HIFU for Prostate Cancer Treatment
At Pacific Coast Urology Medical Center, we’re focused on keeping you whole if you need treatment for prostate cancer
An interview with Robert Pugach, MD – one of the most experienced HIFU surgeons in the United States
by Yvette M. Manard, MPH
According to the American Cancer Society, almost 250,000 prostate cancer cases will be diagnosed annually in the United States and will result in 29,000 deaths every year. These are frightening numbers. But, with prevention strategies and education about new treatment options, you can help do a lot to prevent becoming one of these statistics. In this article, Dr. Robert Pugach, Medical Director of Pacific Coast Urology Medical Center, answers questions about concerns regarding the prevention, diagnosis and treatment of prostate cancer and how HIFU (High Intensity Focused Ultrasound) is advancing treatment and improving outcomes.
HB Magazine: Why are there so many cases of prostate cancer cases? Can it be prevented?
Robert Pugach, MD: This common cancer strikes men far too often. One reason is our increasing life expectancy – prostate cancer is a disease of getting older and most men now live long enough to develop it. I am a strong advocate of annual PSA screening and a simple physical examination. Most cases of prostate cancer can be cured when it is detected at an early stage.
New research is showing us the genetic basis of prostate cancer. We’re now able to look at prostate cancer at a molecular level to understand which tumors are aggressive and which ones can be observed without treatment. Common substances like Vitamin E may actually increase the risk of developing prostate cancer while natural additives like flaxseed and lycopenes may help to prevent it.
HBM: How is prostate cancer treated? I’m scared about the side effects!
Dr. Pugach: Historically, the conventional treatment for prostate cancer is the surgical removal of the prostate. While, nowadays, surgery is done robotically, it still has the potential to cause significant side effects, such as permanent urine leakage and erectile dysfunction. Radiation may slow the cancer growth but it often allows it to grow again, making future treatment difficult. At Pacific Coast Urology Medical Center, we’re focused on keeping you whole if you need treatment for prostate cancer.
HBM: Are there non-surgical options to treat prostate cancer that don’t use radiation?
Dr. Pugach: Yes! One procedure is called cryoablation. It utilizes sub-freezing temperatures to kill cancers cells. A more advanced, minimally invasive procedure that I am very excited about is High Intensity Focused Ultrasound (HIFU). HIFU is a treatment for prostate cancer that utilizes ultrasound waves to heat and destroy cancer cells without an incision!
HBM: How does HIFU work?
Dr. Pugach Precisely focused ultrasound waves raise the temperature of the targeted prostate tissue in a matter of seconds. It can destroy cancer cells while leaving structures outside the targeted tissue unharmed. Side effects of traditional treatments, like urine leakage and erectile dysfunction, are dramatically reduced.
HBM: Since HIFU isn’t performed in the United States where do you treat your patients?
Dr. Pugach: Currently HIFU isn’t being performed in the US as it is going through the rigorous FDA approval process. It’s unfortunate that we don’t offer it here yet, and that’s due to our FDA. But it’s available throughout the world – from Europe to Asia, the Middle East, South and Central America, Mexico and Canada. The technology is not new to the United States as it originated in 1970’s at the Indiana University School of Medicine! I travel outside of the US every 2 months to treat patients with prostate cancer with HIFU.
HBM: I understand that you are the 4th most experienced HIFU urologist in the US. What has been your experience with this technology?
Dr. Pugach I am pleased to be among the most experienced urologists in the US to use HIFU technology. Many years ago, I became fascinated with the HIFU technology because it is a non-invasive treatment for prostate cancer that significantly improves outcomes related to a man’s quality of life issues. HIFU fit perfectly within the focus of my minimally invasive urologic practice and I gained a great deal of experience to offer this treatment to my patients. We are now at the cusp of being able to treat small prostate cancers in less than an hour and allow patients to return to normal activities within a few days without the side effects of erectile dysfunction or incontinence.