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NanoKnife procedure offers new hope to pancreatic cancer patients in Iowa

University of Iowa Health Care is the only place in Iowa offering a unique, minimally invasive technique for patients with pancreatic cancer

Aug 27, 2025 by UI Health Care

A minimally invasive therapy, available in Iowa only at UI Health Care, offers a treatment option for pancreatic cancer patients for whom surgery is not possible.

The NanoKnife, technically known as irreversible electroporation (IRE), uses electrical pulses to destroy cancer cells within tumors that can’t be removed by traditional surgery. While the technology itself isn’t new—it’s been used in laboratories for decades—it’s only recently been used as a therapy for pancreatic cancer patients.

Carlos Chan, MD, PhD, associate professor of surgery and an expert in pancreatic cancer at UI Health Care, has led the charge in bringing this highly specialized technique to Iowa.

“We started doing NanoKnife procedures about five years ago, during the pandemic,” Chan says. “Since then, we’ve treated more than 50 patients.”

"Many patients are told they only have a few months to live. But there are advances out there. We want people to know that they have options, and hope."
Carlos Chan, MD, PhD

Pancreatic cancer often goes undetected in patients until it’s in an advanced stage. More than half of all patients are diagnosed with stage IV disease, meaning the cancer has already spread to other parts of the body.

“Many patients are told they only have a few months to live,” he says. “But there are advances out there. We want people to know that they have options, and hope.”

Even among those with earlier-stage pancreatic cancer, many tumors are considered inoperable due to their location near vital blood vessels. 

“This technology allows us to help patients we previously had no surgical options for,” Chan says. “The electric pulses don’t damage blood vessels, which means we can treat tumors that are wrapped around or touching critical structures.”

In some cases, the NanoKnife is used to destroy a tumor exactly where it is located. In other instances, the procedure helps remove cancer cells from nearby vessels, making surgical removal possible when it wasn’t before.

Hope for future patients

"This technology allows us to help patients we previously had no surgical options for. The electric pulses don’t damage blood vessels, which means we can treat tumors that are wrapped around or touching critical structures."
Carlos Chan, MD, PhD

Though not every patient is a candidate, and recurrence is still a risk, NanoKnife improves local tumor control and expands the number of people who can benefit from surgery.

“Without surgery, there’s no chance for a cure,” Chan says. “This gives patients a chance at treatment—and in some cases, even at long-term survival.”

While the procedure doesn’t stop the cancer from spreading elsewhere in the body, it plays a critical role in treating the disease at its origin.

“Some patients do go on to develop metastatic disease later,” Chan says. “But for local control, and for giving people another option when there seemed to be none, it’s been very successful.”

While UI Health Care currently uses the NanoKnife primarily for pancreatic cancer, the technology is also approved for use in liver and prostate cancers. There’s growing research into its potential for other types of cancer.

“It’s a versatile tool,” Chan says. “We’re also studying how to combine it with other therapies to improve outcomes even more.”

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