Does anyone have first hand experience with Nanoknife procedure?

I had NanoKnife treatment by Dr. Lomas at Mayo Rochester in October of 2021. I couldn’t be happier with the results (as far as PSA and MRIs can indicate with focal treatments) and the overall care I received. Virtually no side effects. Now… perpetual active surveillance.

I am with you! 20yr Air Force veteran
Desert Storm. When my PSA climbed to 5.1 ... 11-7-2023 the VA immediately wanted to do a trans-rectal Biopsy and remove my prostrate I said let me do some research. I felt very uncomfortable even talking with the VA Doctor! I fought with the VA to see a Urologist out side the VA for two years meanwhile my PSA continued its climb!
Finally got approved to see a Urologist and did the trans-rectal random Biopsy, I asked the Doctor what are the chances of finding anything he said 50/50 I regret doing it He also wanted to remove my prostrate After another year of MRI's & Pet-ct scans you could clearly see my Pirads 5 targets which the random Biopsy missed!
Once I turned 65 it seems the sky opened up ..... I had Medicare A&B and Tricare for life which meant I could chose everything!
The Doctor, hospital and the exact treatment I wanted "NOT WHAT THE DOCTORS SCARE YOU INTO" This year Mar 12-2026 1 got the Trans-perineal Targeted fusion Biopsy and finally found Gleason 3+4=7 one main target and one smaller target. May 19-2026 I chose Nano Knife at Mayo Clinic AZ it seemed to be the best option for my particular situation at the time of treatment my PSA climbed to 20.1.
Just had a recent PSA test it came back 2.9 and still dropping I have a follow up
August 21-2026 with Mayo hoping for another big drop. Hope this info helps you 😊

@gleason3plus4
How are your MRI results. I will be having procedure done by Dr Lomas. What time should I plan on staying at Mayo

@therock
Sorry for the late reply and the different User ID. (I used the same email address for MayoConnect and my Mayo MyChart account and it caused confusion for password resets.)

My last MRI (May 2026) showed no evidence of new or recurrent disease. I was/am concerned that my PSA has risen from about 0.6 to 0.95 in the past year but my urologist feels strongly that it’s just due to normal BPH of the remaining prostate tissue.

You are in great hands with Dr. Lomas and the whole Mayo team!!!

If I recall correctly, I had the procedure early on Friday morning, was discharged by noon that day and spent the next three days in a hotel (on campus) with a my catheter binge watching Breaking Bad and Below Deck. I got the catheter out Monday morning followed by a post-procedure MRI and flew home to Virginia on Tuesday. (I think I got off easy in that a lot of guys seem to report having the catheter for a full week.)

After almost five years, I couldn’t be happier with the results of my NanoKnife treatment! Time will tell. So far, so good.

Good luck! Needless to say, I think you’ve picked the best focal therapy delivered by the best people at the best facility!

Thank @mrplow

Always great to hear your doing great! And also a great experience at Mayo also! And you can’t go wrong with Breaking Bad! Walt’s my Hero lololol……

I am 2.5 months out from my procedure and my PSA was 20.1 May 19-2026 I just had blood work done this week it was 2.2 and dropping. May I ask how long your PSA took to drop to 0.6 ?

Ray Thanks Brother ✈️😊🇺🇸

Hi @cole5055

That’s a great PSA drop! Here’s my history. I’m not sure how it will format here but you’ll be able to pick out the relevant dates and values. (But the answer is that it took about 2.5 years to hit the nadir of 0.59.)

PSA/Procedure History
17-Mar-2021 5.9
13-Apr-2021 Fusion Biopsy Gleason 3+4=7
04-Aug-2021 3.9
16-Sep-2021 4.4
17-Sep-2021 Repeat Biopsy required for NanoKnife Clinical Safety Trial: Gleason 3+4=7.
22-Oct-2021 NanoKnife IRE Procedure Right-Sided Index Lesion
25-Oct-2021 MRI Good ablation zone indicated.
17-Nov-2021 0.84
27-Jan-2022 1.1
21-Apr-2022 0.92
21-Apr-2022 MRI No imaging evidence of recurrence.
22-Apr-2022 Ablation Zone Biopsy No evidence of disease.
25-Jul-2022 0.82
27-Oct-2022 0.72
13-Apr-2023 0.7
08-Nov-2023 0.59
08-Nov-2023 MRI Post ablation change. Stable, no new concerns.
08-May-2024 0.57
03-Dec-2024 0.603
07-Mar-2025 MRI: No imaging evidence of new or recurrent disease.
12-Sep-2025 0.86
03-Mar-2026 0.891
23-Mar-2026 0.978
11-May-2026 MRI: No imaging evidence of new or recurrent disease.

I moved to Spain in 2024 so I’ve lost the PSA lab/assay consistency that I had from Mayo Laboratories. I’ve also been on Dutasteride for decades so all my PSAs need to be doubled for comparison purposes. That means my current PSA is considered to be around 2 and 2.5 is the threshold in Spain for consideration of recurrent or new disease.

I know PSA is only one component, but you must be ecstatic over your drop! Hopefully your side effects have been equally low!

Hi @cole5055

That’s a great PSA drop! Here’s my history. I’m not sure how it will format here but you’ll be able to pick out the relevant dates and values. (But the answer is that it took about 2.5 years to hit the nadir of 0.59.)

PSA/Procedure History
17-Mar-2021 5.9
13-Apr-2021 Fusion Biopsy Gleason 3+4=7
04-Aug-2021 3.9
16-Sep-2021 4.4
17-Sep-2021 Repeat Biopsy required for NanoKnife Clinical Safety Trial: Gleason 3+4=7.
22-Oct-2021 NanoKnife IRE Procedure Right-Sided Index Lesion
25-Oct-2021 MRI Good ablation zone indicated.
17-Nov-2021 0.84
27-Jan-2022 1.1
21-Apr-2022 0.92
21-Apr-2022 MRI No imaging evidence of recurrence.
22-Apr-2022 Ablation Zone Biopsy No evidence of disease.
25-Jul-2022 0.82
27-Oct-2022 0.72
13-Apr-2023 0.7
08-Nov-2023 0.59
08-Nov-2023 MRI Post ablation change. Stable, no new concerns.
08-May-2024 0.57
03-Dec-2024 0.603
07-Mar-2025 MRI: No imaging evidence of new or recurrent disease.
12-Sep-2025 0.86
03-Mar-2026 0.891
23-Mar-2026 0.978
11-May-2026 MRI: No imaging evidence of new or recurrent disease.

I moved to Spain in 2024 so I’ve lost the PSA lab/assay consistency that I had from Mayo Laboratories. I’ve also been on Dutasteride for decades so all my PSAs need to be doubled for comparison purposes. That means my current PSA is considered to be around 2 and 2.5 is the threshold in Spain for consideration of recurrent or new disease.

I know PSA is only one component, but you must be ecstatic over your drop! Hopefully your side effects have been equally low!