NanoKnife is the brand name for irreversible electroporation (IRE). Thin needle electrodes are placed around a tumour and deliver very short, high-voltage electrical pulses that punch permanent holes in cell membranes, so the cells die. Because it does not rely on heat, the supporting framework of nearby blood vessels, bile ducts, nerves and the urethra tends to survive.
That property makes it attractive for tumours close to delicate structures: as focal therapy for localised prostate cancer, and for some pancreatic, liver and kidney tumours that cannot be removed or safely heated. The evidence is still maturing. Medium-term results for focal prostate treatment are encouraging, while in pancreatic cancer there is no firm proof that it lengthens life, and guidelines treat it as an option within studies or specialised centres.
What NanoKnife (Irreversible Electroporation, IRE) involves
Selection depends on precise imaging. For prostate cancer this means multiparametric MRI and targeted plus systematic biopsies to show that significant disease is confined to one area. Under general anaesthetic with full muscle relaxation (the pulses would otherwise make muscles contract), 2 to 6 electrodes are inserted, through the perineum under ultrasound guidance for the prostate, or through the skin under CT, or at open surgery, for abdominal organs. Spacing must be accurate to within millimetres. Pulses are synchronised with the heartbeat to avoid rhythm disturbance, and 70 to 90 are delivered between each pair of needles. The needles are removed and a urinary catheter is left after prostate treatment.
Who is a good candidate for NanoKnife (Irreversible Electroporation, IRE)?
It suits carefully chosen patients after discussion in a multidisciplinary cancer meeting.
- Localised, intermediate-risk prostate cancer visible on MRI and confined to one region, in men wishing to reduce the urinary and sexual side effects of whole-gland treatment
- Locally advanced pancreatic cancer that remains inoperable but stable after chemotherapy
- Small liver tumours or metastases next to major vessels or bile ducts where heat ablation is unsafe
- Patients who accept close surveillance and the possibility of further treatment
It is usually not the right choice if:
- Prostate cancer that is high risk, multifocal or spread beyond the gland
- Metastatic pancreatic cancer
- Pacemakers, implanted defibrillators or serious heart rhythm problems
- Metal stents or implants lying within the treatment zone
- Anyone seeking it as a replacement for standard curative surgery or radiotherapy that they are fit for, without understanding the difference in evidence
Technique options
- Focal prostate IRE: Treats the index lesion with a margin through the perineum. Day case or one night.
- Percutaneous CT-guided IRE: For liver, kidney or pancreatic targets through the skin.
- Open or laparoscopic IRE: Done during an operation, sometimes to treat margins of a pancreatic resection.
- Alternatives: HIFU, cryotherapy, radiofrequency or microwave ablation, SBRT: Each has different strengths; heat-based methods are better proven for small liver and kidney tumours away from critical structures.
What happens during your treatment
The procedure takes 1 to 2 hours under general anaesthetic. After prostate treatment most men go home the same or next day with a catheter. After pancreatic or liver IRE, expect 1 to 3 nights in hospital with monitoring for pain, pancreatitis and bleeding.
Preparing for your trip
Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.
- Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
- Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
- Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
- Book a changeable return flight; your surgeon confirms when you are fit to fly
Recovery and results
For the prostate, the catheter stays 3 to 7 days; blood in the urine, urgency and perineal bruising settle over 2 to 4 weeks. Most men return to normal activity within a week. PSA is checked every 3 months, MRI at 6 to 12 months, and a repeat biopsy at about 12 months confirms whether the treated area is clear. After abdominal IRE, recovery takes 1 to 2 weeks, with CT or MRI follow-up at 1 and 3 months. All surveillance can be done at home if results are shared.
- Back to everyday activity: 1 to 2 weeks
- When results show: Judged by PSA, MRI and biopsy over 6 to 12 months
- How long they last: Uncertain long term; ongoing surveillance required
Safety, risks and revision policy
Side effects are generally milder than with whole-gland or heat-based treatment, though serious events have been reported, particularly in the pancreas.
- Residual or recurrent cancer in or outside the treated zone, needing repeat focal therapy, surgery or radiotherapy in roughly 1 in 5 to 1 in 4 men over several years
- Temporary urinary retention, infection or blood in urine or semen
- Erectile dysfunction in a minority, and urinary leakage rarely
- Heart rhythm disturbance during pulse delivery
- After pancreatic IRE: pancreatitis, bleeding, portal vein thrombosis, bile leak or duodenal injury
- Needle-track bleeding or, very rarely, tumour seeding
Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.
Cost of NanoKnife (Irreversible Electroporation, IRE) in Türkiye
Clinic-Y does not publish a single price for NanoKnife (Irreversible Electroporation, IRE), because the honest figure depends on your case. What moves it:
- Single-use electrodes, with the number needed set by tumour size
- Imaging guidance and general anaesthesia
- MRI and biopsy work-up beforehand
- Hospital nights, more for abdominal targets
- Follow-up imaging and biopsies
Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.
Frequently Asked Questions
Is NanoKnife a proven cure for prostate cancer?
It controls the treated area in most selected men at 3 to 5 years, with good preservation of continence and erections. Data beyond 10 years, as exist for surgery and radiotherapy, are not yet available.
Does it help pancreatic cancer?
It can achieve local control in some patients, but trials have not clearly shown longer survival, and complications can be serious. It should be considered only after chemotherapy and a specialist team discussion.
Can treatment be repeated?
Yes. Repeat IRE, or later surgery or radiotherapy, remains possible after focal prostate treatment.
What should I send for assessment?
MRI images (not only the report), biopsy pathology with the core map, PSA history, and for abdominal tumours the latest CT or PET-CT and treatment summary.