Previously Treated/Recurrent Prostate Cancer

Many men come to us at Western States HIFU because they have recurrent prostate cancer. This typically occurs after radiation treatment.

Does Prostate Cancer Occur After All Forms Of Radiation Treatment?

YES. Prostate cancer can re-occur after any type of radiation, including brachytherapy (seed implants), Proton beam therapy, CyberKnife, external radiation of any type, high dose radioactive implants, etc. Estimates now are that up to 80,000 men per year return to urologists’ offices as radiation failures.

So, it’s not just the radiation side effects (scar tissue, urinary incontinence, chronic diarrhea, skin burns) that can be problematic for patients who have chosen radiation to treat their prostate cancer, it’s dealing with the challenges of treating recurrent cancer.

Can I Have More Radiation if My Prostate Cancer Re-Occurs?

In almost every case the answer is NO. The dose of radiation used to initially treat prostate cancer is typically the maximum amount that is safe to use. Giving more radiation can result in staggering complications including tissue breakdown, damaging surrounding structures like the rectum, severe urinary incontinence, etc.

How Can Recurrent Prostate Cancer Be Treated After Radiation Fails?

MRI Images

A few of the hundreds of MRI images reviewed at the Oct. 2018th HIFU Experts meeting.

There are 3 principal ways to try to cure prostate cancer when it re-occurs after radiation.

  • Radical surgery. A prostate that has been radiated can be removed. However, the challenge is that radiated prostates are fixed to surrounding tissues and cannot be removed easily. The best analogy is to consider the prostate like a tennis ball before radiation. Afterwards, it’s like a block of wood. While we can remove it, the likelihood of severe urinary incontinence approaches 100%. In many cases, the bladder is fused to the prostate so it must be removed, too. The end result is that some patients live the rest of their lives with a urine drainage bag on their abdomen. (Learn more about robotic surgery)
  • Cryoablation. Dr. Robert Pugach is the most experienced practitioner of cryoablation in the western United States. He performs this freezing procedure on prostates with newly diagnosed prostate cancer as well as recurrent prostate cancer. Some prostate can be successfully frozen after radiation. However, it’s important to remember that the ice that forms in a prostate during cryoablation forms differently than in an untreated prostate so the potential for urinary incontinence, erectile dysfunction and future cancer recurrences is higher than if cryoablation had been used initially. (Learn more about cryoablation)
  • High Intensity Focused Ultrasound. HIFU can be an excellent option for men with recurrent prostate cancer after radiation fails. In fact, it is probably the best option because it has the highest potential for a cure while minimizing the potential side effects of urinary incontinence or erectile dysfunction. One important consideration is for patients who have had brachytherapy (radioactive seeds)… in some cases, the HIFU ultrasound beam may not be able to achieve adequate heat levels in areas of the prostate where there is a large concentration of metal seeds.

What Is My Next Step?

Call Western States HIFU for a consultation. If you’re in our geographic area we offer convenient appointments with lots of time so you won’t feel rushed as we discuss your prostate cancer.

For patients who live in Southern California, Dr. Robert Pugach has two Los Angeles and Orange County private practice urology offices located in Los Alamitos and Huntington Beach, CA.  These offices that are freeway accessible for residents of greater Los Angeles, Orange, Riverside, San Bernardino and San Diego Counties, CA.

 For patients who live out-of-the-area (United States) and for international patients who want to discuss prostate cancer treatment options with Dr. Pugach, we offer telephone and online (virtual) consultations  to help you connect with us. 

 To schedule a consultation at one of our offices in ,  call 844-HIFUDOC (844.443.8362) or email us via our contact us form on this website. We’re here to help you!  

Live out of the Southern California area? Learn more about our telephone or virtual (online) consultation and out-of-area travel arrangements.