Standard treatments for prostate cancer are surgical removal of the prostate, technically known as radical prostatectomy (RP) (from the ancient Greek -ectomy for cutting out), and radiotherapy. Both forms of therapy aim to destroy prostate tissue. This approach is based on the outdated assumption that the cancer is completely removed from the body along with the prostate and that the patient is therefore cured. The so-called "liquid biopsy" shows that this assumption is not correct. With this procedure, cancer cells can be detected 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 destroyed. This also explains the relatively high recurrence rates (the recurrence of cancer) after surgery and/or radiotherapy (see Han Tables, Johns Hopkins University, Department of Urology.
For this reason, the focus is increasingly shifting to focal therapy. Here, only the tumor itself is destroyed. The healthy areas of the prostate, and therefore 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. This is because these methods use extreme heat or cold to "melt down" the treated tissue and cause the affected cells to die. For this reason, focal therapy is increasingly coming into focus. 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 carried out the most prostate cancer treatments with NanoKnife™ worldwide. In total, more than 1700 patients have been treated in this way. Summaries of our data on side effects (incontinence and impotence) as well as oncological data have already been presented at several congresses.
The data show significant progress in terms of both side effects and oncological outcomes compared with established treatment methods. However, the data was not collected as part of a clinical trial. Their scientific significance is therefore limited. Nevertheless, in contrast to radiotherapy or a prostatectomy, IRE is a gentle procedure that works at the cellular level and can be repeated as often as required, even in the case of recurrences.

No medical procedure can offer a one hundred percent guarantee of success. Human biology is too complex for this and the differences between individual people are too great.

The current, common treatment methods for prostate cancer do not guarantee a cure and have considerable side effects (impotence in around 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 the side effects are therefore very low. 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 treatment methods available for your particular case and stage of the disease. Before we start treatment, we will discuss the various options, your priorities and preferences with you.

Treatment with NanoKnife takes about two hours and is performed under general anesthesia. A bladder catheter is inserted, which is removed by your urologist or by us after approx. 10 to 14 days. After the treatment, you will spend one night under medical supervision in our private clinic. You will normally be able to return home 24 hours after the treatment. For most patients, the NanoKnife treatment does not cause any pain, but they do find the bladder catheter slightly uncomfortable

NanoKnife is manufactured by a company called AngioDynamics and is approved in the USA by the FDA (Food and Drug Administration) and in Europe (CE marking) as well as in Germany (according to the Medical Devices Act). These approvals relate to tissue ablation in the entire body, including the prostate. You would therefore in no way be a guinea pig.

In view of 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 an improvement in the 5-year survival rate of only one percent with prostate removal), we must assume that a new procedure with fewer side effects is better - even if the long-term results are still pending.
At the Prostate Center, in Germany, more than 1700 patients with prostate cancer have been treated and the results have been published at all major radiology congresses.

Contact us if you would like us to provide you with scientific publications.

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

Since IRE does not damage structures such as large blood vessels, even lymph nodes affected by metastases that are located in the immediate vicinity can be treated with the NanoKnife procedure.
IRE can also be combined synergistically with immunotherapy.

Whether these measures are curative or merely palliative, i.e. whether they contribute to a cure or only alleviate the symptoms, depends on the circumstances. A combination therapy is often the most sensible approach for advanced-stage tumors.

After a previous treatment, whether surgical or e.g. using HIFU (high-intensity focused ultrasound), scars often occur that make further surgery more difficult. In addition, further operations or HIFU treatments are often associated with an increased risk of impotence or incontinence. Radiotherapy makes the treated tissue so fragile that surgery is practically impossible. Furthermore, it is not possible to repeat conventional radiotherapy immediately after radiotherapy has already been carried out. This would cause too much damage to the surrounding structures, such as the bowel and bladder.
In these cases, IRE (Irreversible Electroporation) can be used to treat recurrences in a minimally invasive way, with minimal risks and without additional stress for the patient. IRE thus represents a unique method for the treatment of tumor tissue at otherwise inoperable sites. IRE treatment can be repeated as often as necessary. The only prerequisite for such treatment is precise diagnosis 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 necessary for the muscles to relax and for the IRE procedure to be performed safely. The health-limiting 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 responsible anesthesiologist. It is therefore necessary for a health assessment to be carried out prior to treatment, which includes diagnostic tests such as an exercise ECG, blood tests, X-rays, ultrasound, etc. A full cardiology examination may also be required to provide a full assessment of your general health and ability to undergo anesthesia.

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