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Prostate Cancer

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

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

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

New Study: PSA levels in younger men might predict future risk of prostate cancer

mountain-bikers-in-brazil-1-1433086Prostate cancer screening with prostate-specific antigen (PSA) has been shown to reduce death and the spread of prostate cancer to other parts of the body, but the PSA test remains highly controversial as it frequently leads to over diagnosis and over treatment of men who may not be at risk.

Smarter screening strategies that can improve the accuracy of diagnosing lethal prostate cancer are urgently needed. Through a prospective study of US men, investigators from Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health have found that measuring PSA levels in younger men (between the ages of 40 and 59) could accurately predict future risk of lethal prostate cancer later in life. Their findings suggest that screening PSA levels in men at mid-life may help identify those who are at greater risk and should be monitored more closely.

“We found a single baseline PSA-level measurement during midlife could accurately predict future risk of lethal prostate cancer,” said co-lead author Mark Preston, MD, MPH, a physician in BWH’s Division of Urology. “These data identify subgroups of men, based on their PSA levels at a given age, who could benefit from screening intervals tailored to their actual magnitude of risk.”

Read the full story here …

Dr. Michael Lazar, a Santa Rosa urologist and prostate cancer expert, 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 now offers a HIFU Program in partnership with HIFU Prostate Services, LLC (HPS). HIFU Prostate Services, LLC (HPS) is a leading provider of minimally-invasive prostate cancer treatments using High Intensity Focused Ultrasound (HIFU). HIFU prostate treatments are performed at San Francisco Surgery Center (SFSC). SFSC offers patients a state-of-the-art facility that is convenient to hotels and the airport. For more answers on HIFU visit this page ...  For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

By | June 21st, 2016|News, Prostate Cancer, Urology|0 Comments

California HIFU and Dr. Michael Lazar Recognizes Men’s Health Month With a Look at Prostate Cancer

California HIFU and Dr. Michael Lazar are helping to recognize Men’s Health Month by providing some valuable information and resources for men on Prostate Cancer. The idea behind Men’s Health Month is to heighten the awareness of preventable health problems like prostate cancer, and to encourage early detection and treatment. Dr. Lazar and his staff are proud to be early leaders in the usage of HIFU, a medical procedure that applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue with prostate cancer through ablation.

Informed Decision Making

your-questions-answeredAccording to The Center for Disease Control and Prevention (CDC) it is important for men to be aware of prostate cancer risks and to make informed decisions. This happens best when a man—

  • Understands the nature and risk of prostate cancer.
  • Understands the risks of, benefits of, and alternatives to screening.
  • Participates in the decision to be screened or not at a level he desires.
  • Makes a decision consistent with his preferences and values.

The CDC as well as other federal agencies follow the prostate cancer screening recommendations set forth by the U.S. Preventive Services Task Force, which recommends against prostate specific antigen (PSA)-based screening for men who do not have symptoms. Other organizations, like the American Urological Association,[PDF-310KB] the American Cancer Society, and the American College of Physicians may have other recommendations. It is important to talk to a doctor and get routine screenings.

Some men may be having prostate problems and want to learn more about prostate cancer symptoms and risk factors, the PSA screening test, and conditions that are not cancer such as an enlarged prostate (BPH) and prostatitis. To learn more follow this link for practical lists, tips, and medical images …

Knowing your prostate cancer therapy options empowers you to make smart choices

Prostate cancer is the leading solid organ cancer in the USA and the second most common cause of cancer related death. Worldwide, it is the fourth most common cancer with differing biologic activity in different cultures, probably related to different lifestyles. Many prostate cancers can be managed conservatively, especially in elderly men. But larger tumors, those with higher Gleason score and higher (and rising) PSA levels, especially in younger men, should be treated more aggressively.

Prostate Cancer Therapy Options

There are many options available to residents of Northern California. Prostate cancer is usually managed with active surveillance, radiation therapy, surgery to remove the cancerous gland, freezing (cryotherapy), or high intensity focused ultrasound (HIFU). Hormonal therapy is used to control cancer that has spread beyond the prostate and is no longer curable, or for very elderly patients with a limited life expectancy.

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. However, at the focal point of the sound waves (like a magnifying glass focusing the rays of the sun to burn a leaf), the tissue temperature is raised to 90 degrees Celsius, destroying the targeted tissue.

Learn more about HIFU treatment for prostate cancer …

By | June 14th, 2016|News, Prostate Cancer|0 Comments

Focal Therapy For Prostate Cancer

hifu mini article cropped-logo-square.jpgFocal therapy, often referred to as a “male lumpectomy,” is a general term for a variety of noninvasive techniques for destroying small tumors inside the prostate while leaving the gland intact and sparing most of its normal tissue

As technology has advanced, physicians now have the ability to diagnose patients with prostate cancer earlier which means that often times tumors within the prostate are small and contained to the prostate.

Advanced imaging techniques, allow doctors to pinpoint exactly where the tumor within the prostate is located using multi-parametric MRI and UroNav fusion biopsies, enabling them to target only the tumor within the prostate, leaving other tissue unharmed.

Focal therapy is being studied all over the world because of the large potential for reducing side effects such as urinary incontinence and erectile dysfunction. Additionally, due to the noninvasive nature of focal therapy, treatment and recovery times are dramatically reduced.

Read this article on HIFU Prostate Services.

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 at: www.californiahifu.com.

Santa Rosa Urologist Dr. Michael Lazar is Making History with a Nonsurgical, Outpatient Treatment for Prostate Cancer

Dr. Lazar and his staff are proud to be early leaders in the usage of HIFU.

Dr. Lazar and his staff are proud to be early leaders in the usage of HIFU.

High-intensity focused ultrasound (HIFU) waves target cancer cells with precision in a one-to-four-hour procedure that has little or no side affects and a quick recovery rate, giving those diagnosed with prostate cancer another choice over surgery or radiation.

HIFU has been used in other countries for years, and Dr. Lazar has been instrumental in bringing this innovative treatment to the United States. It was approved by the Food and Drug Administration last October, and he has since been performing the procedure at San Francisco Surgery Center for patients who travel from across the country to receive this leading edge treatment.

“The oncological results for HIFU are broadly comparable to radical surgery or radiation but the side effects are less,” says Dr. Lazar. “If the HIFU procedure is performed in the morning, a patient is typically up and around by dinnertime and can often return to normal activity within a few days without the use of pain-killers.”

Dr. Lazar has recently become involved with HIFU Prostate Services, LLC as their Medical Director.  HIFU Prostate Services is the first company to establish centers in the United States offering Sonablate HIFU technology. HIFU Prostate Services makes the non-invasive treatment option available through partnerships with some of the largest urology practices and experienced physicians that establish Sonablate HIFU Centers of Excellence.  Urologists are able to create their own HIFU program and offer treatment within their region. These centers also offer training and proctorship opportunities.

Along with serving as the Medical Director of HIFU Prostate Services, LLC. Dr. Lazar is also a clinical partner with his HIFU Center of Excellence at the state-of-the-art SFSC in downtown San Francisco. Dr. Lazar and his staff are proud to be early leaders in the usage of HIFU. He has worked tirelessly with SonaCare, the manufacturer of the instruments, to bring this innovative service for prostate cancer treatment to patients in the United States.

The HIFU technique is also being developed to treat many other types of cancer including breast, uterine, liver, kidney, and brain.

For those with prostate cancer, HIFU treatment is most effective for patients with early stage cancer, where it is localized to the prostate. It is performed on an out-patient basis that takes one to four hours. A urinary catheter is placed after the procedure for one to three weeks.

While some patients might experience slight irritation, “some patients can have a catheter and they don’t even know it.”

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.

Another advantage is recovery time. With surgery or radiation treatment, recuperation time for patients is six to eight weeks, whereas HIFU patients return to normal activities within days.

Dr-michael-lazarDr. Lazar has been treating U.S. prostate cancer patients in Mexico since 2007, where he performed hundreds of outpatient procedures at a U.S. Joint Commission approved bilingual hospital. There, he also served as a HIFU instructor for other physicians and is now training doctors in San Francisco.

Because the treatment is so new, it will take another couple of years before it will be routinely covered by insurance. Those with non-Medicare insurance may get reimbursed to varying degrees.

“What will really make this explode is when the insurance companies are routinely covering the procedure and it will become widely available to all patients. The costs for this procedure are drastically less than for radical surgical and radiation procedures, and with fewer complications so insurance companies will be incentivized to cover it,” Dr. Lazar commented.

As soon as more doctors are trained to perform the procedure in San Francisco, Dr. Lazar plans to bring the treatment to his Santa Rosa office.

“I expect as word gets out there will be a progressive demand for this procedure, so training physicians will be a high priority. It’s already expanding rapidly and we put in an order for our tenth machine,” said Dr. Lazar, adding he won’t be giving up his general urology practice any time soon. “This is what I love to do.”