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Doctors believe it’s important to discuss pros and cons of prostate cancer screening with patients

A new study finds that while a blood test that helps to screen for prostate cancer remains common, only 30 percent of men in a large national survey reported having a balanced discussion of the advantages and disadvantages of the screening with their doctor. Moreover, having such a discussion of both pros and cons has become less likely since the U.S. Preventive Services Task Force issued a recommendation against performing prostate-specific antigen (PSA) testing in 2012.

“That only about a third of patients reported having a discussion of advantages and disadvantages is an alarming statistic,” said study lead author Dr. George Turini III, clinical instructor in medical science at the Warren Alpert Medical School of Brown University and a urologist with the Southcoast Physician Group.

Co-author Dr. Joseph Renzulli, associate professor of surgery and a urologist at the Minimally Invasive Urology Institute at Miriam Hospital, added, “The concept of ‘shared decision making’ for prostate cancer screening is not occurring in the community.”

For example, in 2014 out of a sample of 111,241 men who responded to the national Behavioral Risk Factor Surveillance System survey, 29.5 percent reported discussing both advantages and disadvantages, 33.9 percent discussed neither, 35.7 percent reported discussing only advantages of PSA, and 0.8 percent reported discussing only disadvantages. In data from 2012, before the task force made its recommendation against the test, out of 105,812 men who responded to the survey, 30.1 percent discussed both, 30.5 percent discussed neither, 38.5 percent discussed only advantages, and 0.8 percent discussed only disadvantages.

Meanwhile, 63.0 percent of the men in 2012 had PSA tests, as did 62.4 percent of the men in 2014, according to the study published online in the journal Urology. In each year thousands of men had the test without having a discussion of how it could either benefit them, for instance via early detection of cancer, or lead to unnecessary adversity, such as a side effects from biopsy or unneeded treatment. They either got no information or only one side of the story.

In addition, the researchers found, men who have low incomes, did not finish high school, lack insurance, or are Hispanic were significantly less likely than men overall to report hearing about the pros and cons of screening via the PSA test, the study found.

“The most vulnerable men are getting less counseling,” said co-author Annie Gjelsvik, assistant professor of epidemiology in the Brown University School of Public Health.

A controversial topic

The PSA test reveals blood levels of a protein naturally secreted by the prostate. Levels could become elevated for a number of reasons including the normal enlargement of the prostate as men age, Turini said. But cancer could also elevate them.

When the task force in 2012 discouraged PSA testing, Turini said, it was because there are risks to what follows from screening. If cancer is suspected, it can only be confirmed with a biopsy and that could cause problems such as infection, bleeding or discomfort.

Beyond those concerns, if prostate cancer is confirmed, the risks inherent in treatment options such as surgery, radiation or hormonal alteration, can be “truly life altering,” he said.

“In some cases, a low volume of less aggressive prostate cancer may not necessitate treatment, but even in those cases where a ‘treatment’ is not performed in favor of active surveillance, the emotional distress of a cancer diagnosis shouldn’t be underestimated,” Turini said.

But whenever a cancer does present a threat to health, there are also clear advantages to catching it early. Therefore many urologists still believe that doctors and their patients should weigh these pros and cons of screening. For that reason, the authors wrote, the American Urologic Association and the American Cancer Society advocate thorough discussion and decision-making between doctors and patients.

The study authors sought to understand the state of those discussions and how the task force recommendation may have changed them. Gjelsvik noted that it’s important to measure and track the full spectrum of effects of public health actions, such as the new national recommendations.

The findings could be explained by factors independent of the U.S. Preventive Services Task Force recommendation, the authors acknowledged, but they concluded the paper with this concern: “We believe our findings may be indicative of a shift in practice patterns away from detailed pre-screening discussions among health care providers who have implemented the [USPSTF] recommendation into their care giving. Long-term evaluation of this trend is necessary, particularly to ensure that men who are given an order for a PSA test receive the absolutely necessary counseling required to allow them to appreciate the important consequences associated with the decision to pursue screening.”

Amid all the findings of concern, including the overall trend and disparities of income, education, insurance and ethnicity, the researchers did find one bright spot: Black men, who are known to be at higher risk for prostate cancer incidence and death, were more likely to report having discussed advantages and disadvantages than men on average.

Turini said the study suggests that urologists may be able to do more to help their primary care physician colleagues have balanced and informative conversations with their patients. Primary care physicians are increasingly pressed for time with each patient and it can seem easy to order an additional test if blood is going to be drawn for other purposes anyway, Turini said. But the moment when a PSA test comes back with an elevated reading is not the ideal moment to only begin the conversation of what that could mean.

“It’s our job in the urology community to make it as easy as possible for the primary care physicians and other general practitioners to comfortably disseminate as complete and balanced information as possible,” he said.


Story Source:

Materials provided by Brown University. Note: Content may be edited for style and length.


Journal Reference:

  1. George A Turini, Annie Gjelsvik, Joseph F Renzulli. The State of Pre-Screening Discussions About PSA Testing Following Implementation of the 2012 USPSTF Task Force Statement. Urology, 2017; DOI: 10.1016/j.urology.2016.12.069

Read this article on science daily: www.sciencedaily.com/releases/2017/03/170328132148.htm.

By | April 24th, 2017|Uncategorized|0 Comments

Common Prostate Cancer Therapy May Trigger Dementia

A new analysis of patients who have undergone treatment for prostate cancer shows a connection between androgen deprivation therapy (ADT) — a testosterone-lowering therapy and a common treatment for the disease — and dementia, according to researchers from the Perelman School of Medicine at the University of Pennsylvania. Their previous studies have shown men who undergo ADT may be at an increased risk of dementia, including Alzheimer’s disease, compared to men who were not treated with the therapy.

This new analysis — the largest of its kind ever performed on this topic — shows that all existing studies taken together support the link to dementia and show a possible link to Alzheimer’s. The findings are published this week in Prostate Cancer and Prostatic Diseases. “Since publishing our initial findings, there has been a lot of other research on this topic, and we wanted to see what that research was saying,” said the study’s lead author Kevin Nead, MD, MPhil, a resident in Radiation Oncology at Penn. “This analysis tells us that the composite message of existing studies is that androgen deprivation therapy is associated with dementia.”

The team compiled data from four different global databases looking at studies on ADT patients and dementia and Alzheimer’s. An analysis of more than 50,000 patients worldwide showed a consistent statistical link between men who underwent ADT for prostate cancer and men who developed dementia. Nead says the numbers show correlation, not causation at this point, but that there is evidence of a direct connection.

“Research shows androgens play a key role in neuron maintenance and growth, so the longer you undergo this therapy to decrease androgens, the more it may impact the brain’s normal functions,” Nead said.

The analysis was less conclusive on the question of Alzheimer’s. While there was still a connection, it was not as clearly defined as the link to dementia. Nead says evidence for a link between ADT and neurocognitive dysfunction is growing and should be part of the conversation between doctors and patients.

“There’s enough evidence of these links that patients should know about them when considering their options,” Nead said.


Story Source:

Materials provided by University of Pennsylvania School of Medicine. Note: Content may be edited for style and length.

Journal Reference:

K T Nead, S Sinha, P L Nguyen. Androgen deprivation therapy for prostate cancer and dementia risk: a systematic review and meta-analysis. Prostate Cancer and Prostatic Diseases, 2017; DOI: 10.1038/pcan.2017.10

Read this on Science Daily: University of Pennsylvania School of Medicine. “Link between common prostate cancer treatment, dementia detailed in new study: Analysis elaborates on correlation between dementia and testosterone-lowering therapy.” ScienceDaily, 30 March 2017. www.sciencedaily.com/releases/2017/03/170330114954.htm.


HIFU has many proven advantages over traditional treatment modalities for prostate disease. More: www.californiahifu.com #prostatecancer #HIFU #prostate #menshealth #cancerresearch

By | April 4th, 2017|News, Prostate Cancer|0 Comments

Study Reveals Quality of Life Concerns Paramount in Prostate Cancer Treatment Options

For many men newly diagnosed with early-stage prostate cancer, concerns about potential quality-of-life issues often guide treatment decisions. A new study led by UNC Lineberger Comprehensive Cancer Center researchers identifies distinct patterns of side effects that patients could use to guide their choices.

In the Journal of the American Medical Association, the study examines quality-of-life outcomes for the treatment choices most patients will face. Those choices include active surveillance, radical prostatectomy, external beam radiation treatment, and brachytherapy, a treatment that involves inserting radioactive seeds into the prostate. “Patients diagnosed with early-stage prostate cancer — and that’s the vast majority of patients with this disease — face many treatment options that are thought to be similarly efficacious,” said Ronald C. Chen, MD, MPH, UNC Lineberger member and associate professor in the UNC School of Medicine Department of Radiation Oncology. “Therefore, the quality-of-life differences among these options become an important consideration when patients are trying to make their decisions.”

The study is needed as prostate cancer treatment technologies have advanced, and as active surveillance has emerged as an important strategy for sparing low-risk prostate cancer patients unnecessary side effects. Active surveillance involves regular testing to check for cancer growth rather than immediate treatment, and many patients with low-risk prostate cancer on active surveillance may be able to avoid treatment for several years or altogether. The American Society of Clinical Oncology has endorsed active surveillance for most men with low-risk prostate cancer.

“There has not been a large-scale comparison of the quality-of-life impact for these modern options, until now,” Chen said. “Existing quality of life studies have studied older types of surgery and radiation that are no longer used, and patients need updated information regarding the impact of modern treatment options so they can make informed decisions about the choices they face today.”

For the study, UNC Lineberger researchers surveyed 1,141 men who were diagnosed with early-stage prostate cancer between January 2011 and June 2013. They compared patients’ self-reported quality of life related to bowel, urination, and sexual function across four strategies: active surveillance; prostatectomy; external beam radiotherapy; and brachytherapy. Almost all prostatectomy patients received robotic surgery, and almost all external beam radiotherapy patients received intensity-modulated radiation, reflecting modern treatment technologies.

Prostatectomy was linked to higher sexual dysfunction and urinary leakage than the other options. At two years after treatment, more than 57 percent of men who had normal sexual function prior to treatment reported poor sexual function after surgery, compared with 27 percent who reported poor sexual function after external beam radiation, 34 percent after brachytherapy, and 25 percent after active surveillance. “With modern robotic surgery, sexual dysfunction and urinary incontinence continue to be some of the side effects that surgery can cause,” Chen said. “While we do see improvement over time, even at the two-year point, surgery still causes more of these issues than other treatments.”

Meanwhile, other treatment choices were linked to worse scores for other side effects. External beam radiotherapy and brachytherapy caused more short-term urinary tract obstruction and irritation, while external beam radiotherapy was linked to more short-term bowel symptoms.

For the group of men who chose active surveillance, urinary issues and sexual function worsened over time. This is likely partly due to aging, and partly due to some men who experienced cancer progression that necessitated treatments that caused these side effects.

“At the two-year time point, patients who chose radiotherapy or brachytherapy actually had quality-of-life results similar to patient who chose active surveillance, and that may be surprising to some patients,” Chen said. “With advances in treatment technologies for both surgery and radiation, patients and physicians today must base their decisions on the quality-of-life results of modern treatments, not on results for outdated treatment modalities that caused much more side effects historically.” Overall, Chen said the data can help patients weigh their treatment options based on their own baseline health and on their priorities.

“With all of the modern treatment options, patients should have accurate and realistic expectations about the frequency of side effects from treatment,” Chen said. “We found that the different treatment options have trade-offs in side effects. Each patient can look at these data to see what they care about most.”


Story Source:

Materials provided by University of North Carolina Health Care System. Note: Content may be edited for style and length.


Journal Reference:

  1. Ronald C. Chen et al. Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer. JAMA, March 2017 DOI: 10.1001/jama.2017.1652

See this article on ScienceDaily: 21 March 2017. www.sciencedaily.com/releases/2017/03/170321124231.htm.
By | March 27th, 2017|Dr. Michael Lazar, News|0 Comments

Study reveals genetic connection to aggressive prostate cancer

An international study published in the Journal of the National Cancer Institute has identified a genetic connection to the aggressive form of prostate cancer. The study showed a threefold increase in the risk of aggressive prostate cancer for men with the genetic mutation. The frequency of the gene variants varied from 6 to 14% of the population of men with prostate cancer.

Much like the association between BRCA gene mutation and the risk for breast cancer in women changed the approach to treatment/ prevention, the identification of the Kallikrein 6 gene region may change the course of prostate cancer care through a blood test developed by the Lunenfeld-Tanenbaum Research Institute.

The study was led by Dr. Alexandre Zlotta, Director of Uro-Oncology at Mount Sinai Hospital, and researcher with the Lunenfeld-Tanenbaum Research Institute, part of Sinai Health System in Toronto, Canada, and Dr. Paul Boutros, Principal Investigator, Informatics and Bio-computing, Ontario Institute for Cancer Research (OICR). The first author of the paper was Dr. Laurent Briollais, Senior Investigator, Lunenfeld-Tanenbaum Research Institute.

These findings are important because it is well established that most men will die with prostate cancer, and not from the disease. Dr. Zlotta was the lead author of a study in 2013 which revealed the unexpected high prevalence of indolent prostate cancer in men. Diagnosing the aggressive form of the disease is an important unmet need.

“As an oncologist I know firsthand how valuable it would be to have a genetic tool that could help choose the best course of action with my patients,” explains Zlotta. “It would help spare patients with indolent disease from unnecessary treatments and their side effects and aid in the diagnosis and directing patients with aggressive disease to the appropriate treatment.” Up until now, no single test could predict the severity of the cancer type- the current PSA test (Kallikrein 3), which is located near Kallikrein 6, only identifies the risk of prostate cancer, not the severity.

To identify the relevant mutations the scientists analyzed the blood samples of 1,858 men from three independent cohorts in Europe and North America: the Swiss arm of the European Randomized Study for Prostate Cancer Screening, the large American Screening trial, Prostate, Lung, Colorectal, and Ovarian (PLCO), Princess Margaret Cancer Centre (University Health Network) and Mount Sinai Hospital (Sinai Health System) in Toronto. The KLK6 variants also independently predicted treatment failure after surgery or radiation for prostate cancer in an independent cohort of 130 men from the International Cancer Genome Consortium (ICGC).


Story Source:

Materials provided by Lunenfeld-Tanenbaum Research Institute. Note: Content may be edited for style and length.


Journal Reference:

  1. Laurent Briollais, Hilmi Ozcelik, Jingxiong Xu, Maciej Kwiatkowski, Emilie Lalonde, Dorota H. Sendorek, Neil E. Fleshner, Franz Recker, Cynthia Kuk, Ekaterina Olkhov-Mitsel, Tristan Juvet, Ioannis Prassas, John Trachtenberg, Ants Toi, Michael Fraser, Theodorus van der Kwast, Robert G. Bristow, Bharati Bapat, Eleftherios P. Diamandis, Paul C. Boutros, Alexandre R. Zlotta. Germline Mutations in the Kallikrein 6 Region and Predisposition for Aggressive Prostate Cancer. JNCI: Journal of the National Cancer Institute, 2017; 109 (4) DOI: 10.1093/jnci/djw258

Read this article on ScienceDaily:

“Genetic association with aggressive prostate cancer discovered: Study showed a threefold increase in the risk of aggressive prostate cancer for men with the genetic mutation..” 16 March 2017. www.sciencedaily.com/releases/2017/03/170316141120.htm.

By | March 21st, 2017|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments

Dr. Michael Lazar Offers Free HIFU Presentation Online

Dr. Michael Lazar of California HIFU recently gave a presentation in Santa Rosa discussing the benefits of high-intensity focused ultrasound for prostate cancer and now offers the presentation online.

A public presentation recently held in Santa Rosa for a group gathered to learn more about high-intensity focused ultrasound (HIFU) provided an overview of how this exciting new prostate cancer treatment works, and included comparisons to other treatment options, as well as HIFU patient outcomes. The event also offered people a chance to meet Dr. Lazar who is a four-time board certified urologist and prostate cancer specialist providing HIFU to patients in California. It also gave attendees a chance to learn more prostate cancer and to ask important questions.

During the presentation, Dr. Lazar discussed how HIFU offers hope for prostate cancer patients by targeting cancer cells through a focused precision technology with minimal to no side effects. The procedure is accomplished in a one to four-hour session and patients return to their normal routines fairly quickly. “Our recent presentation was so well received, we wanted to be able to offer it to a wider audience,” explained Dr. Lazar. “By providing this information to patients online we hope to be able to educate men who currently have prostate cancer about HIFU as a treatment option, and to perhaps provide some important answers to unasked questions.”

About HIFU

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 more than 15 years. Approximately 4,000 U.S. men have received HIFU treatment outside the U.S. prior to FDA approval.

“I started treating with HIFU in 2007 and since receiving FDA approval in 2015 began offering the treatment in San Francisco,” Dr. Lazar said.  Prior to FDA approval Dr. Lazar explained that 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 HIFU for prostate cancer in San Francisco.

Serving as Medical Director for HIFU Prostate Services (HPS) Dr. Lazar 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.

For patients with prostate cancer, HIFU treatment is most effective in the early stages, where it is localized to the prostate. Performed on an out-patient basis, the procedure is able to preserve healthy tissue and nerves, so urine flow and erectile function is maintained in a high percent of cases. “This is an extremely well tolerated procedure,” said Dr. Lazar. “Patients return to normal activity very quickly. There is no blood loss and very little pain when compared to other treatments for prostate cancer.”

Dr. Lazar explains how all prostate cancer treatments can have side effects. But with HIFU the side effects are lower than with any of the other treatments for prostate cancer. “Unique to HIFU, if you have an HIFU treatment and still require additional treatment, patients can opt to have a second HIFU treatment, or any other treatment they decide to pursue,” he says.

The presentation is free and available online on the California HIFU YouTube Channel accessible by following this link: 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.

 

 

By | March 6th, 2017|HIFU, News|0 Comments

Researchers target cholesterol to stop prostate cancer

Advanced prostate cancer and high blood cholesterol have long been known to be connected, but it has been a chicken-or-egg problem.

Now a team led by researchers at the Duke Cancer Institute have identified a cellular process that cancer cells hijack to hoard cholesterol and fuel their growth. Identifying this process could inform the development of better ways to control cholesterol accumulation in tumors, potentially leading to improved survival for prostate cancer patients.

The findings are published online this month in the journal Cancer Research.

“Prostate cancer cells, as well as some other solid tumors, have been shown to contain higher cholesterol levels than normal cells,” said senior author Donald McDonnell, Ph.D., chairman of the Department of Pharmacology and Cancer Biology at Duke. “All cells need cholesterol to grow, and too much of it can stimulate uncontrolled growth.

“Prostate cancer cells somehow bypass the cellular control switch that regulates the levels of cholesterol allowing them to accumulate this fat,” McDonnell said. “This process has not been well understood. In this study, we show how prostate cancer cells accomplish this.”

McDonnell and colleagues began by identifying genes involved in cholesterol regulation in prostate tumors. They homed in on a specific gene, CYP27A1, which is a key component of the machinery that governs the level of cholesterol within cells.

In patients with prostate cancer, the expression of the CYP27A1 gene in tumors is significantly lower, and this is especially true for men with aggressive cancers compared to the tumors in men with more benign disease. Downregulation of this gene basically shuts off the sensor that cells use to gauge when they have taken up enough cholesterol. This in turn allows accumulation of this fat in tumor cells. Access to more cholesterol gives prostate cancer cells a selective growth advantage.

“It remains to be determined how this regulatory activity can be restored and/or whether it’s possible to mitigate the effects of the increased cholesterol uptake that result from the loss of CYP27A1 expression,” McDonnell said.

He said statin use alone might help, but perhaps not enough, since tumors could simply rev up the regulation of the cholesterol manufacturing process in tumors to compensate.

McDonnell said is lab is continuing the research, including finding ways to induce cells to eject cholesterol, reverse the inhibition of CYP27A1 activity, or introduce compounds that interfere with cholesterol-production in the tumor.


Story Source:

Materials provided by Duke University Medical Center. Note: Content may be edited for style and length.


Journal Reference:

  1. Mahmoud A Alfaqih, Erik R Nelson, Wen Liu, Rachid Safi, Jeff S Jasper, Everardo Macias, Joseph Geradts, Laura G Dubois, Will Thompson, Michael R Freeman, Ching-yi Chang, Jen-Tsan Chi, Donald P McDonnell, Stephen J. Freedland. CYP27A1 loss dysregulates cholesterol homeostasis in prostate cancer. Cancer Research, 2017; canres.2738.2016 DOI: 10.1158/0008-5472.CAN-16-2738

Duke University Medical Center. “Prostate cancer cells grow with malfunction of cholesterol control in cells: Shutting down this source at the root cause could improve cancer survival.” ScienceDaily. ScienceDaily, 21 February 2017. www.sciencedaily.com/releases/2017/02/170221130703.htm.
By | March 1st, 2017|Dr. Michael Lazar, News, Prostate Cancer|0 Comments

New discovery may lead to blood test predicting and preventing prostate cancer spread

University of Adelaide researchers have uncovered a new pathway which regulates the spread of prostate cancer around the body.

Published in the journal Cancer Research, the discovery has potential to lead to the development of a blood test that could predict whether cancer will spread from the prostate tumour to other parts of the body. The research also reveals potential new targets for drugs that may inhibit the spread of cancer.

“Prostate cancers only kill men after they have spread or ‘metastasised’ from the prostate,” says project leader Dr Luke Selth, Senior Research Fellow at the University of Adelaide’s Dame Roma Mitchell Cancer Research Laboratories and a member of the Freemasons Foundation Centre for Men’s Health.

“The identification of markers that accurately predict, at an early stage, prostate tumours that are likely to metastasise could guide the urgency and aggressiveness of treatment — and this could save lives.”

The international research team — led by the University of Adelaide and including members from the University of Michigan, Vancouver Prostate Centre, the Mayo Clinic and Johns Hopkins University — showed that a specific microRNA (a type of molecule involved in regulating the level and activity of genes) called miR-194 promotes cancer metastasis by inhibiting a key protein called SOCS2. SOCS2 can suppress the spread of cancer cells.

“In previous work, we had found that a high level of miR-194 in a patient’s blood was associated with rapid relapse of prostate cancer following surgical removal of the tumour,” says Dr Selth. “This new work explains why miR-194 is associated with a poor outcome, and in the process reveals a completely novel pathway regulating prostate cancer metastasis.

“Importantly, measuring miR-194 in a patient’s blood at the time of diagnosis could become a test for the likelihood of metastasis. Patients with high levels of miR-194 in their blood could receive more aggressive treatment to reduce the chance of the cancer spreading to other parts of the body.” Dr Selth’s team is currently testing this idea using larger patient groups to validate their findings.

Dr Selth says miR-194 also represents a potential therapeutic target. “There are currently no drugs that effectively inhibit the spread of prostate cancer,” he says. “We propose that inhibiting miR-194 could reduce rates of metastasis in patients with aggressive disease, but the development of a drug to achieve this goal is still a long way off.”

Story Source:

Materials provided by University of Adelaide. Note: Content may be edited for style and length.

Journal Reference:

  1. Rajdeep Das, Phillip A Gregory, Rayzel C Fernandes, Iza Denis, Qingqing Wang, Scott L Townley, Shuang G. Zhao, Adrienne Hanson, Marie A Pickering, Heather K Armstrong, Noor A Lokman, Esmaeil Ebrahimie, Elai Davicioni, Robert B. Jenkins, R. Jeffrey Karnes, Ashley E. Ross, Robert B Den, Eric A. Klein, Kim N. Chi, Hayley S Ramshaw, Elizabeth D Williams, Amina Zoubedi, Gregory J Goodall, Felix Y. Feng, Lisa M. Butler, Wayne D Tilley, Luke A Selth. MicroRNA-194 promotes prostate cancer metastasis by inhibiting SOCS2. Cancer Research, 2016; canres.2529.2016 DOI: 10.1158/0008-5472.CAN-16-2529

Read this article on ScienceDaily:

University of Adelaide. “Predicting and preventing prostate cancer spread.” ScienceDaily. ScienceDaily, 25 January 2017. www.sciencedaily.com/releases/2017/01/170125091702.htm.
By | February 21st, 2017|HIFU, News, Prostate Cancer|0 Comments

Prostate Cancer News: Emotional distress may lead to more aggressive treatment

The anxiety many men experience after being diagnosed with prostate cancer may lead them to choose potentially unnecessary treatment options, researchers from the University at Buffalo and Roswell Park Cancer Institute report in a new study.

“Emotional distress may motivate men with low-risk prostate cancer to choose more aggressive treatment, such as choosing surgery over active surveillance,” said UB’s Heather Orom, the lead author on the study, published in the February issue of the Journal of Urology.

“It underscores what we have been pushing a long time for, which is, ‘Let’s make this decision as informed and supported as possible.’ If distress early on is influencing treatment choice, then maybe we help men by providing clearer information about prognosis and strategies for dealing with anxiety. We hope this will help improve the treatment decision making process and ultimately, the patient’s quality of life,” added Orom, PhD, associate professor of community health and health behavior in UB’s School of Public Health and Health Professions.

The study involved 1,531 men with newly diagnosed, clinically localized prostate cancer, meaning the disease hadn’t spread to other parts of the body.

Researchers measured participants’ emotional distress with the Distress Thermometer, an 11-point scale ranging from 0 (no distress) to 10 (extreme distress). The men were assessed after diagnosis and again as soon as they had made their treatment decision.

The majority of study participants had either low- or intermediate-risk disease, and were more likely to have been treated with surgery, followed by radiation and active surveillance.

“Men’s level of emotional distress shortly after diagnosis predicted greater likelihood of choosing surgery over active surveillance,” the researchers report. “Importantly, this was true among men with low-risk disease, for whom active surveillance may be a clinically viable option and side effects of surgery might be avoided.”

While prostate cancer is a major disease in the U.S., it is not a death sentence, according to the American Cancer Society, which estimates there are nearly 3 million prostate cancer survivors alive today.

However, overtreatment is a concern, and surgery and radiation therapy have side effects that include erectile dysfunction and incontinence, which, for the majority of men diagnosed with low-risk prostate cancer, can be avoided by instead choosing active surveillance to monitor the cancer and considering treatment if the disease progresses.

“There’s an interest in driving the decision-making experience to prevent overtreatment and ensure that men have full information about all the side effects so they can make a choice that’s preference and value driven,” Orom said. “We don’t want men to make a decision that they’ll regret later on.”

“The goal of most physicians treating men with prostate cancer is to help their patients and family members through a difficult process and help their patients receive appropriate treatment,” said Willie Underwood III, MD, MS, MPH, an associate professor in Roswell Park’s Department of Urology, and a paper co-author.

“To do so, it is helpful for physicians to better understand what is motivating men’s decisions and to address negative motivators such as emotional distress to prevent men from receiving a treatment that they don’t need or will later regret,” Underwood added.


Story Source:

Materials provided by University at Buffalo. Original written by David J. Hill. Note: Content may be edited for style and length.


Journal Reference:

  1. Heather Orom, Willie Underwood, Caitlin Biddle. Emotional Distress Increases the Likelihood of Undergoing Surgery among Men with Localized Prostate Cancer. The Journal of Urology, 2017; 197 (2): 350 DOI: 10.1016/j.juro.2016.08.007

Read this article on ScienceDaily: University at Buffalo. “For men with prostate cancer, emotional distress may lead to more aggressive treatment.” ScienceDaily. ScienceDaily, 11 January 2017. www.sciencedaily.com/releases/2017/01/170111103920.htm.
By | February 14th, 2017|Dr. Michael Lazar, News, Prostate Cancer|0 Comments

Free HIFU Info Session Scheduled for February

Do you have prostate cancer?

There is now a non-invasive treatment option.

Join Dr. Michael Lazar of California HIFU for a special Prostate Cancer Treatment Information session scheduled for Thurs., Feb. 16, 2017 at 7 p.m. This free session will be held at the Friedman Event Center, 4676 Mayette Ave., Santa Rosa, CA 95405. Dr. Lazar will discuss how Sonablate HIFU can treat Prostate Cancer with lower risk of side effects such as impotence and incontinence. HIFU is radiation free – provides quick recovery – requires no chemotherapy and no surgery.

Free and open to the public. Call for reservations today Jennifer Radovich 707-546-5553.

Refreshments will be provided.

Brought to you by HIFU Prostate Services and California HIFU.

By | January 31st, 2017|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments

Prostate Cancer Rates Take a Nose Dive Per Latest Statistics

Dr. Michael Lazar of California HIFU, Urologist and Prostate Cancer expert reflects on the latest American Cancer Society statics

The results from the American Cancer Society’s newest report on cancer rates is good news for everyone and particularly good news for prostate cancer patients: incidents of cancer is down as is the likelihood of prostate cancer patients dying from the diagnosis.

According to the report the cancer death rate has dropped from its peak of 215.1 in 1991 to 161.2 in 2014 (per 100K population), the most recent year for which data was available to analyze. Overall the decline in cancer is linked with decreases in smoking and advances in early detection and treatment. The four major cancer drops are:

  • lung (- 43% between 1990 and 2014 among males and -17% between 2002 and 2014 among females)
  • breast (-38% from 1989 to 2014)
  • prostate (-51% from 1993 to 2014)
  • colorectal (-51% from 1976 to 2014)

“This is really exciting news for anyone who specializes in prostate cancer,” says Michael Lazar, M.D. “And its particularly good news for our patients. When a man is diagnosed with cancer, whether it’s prostate cancer or some other cancer – the news is always difficult to accept. With the number of people being diagnosed with prostate cancer dropping steadily along with the expected death rates, patients are now more empowered to be optimistic about their treatment options.”

According to the American Cancer Society, the decline in new cancer rates for men can be attributed to the recent drop in prostate cancer diagnoses. This has to do with the fact that routine screening with the PSA blood test is no longer recommended out of concerns for over-diagnosis and treatment of positive results that are best left untreated. Therefore, fewer cases of prostate cancer are now being detected. But this does not need to lessen the importance of getting screened for prostate cancer when symptoms are apparent.

“Although this is really good news, men who are concerned about prostate cancer, and anyone in the high-risk group still needs to be to screened early and at regular intervals,” says Dr. Lazar. “Once cancer has advanced beyond the prostate gland, available treatment options become more radical.”

The highest risk groups for prostate cancer are men over the age of 50, African-American men, and men who have a father, brother or son who has had prostate cancer.

About Prostate Cancer

Most prostate cancers tend to grow slowly, and don’t cause obvious health problems for men who have received a diagnosis. In certain situations, prostate cancer can be managed conservatively, especially in elderly men. But one treatment that stands out among more invasive options for prostate cancer is High-intensity focused ultrasound (HIFU) and it is most effective for men who have been diagnose and are in the early stages of the disease. Therefore, this is one technology that requires vigilance at the early stages when HIFU would be most effective for prostate cancer eradication.

“For patients with prostate cancer, HIFU treatment is most effective in the early stages,” explains Dr. Lazar. “When the cancer is localized to the prostate treatment by HIFU is extremely effective. Unlike other treatments, this 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.”

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.

About Dr. Lazar

Dr. Michael Lazar is the only Northern California physician recognized as a leader in the use of high-intensity focused ultrasound (HIFU) for prostate cancer. He has been successfully treating patients with HIFU since 2007. Dr. Lazar formed California HIFU to offer minimally invasive prostate cancer treatment to men with the Sonablate.

For more information about HIFU treatment which is now available in San Francisco, or to make an appointment call: (707) 546-5553. Visit us online to learn more.