Pancreatic cancer has a rising incidence in the Western world and is the 5th most common cancer in the UK. Five-year survival rates are reported to be as low as 5%. Thirty percent of patients have unresectable disease due to the disease being locally advanced, and in this group median overall survival varies between 9 to 32 months. Irreversible electroporation (IRE) is a new technique with the potential to improve survival in these patients. This is a soft tissue ablation technique which involves the pulsation of electric currents through the tumour. It does this without significant heating of the targeted tissues and so limits damage to surrounding structured cells such as vessels and ducts. Studies have reported a median overall survival of up to 22-35 months following treatment of localised disease with IRE.

Intraoperative IRE debuted in Northern Ireland in November 2018 at the Mater Hospital, Belfast in a patient who had a locally advanced tumour and a previously failed pancreaticoduodenectomy. IRE probes were placed under ultrasound guidance by interventional radiologists following surgical exposure and the tumour was ablated. The patient made a full recovery and a follow-up CT scan showed a satisfactory ablation zone.

IRE provides another treatment modality for patients who previously would have only had the option of palliative chemotherapy. It is great to see this exciting new treatment is now a possibility for patients with inoperable pancreatic tumours in Northern Ireland.

UMJ is an open access publication of the Ulster Medical Society (<http://www.ums.ac.uk>).
