Robert Pugach’s Personal Story

May 17, 2017 10:49 am Published by


Robert Pugach MD Prostate Cancer HIFU Treatment

I have just been treated for prostate cancer with HIFU. This is my personal story.

In the weeks leading up to my treatment, I was surprisingly calm. I can honestly say that I never had a moment of fear, anger, panic or any of the other emotions that many of my patients have shared with me in over 30 years of treating this potentially lethal, terrible disease.

The reason for my attitude was that my cancer was diagnosed at the earliest possible stage. The odds are overwhelmingly likely that it will never return. That meant that I was in charge of my cancer instead of it being in charge of me. I was spared the fear that patients experience when they are diagnosed with advanced prostate cancer that can be extensive or aggressive and, potentially, not curable.

I was also calm because I had the utmost confidence in my doctor. Like me, he had been travelling to other countries for the past 10 years treating patients with HFIU. I knew he was experienced and that I was in good hands.

Monday, May 8: Kim, my wife, and I worked a full day. Office hours ended at 4:00 and we headed for LAX 15 minutes later. We flew north to San Francisco. Outside of the surgery center where I perform HIFU procedures in Los Alamitos, it is the only other one in the western U.S. with a large HIFU experience.

Tuesday, May 9: I awoke at 4:30 am for my final HIFU preparations and then took a 5 minute taxi ride to the surgery center. The staff was marvelous – caring, helpful and kind. The anesthesiologist had a good demeanor that gave me a good level of confidence in his skills. An IV was expertly started. Kim gave me a hug and kiss and I walked down the hallway to the OR. I laid down on the table and the last thing I remember was being given some oxygen through a mask…

I woke up in the recovery room 4 hours later and saw Kim’s smiling face. She looked happy so I knew things must have gone well. I was a bit groggy, but pain free and comfortable. My doctor confirmed that my procedure went perfectly – good words to hear! Within an hour or so after waking up I was ready for a taxi ride to spend the afternoon in our hotel room.

There was no pain. I mean it – NO pain! The catheter was a bit uncomfortable. I had no ill effects from the excellent anesthetic technique used, so my clear liquid diet of the previous 24 hours was replaced with clam chowder and a pizza. By 6:00 p.m., I was hungry again so we accepted an invitation to a dinner meeting with some urologists in the Bay area considering adding HIFU to their practice. I was the poster child for my HIFU doctor who introduced me as the patient he had treated at 7:30 a.m. that day. They were, to put it mildly, amazed to see me vertical, pain free and hungry! Instead of having the common side effects of radical surgery, or contemplating 7 weeks of radiation, I felt great and enjoyed a Ruth’s Chris steak and a good Cabernet!

I arrived in San Francisco with prostate cancer and left cancer free. I had a HIFU procedure that has a 3% chance of bladder control problems and a 5-10% chance of erectile dysfunction. Contrast that with surgery where incontinence rates are typically 35% or higher and erectile dysfunction is common. I was able to return to normal activities 3 days later!

The key to successful treatment of prostate cancer is to have it diagnosed at its earliest stage so HIFU is a treatment option. I can tell you now, from my personal experience, that it’s the key to getting on with your life while leaving you whole.

This post was written by Western States HIFU