1 Recommendations

Guidance

1.1 Evidence on the safety of focal therapy using high-intensity focused ultrasound for localised prostate cancer is adequate, but evidence on its efficacy is limited. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wanting to do high-intensity focused ultrasound for localised prostate cancer should:

Inform the clinical governance leads in their healthcare organisation.
Give people (and their families and carers, as appropriate) clear written information to support shared decision making, including NICE's information for the public. Use the recommendations in NICE's guideline on diagnosing and managing prostate cancer for information on treatment options and decision support.
Ensure that people (and their families and carers, as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.
Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).
Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

1.3 Healthcare organisations should:

Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.
Regularly review data on outcomes and safety for this procedure.

1.4 Patient selection should be done by a multidisciplinary team.

1.5 Further research could include registry data or randomised trials. It should include details of patient selection, including size and classification of tumour, technique used and long-term outcomes such as quality of life.