Treatments for Recurrent Prostate Cancer in Los Angeles, CA

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.

Treatment for Recurrent Prostate Cancer

MRI of Prostate Cancer

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.


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.

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.

Schedule your Appointment at Western States HIFU

Dr. Pugach’s urology office is conveniently located in Los Alamitos.  For patients who live out-of-the-area and for international patients who want to discuss prostate cancer treatment options with Dr. Pugach, we offer telephone or online/virtual consultations.

To schedule a consultation at one of our offices in ,  call 877-884-HIFU (877.884.4438) or email us via our contact us form on this website. We’re here to help you!