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Monthly Archives: November 2016

One year following FDA approval California HIFU is Giving Prostate Cancer Patients Hope for a Healthy Future

Santa Rosa Urologist Dr. Michael Lazar celebrates California HIFU’s first anniversary with look back at October 2015 when HIFU received approval from Food and Drug Administration for use in the U.S.

High-intensity focused ultrasound (HIFU) is a technology that targets cancer cells with precision in a one to four-hour procedure that has little or no side effects, provides a remarkably quick recovery rate, and gives men diagnosed with prostate cancer a less invasive option over surgery or radiation.

“The oncological results for HIFU is comparable to more traditional prostate cancer treatments including radical surgery or radiation. But the side effects for HIFU patients have proven to be much less debilitating than more radical procedures,” says Dr. Lazar. “For example, if the HIFU procedure is performed in the morning, a patient is typically ambulatory by dinnertime and can often return to normal activity within a few days without the use of pain-killers.”

HIFU Background

Sonablate was the first focused ultrasound ablation device to receive regulatory authorization from the FDA for prostate cancer. Although relatively new to the U.S. Sonablate® technology has been used around the world on more than 15,000 patients in over 30 countries for 15 years. Approximately 4,000 U.S. men have received HIFU treatment outside the U.S. prior to FDA approval.

Recognizing its potential as a less invasive treatment option with the ability to eliminate prostate cancer while preserving patient quality of life, Dr. Lazar became one of the early advocates for HIFU. Once fully trained in the technology, he began treating U.S. prostate cancer patients in Mexico beginning in 2007. He performed outpatient procedures at a U.S. Joint Commission approved bilingual hospital in Mexico – helping to bring this innovative prostate cancer treatment to hundreds of men diagnosed with the disease. During that time Dr. Lazar also served as a HIFU instructor for other physicians and is now actively training doctors in San Francisco.

Immediately following FDA approval in 2015, HIFU Prostate Services (HPS) became the first company to establish centers in the United States offering Sonablate HIFU technology to prostate cancer patients. Serving as Medical Director for HPS Dr. Lazar simultaneously founded California HIFU to provide HIFU services in the San Francisco area, the first such facility on the west coast. Since that time HIFU using Sonablate® technology has become available in more than 40 locations across the nation.

How Patients Respond to HIFU

https://youtu.be/oNt1g6p5nOE

Dr. Lazar’s HIFU Patients Share Their Experiences

For patients with prostate cancer, HIFU treatment is most effective in the early stages, where it is localized to the prostate. It is performed on an out-patient basis in just a few hours. The procedure preserves healthy tissue and nerves, so urine flow and erectile function is maintained in a high percent of cases, as compared to radical surgery or radiation.

Several of Dr. Lazar’s HIFU patients recently came together to tell their stories and to share their personal experience with prostate cancer in a poignant new video titled California HIFU Patient Stories video. “The biggest benefit of HIFU for me was lack of risk compared to the other options,” says one patient. The results “have been exactly as Dr. Lazar described it to me,” another patient says. “I think I would be a much more crippled individual with other forms of treatment,” says another, adding “…. there’s very little worry involved in this procedure.” For more patient stories visit the California HIFU YouTube channel.

About Dr. Lazar

Dr. Lazar is part of Northern California Medical Associates and operates California HIFU in Santa Rosa. He is the medical director of HIFU Prostate Services, LLC, a leading provider of minimally-invasive prostate cancer treatments using High Intensity Focused Ultrasound (HIFU). Dr. Lazar is also a clinical partner with HPS with the HIFU San Francisco Surgery Center of Excellence, a state-of-the-art facility that is convenient to hotels and the airport.  For more information about Dr. Lazar, HIFU treatment for prostate cancer visit the HIFU website or to make an appointment call: (707) 546-5553.

Researchers Find that blood samples may help predict prostate cancer spread

Researchers have found a group of circulating tumor cells in prostate cancer patient blood samples which are linked to the spread of the disease, according to new research presented at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool.

This is the first time these cell types have been shown to be a promising marker for prostate cancer spread.

In a study of around 80 samples from men with prostate cancer, scientists at the Barts Cancer Institute at Queen Mary University looked for cells that were gaining the ability to migrate and invade through the body.

Samples with more of these cells were more likely to come from patients whose cancer had spread or was more aggressive.

This means that, in the future, these particular cells could potentially be used as a marker to monitor prostate cancer patients and predict if the disease is going to spread — alongside other monitoring techniques.

There are around 46,500 new cases of prostate cancer each year in the UK, and around 11,000 people die from the disease each year.

Dr Yong-Jie Lu, lead author from QMUL’s Barts Cancer Institute, said: “Our research shows that the number of these specific cells in a patient’s sample is a good indicator of prostate cancer spreading. By identifying these cells, which have gained the ability to move through the body, we have found a potential new way to monitor the disease.

“If we’re able to replicate these studies in larger groups of people, we may be able to one day predict the risk of someone’s cancer spreading so they can make more informed treatment decisions.”

Dr Chris Parker, Chair of the NCRI’s Prostate Cancer Clinical Studies Group, said: “There’s a need to develop better tests to identify and monitor men with aggressive prostate cancer. This research has found a promising new marker that could one day make it to the clinic to guide treatment decisions.”

This research was funded by Orchid Cancer Appeal, ANGLE plc and Chinese Scholarship Council. The scientists used a highly innovative cell separation technology Parsortix™, developed by UK company ANGLE plc that is able to capture the circulating tumor cells.


High-intensity focused ultrasound or HIFU has many proven advantages over traditional treatment modalities for prostate disease. Visit our website to learn more: www.californiahifu.com or call (707) 546-5553 to make an appointment.


“Tumor cells in blood samples could predict prostate cancer spread.” ScienceDaily. ScienceDaily, 4 November 2016. <www.sciencedaily.com/releases/2016/11/161104102140.htm>.
By | November 15th, 2016|Dr. Michael Lazar, News|0 Comments

Researchers discover three novel intrinsic subtypes of prostate cancer

pipet-1440965In the largest study of its kind to date, researchers have identified and validated three distinct molecular subtypes of prostate cancer that correlate with distant metastasis-free survival and can assist in future research to determine how patients will respond to treatment, according to research presented at the 58th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Findings represent a step toward the implementation of personalized medicine in prostate cancer care.

To diagnose and determine treatment for prostate cancer, clinicians consider many factors, including a digital rectal exam, the prostate specific antigen (PSA) level in a patient’s blood and prostate tumor biopsy results. Molecular subtyping of tumor cells allows oncologists to individualize care and tailor treatment based on the actual biology of each patient’s individual disease.

“Tumors that appear similar under a microscope can behave very differently, from a clinical standpoint,” said Daniel E. Spratt, MD, lead author of the study and Chief of the Genitourinary Radiotherapy Program at the University of Michigan in Ann Arbor, Michigan. “One promise of genomic analyses is to elucidate subtypes of cancer based on the genetics of the tumor rather than merely how they look or what size they are.”

To identify genomic profiles for prostate cancer, researchers analyzed RNA expression patterns in 4,236 samples from nine separate groups of men treated with radical prostatectomy for localized prostate cancer. In an effort to create “intrinsic” subtypes specific to the cancer itself rather than the associated surrounding tissue, data were refined to remove non-tumor genes from the training (i.e., identification not validation) dataset. Through K-median clustering analysis, researchers identified three molecular subtypes of prostate cancer that could be characterized through a profile of 100 distinct genes, named the Prostate Cancer 100 (PC100) by study investigators.

“We were surprised to find that prostate cancer subtyped into only three very distinct subtypes,” said Dr. Spratt. “We knew that primary prostate cancer was a relatively quiet tumor, genomically, but similar cancers that are endocrine-driven, like breast cancer, have been shown to be able to be clustered into a finite number of subtypes.”

Researchers validated the subtypes across six additional retrospective cohorts, representing a variety of RNA sequencing platforms and tissue storage methods, and two prospective cohorts comprising 2,610 patients. The intrinsic subtypes were associated with androgen receptor (AR) activity, expression of the ERG oncogene and other known drivers of prostate tumor growth and progression, but researchers did not find a link from mutations or genetic rearrangements to the subtypes.

Rates of distant metastasis-free survival (DMFS) at ten years varied significantly among the three subtype groups. DMFS rates were 57.1 percent for subtype A, 64.4 percent for subtype B, and 73.6 percent for subtype C (B vs. A: Cox Hazard Ratio (HR), 1.31, p = 0.02; C vs. A: HR, 1.65, p = 0.0001). After controlling for clinocopathologic variables, the profile remained independently associated with DMFS (B vs. A: Cox HR, 1.31, p = 0.026; C vs. A: HR, 1.33, p = 0.024). Additionally, multivariate interaction analysis determined that subtypes B and C shared a significant correlation with response to post-operative radiation therapy (RT) (Wald p = 0.0016).

“We have discovered and independently validated a highly stable 100-gene intrinsic molecular profile of prostate cancer that is both prognostic and predictive for radiation therapy,” said Dr. Spratt. “We believe that these subtypes reflect truly distinctive underlying biology and that this work represents a significant advance in our understanding of prostate cancer biology. Moreover, our findings identify numerous genes and enriched biologically active pathways in prostate cancer that have been underappreciated to date but may be potential targets to improve cure rates in this disease by developing new targeted therapies.”


Story Source:

Materials provided by American Society for Radiation Oncology (ASTRO). Note: Content may be edited for style and length.


American Society for Radiation Oncology (ASTRO). “Three novel intrinsic subtypes of prostate cancer identified.” ScienceDaily. ScienceDaily, 26 September 2016. www.sciencedaily.com/releases/2016/09/160926100610.htm.
By | November 1st, 2016|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments