A trial looking at a device called Nanoknife to treat small areas of prostate cancer (NEAT)

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Prostate cancer





This trial is looking at a new way of treating prostate cancer with a device called a Nanoknife. It uses electrical current to destroy areas of cancer.

If prostate cancer has not spread outside the prostate gland, there are different treatments that men can have, such as surgery or radiotherapy. But treatment to the whole prostate gland often causes side effects such as problems getting an erection, urinary problems, diarrhoea and pain or bleeding from the back passage.

For some men, radiotherapy or surgery to remove the prostate gland is not a suitable treatment, or they don’t want to have the side effects of these treatments. For these men, monitoring the cancer until it starts to grow may be an option. This called active surveillance.

One other option may be to treat only the area of the prostate that contains cancer. This is called focal therapy. Nanoknife is a type of focal therapy. It has already been used to treat some other types of cancer. Researchers now want to see how well it works for prostate cancer.

If there is only a small area of cancer, doctors can treat all of it with focal therapy. But if there is more than one area, they may use focal therapy to treat only the biggest cancer. This is because they think it is only larger areas of prostate cancer that are likely to get worse or spread. Doctors describe these areas as being clinically significant.

In this trial, doctors will only treat clinically significant areas of cancer in the front part of the prostate gland. But they will watch the untreated areas carefully to check they are not getting worse.

The aims of this trial are to see

  • How safe Nanoknife is
  • How well it controls prostate cancer in the short term

If successful, this may lead to other trials looking at how good this treatment is at controlling prostate cancer in the medium and long term

Who can enter

You may be able to enter this trial if

  • You have been diagnosed with prostate cancer that has not spread outside your prostate gland (localised prostate cancer)
  • An MRI scan and a template biopsy both show that your cancer is at the front of your prostate gland] and can be reached with Nanoknife treatment
  • You don’t have any areas of clinically significant cancer outside the part of your prostate gland that will be treated with Nanoknife
  • You have a PSA level no higher than 15 and a Gleason score of no more than 7
  • You are at least 40 years old, are well enough to take part and can understand written and spoken English

You cannot enter this trial if you

  • Have cancer that has spread outside your prostate gland
  • Have already had Nanoknife treatment, HIFU, cryosurgery, microwave or heat (thermal) therapy to your prostate
  • Have already had radiotherapy to the area between your hips (the pelvis Open a glossary item)
  • Have had hormone therapy for prostate cancer in the last year
  • Have had surgery to relieve symptoms caused by the prostate gland pressing on the tube that carries urine from the bladder (a transurethral resection of the prostate) in the last 6 months
  • Have had certain other types of surgery to your back passage (your rectum) – the trial team can advise you about this
  • Can’t have a rectal ultrasound
  • Are not fit enough to have a general anaesthetic Open a glossary item
  • Can’t have an MRI scan for any reason
  • Have a metal implant or stent Open a glossary item in the tube that carries urine away from your bladder (the urethra)
  • Have kidney problems
  • Are allergic to rubber (latex)

Trial design

This trial aims to treat 20 men at University College Hospital, London. Everybody taking part has Nanoknife treatment.

On the morning of the Nanoknife treatment, you may have an enema Open a glossary item to clear your back passage. Or you may have a suppository Open a glossary item the night before to do this.

You have the treatment while you are asleep under general anaesthetic Open a glossary item. Before the treatment starts, a tube called a catheter is put into your bladder to drain your urine.  

When you have the treatment, the trial doctor puts a probe into your back passage. They then put needles through the skin in front of your back passage into your prostate gland. They deliver an electrical current to destroy the cancer cells.

Most men will be able to go home 4 to 5 hours later, but it is possible that you may need to stay in hospital overnight.

The catheter stays in when you go home. The trial team will teach you how look after it. They will also give you painkillers, laxatives and antibiotics to take at home for a week.

After the Nanoknife treatment, you have follow up appointments with the trial team and they will ask you to complete questionnaires asking about

  • Any problems you have with leaking urine or getting an erection
  • Any bowel problems you have

As part of this trial, the researchers are looking at different ways men can answer these questionnaires and have follow up after treatment. They want to see if asking men to send information over the internet and having telephone conversations are better than hospital visits.

If you agree to join this part of the study, they will test 3 different things with you

  • Having a telephone conversation and filling in paper questionnaires that you return by post.
  • Having a face to face appointment at hospital where you fill in some questionnaires on a tablet computer – the trial team will show you how to use this
  • Having a telephone conversation and filling in questionnaires using a computer away from the hospital

At the end of the study, the team will ask you to take part in an interview to see what you thought of the different methods. The interview will last up to 30 minutes and the researcher will audio record it.

If you don’t want to take part in the follow up study, you don’t have to. You can still take part in the trial and have normal hospital visits.

Hospital visits

You see the trial team and have a physical examination and blood tests before you have Nanoknife treatment.

Between 3 and 10 days after having the treatment, you go back to see the trial team. You have an MRI scan and they will remove your catheter. If you can’t pass urine very well, it is possible that you may need to have another catheter for a while. The trial team will explain this to you.

You have appointments 6 weeks, 3 months, 6 months, 9 months and 1 year later. At these appointments, you have blood tests. The trial team will also ask about any symptoms you’ve had following Nanoknife treatment and about any other treatment you’ve had.

At the 6 month visit, you have an MRI scan and a biopsy Open a glossary item will be taken from the treated area of your prostate gland.

After the first year, you will see your doctors in the same way as you would if you hadn’t taken part in the trial.

Side effects

As Nanoknife is a new treatment for prostate cancer, there may be side effects we don’t know about yet. The side effects may include

  • Muscle contraction
  • Burns
  • Electric shock
  • Change to your heart
  • Infection

The trial team will talk to you about all the possible side effects of treatment before you agree to join the trial.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Mr Hashim Uddin Ahmed
Professor Mark Emberton

Supported by

Angiodynamics Inc
National Institute for Health Research Cancer Research Network (NCRN)
Prostate Cancer UK
University College London Hospitals NHS Foundation Trust

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle - 11342

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Keith took part in a trial looking into hormone therapy

A picture of Keith

"Health wise I am feeling great. I am a big supporter of trials - it allows new treatments and drugs to be brought in.”

Last reviewed:

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