Standard treatments for prostate cancer are surgical removal of the prostate, known medically as radical prostatectomy (RP) (from the ancient Greek -ectomy, meaning to cut out), and radiation therapy. Both forms of therapy aim to destroy prostate tissue. This approach is based on the outdated assumption that when the prostate is removed, the cancer is also completely removed from the body, thus curing the patient. The so-called "liquid biopsy" shows that this assumption is incorrect. This procedure can detect cancer cells in the blood of every cancer patient. They are therefore always distributed throughout the body. Consequently, cancer cells remain in the patient's body even if the prostate has been removed or the prostate tissue has been destroyed. This also explains the relatively high recurrence rates (the reappearance of cancer) after surgery and/or radiation therapy (see Han Tables, Johns Hopkins University, Department of Urology).
For this reason, focal therapy is increasingly gaining attention. Here, only the tumor itself is destroyed. The healthy areas of the prostate, and thus the functions of the urogenital tract (which are essential for erectile function and potency), are preserved.

IRE (Irreversible Electroporation) is a new technique for ablating tissue. It differs from other procedures such as HIFU (high-intensity focused ultrasound), RFA (radiofrequency ablation), laser treatments, and cryoablation. These methods use extreme heat or cold to "melt" the treated tissue and cause the affected cells to die. For this reason, focal therapy is increasingly gaining attention. Here, only the tumor itself is destroyed. The healthy areas of the prostate, and thus the functions of the urogenital tract (which are essential for erectile function and potency), are preserved.

New methods require lengthy clinical trials, and there are financial and structural hurdles, such as high investments in radiotherapy equipment.

Our partner clinic here in Germany has performed the most prostate cancer treatments worldwide using NanoKnife™. A total of more than 1,700 patients have been treated this way. Summaries of our data regarding side effects (incontinence and impotence) as well as oncological data have already been presented at several conferences.

The data show significant improvements in both side effects and oncological outcomes compared to established treatment methods. However, the data were not collected as part of a clinical study. Their scientific significance is therefore limited. Nevertheless, unlike radiation therapy or prostatectomy, IRE is a gentle procedure that works at the cellular level and can be repeated as often as needed, even in the event of recurrence.

No medical procedure can offer a 100% guarantee of success. Human biology is too complex, and the differences between individuals are too great.

Current, common treatment methods for prostate cancer do not guarantee a cure and carry significant side effects (impotence in approximately 70 percent of cases, incontinence in 10 to 50 percent of patients). Focal therapy with IRE is therefore a very interesting alternative.

In many cases, IRE treatment may be the best treatment approach because the tumor tissue is only treated within the treatment area, and side effects are therefore very minimal. Each case is closely monitored for possible side effects such as impotence and incontinence.
However, IRE is not a miracle treatment for all tumors at all stages. We will advise you on all available treatment methods for your specific case and the stage of your disease. Before starting treatment, we will discuss the various options, your priorities, and preferences with you.

The NanoKnife treatment takes approximately two hours and is performed under general anesthesia. A urinary catheter is inserted, which is removed after approximately 10 to 14 days by your urologist or by us. After the treatment, you will spend one night under medical supervision in our private clinic. You can usually return home 24 hours after the treatment. For most patients, the NanoKnife treatment is painless, but they find the urinary catheter slightly uncomfortable.

NanoKnife is manufactured by a company called AngioDynamics and is approved in the US by the FDA (Food and Drug Administration), in Europe (CE Mark), and in Germany (according to the Medical Devices Act). These approvals cover tissue ablation throughout the body, including the prostate. So, you would by no means be a guinea pig.

Given the poor results achieved by conventional prostate therapies (impotence in 70 percent of patients, incontinence in 10 to 50 percent, a 30 percent relapse rate, and only a one percent improvement in the five-year survival rate after prostatectomy), we have to assume that a new procedure with fewer side effects is better—although long-term results are still pending.
At the Prostate Center in Germany, more than 1,700 prostate cancer patients have been treated, and the results have been published at all major radiology conferences.

Contact us if you would like us to approve your scientific publications.

The clinic regularly treats patients whose tumors have spread to neighboring structures of the prostate, such as the seminal vesicle, pelvic floor, etc. In most cases, at this stage of the tumor, additional treatments, such as anti-hormone therapy, are necessary in addition to focal therapy. However, there is evidence that reducing tumor size has a positive effect on treatment success even in advanced stages of the disease.

Because IRE does not damage structures such as large blood vessels, even lymph nodes affected by metastases that are located in close proximity to them can be treated with the NanoKnife procedure.

IRE can also be combined synergistically with immunotherapy.

Whether these measures are curative or merely palliative—that is, whether they contribute to a cure or merely alleviate symptoms—depends on the specific circumstances. Combination therapy is often the most appropriate approach for advanced-stage tumors.

After previous treatment, whether surgical or using HIFU (high-intensity focused ultrasound), scarring often occurs, making subsequent surgery difficult. Furthermore, subsequent surgeries or HIFU treatments are often associated with an increased risk of impotence or incontinence. Radiation therapy makes the treated tissue so fragile that surgery is practically impossible. Furthermore, it is not possible to repeat conventional radiation therapy immediately after radiation therapy has already been performed. This would cause excessive damage to surrounding structures, such as the bowel and bladder.
In these cases, IRE (irreversible electroporation) can be used to treat recurrences minimally invasively, with minimal risks and no additional stress for the patient. IRE thus represents a unique method for treating tumor tissue in otherwise inoperable areas. IRE treatment can be repeated as often as necessary. The only prerequisite for such treatment is precise diagnostics using MRI. We have already successfully treated several complicated cases with residual tumor tissue. However, long-term experience and statistics are not yet available.

General anesthesia is required to relax the muscles and allow the IRE procedure to be performed safely. The limiting health factors for IRE treatment are therefore the normal risks associated with general anesthesia. Therefore, the question of whether general anesthesia is possible must be clarified by the attending anesthesiologist. Therefore, a health assessment is required prior to treatment, which includes diagnostic tests such as a stress ECG, blood tests, X-rays, ultrasound, etc. A full cardiology examination may also be required to fully evaluate your general health and determine your suitability for anesthesia.

If you are interested in IRE treatment and/or a personal consultation, please contact us.