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Dr. Michael Lazar

Key ingredients to thwart the growth of prostate cancer found in certain foods

When you dine on curry and baked apples, enjoy the fact that you are eating something that could play a role starving — or even preventing — cancer.

New research from The University of Texas at Austin identifies several natural compounds found in food, including turmeric, apple peels and red grapes, as key ingredients that could thwart the growth of prostate cancer, the most common cancer afflicting U.S. men.

Published online this week in Precision Oncology, the new paper uses a novel analytical approach to screen numerous plant-based chemicals instead of testing a single agent as many studies do, discovering specific combinations that shrink prostate cancer tumors.

“After screening a natural compound library, we developed an unbiased look at combinations of nutrients that have a better effect on prostate cancer than existing drugs,” says corresponding author Stefano Tiziani, assistant professor in the Department of Nutritional Sciences and Dell Pediatric Research Institute at UT Austin. “The beauty of this study is that we were able to inhibit tumor growth in mice without toxicity.”

During the past decade, some cancer research has highlighted the potential therapies found in plants, including chemicals found in foods such as turmeric, apple peels and green tea. These compounds minimize one of the risk factors for cancer, inflammation within the body. People who have chronic inflammation because of chronic infection, autoimmune disease or conditions such as obesity have a higher cancer risk because of damage to normal cells.

The researchers first tested 142 natural compounds on mouse and human cell lines to see which inhibited prostate cancer cell growth when administered alone or in combination with another nutrient. The most promising active ingredients were then tested on model animals: ursolic acid, a waxy natural chemical found in apple peels and rosemary; curcumin, the bright yellow plant compound in turmeric; and resveratrol, a natural compound common to red grapes or berries.

“These nutrients have potential anti-cancer properties and are readily available,” says Tiziani. “We only need to increase concentration beyond levels found in a healthy diet for an effect on prostate cancer cells.”

The new research paper also demonstrates how the plant-based chemicals work together. Combining ursolic acid with either curcumin or resveratrol prevents cancer cells from gobbling something that they need to grow, glutamine. This is a neat solution: blocking the uptake of a nutrient needed by prostate cancer cells with nutrients that are commonly in the human diet.


Story Source:

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


Journal Reference:

  1. Alessia Lodi, Achinto Saha, Xiyuan Lu, Bo Wang, Enrique Sentandreu, Meghan Collins, Mikhail G. Kolonin, John DiGiovanni, Stefano Tiziani. Combinatorial treatment with natural compounds in prostate cancer inhibits prostate tumor growth and leads to key modulations of cancer cell metabolism. npj Precision Oncology, 2017; 1 (1) DOI: 10.1038/s41698-017-0024-z

Read this article on Science Daily: University of Texas at Austin. “Starving prostate cancer with what you eat: Apple peels, red grapes, turmeric.” ScienceDaily. ScienceDaily, 6 June 2017. www.sciencedaily.com/releases/2017/06/170606112750.htm.

Hal & Mary: Another Happy HIFU Story

Posted on HIFU Prostate Services 5/27/2017

If you ask Hal Plimpton, he will tell you that he is a semi-retired, international logistics consultant who has owned and operated his own business for many years.

If his wife, Mary, happens to hear him say he is “semi” retired, she will laugh and probably roll her eyes. “He was supposed to retire 15 years ago, but he’s still working,” said Mary.

However, one thing that Hal and Mary can agree on is that they made a good treatment decision several years ago when Hal was diagnosed with prostate cancer.

“I could tell that he felt really good about HIFU (high intensity focused ultrasound). He had confidence in the technology that it was going to work. I was a little nervous about all the unknowns, but ultimately I knew that if he felt good about it he would have a good experience – so I felt good about it too, “ said Mary.

Hal may have ultimately been confident in HIFU, but it wasn’t a conclusion he came to without doing a lot of research first – and connecting with a lot of people.

Mary and Hal’s prostate cancer journey included ups and downs that finally led them to the right decision for Hal but their experience with diagnosis and research on treatments was extensive – and in some respects, disconcerting.

“I followed my PSA for many years with my family doctor but in February of 2011, he referred me to a urologist for a biopsy,” said Hal. The pathology report indicated that he had prostate cancer with a Gleason score of 7.

“The first urologist we saw outlined several traditional treatments including surgery and radiation; I felt really uncomfortable with what I heard about the potential side effects,” said Hal.

“We were given some brochures and told to read them and decide what we wanted to do,” Mary said. “At that point, we went into research mode

“We saw a handful of doctors and it was not pleasant, informative or reassuring,” said Mary. “The physicians were focused on conventional treatment options, and we felt like each of them was trying to sell us on a specific treatment that they were personally invested in. It was very disheartening.”

“We found one book that had a single page about HIFU. Hal is kind of an ‘early adopter,’ and he was intrigued. But a urologist we spoke with was dismissive.” Mary said.

Coincidentally, Mary and Hal talked to a neighbor who connected them to a friend who had had a successful HIFU procedure some 5 years previously in Canada. Hal was able to talk to him at length and felt a heightened interest in the technique.

Mary was also learning more about HIFU. Curious about this new-to-them technology which she knew was of interest to Hal. She Googled the topic, picked up the phone, and called a company called, USHIFU in North Carolina. She was connected to a nurse, Karen, who was teamed with Dr. Michael Lazar, the then-sole HIFU-trained urologist in northern California.

Karen was wonderful. Our conversation was educational, but more than that she was a sympathetic ear,” said Mary. “She sent me a packet of information and before long we had an appointment to see Dr. Lazar.”

Meeting with Dr. Lazar was very different than their experiences with the other doctors they had seen. “He was so open and empathetic. He answered all our questions and was just very informative,” said Hal.

“He was was not selling any one particular approach. It was a very different kind of appointment from others we’d had,” added Mary.

Hal had HIFU with Dr. Lazar in Puerto Vallarta, Mexico in June of 2011 (HIFU wasn’t available in the U.S. outside of a clinical trial until after October 2015). A couple of friends accompanied them to PV for moral support – and one ended up having HIFU himself a few months later, also with Dr. Lazar.

“I might have opted for something more conventional but I knew this is what HAL WANTED, and, to me, I felt that if he believed in it, that elevated the likelihood of a positive outcome,” said Mary. “I cannot imagine that we could have had a better experience – in all respects – and it worked for us.”

Hal is happy to report that after HIFU, his PSA dropped from 7 to 0.1 and has stayed stable ever since. Almost more importantly, he had no adverse side effects.

“We are believers in HIFU for sure,” said Hal. “HIFU may not be ‘the answer’ for every man, but for families researching their options, we would urge you to consider HIFU. – And we cannot say enough good things about Dr. Lazar.”

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

Doctor’s Own Prostate Cancer Diagnosis Leads to Early Intervention and Positive Results with HIFU

Dr. Michael Lazar of California HIFU shares the story of how friend and fellow surgeon Dr. Robert Pugach underwent HIFU treatment for prostate cancer following an early diagnosis with the disease.

Dr. Robert Pugach

It’s the news no man wants to hear from a doctor, “… you have prostate cancer.” And when you are a practicing physician who receives this news, all the more room for concern. Dr. Robert Pugach, medical director of Pacific Coast Urology Medical Center was diagnosed with prostate cancer last year and opted to undergo HIFU treatment with urologist and prostate cancer specialist Dr. Michael Lazar of California HIFU earlier this month. What transpired is truly an inspirational account of one man’s journey from diagnosis to cure. Dr. Pugach has chronicled his experience in a series of blog posts featured on the HIFU Prostate Services Website.

Following a cancer diagnosis by an internist and a follow-up biopsy with Dr. Lazar, Dr. Pugach opted to forgo the wait and watch approach most commonly prescribed for men testing with low levels of PSA. “I’m not a gambler, especially when it comes to my health,” he says. “I plan to live a long, healthy life.”

As a prostate cancer expert himself, Dr. Puach was all too aware of the potential for permanent urinary incontinence and erectile dysfunction with more conventional treatments, and was adamant about avoiding radiation due to the likelihood of a cancer recurrence in the future. Bolstered by his own experience with HIFU combined with positive results viewed first-hand with his own brother who underwent HIFU almost a decade earlier, Dr. Pauch was in the perfect frame of mind for pursing HIFU for himself.

In the weeks leading up to the procedure with Dr. Lazar and California HIFU, Dr. Pauch reasoned that there was absolutely nothing to fear, having been diagnosed early and having confidence in his doctor gave him a sense of empowerment over the disease.

“I had complete and total confidence in my doctor. I had the luxury of knowing Dr. Lazar well for 10 years when we travelled out of the country with our patients to treat their cancers with HIFU. When you watch someone in the OR, a fellow doctor like me can tell instantly what his skill level is. In Michael Lazar’s case, he is as good as one can get and is a true professional,” he explains.

HIFU: Non-invasive Treatment for Prostate Cancer

HIFU is a FDA approved precise and targeted therapy for the treatment of prostate cancer, 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 only high enough to destroy the targeted tissue.

“Although recommendations are that most men opt to wait and watch when diagnosed with prostate cancer, HIFU is a treatment that is most effective for men who have early stage, localized prostate cancer that has not spread or metastasized outside the prostate,” explains Dr. Lazar. “As with Dr. Pugach the results are most promising when the cancer is caught while it is at the early, more treatable stage. That means; taking action relatively soon following the diagnosis.”

A happy ending to a terrifying diagnosis

On May 9th Dr. Pugach took a taxi to the San Francisco Surgery Center where Dr. Lazar performs HIFU. There the new patient was greeted by “… a wonderful and caring staff.” A short four hours later, the procedure is over and Dr. Lazar reported to the patient that all is well. “Dr. Lazar told me my procedure went perfectly – good words to hear!”

As most HIFU patients report, Dr. Pugach says there was no pain following the procedure and recovery was swift. “I learned that what I had always told my patients about how good they would feel afterwards was now proven to me to be true. Instead of having the common side effects of radical surgery, or contemplating seven weeks of radiation, I felt great…”

Dr. Pugach says he knows how good it feels to have a potentially serious or lethal disease diagnosed at a stage where it is less frightening to deal with. “I’ve learned how wonderful and enduring a good doctor-patient relationship can be and how a good bedside manner does more than many medications in helping a patient feel good.”

The moral of this story may well be to consider all of the options when dealing with prostate cancer, and although the temptation might be to put off routine screenings, early diagnosis might just save your life.

“Screening for prostate cancer is a simple process that allows us to look for cancer before any symptoms become obvious to the patient,” explains Dr. Lazar. “This process can help us discover the cancer at an earlier stage while the patient has the opportunity to take advantage of newer, less invasive options for treating prostate cancer such as HIFU.”

About California HIFU and Dr. Lazar

Dr. Michael Lazar is the only Northern California physician recognized as a leader in the use 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 or to make an appointment call: (707) 546-5553 or visit our website: www.californiahifu.com.

Dr. Pugach’s full story “When the Doctor Becomes the Patient” may be viewed online in an ongoing series on the HIFU Prostate Services Website.

 

New blood test better at predicting prostate cancer risk than PSA

A new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease. By identifying molecular changes in the PSA protein, the findings of this study suggest that once validated, use of IsoPSA may reduce the need for biopsy, and may lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.

A team of researchers from Cleveland Clinic, Louis Stokes Cleveland VA Medical Center, Kaiser Permanente Northwest, and other clinical sites have demonstrated that a new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease.

By identifying molecular changes in the prostate specific antigen (PSA) protein, the findings, published online last month by European Urology, suggest that once validated, use of IsoPSA may substantially reduce the need for biopsy, and may thus lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.

The research team, led by Cleveland Clinic’s Eric Klein, M.D., conducted a multi center prospective study of 261 men scheduled for prostate biopsy at five academic and community centers in the U.S. enrolled between August 2015 and December 2016.

“Despite criticism, PSA has transformed the landscape of early detection, screening, and management of prostate cancer in the last few decades,” said Dr. Klein, chair of Cleveland Clinic’s Glickman Urological & Kidney Institute. “Unfortunately, PSA is tissue-specific but not cancer-specific, leading to overdiagnosis and overtreatment of biologically insignificant cancers, which is widely recognized as a key limitation in its clinical utility.”

The study directly compared the clinical performance of a new test based on PSA, called IsoPSA, to PSA itself with patients already scheduled for prostate biopsy. IsoPSA proved significantly superior to PSA in two key indications: discriminating between prostate cancer and benign conditions; and identifying patients with high-grade disease. The former indication is potentially useful for using IsoPSA for screening by primary care physicians, while the second is helpful for urologists in identifying patients who would benefit from curative intent therapy and other applications.

The results show that if validated and adopted clinically, IsoPSA could significantly reduce the rate of unnecessary biopsies by almost 50 percent. “The methodology used in the IsoPSA assay represents a significant departure from conventional ways to define biomarkers in blood, and may be applicable to improving other cancer biomarkers,” said Dr. Klein.

“Due to its inherent simplicity, requiring only a blood draw and presenting information to the physician in familiar context using a single number — just like PSA itself — we are quite hopeful in IsoPSA’s future utility after further validation studies,” said Mark Stovsky, M.D., co-author and staff member, Cleveland Clinic Glickman Urological & Kidney Institute.


Story Source: Materials provided by Cleveland Clinic.

Journal Reference: Eric A. Klein, Arnon Chait, Jason M. Hafron, Kenneth M. Kernen, Kannan Manickam, Andrew J. Stephenson, Mathew Wagner, Hui Zhu, Aimee Kestranek, Boris Zaslavsky, Mark Stovsky. The Single-parameter, Structure-based IsoPSA Assay Demonstrates Improved Diagnostic Accuracy for Detection of Any Prostate Cancer and High-grade Prostate Cancer Compared to a Concentration-based Assay of Total Prostate-specific Antigen: A Preliminary Repo. European Urology, 2017; DOI: 10.1016/j.eururo.2017.03.025

Read this article on Science Daily. “New blood test is more accurate in predicting prostate cancer risk than PSA: IsoPSA assay can help in determining the need for prostate biopsy for patients.” ScienceDaily. ScienceDaily, 15 May 2017. www.sciencedaily.com/releases/2017/05/170515122149.htm.

By | May 16th, 2017|Dr. Michael Lazar, HIFU, 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

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

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.