Nanoknife for pancreatic cancer

Posted by hopefulandpositive @hopefulandpositive, Apr 10, 2024

Hi,
My husband was diagnosed with pancreatic adenocarcinoma 7 months ago. It is inoperable because it is wrapped tightly around superior mesenteric artery. He has done 12 cycles of chemo (oxaliplatin, irinotecan and floururacil) but tumor has not shrunk but it hasn't spread/grew either. We were told that continuing chemo after this many sessions is not good for his bone marrow and another chemo regimen is unlikely to going to help if 5FU didn't. We are given an option to go through Nanoknife procedure to "freeze" the tumor. The surgeon said he has done 200 procedures in the last 7 years and there are still some patients who haven't had any additional growth. Does anyone have experience with nanoknife? How was it? Any concerns? Just trying to get more information on this procedure as we were told to make a decision as soon as possible as the tumor hasn't spread to other organs yet and he will no longer be a candidate if it presents spread.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

hopefulandpositive | @hopefulandpositive | Aug 10 2:26pm

In reply to @keepingoptimistic "Who is the doctor?" + (show)

I recommend Dr. Carlos Chan at university of Iowa.

keepingoptimistic | @keepingoptimistic | Aug 10 7:04pm

In reply to @hopefulandpositive "I recommend Dr. Carlos Chan at university of Iowa." + (show)

Many Thanks.

keepingoptimistic | @keepingoptimistic | Aug 10 7:08pm

In reply to @colleenyoung "@hopefulandpositive, have you and your husband decided to go ahead with NanoKnife (irreversible electroporation [IRE]) treatment?" + (show)

Still in Folfirinox treatment but researching Nanoknife as it appears to be able to remove tumors that have wrapped around arteries.

hopefulandpositive | @hopefulandpositive | Aug 10 8:03pm

FYI, Nanoknife doesn’t remove the tumor but attempts to kill the cancerous cells by using high voltage electric pulses.

hopefulandpositive | @hopefulandpositive | Aug 10 8:12pm

In reply to @keepingoptimistic "Still in Folfirinox treatment but researching Nanoknife as it appears to be able to remove tumors..." + (show)

@keepingoptimistic Have you checked with your doctor to see what mutation you have? There are multiple kras inhibitor trials going on with some in late stage and our doctor says it is very promising and likely the broad one will be approved and available next year (my husband’s mutation is a rare one with no active trial). If not eligible for nanoknife, I recommend exploring if you can get the inhibitor and also ask about photon radiation therapy.

lvtexas | @lvtexas | Aug 30 4:55pm

In reply to @tiffboss "Hi! It has been about a year and a half since my surgery, and I can..." + (show)

@tiffboss How are you doing now? It's almost a year later, 8/30/2025. Were you not a whipple candidate? What did you do before Nanoknife to help make it more successful?

Thanks!

tiffboss | @tiffboss | Aug 31 7:08am

In reply to @lvtexas "@tiffboss How are you doing now? It's almost a year later, 8/30/2025. Were you not a..." + (show)

I’m doing really well (knock on wood)! It’s been 2 years and 3 months since my NanoKnife surgery. My last scan was at the 2 year mark in May, and I’m still NED with a CA 19-9 of 14. Scans are every 6 months now so I get my next one in November.
I was not able to get the Whipple surgery because the tumor was wrapped around my SMA. I had 8 rounds of chemo and 25 rounds of chemo/radiation before surgery to shrink the tumor. It went from about 3.5 cm to 1.8 cm.
Aside from a minor dairy sensitivity, I don’t have any lingering side effects. I’m incredibly lucky, and so very thankful!!

lvtexas | @lvtexas | Aug 31 12:29pm

@tiffboss How was your recovery? I had folfirinox 8 rounds then the whipple in March 2023. Then, I had recurrence in March 2025 (crushed) in the pancreatic bed and around the vein and arteries (not eligible for re-section/surgery). I was offered photon radiation as palliative. I have chosen to do Nano knife with a reconstruction at part of the whipple surgery (it came back there at the juncture). Are you doing any chemo now or you are in monitor mode? Any immunotherapy? Yes, keep doing well.

tiffboss | @tiffboss | Aug 31 8:57pm

In reply to @lvtexas "@tiffboss How was your recovery? I had folfirinox 8 rounds then the whipple in March 2023...." + (show)

My recovery wasn’t too bad. I was sore and tired for a good 3 weeks. Not terribly painful, but uncomfortable. It was at least 6 weeks before I got my energy back. Getting back to a normal diet was a gradual process.
If you’ve had the whipple, I would imagine that the NanoKnife would be a significantly easier recovery.
I have not had any type of treatment since my surgery. Strictly monitoring.
Very sorry for your recurrence. It’s always in the back of my mind that this sneaky damn disease can come back. I wish you the best of luck, and hope your surgery is successful!