May 24, 2017
There may be no greater an endorsement for a medical procedure other than a physician saying he would have it performed for himself. That was the case this month for Los Angeles surgeon Dr. Robert Pugach who was diagnosed with prostate cancer. Dr. Pugach has been administering a treatment on his patients called HIFU, High Intensity Focused Ultrasound, a minimally-invasive option to surgery and radiation. This time, Dr. Pugach determined to have the procedure performed on his own prostate cancer. To do so, he turned to Dr. Michael Lazar, San Francisco’s own go-to surgeon for HIFU.
Dr. Lazar was an early user of the HIFU technology, beginning his work with the procedure in 2007. He was credentialed as proctor in 2010 when he helped edit the user manual for the HIFU system. To date, Dr. Lazar has been involved in the treatment of over 200 HIFU patients.
HIFU gives men diagnosed with prostate cancer a non-surgical, radiation-free, outpatient procedure that uses focused sound waves to heat and destroy tissue in the prostate. The FDA cleared HIFU for prostate tissue ablation on October 2015.
Focal 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. The HIFU System is a game-changer in prostate treatment, replacing the standard procedure that required surgical removal of the entire gland with a diagnostic system that treats the specific tumor location. As a result, patients have a less invasive treatment option when they are diagnosed with prostate cancer versus the many prostate cancer treatments that require radical surgery with the potential of permanent urinary incontinence an erectile dysfunction.
The surgery began at 7:30AM at the San Francisco Surgery Center. By 11:00am, Dr. Pugach was back in hotel room and went on to enjoy dinner that evening with friends.
The U.S. Food and Drug Administration (FDA) has approved 2 types of minimally invasive, high intensity focused ultrasound (HIFU) therapy for treating prostate cancer. However, this advanced revolutionary technology requires significant urologic training as the technology is complex and caution is being urged.
“Well-selected prostate cancer patients can benefit by maintaining their quality of life and still treating their prostate cancer. Patients should be cautioned that excellent outcomes are only consistently obtained by highly trained users of the technology,” said Stephen Scionti, MD, who is medical director of Vituro Health and founder of the Scionti Prostate Center in Sarasota, FL.
HIFU has already been approved for use in prostate tissue outside the US, and according to the manufacturer, more than 50,000 men globally have been treated with focused ultrasound for prostate cancer. It is the leading clinical application of the technology, with more than 50% of patients having undergone the procedure for this indication.
Focused ultrasound has already been available in the US to treat uterine fibroids and relieve pain from bone metastases. In addition, there are also a growing number of clinical applications in various stages of research and development around the world, including Parkinson’s disease, essential tremor, breast cancer, pancreatic cancer, and brain tumors.
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