The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland intravesical microwave hyperthermia with intravesical chemotherapy for superficial bladder cancer in October 2007. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
 
Status In progress
Process IP
Description Intravesical hyperthermia combined with intravesical chemotherapy can be used as neoadjuvant therapy prior to TUR, with the aim of eradicating tumours. Alternatively the procedure can be used after TUR, as adjuvant therapy (sometimes referred to as prophylactic treatment), with the aim of preventing recurrence. Hyperthermia is believed to have a direct and immune-mediated cytotoxic effect on tumour cells and to improve the efficacy of chemotherapy drugs. The procedure can be done on an outpatient basis. Using local anaesthetc urethral gel, a balloon catheter, containing an antenna and several insulated thermocouples, is inserted through the urethra into the bladder. Ultrasound is sometimes used to assess the position of the device. The antenna emits microwaves which heat the superficial layers of the bladder wall. The thermocouples, which are spread out from the catheter and pushed against the bladder lining, monitor temperature to help prevent overheating. A solution of a cytostatic agent, usually mitomycin C, is instilled into the bladder, between the bladder wall and the balloon surface. The solution is continuously pumped out of the bladder, cooled, and recirculated to prevent overheating. Treatment sessions typically last for 40–60 minutes and are usually repeated weekly for 4–8 weeks, or longer for adjuvant treatment.

Provisional Schedule

Interventional procedure consultation 26 April 2018 - 24 May 2018

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance