What is IRE (NanoKnife)?

IRE is sometimes known as NanoKnife®. This is the brand name for the machine used to deliver the treatment.

IRE for pancreatic cancer involves inserting thin needles around the cancer. Electrical currents are passed between the needles. These currents damage and destroy the cancer cells.

The aim is to slow the growth of pancreatic cancer by destroying the cancer cells. This may help people live longer and may also help control symptoms such as pain.

Research on IRE for pancreatic cancer

It’s important to remember that there has not been much research into IRE for people with pancreatic cancer. There have only been a few small studies, which means that we don’t know enough about how well it works, who it is most suitable for, and the side effects and complications.

The National Institute for Health and Care Excellence (NICE) has said that at the moment IRE should only be used in research studies looking at how well it controls pancreatic cancer. Researchers are setting up a in the UK to look at IRE for pancreatic cancer. We will provide information about the trial when it’s available on our Trial Finder. Until there is a clinical trial available, NHS hospitals that provide IRE are collecting information about how well it works. Read more about clinical trials for pancreatic cancer.

Who can have irreversible electroporation (IRE)?

Locally advanced pancreatic cancer

IRE may be suitable for some people with locally advanced pancreatic cancer. This is cancer that has grown into large blood vessels around the pancreas, and can’t usually be removed by surgery. The aim of IRE is to slow the growth of the cancer, to help people live longer and to treat symptoms.

If your cancer is close to major blood vessels (borderline resectable pancreatic cancer) 

In some hospitals that provide IRE, it may be suitable for a small number of people with borderline resectable pancreatic cancer. This is cancer that has grown very close to large blood vessels near the pancreas. It may be possible to remove the cancer with surgery, but it depends which blood vessels are affected.

During surgery to remove the cancer, IRE may be used for margin accentuation. This means that the IRE is used to treat the cells around the around the edges of the tumour before it is removed. The aim is to try to make the surgery as successful as possible.

Some people with borderline resectable cancer may be offered surgery to remove the cancer, but during the operation the surgeon finds the cancer has grown too close to the large blood vessels to remove it. Although it’s not possible to remove the cancer, IRE may be used during the operation to treat it. The aim is to try to slow down the growth of the cancer. You may then be offered chemotherapy once you have recovered from the operation.

We don’t know much about IRE for borderline resectable pancreatic cancer and we need more research into this. If this is an option for you, your doctor will discuss it with you.

What else can affect whether I can have IRE? 

There are other things that can affect whether IRE is suitable for you. For example, you will need to be fit enough to have a general anaesthetic. It may also depend on what other treatments you have already had, or how big the tumour is. It can be difficult to treat the whole tumour if it is larger.

IRE may not be suitable if you have an irregular heartbeat (atrial fibrillation), a pacemaker or other types of heart problems such as congestive heart failure or coronary artery disease. This is because the electrical currents can affect your heartbeat. Speak to your doctor about this. They may need to do an assessment to check whether you are fit enough for IRE.

Speak to your doctor about whether IRE might be an option for you and what it involves before making any decisions about your treatment.

How can I have irreversible electroporation (IRE)?

At the moment, IRE is only available in a few NHS hospitals. If it is suitable for you, but isn’t available at your hospital, your doctor may be able to refer you to a hospital that does provide IRE. Speak to your doctor about this. IRE may also be available privately.

Speak to our specialist nurses

You can speak to our specialist nurses on our Support Line for more information about IRE, where it is available, and how to access it.

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

Updated: February 2021

Review Date: February 2023