What is Focal therapy and what are the treatment methods
Focal therapy is a local treatment for tumor removal. This treatment came to replace the prostatectomy (prostate removal). The treatment reduces the side effects compared to the prostate removal procedure and is thus easier on the patient.
There are several methods for focal prostate cancer treatment… The differences are characterized by the type of energy used:
Methods for Focal prostate cancer treatment:
Nano-Knife treatment
Our bodies are wrapped in a thin film, called the membrane. The role of the membrane is to separate the cell from the environment (akin to walls of a house). With the help of the membrane, the cell is able to exist in an internal environment and to decide which materials would go in and out.
Nano-Knife technology delivers an electrical current between thin electrodes that surround the tumor and damage its’ cells’ membrane integrity. The idea came from trials of chemotherapy treatments that were able to show that, by transferring a short current for a limited amount of time, the affected membrane would puncture and the flow of chemotherapy would rise without the ability of a cancer cell to resist. Later, it was shown that if the current was transferred for a longer period of time, the cancer cell would be unable to repair the punctured holes and would, in effect, die due to a lack of ability to maintain its’ internal environment (just like a house whose walls were torn down). The current does not pass between the electrodes surrounding the tumor and thus poses no danger to the other areas.
+ What are the pros and cons of the treatment
Each of the methods we have mentioned has its advantages and disadvantages.
The advantage of the Nano-Knife method is that it does not use heat/cold, the danger of damaging adjacent organs and tissue, like the rectum which is found near the prostate, decreases significantly, and the electric current damaging the membranes is relatively benign on the urethra passing through the center of the prostate.
The disadvantage of the Nano-Knife method is that although the results are successful and very promising, the method is considered to be innovative and experimental.
+ How is the Nano-Knife treatment carried out
As part of a surgical day hospitalization in Medica – Medical Centers, under general anesthesia and with marking the tumor area on an MRI scan performed by the patient in advance, several thin needles (electrodes) are inserted through the skin into the prostate while guided by ultrasound, in order to surround the tumor area. The number of electrodes ranges from 4-6. The current is then transferred between pairs of electrodes and thus the current covers the entire tumor area. At the end of the treatment, the patient is given a local anesthetic injection that relieves the pain in the prostate area and facilitates recovery.
The operation takes a little less than an hour and after several hours of recovery the patient is released to their home.
+ What happens after the treatment
Several days after treatment (between 2-5 days) the catheter is removed and the patient can return to full activity.
One week after treatment, the patient will undergo an MRI scan to ascertain the extent of the treatment area and that the entire affected area is contained within it.
A PSA test will be performed every 3 months for the first two years after treatment for a follow-up.
After six months, the patient will undergo another MRI scan.
From then on, the patient will visit the clinic every six months and will perform an MRI scan for follow-up once a year.
Possible side effects: feeling of discomfort/slight pain in the needle insertion area (area of skin between the anus and the scrotum) or swelling of the area, urine blood in the first days following the treatment and semen blood in the first few weeks. In addition, a burning sensation while urinating is possible. Occasionally, localized edema of the prostate appears due to the treatment, if the treatment area was located near the center of the prostate (the urethra), we will leave the catheter for five days instead of two in order to reduce the risk of urinary retention after catheter removal.
