Prostate Awareness 10: Date Set For The Operation

Mark Emberton did a Template Guided Biopsy on me on September 14. This is a more accurate form of biopsy than many other methods. Here is information about such a biopsy, though mine was done via the perineum.

The work was done at the Princess Grace Hospital. Checking in at 7.30 am for a 10.15 biopsy, I had a succession of visitors – people who were going to help with the biopsy. They explained what was going to happen and what to expect afterwards.

One person asked if I had any allergies. I said my only allergy was to negative people. They said: “Well, you are okay here. We only have positive people at the Princess Grace.”

Had a general anaesthetic at 10.15 and woke up at 11.05. All seemed fine and was wheeled back to my room. Recovered with a cheese and tomato sandwich, of course, and some apple juice.

Patients are advised to stay for at least two hours after the general anaesthetic. So I chose to be good and waited until 2.00 pm.

Caught a cab to Paddington and found myself running along the platform to catch the train. Few side effects and had a fine weekend.

The Results

Got the biopsy results 10 days later. One part of the prostate has a Gleason Score of 4+3, so needs treatment. Some other parts need treating. These are not as aggressive, but can be treated at the same time.

The main targeted part is in the furthest place to reach – the anterior. This is the part where many cancers are missed when using more conventional forms of biopsy. So good with the Template Guided Biopsy.

Everybody very reassuring. Because the illness has been found at Stage One, then all perfectly treatable.

The Chosen Treatment

Will have the operation on November 2. Because the main targeted area is in the anterior, this will be hard to reach with HIFU. So the suggestion is to treat it with Electroporation.

Here is the overview of this treatment. This is taken from the LUA web site.

Nanoknife or irreversible electroporation was developed in 2007 by a team of biomedical engineers at Virginia Technikon and the University of California in Berkeley.

It was FDA approved in 2008 and has been used around the world to treat liver, lung, kidney and more recently prostate cancer.

It is especially useful in tumours which are deemed ‘inoperable’ and in prostate cancer for tumours which cannot be reached by other minimally invasive techniques (such as HIFU) or in certain salvage cases (where previous treatment has taken place).

The Nanoknife uses an electric field that be precisely targeted to create tiny holes in tumour cells while not affecting adjacent organs.

Ultraprecision allows treatment of particular areas within the prostate that are difficult to reach by other minimally invasive techniques. Better treatment appears to be produced in small tumours.

Delivery of quick bursts of energy through a set of electrodes which are inserted into and around the tumour create pulses that can last 100 microseconds and create an electric field of up to 3000 volts per centimetre.

A cell within range of the electric field will form pores in its fatty membrane, allowing ions to rush through. Exposure to higher voltages and longer pulse duration causes the pores in the cell membrane to remain open and a process of induced apoptosis (natural cell death) occurs.

After treatment, adjacent non-cancerous cells migrate in and replace the dead cancer cells. There is some evidence that healthy cells grow back and regenerate instead of leaving a hole in the organ allowing the organ to continue to function and minimising side effects.


Minimally invasive procedure requiring a short hospital stay

Short recuperation period (usually a couple of days)

Painless procedure with minimal to no side effects

Able to treat tumours previously difficult to treat with minimally invasive procedures or in salvage cases

The procedure can be repeated


Catheter required for a few days

Some men may be infertile due to decreased/absent ejaculatory fluid

No long term data available on side-effects and outcomes

So onwards to the operation on November 2. Feel as if I am being taken care of by wonderful professionals.

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