What does NanoKnife treatment involve?

This page explains what IRE (NanoknKnife®) for pancreatic cancer involves.

This is general information about what IRE involves. Treatment may vary in different hospitals and may depend on your own situation. Speak to your doctor about the treatment and the risk of any side effects before you agree to have IRE.

Before treatment

You will normally have three to six months of chemotherapy before having IRE. This may be on its own or with radiotherapy (chemoradiotherapy). If you have already had chemotherapy or chemoradiotherapy you may not need any more treatment before having IRE.

You will have a CT scan to check the size and position of your cancer before having the IRE.

What happens during treatment?

You will have a general anaesthetic (so that you are asleep and can’t feel anything), and a drug to relax your muscles.

There are two ways the treatment can be done.

  • The doctors may make a large cut in your tummy so they can see the pancreas and the cancer. They will place two to six needles (depending on the size and position of the tumour) around the tumour. They will use an ultrasound scan to help make sure the needles are in the right place.
  • Or the doctors may make several small cuts in the skin of your tummy through to the pancreas. They then insert instruments through the cuts to place the needles around the tumour, using CT scans to guide them.

Your doctor will talk to you about how they will carry out the IRE.

Once the needles are in place, short pulses of electricity are passed between them. The needles may then be moved and the process repeated until the whole tumour and some of the surrounding area has been treated.

The electrical pulses can affect the heartbeat. To prevent this happening, your heart will be monitored during the treatment. Doctors use ECG (electrocardiography) monitoring so that the electrical pulses are delivered between heartbeats, when the heart is least affected by the electrical currents.

Will I have to stay in hospital?

You may have to stay in hospital for a couple of days. This is to make sure that you have recovered from the general anaesthetic and aren’t in any pain or discomfort.

If you had IRE as part of an operation to remove the cancer, you may need to stay in hospital for about 10 days or longer, depending on your recovery and any complications.

Check-ups after treatment

You will have a check-up soon after your treatment to see how you are. You will then have a CT or PET scan around one to three months later, to check how well the treatment has worked. You may also have a blood test to check for tumour markers. These are substances in the blood produced by the cancer and can also be used to help check how well the treatment has worked.

If there are signs that the cancer may have started growing again, it may be possible to have more IRE. Speak to your doctor about this.

If you are still having chemotherapy, speak to your chemotherapy team about what check-ups you will have.

Questions about IRE?

If you have any questions about what IRE involves, speak to your doctor or nurse.

You can also speak to our specialist nurses on our Support Line.

Speak to our nurses
PCUK Specialist Nurse, Dianne Dobson, taking a Support Line call on the phone

Updated: February 2021

Review Date: February 2023