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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

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

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.

 

Researchers unravel genetic codes to determine why inherited prostate cancer is so deadly

Prostate cancer researchers have discovered a key piece in the genetic puzzle of why men born with a BRCA2 mutation may develop aggressive localized cancers that resist treatment and become lethal for up to 50 per cent of patients within five years.

Canadian and Australian prostate cancer researchers have discovered a key piece in the genetic puzzle of why men born with a BRCA2 mutation may develop aggressive localized cancers that resist treatment and become lethal for up to 50 per cent of patients within five years.

The findings, published online in Nature Communications, show that BRCA2-associated tumours are already pre-set to be aggressive, even before treatment. This is because the genes normally involved in regulating cell growth and division are abnormal in the BRCA2-associated cancers right from the get-go and therefore are resistant to therapy right up front, says co-principal investigator Dr. Robert Bristow, clinician-scientist at Princess Margaret Cancer Centre, University Health Network. In the Nature Communications study, Dr. Bristow and co-principal investigators Dr. Paul Boutros at the Ontario Institute for Cancer Research, and Prof.

Gail Risbridger at Monash University, Melbourne, Australia, compared 15 patients with BRCA2-inherited prostate cancer with 500 prostate cancer patients from the general population with non-inherited (“sporadic”) prostate cancer. In the related study of 500 tumours from Canadian men with non-inherited prostate cancer also published in Nature, Drs. Bristow and Boutros analyses led to the discovery of a new genetic fingerprint that identifies when curable disease may turn aggressive.Although BRCA2-inherited disease affects less than 2 per cent of men with prostate cancer, Dr. Bristow says the research sets the stage to rethink ways to use other drugs differently to personalize treatment for more men.

“The pathways that we discovered to be abnormal in the localized BRCA2-associated cancers are usually only found in general population cancers when they become resistant to hormone therapy and spread through the body,” says Dr. Bristow. “These include pathways related to the repair of DNA damage, cell division, the receptor for the male hormone testosterone and cell-to-cell signaling. “We now know need to explore the use of novel therapies to offset the BRCA2-associated aggressiveness earlier on in the treatment of these men and improve survival in an otherwise lethal tumour,” he says. “This might include different types of chemotherapy or the use of molecular-targeted drugs that specifically target the changes associated with BRCA2 mutation.”

“This is an exciting time in prostate cancer research in which the genetics of individual men and their cancers are beginning to dictate precise and customized treatment,” he adds. “It is an example of the power of international collaboration and team science to crack the genetic code even in the rarest of tumours.”

See this story on Science Daily: 9 January 2017. www.sciencedaily.com/releases/2017/01/170109125240.htm
Story Source: Materials provided by University Health Network (UHN). Note: Content may be edited for style and length.
By | January 10th, 2017|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments

Sonablate HIFU Tissue Change Monitoring

HIFU, which stands for high intensity focused ultrasound is a recently approved new technology for prostate tissue ablation. Many urologists have worked with HIFU for several years to offer their patients a minimally invasive treatment option for prostate cancer, either as a part of a clinical trial or at international treatment centers outside the United States.

There are currently two different medical devices that use HIFU energy to heat and destroy tissue in the prostate. The most technologically advanced HIFU device for prostate cancer is called the Sonablate. The Sonablate is a software directed device that includes a computer console, a transrectal probe and a chilling unit. The Sonablate software that physicians use to plan and execute Sonablate HIFU treatment has state-of-the-art features that make it the safest and most precise HIFU device for prostate disease available.

Using the Sonablate state-of-the-art software physicians obtain real-time images of the prostate that are used to map out and target exactly where HIFU should be delivered. Once treatment plan is mapped, HIFU energy is delivered to those areas.

One of the unique key features that the Sonablate has is called Tissue Change Monitoring, or more simply, TCM.

What is TCM?

The most simple way to explain it is that TCM allows the treating HIFU doctor to monitor changes that happen to the tissue in the prostate after the HIFU energy has been delivered. This monitoring of tissue is important because the doctor will immediately know if enough energy has been delivered to effectively destroy the tissue.

While HIFU is being delivered to heat and destroy tissue in the prostate, physicians have the ability to monitor how the tissue is changing and reacting. The Sonablate gives unique feedback on changes to the tissue so the doctor can monitor exactly what is happening and make adjustments as needed for the best outcomes.

Read the full story here …

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 #prostatecancer #HIFU #prostate #menshealth

By | December 20th, 2016|HIFU, News, Prostate Cancer|0 Comments

New study suggests a more accurate system for early detection, treatment of prostate cancer

A new study may lead to a more accurate system for early detection, diagnosis, and treatment of prostate cancer. It’s a promising development given prostate cancer is the second most common cancer among men worldwide, responsible for 308,000 deaths in 2012 and estimated to take 26,120 lives in the U.S. alone in 2016.


New research coauthored by Brigham Young University researchers may lead to a more accurate system for early detection, diagnosis, and treatment of prostate cancer.

The new study, published this week in Proceedings of the National Academy of Sciences, details a computer model that uses medical images to reproduce the growth patterns of prostate cancer on the anatomy of a patient’s prostate.

This type of mathematical modeling and simulation of disease (aka predictive medicine) can lead to personalized treatment and more accurate forecasting of clinical outcomes.

“There is a lot of room for improvement in both the diagnosis and management of prostate cancer,” said study coauthor Michael Scott, BYU professor of civil and environmental engineering. “We’re using computer modeling to capture the behavior of prostate tumor growth which will hopefully lead to minimally invasive predictive procedures which can be used in clinical practice.”

Current diagnosis methods include invasive biopsy procedures which too often lead to patients being over-treated or under-treated. Complicating matters is the fact that prostate cancer can remain undiagnosed because early stages of the disease may not produce symptoms until a tumor is either very large or has invaded other tissues.

The new system could lead to both earlier diagnosis and less invasive testing. It’s a promising development given prostate cancer is the second most common cancer among men worldwide, responsible for 308,000 deaths in 2012 and estimated to take 26,120 lives in the U.S. alone in 2016.

Scott, and fellow BYU professor Kevin Tew teamed up with colleagues at the University of Coruna, UT-Austin and Carnegie Mellon for the study. The personalized tumor growth simulations leveraged the high-performance computing resources available through BYU’s Fulton Supercomputing Lab.

Scott said the research is still in its infancy and extensive validation and refinement of the model must occur before it is ready for clinical application. That said, “it’s likely that these types of models will eventually turn up in medical practice,” he added.

“We are entering an age where we will see the emergence of tools which leverage computation to improve diagnosis of disease,” Scott said. “And we’re not the only people working in this area — it’s rapidly growing.”


Story Source:

Materials provided by Brigham Young University. Original written by Todd Hollingshead. Note: Content may be edited for style and length.

Read on ScienceDaily: Brigham Young University. “Computer modeling could lead to new method for detecting, managing prostate cancer.” ScienceDaily. ScienceDaily, 22 November 2016. www.sciencedaily.com/releases/2016/11/161122080748.htm.


High-intensity focused ultrasound or HIFU has many proven advantages over traditional treatment modalities for prostate disease. HIFU is most effective for patients with early stage prostate cancer where the cancer is localized to the prostate. Visit our website to learn more: http://www.californiahifu.com/ #prostatecancer #HIFU #prostate #menshealth

By | December 6th, 2016|HIFU, News, Prostate Cancer|0 Comments

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 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