Find a doctor who treats prostate cancer with focal therapy

If you have been diagnosed with localised prostate cancer, surgery to remove the prostate or radiation to the whole prostate may not be your only option. Focal therapy treats only the tumour. Search the doctors who offer irreversible electroporation (IRE), the focal therapy known as NanoKnife®, near you or abroad.

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Is focal therapy right for me?

It may be an option if

Your cancer is confined to the prostate, shows up as one main area on MRI, and is low or intermediate risk (often Grade Group 2 or 3). Some clinics also treat cancer that has come back after surgery, radiation or HIFU.

It may not suit you if

The cancer is in many parts of the prostate, has spread outside it, or is high grade. In those cases whole-gland treatment or active surveillance is usually discussed instead.

How you find out

A focal therapy doctor reviews your PSA, your multiparametric MRI and a targeted or mapping biopsy. Bring copies of your reports and images to the first consultation, or ask the clinic whether they can review them remotely.

Questions to ask a focal therapy doctor

Am I a candidate for focal therapy, and why?
Which focal treatments do you offer (IRE, HIFU, cryotherapy), and which would you recommend for where my tumour is?
How many IRE procedures for prostate cancer have you performed?
Which scans and biopsy do I need before treatment, and can you use the ones I already have?
What are the possible side effects, and how often do you see them in your own patients?
How will I be followed up (PSA, MRI, biopsy), and what happens if cancer is found again?
Is the procedure covered by my insurance or Medicare, and what will I pay?

How irreversible electroporation works

Irreversible electroporation (IRE) uses very short, high-voltage electrical pulses delivered through thin needles placed around the tumour. The pulses open permanent pores in the cell membranes of the targeted tissue, and those cells die. The method does not rely on heat or freezing, so it is often described as non-thermal tissue ablation.

For prostate cancer, IRE is used as a focal therapy: only the area of the prostate that contains the tumour is treated, rather than removing or irradiating the whole gland. The needles are usually placed through the perineum (transperineal) under general anaesthesia, guided by ultrasound and by MRI maps made before the procedure.

The best-known IRE device is the NanoKnife® System by AngioDynamics. In December 2024 the US FDA cleared it for prostate tissue ablation, based on the PRESERVE trial in men with intermediate-risk prostate cancer. In Europe the system carries a CE mark, and in February 2026 its European indications were expanded to include tumours of the prostate, including intermediate-risk prostate cancer. Other IRE devices exist too, such as the CE-marked Dophi™ N3000 and the high-frequency IRE (H-FIRE) systems used in China.

Whether IRE suits a given patient depends on the tumour's size, grade and location, on imaging and biopsy results, and on prior treatment. Only a doctor who has reviewed those results can say. This directory does not recommend any doctor or treatment.

Primary focal therapy

Treating a localised, MRI-visible tumour as the first treatment, usually in low- or intermediate-risk disease.

Treatment after recurrence

Some centres use IRE when cancer returns after surgery, radiation, HIFU or brachytherapy (often called salvage treatment).

Combined approaches

A few centres combine IRE with electrochemotherapy (IRECT) or immunotherapy. Ask each clinic which approaches it offers.

Glossary

Irreversible electroporation (IRE): Non-thermal tissue ablation with short electrical pulses that permanently open cell membranes.
NanoKnife®: The brand name of AngioDynamics' IRE system; FDA-cleared for prostate tissue ablation in December 2024.
Focal therapy / focal ablation: Treating only the part of the prostate that holds the tumour and keeping the rest of the gland.
H-FIRE: High-frequency irreversible electroporation: bursts of very short bipolar pulses, studied mainly in China.
IRECT / IR-ECT: IRE combined with electrochemotherapy (ECT), where a low dose of chemotherapy is given at the time of the pulses.
Salvage treatment: Treatment of cancer that returns after an earlier treatment such as surgery, radiation, HIFU or brachytherapy.
Multiparametric MRI (mpMRI): Prostate MRI combining several sequences to locate suspicious areas before biopsy and treatment.
MRI-fusion / 3D mapping biopsy: Targeted biopsy that uses MRI images, or a systematic 3D grid of samples, to map exactly where the cancer is.
PSMA PET/CT: A scan using a tracer that binds to prostate cancer cells; used for staging and to look for spread.
Gleason score / Grade Group: The grading of prostate cancer under the microscope; Grade Group 1 is the lowest, 5 the highest.
D'Amico risk groups: Low, intermediate and high risk, based on PSA, Gleason score and clinical stage.
Transperineal approach: Placing needles through the skin between the scrotum and the anus rather than through the rectum.
Radical prostatectomy: Surgical removal of the whole prostate, often robot-assisted.
HIFU: High-intensity focused ultrasound, a heat-based focal therapy and an alternative to IRE.
Neurovascular bundles: The nerves and vessels beside the prostate that matter for erectile function.
Active surveillance: Monitoring low-risk cancer with PSA tests, MRI and biopsies instead of treating right away.

Approval and coverage by region

United States: FDA 510(k) clearance: The FDA cleared the NanoKnife System for prostate tissue ablation in December 2024, based on the PRESERVE trial in intermediate-risk prostate cancer.
United States: billing code and Medicare: A dedicated Category I CPT code for prostate IRE took effect on 1 January 2026, and Medicare coverage criteria (Palmetto GBA LCD) apply from July 2026. Humana Medicare Advantage follows those criteria from October 2026. Ask your doctor and insurer what applies to you.
Europe: CE mark: The CE mark is the European conformity marking a medical device needs to be sold in the EU. NanoKnife has long been CE-marked for soft-tissue ablation. In February 2026 AngioDynamics expanded its European indications to tumours of the liver, kidney, pancreas and prostate, including intermediate-risk prostate cancer.
United Kingdom: NICE guidance: NICE guidance IPG768 (July 2023, now HealthTech guidance HTG688) allows IRE for prostate cancer under "special arrangements": patients are told the long-term evidence is still limited, and results are audited. It is offered at selected NHS and private centres.
Germany: OPS procedure code: Germany introduced procedure codes for IRE in 2014, including one for the prostate (OPS 5-601.8), so hospitals can bill the treatment. Coverage by statutory and private insurers still varies, and many patients pay privately.
Dophi™ N3000: An IRE system made by SurgNova (China). It is CE-marked and FDA-cleared for soft-tissue ablation, but it is not specifically cleared for the prostate in the US. Distributors market it for prostate cancer in some countries.