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

cholesterol and prostate cancer

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.

 

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