The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Focal therapy using high-intensity focused ultrasound for localised prostate cancer in April 2012. 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
ID number 839
Description Imaging and biopsy mapping studies are used to confirm that the tumour is suitable for focal therapy and to show its precise location. With the patient under local or general anaesthesia, the bladder is catheterised using a supra-pubic catheter and the HIFU probe is inserted transrectally. Real-time ultrasound imaging guidance is used to position the probe and to monitor the procedure. Pulses of HIFU are directed at the targeted part of the prostate, inducing tumour necrosis by a thermal effect and causing cavitation (which can be visualised by ultrasound to assess the adequacy of treatment) until satisfactory ablation of the target area is judged to have occurred. After treatment patients are usually followed up regularly with prostate-specific antigen (PSA) measurements and repeated biopsies to detect recurrence.

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