks. There are 60,000 miles alone in the vascular system of the average adult male.
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