Matthew Hoffman, 59, was having regular annual physical exams that included blood tests. In 2010 one test showed that the Prostate-Specific Antigen (PSA) was high. Dr. Michael Lazar advised him to have a biopsy, which was negative. However, precursors for cancer were present, meaning that his situation had to be watched closely. A year later, his PSA level had risen to 7. Another biopsy confirmed that something should to be done.
“Dr. Lazar explained various options, including surgery, radiation and High Intensity Focused Ultrasound (HIFU). Most of the alternatives had side effects I didn’t like, so I chose HIFU. Overall, it was a pretty good experience.”
As an engineer involved with developing software to test cell phones, Matthew was intrigued by the fact that high intensity sound waves could be used as medical therapy. As this happened before HIFU became FDA approved, he and his wife flew to Puerto Vallarta, a resort town on Mexico’s Pacific coast known for its beaches, water sports and nightlife. After a night in a Marriott
Hotel, Matthew went to the well-appointed hospital to meet the HIFU team.
“I conferred with Dr. Lazar, an anesthesiologist and two nurses. I have never had surgery, and HIFU is minimally invasive. I woke up a few hours later and was able to get up and walk out of the facility. We went to town that afternoon and decided to stay two more days.”
Avid cyclist returns after HIFU
Cancer was found throughout Matthew’s prostate. A full ablation had to be performed. HIFU uses extreme temperatures generated by short bursts of high intensity ultra-sound waves to destroy tumors and cancer cells. Since the urethra passes through the prostate, a temporary catheter was inserted to allow urine to flow as the urethra healed.
“It was not bad at all. I did experience short-term pain and a little incontinence, which subsided soon after the procedure. I took ED medications to help maintain healthy circulation. I don’t need them any more. Before the procedure I had to urinate more often, but not now.”
Matthew had no physical limitations after recovery. Over the years he has logged more than 1,600 miles on his bicycle.
“I’ve done a lot of mountain biking for 15 years and road biking for seven. The HIFU procedure has not slowed me down. In fact, I’ve been able to resume all of my normal activities.”
Dr. Lazar and his staff are proud to be early leaders in the usage of HIFU. HIFU is a medical procedure that applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue with prostate cancer through ablation. Dr. Lazar has worked tirelessly with SonaCare to bring this innovative treatment for prostate cancer to patients in the United States.
High Intensity Focused Ultrasound (HIFU)
HIFU is an FDA approved precise and targeted therapy that reduces the risk of complications caused by surgery and radiation.
HIFU uses ultrasound energy, or sound waves, to heat and destroy specifically targeted areas of tissue. During HIFU, the sound waves pass through healthy tissue without causing damage. However, at the focal point of the sound waves (like a magnifying glass focusing the rays of the sun to burn a leaf), the tissue temperature is raised to 90 degrees Celsius, destroying the targeted tissue.
Men treated with HIFU wake up and go home without pain or bleeding. They are able to travel the same day, drive the next day, and resume normal activities within a few days. Those with office based jobs can go back to work the next day. A catheter is left in for 5 days to 3 weeks, depending on how much of the gland is treated and/or the degree of swelling.
Focal Therapy is not associated with incontinence, and erectile dysfunction is just under 10%. Sparing of the urethra avoids scar tissue formation which, when present, may diminish the urinary stream. The eventual need for additional therapy is now under 10%.
Total Gland Therapy is necessary for men with significant cancer on both sides of the gland. Incontinence of a few drops of urine (soaking pads is not seen) is limited to 2-3%. Erectile dysfunction is only 10-20% as opposed to the much higher rates seen with surgery or radiation. Scar tissue formation occurs in 10-20% of men who have the whole gland treated due to the involvement of the urethra. We are developing techniques to treat the whole gland while sparing the urethra. Cancer cure rates are comparable to surgery and radiation.
Insurance coverage is now available on a limited basis. A big help is the issuance of a facility billing code by Medicare which will save Medicare patients about $7,000, and help to mainstream HIFU. Hopefully conventional insurance companies will follow suit in the near future. This therapy should not be available only to those who can afford it.
Dr. Lazar offers a HIFU Program in partnership with HIFU Prostate Services, LLC (HPS). HIFU Prostate Services, LLC (HPS) is a leading provider of minimally-invasive prostate cancer treatments using High Intensity Focused Ultrasound (HIFU). HIFU prostate treatments are performed at San Francisco Surgery Center (SFSC). SFSC offers patients a state-of-the-art facility that is convenient to hotels and the airport. Call Dr. Lazar at (707) 546-5553 for more information and to learn if you qualify , or simply fill out and submit our form.