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I want to know the symptoms I have pancreatic cancer Someone I know has pancreatic cancer

What is irreversible electroporation (IRE) for pancreatic cancer?

Irreversible electroporation (IRE) is a treatment that uses electrical currents to damage and destroy cancer cells. It is also called NanoKnife®.

What's in the 'IRE' section?

Key facts

  • NanoKnife® is the brand name for the machine used to deliver irreversible electroporation (IRE) treatment.
  • IRE uses needles, which are placed around the cancer. Electrical currents are passed between the needles. These currents damage and destroy the cancer cells.
  • IRE may be an option for a few people with borderline resectable pancreatic cancer where surgery to remove the cancer may be possible. IRE may also be suitable for some people with locally advanced cancer.
  • IRE can cause side effects such as pain, feeling and being sick, heartburn, and inflammation of the pancreas (pancreatitis). More rarely, it can cause a blood clot in a vein or other complications.
  • There hasn’t been much research into IRE. If you are thinking about having it, it’s really important you speak to your doctor before making any decisions.

IRE is currently used “off label” for pancreatic cancer. Hospitals can still use it, but your doctor will need to explain what this means to you.

What research is there on IRE for pancreatic cancer?

  • There has not been much research into IRE for pancreatic cancer. This means that we don’t know enough about how well it works and who it is most suitable for.
  • The National Institute for Health and Care Excellence (NICE) has said that IRE for pancreatic cancer should only be used in research. This means that NHS hospitals which provide IRE are collecting information about how well it works.
  • As there isn’t much research into IRE, make sure you speak to your doctor before making any decisions about having it. Ask them any questions you have, including whether IRE is suitable for you, how effective it is, and the possible side effects. You can find more questions below.
  • Don’t stop any treatment while you are thinking about having IRE.

How well does IRE work for pancreatic cancer?

We need more research to show how well IRE works for pancreatic cancer.

IRE aims to slow the growth of pancreatic cancer. This may help some people with borderline resectable or locally advanced cancer to live longer. It may also help treat symptoms such as pain.

Where can I have irreversible electroporation (IRE)?

IRE is only available at a few NHS hospitals. If it may be suitable for you, but isn’t available at your hospital, speak to your hospital doctor. They may be able to refer you to another hospital which does provide it.

Speak to our specialist nurses

You can speak to our specialist nurses on our Support Line for more information about IRE.

Speak to our nurses
Specialist nurse

Questions to ask your doctor or nurse

  • Is IRE an option for me?
  • If it is an option, how can I access it?
  • How does IRE treat pancreatic cancer?
  • What are the risks and benefits of IRE?
  • Will IRE help me to live longer?
  • Will IRE make surgery more likely?
  • Will IRE help any of my symptoms?
  • What treatment will I need before having IRE?
  • What will happen during the IRE treatment?
  • How long does the treatment take?
  • Will I need to stay in hospital after the treatment?
  • What side effects am I likely to have, and how can these be managed?
  • How long will it take to recover from IRE?
  • Will I need further treatment after IRE?

Read our fact sheet about irreversible electroporation (IRE)

To read more about irreversible electroporation (IRE), download our fact sheet, Irreversible electroporation (IRE) for pancreatic cancer.

Download our fact sheet

References and acknowledgements

References

If you would like the references to the sources used to write this information, email us at publications@pancreaticcancer.org.uk

Acknowledgements

We would like to thank the following people who reviewed this information:

  • Brian Davidson, Consultant HPB and Liver Transplant Surgeon, Royal Free London NHS Foundation Trust and Wellington Hospitals, Professor of Surgery at UCL
  • Nicola de’ Liguori Carino, Consultant Hepatobiliary and Pancreatic Surgeon, HPB Lead, Manchester University Hospitals Foundation Trust
  • Peter Littler, Consultant Interventional Radiologist, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Trust
  • Praveen Peddu, Consultant Radiologist, King’s College Hospital
  • Pancreatic Cancer UK Lay Information Reviewers
  • Pancreatic Cancer UK Specialist Nurses

References

We have listed some of the references to the sources used to write this information. If you would like the full list of references, email us at publications@pancreaticcancer.org.uk

  • Lafranceschina S, Brunetti O, Delvecchio A, Conticchio M, Ammendola M, Currò G, et al. Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer. Cancers. 2019;11:1718. doi:10.3390/cancers11111718.
  • Moris D, Machairas N, Tsilimigras D, Prodromidou A, Ejaz A, Weiss M, et al. Systematic Review of Surgical and Percutaneous Irreversible Electroporation in the Treatment of Locally Advanced Pancreatic Cancer. Ann Surg Oncol. 2019;26:1657-1668.
  • National Institute for Health and Care Excellence. Irreversible electroporation for treating pancreatic cancer. NICE Interventional procedures guidance [IPG579] May 2017.
  • Scheffer H, Vroomen L, de Jong M, Melenhorst M, Zonderhuis B, Daams F, et al. Ablation of Locally Advanced Pancreatic Cancer with Percutaneous Irreversible Electroporation: Results of the Phase I/II PANFIRE Study. Radiology. 2017;282(2).
  • Shuiqing H, Sheng L. Is irreversible electroporation (IRE) an effective and safe ablation method for locally advanced pancreatic cancer: A meta-analysis. Health Sciences Review. 2022;3:100029.
  • Stephens K, Phillips PP, Egger ME, Scoggins CR, McMasters KM, Martin RCG. Multi-institutional review of adverse events associated with irreversible electroporation in the treatment of locally advanced pancreatic cancer. Surgery. 2024;175(3):704.
  • Sugumar K, Hurtado A, Naik I, Hue JJ, Rothermel LD, Ammori JB, Mardacre JM, Winter JM, Ocuin LM. Multimodal therapy with or without irreversible electroporation for unresectable locally advanced pancreatic adenocarcinoma: a systematic review and meta-analysis. HPB. 2022;24:586-595. https://doi.org/10.1016/j.hpb.2021.12.014.

More resources

Find out about other treatments for pancreatic cancer

Read more

Read about other treatments for locally advanced cancer

Read more

What treatments are there for advanced cancer?

Read more

Updated: September 2025

To be reviewed: September 2027

 

 

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