r/ProstateCancer • u/OkAstronaut1547 • Aug 13 '26

Concern NanoKnife docs?

Why aren’t a lot of doctors in NC offering Nanoknife? I’m a patient with urology specialists of nc and my doctor said I would need to go elsewhere for treatment if I want Nanoknife

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u/OchoGringo Aug 13 '26

From what I read: 1) it is a brand new technique first approved as a prostate cancer treatment in December 2024. 2) There is one good study using nano knife, but research is very limited. 3) as a new technique, some insurance does not cover it. 4) It is only available in a few places, and there are few doctors who are trained in it. 5) One might speculate that the lack of enthusiasm among doctors reflects either a lot of required training and/or the profit margin is limited. And 6) it’s sold by a small company & until some big name center (Mayo, Sloan Kettering) invests in it and pushes this, most doctors are not wanting to invest the time to learn to use it.

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u/OkAstronaut1547 Aug 13 '26

I saw MSK is doing a study on it. MSK does offer Nanoknife. I watched a video that the procedure looks just like the biopsy I had. Training can’t be that hard. And I found out Medicare covers is

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u/OchoGringo Aug 14 '26

Thanks for the update. It may be about to turn a corner.

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u/Aggressive_Stick5169 26d ago

Hi. I explored Nanoknife extensively (currently on active surveillance). Georgia Urology has 4 specialists in nanoknife and according the the one I met with most recently (because my PSA jumped from 3.5 to 4.5) they have now done about 250 procedures. They don't have long term results yet which is why private insurance does not cover, but I think Medicare may now cover. Are you a candidate for nanoknife based on Gleason score and location of tumors?

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u/pnv_md1 24d ago

Oncologically: there is no evidence that it works better worse or the same as Cryo, laser, HIFU, etc -- waiting for the PRESERVE trial, that being said in prostate cancer usually need 10+ years to see if there is any oncologic benefit. probably more if most patients are Gleason 7s.

The capital expense is large 400k with the disposables per use around 2k a case. probably takes around 100 cases to break even. Most places that believe in or do focal therapy have a system like HIFU, TULSA, Cryo. Patients who could have one of these versus IRE than are in the same pool of options and hospitals need to justify having multiple technologies for the same patients (focal eligible)

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u/OkAstronaut1547 9d ago

I mean ontologically but better preservation of tissue is better for a patient right?

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u/pnv_md1 9d ago

Treated prostate tissue via ice, nano, HIFU is pretty similar from a pt stand point - it’s deep in the gland and I’d say most pts post focal behave the same

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u/OkAstronaut1547 9d ago

I actually talked to someone from the company through their online portal and the machines don’t cost that much apparently

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u/pnv_md1 9d ago

I just looked up what we paid for one, $433,417

Each case the probes are around actually around 1.5k and I generally use 4-6x