Choosing a prostate cancer treatment isn’t about preference — it’s about precision. Every tumour behaves differently, and every prostate has its own anatomy.
At Urology Innovations Canada (UIC), decisions start with data: tumour size, location, distance from critical structures, number of positive biopsy cores, and how contained the disease appears on MRI.
Those factors determine whether thermal energy (HIFU) or electrical energy (NanoKnife IRE) will destroy the cancer most effectively while preserving urinary and sexual function. Both approaches target cancerous tissue while sparing healthy areas, but they do so in completely different ways.
How HIFU Works
HIFU uses focused sound waves, delivered using a transrectal probe, to heat and destroy targeted cells within the prostate. It’s completely non-invasive — no incisions, no radiation — and ideal when the cancer is confined to one well-defined area. In some cases, when the disease is more diffuse, HIFU can also be used for whole-gland (total) ablation, offering a non-surgical alternative to radiation or prostate removal.
At UIC, we introduced HIFU to North America in 2006, setting a new standard for outpatient, non-invasive, tissue-sparing prostate cancer care.
Best suited for:
- Localized tumours visible on MRI
- Small-to-moderate prostate size
- Patients wanting quick recovery and minimal downtime
How NanoKnife (IRE) Works
NanoKnife works through electricity, not heat. It delivers ultra-short electrical pulses that create microscopic openings in the cancer cell membranes, causing them to die naturally while leaving surrounding structures — like nerves and the urinary passage — intact.
This unique mechanism makes NanoKnife ideal for tumours near critical areas, for men with larger or irregularly shaped prostates, or where the tumour is located far from the rectum. It’s the latest evolution in focal therapy — and UIC was among the first in Canada to adopt it for the treatment of localized prostate cancer.
Best suited for:
Prostate Cancer Treatment Options
- Tumours close to sensitive structures requiring maximum precision
- Tumours located more than 3.5cm away from the rectum
- Larger or irregularly shaped prostates
- Patients seeking maximum tissue preservation
How We Decide
Our decisions are driven by data, not assumptions. Every patient at UIC considering focal therapy for prostate cancer undergoes detailed MRI imaging and targeted biopsy mapping. These results tell us exactly where the cancer sits and how it behaves, allowing our specialists to select the right tool — thermal (HIFU) or electrical (NanoKnife) — for the most effective and least invasive outcome.
And in prostate cancer, numbers do matter — from your Gleason score to PSA levels and prostate volume. They guide how we plan treatment, predict outcomes, and determine whether HIFU or NanoKnife will achieve the best result.
Both procedures are performed as outpatient treatments under anaesthesia. You arrive in the morning, go home — or back to your hotel, if you’re travelling — the same day, and typically resume normal activities within days.
After either HIFU or IRE, you’ll go home with a catheter in place for a set number of days while the prostate heals. This helps prevent urinary retention caused by temporary swelling in the treated area – a normal and expected part of recovery.
The Bottom Line
HIFU and NanoKnife aren’t competing technologies — they’re complementary instruments in a precise, modern approach to prostate cancer treatment. The question isn’t which one is “better.” It’s which one is right for you — and at UIC, that decision is made with evidence, imaging, and surgical precision on your side.
UIC is the only cancer centre in Canada offering both technologies, and one of only a few in North America with HIFU, IRE, and MRI fusion guidance available in one location.
Coming soon: How total ablation with HIFU compares to surgery and radiation — and when it may be the better choice.