Australian first: ‘NanoKnife’ zaps cancer cells


An Australian-first study is looking at whether electrical charges can be used to destroy pancreatic cancer cells, leading to greater survival rates for some patients.

The four-year DIRECT-INSPIRE study is investigating the use of Irreversible Electroporation (IRE) on otherwise inoperable pancreatic cancer.

With IRE, a surgeon implants several small electrodes – using a technology called NanoKnife – into the cancerous tumour.

Electrical pulses are then used to puncture nanometre-sized holes in the tumour, causing cancer cells to die.

Melbourne woman Jill Forbes was the first patient to undergo NanoKnife surgery for pancreatic cancer at Epworth Freemasons hospital as part of the study.

Diagnosed in December 2020, she had chemotherapy this year before having surgery using the NanoKnife to destroy the tumour, and is now continuing her treatment.

She said it was fortunate the cancer was discovered thanks to the efforts of her general practitioner (GP).

“I felt I had indigestion,” Mrs Forbes said.

“Two weeks later, when tablets for indigestion hadn’t worked, my GP requested I undergo a scan. The CT came back showing pancreatic cancer.”

Dr Brett Knowles, a consultant cancer surgeon at Epworth HealthCare, said the NanoKnife gave an option to treat patients where the pancreatic cancer was intertwined with blood vessels.

“The NanoKnife is the only technology that allows to destroy the pancreatic cancer without damaging vital structures like blood vessels and the bile duct,” he said.

The study will focus on patients with pancreatic cancer that has not spread to other parts of their body.

“There is a minority of patients who have pancreatic cancer, where the cancer doesn’t appear to be able to spread,” Dr Knowles said.

“With these patients, we can deliver effective local treatment with NanoKnife, giving them a safer option for an improved quality of life and survival rate.”

Caroline Le, Research Program Manager at the Jreissati Family Pancreatic Centre at Epworth

In February 2021, the Jreissati Family Pancreatic Centre at Epworth was established to streamline care, improve education and pioneer new diagnosis and treatment options for people with pancreatic disease.

Once referred to the centre, patients have an appointment to see an experienced specialist within 72 hours.

The centre has begun 25 studies in its first nine months of operation, and is helping to educate GPs about the importance of early detection of pancreatic cancer – which is often confused with other conditions that have similar symptoms.

“Anecdotally, people think they have gastro," said Caroline Le, the centre's Research Program Manager.

"Often with such vague symptoms, there are a million different things you consider before we even get to pancreatic cancer. Then, once diagnosed, it’s usually too late. By diagnosis, about 80 percent of patients have an inoperable tumour and 60 percent of cases are metastatic or already spread.”

Read more: New centre shines light on cancer’s ‘dark art’

Read more: A fishy tale – new research at Epworth


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