I am aware that NanoKnife (IRE) is a relatively recent procedure, and that (apparently) post op records reveal very limited nerve bundle damage and minimum or no incontinence issues. In UK, there is an organization - the National Institute for Health and Care Excellence (NICE), that has undertaken some trials of this procedure, and they have decided that there is insufficient evidence to prove that IRE is any better than RP in relation to post operative issues.
Given that NICE has not endorsed the process means that the UK National Health Service will not perform NanoKnife surgery in the UK. Therefore, the only recourse I can see is to 'go private' with its accompanying costs. Charges (including pmMRI scans pre and post operation) in UK are around £16,000, and in Germany €18,000.
Are there any on this site (in any country), who have had this treatment, or are thinking about it in the near future?
Does anyone know of any individual who has gone through IRE, and the outcome (if any)of post op issues?
Thanks
Written by
StuartS
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I don't know anyone who has had the treatment but I would like to introduce a few notes of caution about new treatments.
We often think that newer must be better. Newer computers are faster than older ones. New cell phones are better than older ones. But it turns out that the same as not as universally true for new medical treatments.
There are a number of reasons for this. One is that the new treatments haven't been tested as extensively as the older ones and it may turn out that they don't work as well. Another is that all treatments require time and experience before the medical profession learns how to use them most effectively and how to perform effective follow-up care. The first prostatectomies were not as well done as the those done in state of the art surgeries today. The first radiation treatments were much, much worse than the ones used today. It took lots of experience to get the dosage right, to learn how to aim the beams, to fully understand targeting, to understand the side effects, and so on.
If you find someone who can do the treatment you may also face issues in follow-up treatment. If the treatment fails will you be able to find a surgeon or radiation oncologist with experience treating prostate glands that have been treated with electroporation? If you have unexpected side effects who will you turn to for help?
If you decide to roll the dice and go ahead with the procedure anyway, the best way to do it is in the context of a clinical trial, if you can find one. At least you'll be in a group that is being carefully treated by research doctors and carefully followed after treatment.
Many thanks for your comments regarding IRE. IRE is just one of the treatments I am researching in a bid to have a better understanding of what route I might take post my biopsy in a couple of weeks. I have found considerable detail of most of the main treatments, and their post operative issues, but little or nothing regarding IRE, hence my request for more information from any individual who may have gone this route. I have managed to locate details of a couple of IRE trial reports, but both have the same issues, insufficient post operative details and too few patients undergoing the procedure, to allow them to fully validate the process, and comment constructively.
I echo your comments/concerns regarding post operative issues with IRE, as it would appear unless you reside near the clinic conducting the IRE procedure, any follow-up activity, including catheter removal, is left to the patient to organise! Not too sure if a UK GP would get involved, or perhaps A&E at the local hospital however, it does appear to be a bit hit and miss with some loose-ends to be considered before contemplating IRE.
I had IRE as a salvage treatment here in the US performed by Dr Gary Onik, unfortunately it did not work. He uses it in combination with Cryo so whatever side effects I have I can't point to one treatment or the other as the cause but I did have ED after treatment.
There are treatment centers in Germeny using IRE :
Thanks for responding. Given its comparatively recent arrival on the scene, I wondered if anyone had experienced IRE, hence my request for information. I am just putting together a list of the various treatments that are available so that I have some knowledge of the post operative issues before I decide what treatment would be most beneficial.
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