Which hospitals in UK use a NANO Knife for Lung cancer and is this treatment available on NHS

[Molly456mandy]

Friend not suitable for Chemo or Gene Therapy has been told this Nano Knife may be her only option.

[JanetteR57]

I've only ever heard of nano knife being used for liver cancer or pancreatic cancer and it's not in the current approved NICE guidelines for lung cancer. what type of cancer does your friend have? there are many different treatments for lung cancer - mainly guided by specific characteristics in the tumour/patient - with most patients having a combination of therapies including chemotherapy, radiotherapy, immunotherapy and targeted therapies. those detected at earlier stages may also be offered surgery with or without other treatments. Within each of these treatment modes are a range of methods - for example radiotherapy can include cyber knife (ablation) - sometimes called radiotherapy surgery but it doesn't include a knife as such but some of the machines are called cyber or gamma knife - called due to the precision nature of the beam of radiation compared to more general radiotherapy (which can be given radically - for treatment or to palliate symptoms at more advanced stages) and chemotherapy although a generic term may include completely different drugs/infusions.... I've been involved in lung cancer research for several years and tend to see new treatments coming through as clinical trials in Europe or elsewhere through conferences including Worldlung if not currently available in the UK but I've not heard of this for lung cancer... once new treatments have been proved elsewhere under stringent conditions, they are assessed for suitability within NHS framework. Ablation (i.e. cyber knife) was previously available in a limited number of hospitals but instructed for wider inclusion at all Trusts from last April but the pandemic may have delayed its implementation due to staffing/equipment etc.

Nano knife has just been used for prostrate cancer at UCLH and Kings London previously used it for pancreatic cancer but no longer available on the NHS. It's a new procedure used for tumours where surgery is much more difficult - thoracic surgery has many types including minimally invasive which now dominates UK lung surgery - the type of open lung surgery I had in Dec 2010 is now the minority surgical procedure in the UK but it cannot always be guaranteed if the tumour is difficult to reach that the surgery won't be converted into an open type. Sometimes headlines about new treatments for one type of cancer can read as if they're available or suitable for all but as cancers can be very different, each clinical expert team/approval panels would have to consider suitability after respective trials for those types of patients usually. Hopefully the link will explain more about the myriad of lung cancer treatments available for your friend and they should ask their clinical team what might apply to them as even with the same type of cancer, patients may be offered different treatments. good luck to you both. roycastle.org/about-lung-ca...

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Dear Molly456mandy

Sorry to hear about your friend, it may be that they offered your friend Cyber Knife for her lung cancer perhaps, this link will take you to the information on this from the Royal Marsden Hospital: royalmarsden.nhs.uk/your-ca...

JanetteR57 has provided an excellent and informative reply for you, of which there is not much to add.

Cyber Knife is also known as SABR (Stereotactic Ablative Body Radiotherapy) or SBRT.

This link is to our booklet on radiotherapy and the different types, see page 10: roycastle.org/app/uploads/2...

You may be interested to look at the UK national clinical guidelines for lung cancer, this is a flow chart where you can click on the type of lung cancer and the recommended treatments that are research evidence based. NICE is the National Institute for Health and Care Excellence. When you open the link, click on the icon that looks like a mobile phone and this will open up another page where you can click on the flowchart: pathways.nice.org.uk/pathwa...

If you would like to discuss anything you can either email us at [e-mail] or call our free phone nurse led helpline number on 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600

Kind regards

The Roy Castle Support Team