NanoKnife (IRE)
Destroy the tumour, preserve the man.
A precise, minimally invasive prostate cancer treatment that eliminates cancer while preserving function. Now available downtown Toronto.
NanoKnife (IRE) is a next-generation focal therapy that destroys cancerous prostate tissue using electrical energy. This advanced approach minimizes side effects, preserving both continence and sexual function for most men while allowing for a fast recovery.
What is NanoKnife?
NanoKnife Irreversible Electroporation (IRE) is a cutting-edge focal therapy that eliminates prostate cancer cells using high-voltage electrical pulses. Unlike traditional treatments that use heat, cold, or radiation, NanoKnife (IRE) creates tiny openings in cancerous cells, causing them to die while preserving surrounding structures, including nerves and blood vessels. This unique technology significantly reduces the risk of urinary incontinence and erectile dysfunction.
Urology Innovations Canada is the first clinic in downtown Toronto to offer this groundbreaking technology, with dozens of procedures performed to date. We are also the only clinic in Canada to combine IRE with MRI Fusion Guidance, ensuring unparalleled accuracy and optimal patient outcomes.
Prostate Cancer Treatment Options
A prostate cancer diagnosis can feel overwhelming, and choosing the right treatment is a critical decision. While radical prostatectomy and radiation remain common options, they treat the whole prostate and often come with life-altering side effects, including loss of sexual function, urinary incontinence, and extended recovery periods.
NanoKnife (IRE) selectively destroys cancer cells using high-voltage electrical pulses, delivered through precisely-placed fine needles, while preserving the surrounding nerves and blood vessels. Unlike other treatments, NanoKnife (IRE) only treats the cancerous area while preserving the majority of normal, healthy prostate. This makes it an excellent option for men who want an effective cancer treatment while maintaining their quality of life.
At Urology Innovations Canada, we set the standard for precision treatment in localized prostate cancer using advanced focal therapy. Our clinic is among the first in Canada to offer NanoKnife (IRE), ensuring that patients receive the most advanced, evidence-based care available.
Why choose UIC for NanoKnife (IRE)?
- First downtown Toronto clinic to offer NanoKnife IRE.
- Exclusive use of MRI Fusion Guidance – Unlike other clinics that rely on cognitive imaging, we use real-time, live imaging with MRI guidance for unmatched accuracy in tumour targeting.
- Led by Dr. Jack Barkin, a recognized pioneer in men’s health who has introduced multiple groundbreaking prostate cancer treatments, men’s health therapies, and medications to Canada over the last 40 years.
- Proven expertise – We are the most experienced providers of focal therapies for localized prostate cancer in North America, having performed the very first minimally invasive treatment in 2006.
- Comprehensive, personalized care – Every patient undergoes an in-depth evaluation to determine the best treatment plan tailored to their needs.
- A highly specialized NanoKnife (IRE) treatment team – Every procedure is performed by a dedicated team of seven medical professionals, ensuring the highest level of expertise and patient safety:
- Two surgeons
- Full-time anesthesiologist
- Two nurses
- Angiodynamics tech support
- Ultrasound technologist
85%
preserved sexual function 12 months after treatment¹˒²˒³
98%
maintained urinary continence after NanoKnife IRE¹˒²˒³
6.8%
retreatment rate following initial IRE therapy¹˒²˒³
HIFU vs. NanoKnife (IRE)
Both High-Intensity Focused Ultrasound (HIFU) and NanoKnife Irreversible Electroporation (IRE) are advanced focal therapies that precisely target prostate cancer while preserving quality of life. While they share the same goal – treating cancer and minimizing damage to surrounding tissue – they work in different ways.
| FEATURE | HIFU | NANOKNIFE (IRE) |
|---|---|---|
| Mechanism |
Uses ultrasound waves to heat and destroy cancerous tissue |
Uses electrical pulses to destabilize cancer cell membranes, leading to malignant cell death |
| Thermal vs. Non-Thermal |
Thermal – relies on heat to ablate tissue |
Non-Thermal – avoids heat-related side effects |
| Preserves Nerves & Structures |
High precision, but heat can still affect nearby nerves in some cases |
Specifically designed to spare nerves, reducing risks to sexual function |
| Treatment Time |
1-2 hours |
1-2 hours |
| Catheter Requirement |
Usually required for a few days |
Usually required for a few days |
| Repeatability |
Can be repeated if necessary |
Can be repeated if necessary |
| Erectile dysfunction |
Comparable |
Comparable |
| Incontinence |
Comparable |
Comparable |
| Tumour location |
Maximum distance from the surface of the transrectal ultrasound probe = 4cm |
No limitations as to the location of the tumour |
| Tumour size |
Prostate volumes up to 40cc, can treat both sides of the prostate simultaneously |
Single treatment, limited to maximum 20mm x 30mm lesion; for bilateral treatment repositioning of the needles is required |
| Anesthetic |
Spinal or general |
General |
Which one is right for you?
The best treatment depends on your specific grade of prostate cancer, prostate size, cancer location, cancer size, and personal priorities. At Urology Innovations Canada, we offer both HIFU and NanoKnife (IRE), providing personalized treatment recommendations based on your unique case.
The Process
1. Consultation & Diagnosis
We begin with a thorough evaluation of your medical history, family history, biopsy results, MRI imaging, and PSA levels to determine if NanoKnife (IRE) is the appropriate treatment for you. Our specialists will walk you through all available options, ensuring you and your family have a complete understanding before making an informed decision.
2. Pre-Procedure Preparation
Minimal preparation is required. You may need to temporarily stop taking certain medications, such as blood thinners, before the procedure. Additional lab work and possibly electrocardiogram will be performed within 30 days of the planned procedure. Our Patient Coordinator will provide complete and detailed pre-op instructions.
3. The Procedure
NanoKnife (IRE) is performed under general anesthesia to ensure patient safety and comfort.
A small ultrasound probe is inserted transrectally to generate a real-time image of the prostate, which is then fused with preloaded MRI scans to precisely map the location and size of the targeted lesion.
The number and location of transperineal needles is determined based on the tumour location and size, with the help of MRI Fusion imaging. Each needle is then connected to the IRE generator to deliver controlled electrical pulses to the defined lesion with an intentionally added margin of safety.
4. Recovery & Follow-Up
All patients are discharged the same day with minimal discomfort.
A temporary catheter is typically required for several days to allow urination while the treated tissue is naturally expelled and the prostate is recovering.
PSA tests are used to track treatment success. We recommend:
- PSA testing at 3, 6, 9, and 12 months after treatment
- Testing every 6 months during the second year
Once your new baseline PSA is stable, your doctor will determine the appropriate long-term follow-up schedule.
¹ E. Guenther, N. Klein, S. Zapf, S. Weil, C. Schlosser, B. Rubinsky, M. K. Stehling, “Prostate cancer treatment with Irreversible Electroporation (IRE): Safety, efficacy and clinical experience in 471 treatments.”, 2019.
² Zhang, K., Stricker, P., Löhr, M. et al. A multi-center international study to evaluate the safety, functional and oncological outcomes of irreversible electroporation for the ablation of prostate cancer. Prostate Cancer Prostatic Dis 27, 525–530 (2024). https://doi.org/10.1038/s41391-023-00783-y
³ Blazevski A, Scheltema MJ, Yuen B, et al. Oncological and functional outcomes of focal irreversible electroporation as primary treatment for localized prostate cancer. PLoS One. 2019;14(4):e0215093. doi:10.1371/journal.pone.0215093
NanoKnife Irreversible Electroporation (IRE) is an advanced focal therapy that uses electrical pulses to destroy cancerous prostate tissue without heat or radiation. It is particularly effective at preserving surrounding structures like nerves and blood vessels.
NanoKnife (IRE) is ideal for men with localized prostate cancer looking for a non-thermal, highly precise, minimally invasive, outpatient treatment that spares surrounding nerves and blood vessels.
Thin needle electrodes are inserted transperineally into the prostate to surround the tumor, and controlled electrical pulses are delivered via the needles to create tiny pores in cancer cells, leading to cell death.
In most cases, one NanoKnife (IRE) treatment is effective, but it can be repeated if there is a recurrence or a new cancer in an untreated area.
NanoKnife (IRE) is designed to protect urinary function, with 98% of men retaining continence 12 months after treatment.
Over 85% of men maintain normal erectile function after NanoKnife (IRE).
NanoKnife (IRE) is a minimally-invasive (no cutting, no bleeding, no incisions), outpatient procedure. Recovery is largely pain-free and significantly faster than surgery. Most men resume normal activities within 5 to 14 days, as soon as the catheter is removed.
A temporary catheter is placed for several days post-procedure.
NanoKnife (IRE) is a privately paid treatment and is not covered by OHIP or any other provincial insurance health plans.