The NanoKnife: Treatment Option for Complicated Cancer

Some cancers are especially difficult to treat because of their proximity to critical body parts. Surgery and radiation, in particular, may damage healthy tissue close to the tumor.

A few oncologists are treating these types of cancer with the NanoKnife, a new technology, which is not really a knife at all. The NanoKnife uses electrical pulses to destroy cancer cells.

The general procedure of removing or destroying tissue is called ablation. The NanoKnife uses a specific type of ablation called Irreversible Electroporation (IRE). IRE treats small (less than one-and-a-half inches), hard-to-reach soft tissue tumors that are dangerously close to organs, nerves, ducts, or arteries. Other ablation techniques, which typically use heat or cold to kill cancer cells, can lead to adverse effects.

The NanoKnife uses short pulses of electricity to create tiny holes in cancer cell membranes. This helps damage and kill the tumor cells. A brief interval between pulses allows the tissue to cool and prevents heat damage. Oncologists use imaging techniques to determine exactly where to place the needles that deliver the electrical pulses.

One advantage of the NanoKnife is that the procedure is relative fast. It's also non-invasive, so patients recover quickly. Unlike other ablation techniques, the NanoKnife preserves nearby healthy tissue while seeming to do a thorough job removing tumors. Anecdotally at least, the NanoKnife seems to treat otherwise untreatable cancers.

To date, oncologists have used the NanoKnife to treat liver cancers and soft tissue tumors in the lung, prostate, head and neck, kidneys, and pancreas. At the annual meeting of the Society of Intervention Radiology in April 2012, oncologists reported promising results using the NanoKnife in a small number of pancreatic cancer cases, which are particularly complicated.

As with any procedure there are risks, of course. The primary known risks of the NanoKnife is causing injury to blood vessels from the needles used to deliver the electricity and triggering a fast heartbeat in some patients.

The FDA has approved the NanoKnife for surgical ablation of soft tissue, but not for the therapy or treatment of any specific disease or condition. To date, about 13 hospitals nationwide have the NanoKnife.

Some physicians are concerned about the rapid implementation of the NanoKnife. They don't have large-scale safety and effectiveness studies and no long-term, follow-up data to determine if patients remain cancer free years later. The NanoKnife procedure is expensive and, because of the lack of research data, insurance generally does not cover it.




Burton, Thomas M. "Some Doctors Question New Cancer Treatment." Wall Street Journal. Web.  5 October 2010.

University of Maryland. "NanoKnifeTM IRE: Minimally Invasive Treatment for Inoperable Tumors." Web. 17 May 2011.

Harrison, Laird. "Electrical Pulse Treatment Promising in Pancreatic Cancer." Medscape Medical News. Web. 4 April 2012.

Lee, Edward W., Thai, Susan, and Kee, Stephen T. "Irreversible Electroporation: A Novel Image-Guided Cancer Therapy." Gut and Liver 4(Suppl. 1) (2010): S99-S104. Web. 10 September 2010.

NanoKnife System.