The evidence on the safety of intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive bladder cancer shows there are well-recognised adverse events. Current evidence on its efficacy is limited in quality. 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.
Clinicians wishing to do intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive bladder cancer should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients and their carers understand the uncertainty about the procedure's safety and efficacy, alternative treatments and provide them with clear written information. In addition, the use of NICE's information for the public on intravesical microwave hyperthermia and chemotherapy is recommended.
Audit and review clinical outcomes of all patients having intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive bladder cancer. NICE has identified relevant audit criteria and has developed NICE's interventional procedure outcomes audit tool (which is for use at local discretion).
Patient selection should be by a specialist bladder cancer multidisciplinary team. The procedure should only be done in specialist centres by clinicians who have had supervised training in the procedure.
NICE encourages further research into intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive bladder cancer. Research should include randomised controlled trials, which stratify patients by risk and give adequate follow-up. They should report frequency of adverse events, patient-reported outcome measures, overall and disease-free survival and quality of life.
NICE may review this procedure on publication of further evidence.