Articles

The Case Against Active Surveillance
By: Robert Pugach, MD

I am a prostate cancer survivor. I was diagnosed with cancer late last year. In May of this year, I underwent a urethral sparing HIFU procedure and I am now cancer free. Read Article

USA Today Article, March 2017
The Prostate Cancer Treatment Even Doctors Choose for Themselves

HIFU for prostate cancer is as effective as surgery or radiation in eliminating cancer with a lower risk of side effects such as impotence and incontinence. “Every man is at risk for prostate cancer, even your urologist,” says Dr. Pugach. Dr. Pugach shares his story in USA Today. Read article

HIFU for Prostate Cancer?
Learn why men are selecting this new treatment
Yvette M. Manard, MPH
In October, 2015 the Food & Drug Administration (FDA) approved High Intensity Focused Ultrasound (HIFU) for the treatment of localized prostate cancer. For many men diagnosed with prostate cancer, HIFU is a new treatment that they haven’t heard about nor are they aware of its benefits, including avoiding permanent urine leakage and erectile dysfunction (ED) that surgery or radiation can cause. Read article

HIFU Prostate Cancer Treatment Approved for Use in United States
Yvette M. Manard, MPH
Historically, the conventional treatment for prostate cancer is the surgical removal of the prostate,” explains Dr. Robert Pugach. “While this surgery is now done robotically, it still has the potential to cause significant side effects, such as permanent urine leakage and erectile dysfunction,” continues Dr. Pugach. Read article

HIFU for Prostate Cancer Treatment
An Interview with Dr. Robert Pugach, MD
Yvette Manard, MPH
Dr. Robert Pugach 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. Read article

Prostate Cancer… Common, Curable Disease 
Robert Pugach, MD
Hardly a week goes by without reading or hearing about someone you know, or some celebrity, learning that he has prostate cancer.  Prostate cancer is the second leading cause of death from cancer among US men. Read article

New Genetic Test for Prostate Cancer…Hope or Hype? 
by Robert Pugach, MD
It seems as if not a month goes by where we read headlines proclaiming new medical breakthroughs. In the article, Brave New Worlds in Diagnosing Diseases, several new promising diagnostic tests, including one about a new prostate cancer assay, were outlined. The test they discussed was captioned as a “less-guess” prostate test, the Oncotype Dx Prostate Cancer Assay test. Read Article

Prostate Cancer Screening Controversy?
Dr. Robert Pugach, Medical Director of Pacific Coast Urology Medical Center, gives his opinion of the USPSTF’s finding and what he advises men to do.

Six years ago, the United States Preventive Services Task Force (USPSTF) ignited controversy in the medical community when they advised against most routine screening for prostate cancer with a PSA blood test. Specifically, the recommendation set off a firestorm of debate in the urological community because most urologists are strong advocates of annual prostate testing with a PSA and a rectal examination.  Read article

A New Factor When Choosing a Surgeon
Melanie Evans – Wall Street Journal (WSJ),  September 19, 2016

For patients who need complex surgery, the best surgeon may be one who specializes in one procedure—not just an active surgeon who performs several operations.  Read Article

Clinical Data & Research

Summary of the History of Clinical Research/Studies on HIFU

  • In 1994, Drs. Michael Marberger and Stephan Madersbacher performed the first human prostate cancer study at the University of Vienna in Austria using the Sonablate 200. 29 prostates were treated before performing a radical prostatectomy in order to see if the energy delivered was enough to destroy the targeted tissue. The study found that treatment could be performed safely and be repeated if necessary.
  • In the United States, research on HIFU began in the 1950s at Indiana University in Indianapolis, IN.
  • In 1999, Dr. Toyaki Uchida began treating patients in Japan using the Sonablate® 200, the first generation of the Sonablate device.
  • In Europe, the Sonablate 500 received its approval for use in 2001.
  • In 2004, US HIFU was founded and began placing Sonablate devices in countries throughout the world, including Canada, Mexico, Costa Rica, the Caribbean, India and Argentina
  • In Canada, Health Canada approved the Sonablate 500 in 2005.
  • In the United States, the FDA approved HIFU for prostate treatment in October, 2015

The following list of publications provides information on clinical results and research on Sonablate HIFU for prostate cancer. Please feel free to ask Dr. Robert Pugach for clarification or more information.

Focal Therapy for Localised Unifocal and Multifocal Prostate Cancer: a Prospective Development Study.  Ahmed, Hashim U, Richard G Hindley, Louise Dickinson, Alex Freeman, Alex P Kirkham, Mahua Sahu, Rebecca Scott, Clare Allen, Jan Van der Meulen, and Mark Emberton. The Lancet Oncology 13, no. 6 (June 2012): 622–632.
Summary: Radical whole-gland therapy can lead to significant genitourinary and rectal side effects for men with localized prostate cancer. We report on whether selective focal ablation of unifocal and multifocal cancer lesions can reduce this treatment burden.

Transrectal High-intensity Focused Ultrasound for Treatment of Localized Prostate Cancer. Inoue, Yoji, Keisuke Goto, Tetsutaro Hayashi, and Mutsuo Hayashi. International Journal of Urology 18, no. 5 (2011): 358–363.|
Conclusions: High-intensity focused ultrasound therapy appears to be minimally invasive, efficacious and safe for patients with localized prostate cancer, particularly those with low- and intermediate-risk cancer.

Focal Therapy for Localized Prostate Cancer: A Phase I/II Trial. Ahmed, H.U., A. Freeman, A. Kirkham, M. Sahu, R. Scott, C. Allen, J. Van der Meulen, and M. Emberton. The Journal of Urology 185, no. 4 (April 2011): 1246–1255.
Conclusions: Our results appear sufficiently promising to support the further evaluation of focal therapy as a strategy to decrease some of the harms and costs associated with standard whole gland treatments.

Prostate Cancer Therapy with High-Intensity Focused Ultrasound -Comprehensive Review, Thomas A. Gardner and Michael A Koch, Indiana University Medical Center, Indianapolis. Clinical Genitourinary Cancer Vol 4. No.3, 2005.
Summary: HIFU has been used to ablate benign and malignant prostate tissue for decades.

You can schedule your consultation with Dr. Robert Pugach at one of our two office locations in serving residents of  greater Los Angeles, Orange County, Riverside, San Bernardino and San Diego Counties, CA.  For your convenience we offer telephone and  online (virtual) consultations.

To schedule a consultation to learn more about HIFU, just call 844-HIFUDOC (844.443.8362) or email us via our Contact Us form on this website. We look forward to welcoming you to Western States HIFU. We’re here to help you!