Nanotechnology Made Clear


A new treatment for cancer patients – which kills cancer cells with electricity while not harming surrounding healthy tissue – has been performed for the first time in the state of Texas at Valley Baptist Medical Center in Harlingen.

Dr. Daniel A. Fuentes, Interventional Radiologist with Valley Radiologists & Associates, P.A., performed the state’s first “NanoKnife” procedure which uses electricity -- instead of heat or freezing temperatures -- to destroy cancer cells. Valley Baptist is only the seventh hospital in the entire nation to offer the new procedure – with the closest other hospitals being in Tulsa, Oklahoma and Little Rock, Arkansas.

The first patient, Mr. Joseph Wanja, a 68-year-old Brownsville resident, was recovering and doing well following the procedure at Valley Baptist on March 30. The man was only the fourth lung cancer patient in the United States to benefit from the new technology – and Valley Baptist is only the second hospital in the country to perform a lung procedure with the NanoKnife.

Dr. Fuentes also treated a second patient, this one a Hispanic male in his fifties with a liver tumor, on March 31 at Valley Baptist with the NanoKnife. The second patient has also returned home and is doing well.

"This minimally-invasive procedure with the NanoKnife, using Irreversible Electroporation, or IRE, generates an electric current to treat tumor cells in a way that has not been done before,” Dr. Fuentes said.

The benefit to the patient is that in many cases the surrounding tissue, blood vessels, and organs are left in place and still functioning.

Dr. Fuentes added that since the NanoKnife is a minimally-invasive technique – performed through small needle sticks – there are no incisions.

“In some cases, this technology is an alternative to surgery,” Dr. Fuentes said. “The procedure is done with anesthesia, so the patient doesn’t feel any pain. With many patients, we’re talking about a faster recovery, with less discomfort, and fewer side effects.”

Some patients treated with the NanoKnife require a brief stay in the hospital, while others are able to go home within 24 hours.

As an interventional radiologist, Dr. Fuentes uses ultrasound or computed tomography (CT) imaging as a guide while inserting the NanoKnife’s small needle electrodes into areas where cancer tumors are present. A series of high-voltage electrical pulses are sent through the tumor, with each pulse lasting less than a second.

Dr. Fuentes – who is a graduate of the John Hopkins University School of Medicine in Baltimore, Maryland -- said the precisely-targeted electric pulses may be thought of as “molecular surgery” … at the level of the cell. “All that the electricity does is to create tiny holes in cell membranes – causing the cells to die,” he said.

“Nanotechnology” refers to the technology involved in working on a microscopic level – as small as individual molecules and atoms. So the “NanoKnife” isn’t actually a knife -- but an electric field – that can be precisely targeted to “poke” tiny holes in tumor cells, while not affecting adjacent organs.

The ultra-precision of the NanoKnife allows physicians to treat tumors that in the past would have been difficult or impossible for surgeons to operate on because of their location.

“With the NanoKnife, we can treat tumors that are next to an intestine, kidney, the urinary system or other critical organs,” Dr. Fuentes said. “Because the NanoKnife doesn’t use heat or cold to kill a tumor, it allows us to treat tumors we otherwise wouldn’t be able to treat.”

Dr. Todd Shenkenberg, an oncologist with Valley Cancer Associates in Harlingen, who referred the first NanoKnife patient, said that in many cases, the new technology will also benefit Valley patients and families by allowing them to stay in the Valley when they need treatment -- instead of having to travel to distant cities such as Houston. Dr. Nabeel Sarhill, also an oncologist with Valley Cancer Associates, referred the second NanoKnife patient.

“Valley Baptist is pleased to bring this exciting new technology to the Valley and to the state of Texas for the benefit of our patients,” added James Eastham, CEO for Valley Baptist. “As Valley Baptist prepares to celebrate our 85th anniversary of serving this community, this cutting-edge procedure represents yet another in a long line of ‘firsts’ for our dedicated physicians and staff.”

The state’s first patient to receive the new treatment, Joseph Wanja, is a retired meteorologist with the National Weather Service in Brownsville. “This was a minimally invasive procedure – Dr. Fuentes poked six electrodes into my lung, and I’m ready to go home the next day … I think that’s fantastic,” Mr. Wanja said.

The day after his procedure, Mr. Wanja said he felt very little pain – just a “mild soreness” in his chest area where the needle electrodes were placed.

“It’s really gratifying to see these physicians remain on the cutting edge of technology,” the patient added. “This helps everybody – I’m particularly pleased that it is available here in the Valley for myself and other people. The doctors and nurses at Valley Baptist treated me very nicely. They were very professional and concerned.”

Dr. Fuentes said the new technology allows physicians to treat lesions that are not well treated by other ablation methods such as radiofrequency ablation.

“One of the great strengths of the NanoKnife is it uses electricity to open little holes in the cell membranes – so every cell in the treatment area dies,” Dr. Fuentes added. “But what is really amazing about the NanoKnife is that it doesn’t alter or destroy adjacent tissue. So after the treatment, adjacent, non-cancerous cells migrate in and replace the dead cancer cells. There is evidence that the healthy cells will grow back and regenerate – instead of leaving a hole in the organ. This helps the organ to continue to function.”

The new method can be used with cancers in various parts of the body, such as the kidneys, the prostate, the liver, the lungs, pancreas and lymph nodes. In sensitive cases – like the prostate – doctors hope the NanoKnife will be able to allow them to preserve a patient’s functions, including (urinary) continence and nerves involved in sexual functions.

Dr. Fuentes said that, as a leader in cancer therapy in the Valley, Valley Baptist has been committed to acquiring new technology.

“We have been doing radiofrequency ablation for several years, and have successfully treated many tumors that can’t be removed surgically,” he said. “Through these minimally-invasive techniques, we have been able to help many patients with limited options, such as patients who have already had surgery and chemotherapy but have had recurrences of cancer. The NanoKnife is a tool we can use to treat advanced cancer -- such as in a patient who cannot have another surgery or who has had all the chemotherapy they can have. We can use the NanoKnife to keep the tumors down … to ‘de-bulk the tumors and keep them small and shrunken. In many cases of advanced cancer, we can increase the patient’s life expectancy.”

When treating a patient with the NanoKnife, Dr. Fuentes targets the electric pulses on a computer screen -- then presses on a foot pedal when he is ready to send an intense burst of electricity from an electrical generator through two, three, or more needle-size probes.

Valley Baptist was able to bring the new technology to South Texas through the generosity of the Valley Baptist Auxiliary Volunteers.

“Our Auxiliary has raised money over the past several decades to support various programs and equipment purchases at Valley Baptist,” said Pamela Williams, President of the Valley Baptist-Harlingen Auxiliary. “Funding the NanoKnife is especially exciting because it allows Valley Baptist to acquire technology that is a first in the state of Texas.”

The NanoKnife was approved by the U.S. Food and Drug Administration for surgical ablation of soft tissue and is made by AngioDynamics, a company based in Queensbury, New York. For more information, contact your physician and visit

Source: Valley Baptist Medical Center; May 8, 2010

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