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

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

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

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

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

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

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

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

A controversial topic

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

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

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

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

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

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

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

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

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

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


Story Source:

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


Journal Reference:

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

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

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

New research reveals evidence linking inflammation to increased prostate cancer risk

Dr. Michael Lazar of California HIFU discusses the latest research on prostate cancer which offers hope for future treatments and may help to prevent the disease from becoming aggressive.

An interesting new study, conducted by Dr. Andrew Goldstein, an assistant professor of molecular biology and a team of UCLA researchers, highlights a previously unrecognized type of cell that is found in uncommonly high numbers in inflamed areas of the prostate gland. These cells are now thought to initiate prostate cancer in response to genetic mutations.

The study results suggest inflammation increases overall risk for the disease by increasing the available number of affected cells that can develop into prostate cancer. “The findings from research such as this will hopefully lead to the development of better treatments for prostate cancer and prostatitis and offer new screening methods for the diseases associated with the prostate gland,” explains Dr. Michael Lazar, director of California HIFU.

Background on the research

Scientists have known that one of the risk factors for aggressive prostate cancer is chronic inflammation of the prostate (a process whereby cells from the immune system migrate to the prostate gland), but exactly how that process unfolds has been somewhat of a mystery.

Although prostate cancer itself is more common in older men, prostatitis – or inflammation of the prostate gland – can strike at any age. Statistics suggest that as many as one in every six men have this condition at some stage during their lives.

Prostate Inflammation vs. prostatitis

Prostate disease accompanied by inflammation is any medical problem that affects the prostate gland and can include;

  • benign prostatic hyperplasia (BPH)
  • prostatitis
  • prostate cancer

Inflammation of the prostate gland or ‘prostatitis’ is commonly accompanied by symptoms of soreness and irritation of the prostate gland. It is accompanied by frequent, sometimes painful urination and lower back pain that can eventually lead to fever, chills and muscle pain – hallmarks of bacterial infection.

Prostatitis can be caused by both a bacterial infection (acute) and non-bacterial inflammation (chronic). But no matter which aspect of the disease a man has, it can be very painful and have a negative effect on quality of life. The new research suggests that inflammation of the prostate such as occurs in prostatitis can lead to prostate cancer in predictable ways.

Research details

UCLA-led research has previously shown that two different types of cells, known as basal and luminal, represented potential precursors to prostate cancer. Further research by colleagues at Johns Hopkins Medical Center observed that prostate cells in the proximity of inflammation appeared different under the microscope and expressed different genes, leading to the hypothesis that these types of cells were more likely to multiply than are normal prostate cells not under stress by inflammation.

Under the new study the UCLA team discovered that cells originating from areas with inflammation are indeed the more aggressive cells known to initiate tumors, validating the earlier hypothesis and expanding on the possibility for more research, and potentially better treatment options.

“With this new research urologists now have the opportunity to look at the importance of managing symptoms of inflammation early,” says Dr. Lazar. “Better management of the inflammation could very well lead to prostate cancer prevention. Continuing research on the subject will likely help to direct better treatments as new study results are revealed.”

About California HIFU and Dr. Lazar

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. HIFU has many proven advantages over traditional treatment modalities for prostate disease.

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.

By | January 3rd, 2017|Uncategorized|0 Comments

California HIFU is the Right Choice for Prostate Cancer Treatment

For the past five years, Chris Lockheed’s PSA numbers had been going up. Then, last November, a biopsy revealed that he had two tumors on his prostate. Chris, 68, started doing research into what kind of options for treatment were available to him. When a radiation specialist in Rohnert Park told him about Dr. Michael Lazar and the HIFU procedure, he did more homework. He found that Dr. Lazar had done hundreds of these procedures in Puerto Vallarta, and the treatment was given FDA approval last October.

“Dr. Lazar explained everything, and he’s done over 300 of the procedures, that’s why I went to him. I felt very confident. I looked at all of the choices and said ‘this is for me’.” In March, Chris, who lives in Santa Rosa, drove down to the San Francisco Surgery Center for the three
hour outpatient procedure. Afterwards, feeling no side affects, Chris got some take-out food and drove home. Chris also mentioned he needed no
pain medication. The only side affect he had was the catheter, which was “a little irritating.”

Chris is a pet supplies representative, and his travels take him from Marin to Eureka. He is also a professional drummer who has recorded with Epic, CBS/Columbia, Capitol, Universal, and independent labels. “To be careful, I took a week off from work, but I was still active.” A week after the procedure, he went back to Dr. Lazar to have the catheter taken out.

“There was no leaking urine issues or erectile dysfunction, everything was fine. After getting the catheter out, everything was totally normal.” A
week after the procedure Chris was back at work, drumming on the weekend, and working in the yard. Chris is so satisfied with the results he has been recommending Dr. Lazar and the HIFU procedure to other men as an option to prostate surgery.

Lazar testimonial jpg

For more information about HIFU treatment or to make an appointment call: (707) 546-5553.

Study Supports Hemiablation HIFU for Prostate Cancer

High-intensity focused ultrasound (HIFU) hemiablation offers mid-term promising functional and oncologic outcomes in carefully selected patients with clinically localized prostate cancer (PCa), according to researchers.

In a prospective cohort study of 50 patients who underwent HIFU ablation of a single lobe of the prostate, the 5-year actuarial metastases-free survival, cancer-specific survival, and overall survival rates were 93%, 100%, and 87%, respectively, Roland van Velthoven, MD, and colleagues at the Jules Bordet Institute in Brussels, Belgium, reported in Prostate Cancer and Prostatic Diseases (2016;19:79-83).

The researchers documented complete continence (no pads) and erections sufficient for intercourse in 94% and 80% of patients, respectively.

“Our study suggests that hemiablation HIFU is a valid mini-invasive focal therapy strategy, feasible in day-to-day practice with satisfactory functional outcomes,” the investigators concluded.

The study included patients with localized PCa, a life expectancy of at least 5 years, and a prostate volume less than 40 cm3. The researchers used both multiparametric magnetic resonance imaging (MRI) and MRI-targeted biopsy to localize the tumor.

The cohort had a median follow-up of 39.5 months. The patients had a mean nadir PSA value of 1.6 ng/mL, a 72% reduction compared with initial PSA pre-treatment values. The median time to achieve PSA nadir was 3 months. Biochemical recurrence, according to the Phoenix definition (PSA nadir plus 2 ng/mL) and Stuttgart definition (nadir plus 1.2 ng/mL), occurred in 28% and 36% of patients, respectively.

The 5-year actuarial recurrence-free survival rates for patients with low- and intermediate-risk disease were 75% and 36%, respectively, according to the Phoenix definition and 58% and 27%, respectively, according to the Stuttgart definition.

Three patients showed a residual tumor in the treated lobe, and these were correctly treated with salvage radiation therapy.

Recently FDA approved HIFU for Prostate Cancer makes news in Kentucky

HIFU is making news all over the United States now that it has achieved FDA approval. In the news video below HIFU Prostate Services physician partner, Dr. John Jurige speaks with Louisville’s news station, WHAS about HIFU for prostate cancer. Dr. Jurige treated the first patients in the US with HIFU outside of a clinical trial on November 10, 2015. View the video below …

HIFU Prostate Services has partnered with Dr. Michael Lazar and San Francisco Surgery Center to establish a HIFU Center of Excellence in downtown San Franciso where patients can now receive the Sonablate HIFU treatment. Dr. Lazar also serves as Medical Director of HIFU Prostate Services, has been working with HIFU since 2007, and was one of three physicians who proctored cases during clinical trials.

Dr. Lazar offers HIFU treatment to qualified patients and also provides medical guidance and serves as a proctor to physicians that are being trained on the Sonablate® HIFU system in San Francisco and surgery centers around the country. To learn more about HIFU and who may qualify for this life saving procedure visit our Do You Qualify section.

By | November 18th, 2015|Uncategorized|0 Comments

Validation of Focal Therapy for Prostate Cancer

From August 2015 Journal of Urology:  Study by New York University in which images from mpMRI identified prostate cancer before radical prostatectomy.  The pathologists then took the gland and did step-sections to pinpoint the actual tumor.  They found that a 9 mm “halo” of treatment around the imaged tumor boundaries would have covered 100% of the cancers.  Not 80%, not 90%, but 100%.

The criticism of focal therapy has been the concern that the mpMRI images did not designate the entire tumor, thereby risking leaving some of the tumor untreated if only the imaged area was treated with HIFU.  Since HIFU treats in 3 mm shots, adding 3 shots around the imaged tumor boundaries should cover the entire lesion.

Focal HIFU therapy spares non-cancerous prostate tissue, and the incidence of side effects (ED, Incontinence, Scar Tissue) was no different from “sham” operation in a study from University Central London.  The 5 year cancer free statistics were excellent.  The concept of focal therapy is foreign to physicians who only offer surgery or radiation, but in appropriate patients, it is a very attractive choice.  A mpMRI is mandatory to ascertain significant lesions are not missed, and not all communities have facilities for this study.

By | September 17th, 2015|Uncategorized|0 Comments

“Because of HIFU and the compassionate care I received, I now have a new lease on life …”

Barry Roach, 74, had physical exams and PSA tests performed by his primary doctor every year starting at age 65. His PSA numbers were steady in the 1.0-­to-­3.0 range. Even at age 75, a PSA of 6.0 is considered OK.  “In 2012 my PSA increased to 3.5, then 5.0 in 2013, and 5.4 in 2014, reaching 6.0 by June. A 1.0 or more rise within a year signals a need for action. I read reports from Johns Hopkins devoted to prostate cancer and different procedures. I scheduled an appointment with a urologist who recommended a biopsy. I found an article about proton beam therapy. While there are no side effects, treatments take 60 to 90 days, and the nearest facility was in SoCal. Then I came across HIFU on Google.” While HIFU has been used successfully for decades in Canada, Europe and Asia, it is not yet FDA approved as a accepted treatment in the U.S. in most cases. “I read a news story about Dr. Lazar’s leadership using High Intensity Focused Ultrasound therapy and went to see him. He performed a biopsy and used an ultrasound probe to check my prostate’s size, appearance and symmetry. Twelve samples were taken. The prostate appeared normal. However, three cores had cancer cells -­-­ more than two is a red flag. My Gleason score was 4 + 4, for a combined score of 8. If 6 or less, it would not have been a major concern, 7 is in between, and 8-­to-­10 means the cancer is aggressive.
Lazar bottom half

By | July 2nd, 2015|Alternative Treatment for Prostate Cancer, Dr. Michael Lazar, HIFU, Prostate Cancer, Testimonials, Uncategorized|Comments Off on “Because of HIFU and the compassionate care I received, I now have a new lease on life …”

New High Intensity Focused Ultrasound Minimally-Invasive Treatment for Prostate Cancer Pioneered by Dr. Michael Lazar Soon to Be Approved by FDA for Use in the U.S.

The use of a new technology called High Intensity Focused Ultrasound (HIFU) waves to treat prostate cancer without surgery on an out-patient basis moves closer to U.S. approval thanks to Dr. Michael J. Lazar, Jr. and other urologists utilizing this next-generation technology with patients in other nations.

HIFU technology achieves pinpoint accuracy using an “acoustic scalpel” that destroys prostate cancer, while sparing healthy tissue and preserving nerves, urine flow and erectile function in a majority of cases compared with traditional procedures.

U.S. Food and Drug Administration (FDA) approval of HIFU is expected following a study involving 100 men with prostate cancer recurrence after radiation. HIFU is eradicating cancer in 70 to 72 percent of these cases, compared with cryosurgery (freezing) that historically cures about 40 percent. HIFU success rates are higher in men with previously untreated cancer. The next step will be to seek a U.S. extension of the new HIFU process to non-radiation patients.

“Twenty years ago I attended a lecture sponsored by the American Urological Association telling us that HIFU would be the future for our profession. Now we are on the brink of seeing this procedure accepted,” said Dr. Lazar, an adult and pediatric urology specialist with Northern California Medical Associates, and principal of California HIFU with offices located at 1140 Sonoma Avenue, Suite A, in Santa Rosa.

Prostate cancer is the second leading cause of cancer death in American men behind lung cancer. The American Cancer Society estimated that about 238,590 new cases of prostate cancer would be diagnosed in 2013 and about 29,720 men would die of this disease. Approximately one man in six will be diagnosed with prostate cancer during his lifetime, and one in 36 will die as a result. Prostate cancer is rare before age 40. The average age at the time of diagnosis is about 67.

“The oncological results for HIFU are broadly comparable to radical surgery or radiation but the side effects are less, especially with regard to incontinence and erectile dysfunction. There is almost no pain or blood loss. The treatment is quick and virtually painless following spinal or general anesthesia that wears off in just a few hours,” Dr. Lazar said. “If the 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.”
HIFU 2-2-2-2

Temple Smith, one of Dr. Lazar’s patients, knew that prostate cancer ran in his family. His uncle died of it and his twin brother also had it. His brother underwent a prostatectomy that kept him in bed three to four days, and today he is incontinent.

“When I was diagnosed with prostate cancer, I had the HIFU procedure. Last October marked my fifth anniversary after having this treatment and there has been no cancer recurrence. If you have prostate cancer and the resources to get the HIFU treatment – get it done,” Mr. Smith said.

According to Dr. Lazar, HIFU is the only non-radiation technology that requires no direct contact with the target organ while accurately zeroing-in on selected portions or destroying the entire gland. No other form of treatment gives a surgeon such precise control without damaging surrounding tissue aided by simultaneous ultrasound visual tracking.

Other prostate cancer treatment options include radical surgery, radiation, hormonal and chemo/immunotherapy. Besides the usual risks of incontinence and erectile dysfunction, radiation can cause chromosomal changes that result in cancer of the bladder and rectum.

Dr. Lazar has performed approximately 100 successful HIFH procedures on patients who volunteer to fly south of the border. “Most months for the past seven years I have traveled to Puerto Vallarta for a long weekend of outpatient procedures at a U.S. Joint Commission approved bilingual hospital. I also serve as an HIFU instructor, am one of three FDA study proctors and have aided other doctors who have treated over 200 patients to date.”
In the Western Hemisphere, the HIFU procedure is also conducted in Bermuda, Canada, Cancun and Nassau. Some 15 years of data have been compiled from Japan, 10-12 years from the UK/Germany/Italy, and nine years from Canada focusing on the HIFU procedure and results.

Another patient of Dr. Lazar is San Francisco business owner Harlow Plimpton, who had the HIFU procedure in 2011. “Before the therapy my PSA level was between 6 and 7. Following the treatment my PSA dropped to 0.1. I did not experience any side effects or incontinence. I went to the Puerto Vallarta clinic at 7:30 a.m. and walked out three to four hours later to tour the city. The doctors offered me Cialis and Viagra, but I didn’t need it. Since then I’ve been looking for a downside, but frankly, I haven’t found any.”

The HIFU procedure costs approximately $25,000, compared with robotic prostatectomy and some forms of radiation therapy that can range in cost from $40,000 to $60,000. While a few U.S. insurance companies have covered HIFU, coverage is sporadic at this time.

Within the U.S., the American Medical Association creates Current Procedural Terminology codes (CPT) for doctors to use for billing and insurance purposes. As yet, no CPT code has been established for HIFU. “Meanwhile I tell my patients the cost is like buying a car, and many take out a home equity loan which may be tax deductible,” Dr. Lazar said.

Dr. Lazar has been certified by SonaCare Medical, LLC, a global leader in minimally invasive HIFU technologies, based in Charlotte, North Carolina. SonaCare Medical, through its subsidiary Focus Surgery, Inc., of Indianapolis, manufactures HIFU systems, such as Sonablate®. The Sonablate unit is approved for investigational use only in the United States until the expected FDA approval. However, it is already being used in over 30 countries outside the U.S. for the treatment of prostate cancer.
HIFU 3-3-3-3

“My advice to those diagnosed with prostate cancer is to seek medical counsel on all options, not just surgery or radiation, so you can make an informed decision and see if you are a candidate for HIFU,” he added.
Michael J. Lazar, M.D. graduated from the University of Arkansas in 1978 and completed postgraduate training in surgery and urology at LSU in 1983. He is four-time board certified by the American Board of Urology and is Managing Physician Director of Santa Rosa Surgical Management Co., LLC, which manages Santa Rosa Memorial Hospital’s Ambulatory Surgery Center. He is also Chairman of the Board of Directors of Redwood Health Services and is a member of the American Urological Association.

International HIFU Physician Dr. Michael Lazar

It has been very exciting to be able to offer HIFU to men with prostate cancer the past 6 years. The utility of the procedure continues to grow, with the evolution from merely whole gland therapy to the possibility of focal therapy. With MRI imaging improvements, we can not only limit treatment to the cancer focus in appropriate men, we can now better determine which patients are likely to have successful outcomes with whole gland therapy. Tissue Change Monitoring (TCM) has inspired me to modify the treatment on whole glands to lessen the risk of complications.

It is impressive that many of my patients have done the math and found HIFU to be a relative bargain due their ability to go right back to work. When one considers the convalescent period after radical prostatectomy, or the weeks involved with radiation therapy, not mention the higher side effect profile with both, the cost of HIFU becomes less an obstacle to choosing this innovative option. I am very enthusiastic about teaching this procedure to my colleagues going forward.

To learn more about or be connected to Dr. Lazar please call 1-866-553-1629 or email nurse@internationalhifu.com.

HIgh Intensity Focused Ultrasound

Patients diagnosed with prostate cancer are faced with treatment options. The historical
remedies—radiation therapy, surgery, hormonal therapy, chemotherapy and freezing the cancerous gland—have risks and negative side effects, especially incontinence and impotence. A new technology, however, is coming of age in its ability to diminish these risks and side effects. This nonsurgical outpatient option—high intensity focused ultrasound (HIFU)—takes approximately one to four hours to perform, depending on prostate
size, and has a relatively short recovery period.

With HIFU, most patients are up and walking around within two to three hours and may resume normal activities within a couple of days, with minimal discomfort.1 HIFU patients
also experience fewer side effects than those receiving traditional prostate treatments.2 During the first two weeks after the procedure, patients may experience mild urinary symptoms, such as frequency and/or urgency to void. In the first three months, patients may also pass an occasional small amount of blood or mucus-like materials, which is normal.

HIFU is radiation-free. Unlike radiation, ultrasound energy is non-ionizing, meaning that it will not harm any tissue outside of the targeted area. (Damaged tissue could set the stage for a possible cancer recurrence.) Because HIFU is performed without an incision, patients don’t experience blood loss and can usually be discharged after recovery from the general or epidural anesthesia. Furthermore, because HIFU uses ultrasound rather than radiation to destroy targeted tissue, the procedure can be repeated if necessary.

During the HIFU procedure, all or part of the prostate is ablated, including the prostatic urethra. The urethra is derived from a different type of tissue (bladder squamous-type epithelium) than the prostate (glandular, fibrotic and muscular) and does restore itself with time. A suprapubic or penile catheter is inserted for one to three weeks until prostate swelling resolves.

The machine used to transmit HIFU uses a computer-controlled device designed for transrectal delivery of energy to the prostate. It features a fully integrated probe
with dual treatment transducers that move robotically to follow the physician’s precise treatment plan.

Urologists around the globe, as well as those in U.S. involved in clinical trials, have been using HIFU to treat localized prostate cancer and recurrent prostate cancer/radiation failure with both focal therapy and whole-gland therapy. Worldwide, over 7,000 HIFU prostate treatments have been performed to date.

Accurate imaging is a key component. The technology makes use of integrated biplanar ultrasound imaging for real-time treatment monitoring, treatment planning, and pre- and post-treatment imaging of the prostate. Precise focusing of ultrasound energy during HIFU treatment rapidly elevates the temperature of the tissue to 90 degrees Celsius in the focal zone, while intervening tissue between the transducer and the focal zone is kept
at a safe temperature.

The result of HIFU therapy is an accurate and repeatable lesion at the target sites that are monitored in real time by the treating physician. All treatment zones are pre-planned and checked by the physician prior to HIFU treatment. The procedure allows for a customizable treatment plan tailored to each patient’s prostate cancer diagnosis. The imaging capabilities of the technology also allows for the identification of vital structures, such as the prostate capsule, seminal vesicles, rectal wall, and the physiological location of neurovascular bundles.

A radio frequency (RF) signal is sent to a treatment site prior to delivery of HIFU, and then another signal is sent after delivery to the same site. A sophisticated tissue-change monitoring system calculates the change that took place and displays it on the screen by
quantifying tissue changes based on a comparison of RF ultrasound pulseecho signals at each treatment site. This tracking procedure shows results using real-time ultrasound imaging aided by advanced tissue-change monitoring software.

An integrated Doppler feature in the transrectal probe provides an additional safeguard during treatment. This feature helps physicians identify vital structures that need to be preserved to avoid problems with urinary continence and sexual function. With HIFU’s
precisely targeted accuracy, there is less damage to the surrounding area, such as the muscle controlling urine flow and the nerves controlling erections.

HIFU technology remains investigational in the United States, but it is being studied for the treatment of prostate cancer in U.S. clinical trials. The technology has been approved in more than 30 other countries in Europe, South America and North America (Canada and Mexico). The Food & Drug Administration has scheduled a panel review of HIFU technology for early October that may result in a decision within 60 days.

By | May 7th, 2015|Alternative Treatment for Prostate Cancer, Dr. Michael Lazar, HIFU, Prostate Cancer, Uncategorized|Comments Off on HIgh Intensity Focused Ultrasound