Dr James Thompson is an experienced robotic, laparoscopic, endoscopic and open urological surgeon. He has sub-specialty training in (and passion for) the treatment of prostate, bladder and kidney cancer using the latest robotic surgery techniques and for high-impact cancer research that has the ability to immediately improve quality of life and cancer cure rates for the community.
Nanoknife Focal Therapy for Prostate Cancer
Nanoknife focal ablation procedure via 4 needles placed in the prostate surrounding the tumour
How does nanoknife focal ablation work?
Nanoknife is a minimally invasive day procedure, performed in the operating theatre, under general anaesthesia.
Once asleep, A/Prof Thompson places 4-6 fine needles via the perineal skin (behind the scrotum) into the prostate, surrounding the known site of tumour. The needles are then connected to a special machine, allowing delivery of a precise therapeutic electrical current between the needles which reliably destroys the cancer cells, without disrupting the normal surrounding urethra, muscles, nerves or vessels, thus allowing cure of the cancer with less side effects on sexual and urinary function.
There is no need for any surgical incisions and the patient is discharged home the same day, usually with minimal side effects such as mild perineal discomfort, urinary frequency and tingling, restricted urinary flow and blood in the semen, all of which are temporary and settle within days to weeks.
The Nanoknife 3.0 Machine from Angiodynamics
Is every prostate cancer suitable for Nanoknife Focal Ablation?
Only certain men are suitable for Nanoknife Prostate focal therapy. Men should meet all of the following criteria to be eligible and ensure the best outcome:
Intermediate grade cancer (Gleason 7, ISUP Grade Group 2-3)
Cancer contained to only one area of the prostate (e.g. one quadrant) on all of MRI, PSMA-PET scan and biopsy
Life expectancy of >10 years and fit for general anaesthesia
A desire to reduce sexual and urinary side-effects of treatment and willingness to accept that - as a compromise - focal treatment carries an increased risk of cancer recurrence within the prostate that may require further treatment
Acceptance that the long-term cancer outcomes and side-effects of Nanonknife focal therapy 10+ years later remain unknown, and as such that the treatment remains somewhat experimental compared to traditional ‘whole-prostate’ therapy such as prostate removal or radiotherapy
Willingness to comply with long-term followup including regular PSA blood tests, MRI +/- PSMA PET scans and prostate biopsies
Willingness to accept a theoretical small risk of missing the window of cure if delaying radical treatment and to accept possible effects on urinary and sexual function with salvage treatments.