Low dose rate brachytherapy for localised prostate cancer (IPG132)
Fast, easy summary view of NICE guidance on 'prostate cancer'
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on low dose rate brachytherapy for localised prostate cancer in July 2005.
Further recommendations have been made as part of the clinical guideline on prostate cancer published in February 2008, as follows:
Brachytherapy is not recommended for men with high-risk localised prostate cancer.
Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. More information is available from www.nice.org.uk/cg58. The IP guidance on low dose rate brachytherapy for localised prostate cancer remains current, and should be read in conjunction with the clinical guideline.
Prostate cancer is one of the most common cancers in men. It tends to affect older men, with the risk rising with age. It is not a single disease entity but may be indicated form an incidental biopsy finding to presentation with metastatic prostate cancer, which may or may not cause any symptoms or shorten life. Symptoms when they occur include urinary outflow obstruction and features of metastases, such as bone pain. Prognosis with prostate cancer is variable and depends on the grade of the tumour and stage of the diagnosed cancer. Treatment options depend on the stage of the cancer. Current treatments for localised prostate cancer include watchful waiting, radiotherapy, and radical prostatectomy. Metastatic prostate cancer is usually treated with hormone therapy. Brachytherapy is a form of radiotherapy in which delivery of radiation is targeted directly to the prostate gland through the implantation of small radioactive pellets. Needles are inserted through the skin of the perineum, these needles deliver the seeds which can be left either permanently or temporarily (high dose). These seeds give off radiation at a low dose over several weeks or months, remaining in the prostate gland permanently. In high dose rate brachytherapy thin plastic catheters are inserted through a template, through the perineal skin, and into the prostate gland. They enter the skin below the scrotum and above the rectum. Radioactive seeds are then inserted into each catheter. The catheters are then pulled out, leaving no radioactive material in the prostate gland. Brachytherapy may be used as a primary therapy (monotherapy), in combination with external beam radiation (EBRT) in high dose therapy.
M70.6 Radioactive seed implantation into prostate
Note: Use an additional code to specify radiotherapy delivery (X65)
X65.3 Delivery of a fraction of interstitial radiotherapy
Note: Use a subsidiary code to identify introduction of radioactive material (Y35, Y36)
Y36.3 Radioactive seed implantation NOC
In addition the ICD-10 code C61.X Malignant neoplasm of prostate or C79.8 Secondary malignant neoplasm of other specified sites is assigned
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
- IPG132 Low dose rate brachytherapy for localised prostate cancer: guidance (web format)
- IPG132 Low dose rate brachytherapy for localised prostate cancer - guidance
- IPG132 Low dose rate brachytherapy for localised prostate cancer - information for the public
- Interventional procedures consultation document - low dose rate brachytherapy for prostate cancer (second consultation)
- Interventional Procedures Consultation Document - Brachytherapy for localised prostate cancer (first consultation)
- Overview of brachytherapy for localised prostate cancer
This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.
Visit the NICE Pathway: prostate cancer
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