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NanoKnife, the pioneering new cancer treatment at The Princess Grace Hospital

25 April 2013

A PIONEERING new cancer treatment kills tumours by passing a high-voltage electric current through them. NanoKnife is used to treat patients previously considered unsuitable for surgery because their tumour lies to too close to vital organs. As the procedure does not involve heating the tumour, doctors are able to use it on awkwardly placed cancers situated near major organs without causing any damage. So far, more than 75 people have undergone the new technique.

One of the first patients in Britain to benefit from NanoKnife was a woman in her forties with multiple liver tumours.  She was diagnosed with adrenal cortical cancer — a rare form of cancer affecting the adrenal glands, which sit next to the kidneys - in 2008.
Despite undergoing surgery and courses of radiotherapy and chemotherapy to keep the disease under control, the cancer spread to her liver.

Further surgery to remove the tumours on her liver was unsuccessful after sugeons found six more tumours, one of which was situated right next to her heart.
They said there was nothing more they could do for her because the cancer was spreading, and felt that cutting it out wouldn’t stop it.

Determined not to give up, she contacted Professor Edward Leen, a cancer specialist at the Princess Grace Hospital and Imperial College London NHS Trust Hospitals, who said she was a suitable candidate for Nanoknife.

The procedure, carried out under a general anaesthetic, took about 45 minutes and caused no pain.  After the surgery, there were just two small puncture marks where two fine needles - about one to two millimetres in diameter - had been inserted in her abdomen.

During the procedure, these are attached to the NanoKnife machine and used to pass the high-voltage electric current into the tumour and a one centimetre area around it.
The electric current perforates the membranes of the tumour cells, so the contents leak out and die.

Using an electric current rather than heat reduces the risk of impact on the surrounding cells.  Furthermore, by perforating the cells, it also potentially allows chemotherapy — generally administered after the operation — to work more effectively on cancer cells.
The patient was allowed home the next day.

Scans following the procedure showed the tumour shrank to half its size within six weeks and continued to shrink.

Although NanoKnife is a new technique, it is already approved for use in the U.S. and UK.  Furthermore, a study by Australian doctors showed the treatment completely destroys 83 per cent of primary liver tumours.

Of the 76 patients who have now undergone the technique in the UK over the last 22 months, only nine have died because the cancer has progressed.  Among 10 patients who have had NanoKnife on the pancreas combined with chemotherapy, nine are alive and well.

According to Professor Leen, thousands of patients could benefit from NanoKnife. “It takes less time to do, has fewer side effects and patients can have it multiple times if the cancer returns,” he said.  “If extended to other hospitals around the country, NanoKnife could help thousands of cancer patients”.

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