Phone: (707) 546-5553
Email Us
1140 Sonoma Avenue 1-A
Santa Rosa, CA 95405

News

Researchers say genomic fingerprinting important for treating prostate cancer

While the majority of prostate cancers are slow growing and not fatal, some are aggressive and lethal. Genomic fingerprinting can help predict a tumor’s aggressiveness and tailor treatment plans; however, in the majority of cases involving multiple prostate tumors, only the largest tumor is typically fingerprinted — resulting in more aggressive tumors potentially going undetected.

Writing in the journal European Urology, a research team led by Hannelore Heemers, Ph.D., of Cleveland Clinic’s Lerner Research Institute Department of Cancer Biology, and James Mohler, M.D., chair of the Department of Urology at Roswell Park Cancer Institute in Buffalo, has demonstrated that when genomic fingerprinting is performed on only a single tumor sample, a smaller but more aggressive tumor could potentially be missed.

The finding underscores the importance of new evidence that prostate tumors can be genetically different within an individual patient, which carries important implications for patients and oncologists.

For the study, “Intratumoral and Intertumoral Genomic Heterogeneity of Multifocal Localized Prostate Cancer Impacts Molecular Classifications and Genomic Prognosticators,” the team used next-generation sequencing techniques to genotype prostate tumors from four men who underwent radical prostatectomy at Roswell Park. They also examined public data from the Cancer Genome Atlas to confirm their findings.

“We examined the molecular composition of heterogeneous cancerous tumors in a patient’s prostate. We found a lot of genetic differences among these tumors, and concluded that information from a single cancer biopsy is not sufficient to guide treatment decisions,” said Dr. Heemers. “Precise treatment is more complicated and the findings demonstrate a weakness in current genetic fingerprinting in prostate cancer.”

“High risk prostate cancers differ genetically among patients, among the different tumors within an individual patient and even within different sections of a single tumor,” said Dr. Mohler. “Clinicians need to be careful about using the information from a gene-based test, because the analysis may not have been performed on the most aggressive portion of a man’s prostate cancer.”

In “Disrupting the Status Quo in Prostate Cancer Diagnosis,” an editorial published in the same journal, Alastair David Lamb, MB.ChB., Ph.D., of Cambridge University Hospitals, and co-authors write: “Several aspects of this study are impressive. [The authors] addressed an important clinical and molecular question: What effect does tumor heterogeneity have on decision making in prostate cancer, specifically, with respect to molecular taxonomies of the disease?”

The study authors note that the use of genomic analysis to personalize treatment plans is in its infancy and that many more large studies will be required to develop next-generation prognostic tools that can be relied on to guide treatment selection and planning for men with prostate cancer.


Story Source:

Materials provided by Cleveland Clinic. Note: Content may be edited for style and length.

Source: “One single biopsy not sufficient to guide treatment decisions in prostate cancer, say researchers.” ScienceDaily. ScienceDaily, 22 September 2016.

About California HIFU

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

By | October 4th, 2016|News, Prostate Cancer|0 Comments

New trial results encourage patients to weigh long-term impact of treatment options with their doctors

(Published on ScienceDaily – September 15, 2016)

In light of the findings from the Prostate Testing for Cancer and Treatment (ProtecT) trial published in the New England Journal of Medicine, the American Society for Radiation Oncology (ASTRO) would like to congratulate the authors and investigators for conceiving and completing a difficult clinical trial to randomize care for 2,664 men who volunteered to be a part of this study. Their paper emphasizes the importance of joint decision making between prostate cancer patients and their physicians when weighing treatment options for early stage disease. Findings from the ProtecT trial can help patients understand the full range of approaches to manage their disease, including the risks and benefits of active monitoring versus early treatment with radiation therapy (RT) or surgery.

Ten-year findings from the trial indicate that for men with early stage prostate cancer, there is no difference in mortality rates following active monitoring, surgery or RT, and moreover, that cancer-specific deaths at ten years following diagnosis averaged only one percent for all men enrolled in the trial.

Growth of the cancer outside of the prostate did vary between monitoring and treatment groups. Rates of both regional spread and distant metastases were significantly higher for men who were monitored rather than treated for their early stage disease. Progression did not vary, however, between the surgery and RT groups, although patients in the trial reported different side effects with each modality.

“These findings underscore the essential role of dialogue in treatment selection,” said ASTRO President David C. Beyer, MD, FASTRO. “Men with prostate cancer are all different, and the relative costs and benefits associated with the multiple options to treat it can vary substantially between individuals. The best treatment decisions for prostate cancer, or any cancer, take into consideration the specifics of each individual patient’s disease, expectations and preferences. These options can be confusing, and patients should always make these decisions after consultation with a radiation oncologist and urologist”

ASTRO, the American Urological Association (AUA) and the American Society for Clinical Oncology (ASCO) are currently developing updated guidelines for the management of clinically localized prostate cancer. The recommendations, which update a 2007 collaborative guideline issued by the societies, are scheduled for publication in mid-2017.


Story Source:

The above post is reprinted from materials provided by American Society for Radiation Oncology (ASTRO). Note: Content may be edited for style and length.

By | September 20th, 2016|Dr. Michael Lazar, News, Prostate Cancer|0 Comments

Understanding Prostate Cancer; Know Your Cancer Risk Factors

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 7 men. But who is most at risk of getting prostate cancer and why?

There are several major factors that influence risk, and some of them unfortunately cannot be changed.

Age: The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 14 for ages 60 to 69.

In fact, more than 65% of all prostate cancers are diagnosed in men over the age of 65. The average age at diagnosis of prostate cancer in the United States is 69 years. After that age, the chance of developing prostate cancer becomes more common than any other cancer in men or women.

Race: African American men are more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease. Conversely, Asian men who live in Asia have the lowest risk.

Read the full story here …

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

By | September 13th, 2016|Dr. Michael Lazar, News|0 Comments

California HIFU and Dr. Michael Lazar Offers a Look at September’s Prostate Cancer Awareness Efforts

For this month’s awareness campaign Urologist and Prostate cancer expert Dr. Michael Lazar provides an overview of prostate cancer screening options, helping to empower men to make smart choices.

September is Prostate Cancer Awareness Month giving light to a very important health topic among men and their families. Second only to skin cancer, prostate cancer is the most common cancer among men in the USA and the second most common cause of cancer related death, lung cancer taking the number one spot. Currently it is estimated that one man in seven will be diagnosed with prostate cancer during his lifetime.

How Prostate Cancer differs from other cancers

Most prostate cancers tend to grow slowly, and don’t cause overt health problems for many men who have received a diagnosis. In certain situations, prostate cancer can be managed conservatively, especially in elderly men.

“Of course, prostate cancer is a serious health issue,” says Dr. Lazar. “But contrary to what you might think, the vast majority of prostate cancer patients do not die from the disease.” According to the American Cancer Society more than 2.9 million men in the United States who have been diagnosed with prostate cancer are still alive today.

Who is at risk?

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. The benefits of screening for prostate cancer is a hotly debated issue, and a most likely a decision made best on an individual basis. But for those who are concerned about prostate cancer and anyone in the high-risk group, the more obvious option may be to get screened early and at regular intervals.

To screen or not to screen

There are two schools of thought when it comes to screening for prostate cancer and no golden rule for men to follow coming from the experts. Those who advocate regular screening believe that finding and treating prostate cancer early offers a better chance of a cure, while the other school of thought recommends against regular screening because most prostate cancers grow very slowly and the side effects of over-treatment can be too onerous for an otherwise healthy man to bear.

While the Prostate-Specific Antigen (PSA) Blood Test remains an important tool in the diagnostic process, men over 40 should discuss screening with their physicians to determine if it is right for them. As early treatment options continue to improve, for some men knowing early may give them an opportunity to make a well-informed choice that they might not have otherwise.

Prostate Cancer Therapy Options

There are many treatment options available today including;

  • active surveillance
  • radiation therapy
  • surgery to remove the cancerous gland
  • freezing (cryotherapy)
  • hormonal therapy for very elderly patients
  • high intensity focused ultrasound (HIFU)

All of these treatment options can be effective under the right circumstances, and many of them have side effects that most men would prefer to avoid, if possible. The last option, HIFU is perhaps one of the most exciting non-invasive prostate cancer treatment options today – with few to zero side effects in many cases. The key to success is early detection, and swift treatment.

High Intensity Focused Ultrasound (HIFU)

HIFU is a 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. 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.

Dr. Lazar, a Santa Rosa urologist and prostate cancer expert, is a recognized leader in the use of high-intensity focused ultrasound (HIFU) for prostate cancer. He has been successfully treating patients with HIFU since 2007.

“HIFU may not be appropriate in every situation, but it is most effective for men who have early stage, localized prostate cancer that has not spread or metastasized outside the prostate,” says Dr. Lazar.

About Dr. Lazar and California HIFU

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 in order 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.

By | September 1st, 2016|News|0 Comments

Understanding the prostate cancer diagnosis

A doctor typically diagnoses prostate cancer after closely examining biopsy cells through a microscope. There are several types of cells in the prostate, and each contributes in its own way to the prostate’s development, architecture, and function.

But cancer cells look different than normal prostate cells. Pathologists look for these differences first to detect the presence of cancer and then to determine the cancer grade.

Gleason Grading

The Gleason grading system accounts for the five distinct patterns that prostate tumor cells tend to go through as they change from normal cells to tumor cells.

The cells are scored on a scale from 1 to 5:

  • “Low-grade” tumor cells (those closest to 1) tend to look very similar to normal cells.
  • “High-grade” tumor cells (closest to 5) have mutated so much that they often barely resemble the normal cells.

The Gleason Score

The pathologist looking at the biopsy sample assigns one Gleason grade to the most predominant pattern in your biopsy and a second Gleason grade to the second most predominant pattern. The two grades added together determine your Gleason score (between 2 and 10).

Generally speaking, cancers with lower Gleason scores (2 – 4) tend to be less aggressive, while cancers with higher Gleason scores (7 – 10) tend to be more aggressive.

It’s also important to know whether any Gleason 5 is present, even in just a small amount, and most pathologists will report this. Having any Gleason 5 in your biopsy or prostate puts you at a higher risk of recurrence.

Read the full story here …

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

By | August 23rd, 2016|News|0 Comments

Can prostate cancer be prevented?

National Cancer Institute offer these guidelines for the prevention of prostate cancer …

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied, including:

  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicines to treat a precancerouscondition or to keep cancer from starting.

Get more information about prostate cancer from the National Cancer Institute here …

High-intensity focused ultrasound or HIFU has many proven advantages over traditional treatment modalities for prostate disease. For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

By | August 16th, 2016|News|0 Comments

How early can prostate cancer be detected?

Screening is testing to find cancer in people before they have symptoms. For some types of cancer, screening can help find cancers at an early stage, when they are likely to be easier to treat. According to the American Cancer Society, prostate cancer can often be found before symptoms arise by testing the amount of prostate-specific antigen (PSA) in a man’s blood. Another way to find prostate cancer is the digital rectal exam (DRE), in which the doctor puts a gloved, lubricated finger into the rectum to feel the prostate gland.

If the results of either one of these tests are abnormal, further testing is often done to see if a man has cancer. If prostate cancer is found as a result of screening with the PSA test or DRE, it will probably be at an earlier, more treatable stage than if no screening were done.There is no question that screening can help find many prostate cancers early, but there are still questions about whether the benefits of screening outweigh the risks for most men. There are clearly both pros and cons to the prostate cancer screening tests in use today.At this time, the American Cancer Society (ACS) recommends that men thinking about getting screened for prostate cancer should make informed decisions based on available information, discussion with their doctor, and their own views on the possible benefits, risks, and limits of prostate cancer screening. To learn more about prostate cancer screening and the current American Cancer Society’s screening guidelines, see Prostate Cancer Prevention and Early Detection.

High-intensity focused ultrasound or HIFU has many proven advantages over traditional treatment modalities for prostate disease. For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

By | August 9th, 2016|Dr. Michael Lazar, HIFU, News|0 Comments

Prostate cancer news: Laser ablation becomes viable treatment

Prostate cancer patients may soon have a new option to treat their disease: laser heat. UCLA researchers have found that focal laser ablation – the precise application of heat via laser to a tumor – is both feasible and safe in men with intermediate risk prostate cancer.

An illustration of laser ablation to treat prostate cancer.

The Phase 1 study found no serious adverse effects or changes in urinary or sexual function six months after the procedure. The technique uses magnetic resonance imaging, or MRI, to guide the insertion of a laser fiber into cancerous tumors. When heated, the laser destroys the cancerous tissue.

A follow-up study, presented in a poster presentation at the American Urology Association meeting in May, showed the potential to transfer this treatment for the first time into a clinic setting, using a special device (Artemis) that combines both MRI and ultrasound for real-time imaging. The Artemis device arrived at UCLA in 2009. Since then, 2000 image-fusion biopsies have been performed – the most in the U.S. – and this large experience has paved the way for treatment to be done in the same way.

If the laser technique, known as MRI-guided focal laser ablation, proves effective in further studies — especially using the new MRI-ultrasound fusion machine — it could improve treatment options and outcomes for men treated for such cancers, said study senior author Dr. Leonard Marks, a professor of urology and director of the UCLA Active Surveillance Program. Historically, prostate cancer has been treated with surgery and radiation, which can result in serious side effects such as erectile dysfunction and urinary incontinence.

“Our feeling was that if you can see prostate cancer using the fusion MRI and can put a needle in the spot to biopsy it, why not stick a laser fiber in the tumor the same way to kill it,” Marks said. “This is akin to a lumpectomy for breast cancer. Instead of removing the whole organ, target just the cancer inside it. What we are doing with prostate cancer now is like using a sledgehammer to kill a flea.”

Read the full story here …

In the U.S. HIFU with the Sonablate® 500 has many proven advantages over traditional treatment modalities for prostate disease. For more information about HIFU treatment or to make an appointment call: (707) 546-5553.
By | July 12th, 2016|HIFU, News|0 Comments

Obesity and a high-fat diet promote prostate cancer progression

Metabolites from a fatty diet join forces with the cancer-driving gene MYC to reprogram prostate cancer cells to grow faster, finds new study. This discovery solidifies a direct link between obesity and lethal prostate cancer.

your-questions-answeredAt the 2016 Annual American Association for Cancer Research (AACR) Conference, Giorgia Zadra, PhD, of the Harvard: Dana-Farber Cancer Institute and Brigham and Women’s Hospital, presented results from a study that helped to clarify the relationship between obesity and prostate cancer.

The skinny? Fat increases the activity of a critical cancer-driving gene called MYC.

Cancer is a greedy disease. Tumors plunder the body’s resources – vitamins and nutrients, energy and oxygen, and vital space as tumors grow to ultimately cause lethal damage. Worst of all, cancer steals precious time away from patients and their loved ones.

It follows then, that having a high-fat diet may be like pouring fuel on the fire, by providing cancer cells with even more of the resources they need. In fact, a number of recent population studies have linked obesity and a high-fat diet with an increased risk for advanced, lethal prostate cancer, especially among African-American men. Unfortunately, the exact biological reasons behind this phenomenon have remained elusive.

Investigating this important question required the intersection of four distinct fields of study: dietary metabolism, “epigenetics” (a mechanism of gene regulation), the biology of cancer-causing genes, and public health sciences.

To develop a comprehensive understanding of how obesity and a high-fat diet promote prostate cancer progression, Zadra, who studies cancer cell metabolism, teamed up with Prostate Cancer Foundation (PCF) Young Investigator David P. Labbé, PhD, of the Harvard: Dana-Farber Cancer Institute, who studies the regulation of gene expression in healthy and malignant cells by epigenetics.  Read the full story …

HIFU with the Sonablate® 500 has many proven advantages over traditional treatment modalities for prostate disease. For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

By | July 5th, 2016|Dr. Michael Lazar, News, Prostate Cancer|0 Comments

Mayo Clinic: Tips on Prostate cancer prevention

There’s no proven prostate cancer prevention strategy. But one way to reduce the risk of prostate cancer is by making healthy choices, such as exercising and eating a healthy diet. Study results often conflict with each other and most studies aren’t designed to definitively prove whether something prevents prostate cancer. As a result, no clear ways to prevent prostate cancer have emerged.

In general, doctors recommend that men with an average risk of prostate cancer make choices that benefit their overall health if they’re interested in prostate cancer prevention.

Choose a healthy diet

There is some evidence that choosing a healthy diet that’s low in fat and full of fruits and vegetables may contribute to a lower risk of prostate cancer, though this hasn’t been proved concretely.

good-food-1328410

Choose a low-fat diet. Foods that contain fats include meats, nuts, oils and dairy products, such as milk and cheese.

In some studies, men who ate the highest amount of fat each day had an increased risk of prostate cancer. While this association doesn’t prove that excess fat causes prostate cancer, reducing the amount of fat you eat each day has other proven benefits, such as helping you control your weight and helping your heart.

To reduce the amount of fat you eat each day, limit fatty foods or choose low-fat varieties. For instance, reduce the amount of fat you add to foods when cooking, select leaner cuts of meat, and choose low-fat or reduced-fat dairy products.

Read the full story here …

HIFU with the Sonablate® 500 has many proven advantages over traditional treatment modalities for prostate disease. For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

By | June 28th, 2016|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments