What to do after prostate cancer diagnosis dr. pugach

Prostate cancer is the most commonly diagnosed cancer in men year after year. An estimated 235,000 men will be diagnosed with prostate cancer in 2016! While some prostate cancers are slow growing and may not require treatment, most will progress and need early treatment.

The challenge is to find treatments that will not affect your quality of life! Side effects of traditional prostate cancer treatments like radical surgery and all forms of radiation, include permanent incontinence (bladder control problems) and erectile dysfunction. They may cure or control your cancer, but could leave you with changes in your quality of life that are unacceptable. The Western States HIFU Difference

Our mission is to cure your cancer and preserve your normal quality of life.


We understand, from the thousands of men we’ve treated with prostate problems that the side effects of treatment can be more worrisome than the cancer. Our mission has always been to minimize or eliminate side effects to allow you to go on with your life and be whole.

There are some prostate cancers that do not need treatment. They typically are of a slow growing type, in small amounts, in men with low PSA levels. At Western States HIFU, we use the latest genetic tumor markers to help predict the aggressiveness of your cancer.

Here’s the problem – there are no genetic markers that can accurately predict the aggressive potential of your prostate cancer. There are many tests available today and they all lack long term, confirmatory research to show they can accurately predict the growth of your cancer. In one study, from New York University, 20% of patients who were carefully monitored under a “watchful waiting” or “active surveillance” study and ultimately had radical surgery, had metastatic (incurable) cancer found within 5 years.

Here’s the frightening information – this year (2016), an estimated 32,000 men will die from prostate cancer. That number has been increasing year after year because many men are choosing not to have treatment for their prostate cancer. At Western States HIFU, we’re here to help you make the right decision for your prostate cancer! Can HIFU Treat My Prostate Cancer? Can HIFU for Prostate Cancer Maintain My Quality of Life?

In most cases, the answer is yes! HIFU is the only non-invasive treatment for prostate cancer that has cure and cancer control rates equal to, or better than, radical surgery and radiation without the serious side effects they can cause. Radical surgery, even when done robotically, can result in permanent urinary incontinence. That means you will need pads or diapers to control urine leakage for the rest of your life. Radiation can have a high rate of prostate cancer recurrence. If that happens, your treatment options are few and the side effects are much higher than if you’d had a different treatment to begin with. HIFU, when performed by a skilled, highly trained urologist, has a remarkably low rate of urinary incontinence and erectile dysfunction as compared to radical surgery and radiation. It’s what experienced HIFU practitioners call the “Trifecta” – cancer cure, no incontinence and no erectile dysfunction! Is HIFU for Prostate Cancer Really Non-Invasive or is it Minimally Invasive?

HIFU is truly non–invasive. There is no skin penetration so there’s no need for needles or scalpels. An ultrasound probe in your rectum delivers precise ultrasound energy to the targeted areas in your prostate. You’ll feel nothing during the treatment because you’ll have your HIFU treatment under a general or spinal anesthetic. You’ll leave the surgery center pain free because there has been no skin disruption (other than for the placement of a small bladder catheter). Most men say they feel as if they’ve had no treatment at all because there’s no pain or discomfort afterwards! View our patient’s testimonials for HIFU. How New Is HIFU?

HIFU for prostate cancer was started in Japan in 1999. 16 years later, more than 45,000 men have been treated throughout the world. The U.S. FDA has been slow to approve HIFU for reasons that, to this day, are not well understood. However, now that we have HIFU in the United States, men here can have the same advantages that others have had throughout the world. (See HIFU Clinical Studies/Articles for more information) Should I Have Total Prostate HIFU Or Focal Therapy?

Of all of the issues confronting prostate cancer patients, this is the most significant one. There are some prostate cancers that are small and confined to a few areas in a prostate. The treatment approach can be analogous to a “lumpectomy” for breast cancer – why take out an entire breast when only a small area is involved? So, focal therapy for prostate cancer is now known as the “male lumpectomy.”

Here’s the problem – our imaging tests for prostate cancer are not nearly as good as imaging tests for other cancers, including breast cancer. At Western States HIFU, we utilize the latest imaging studies, like multiparametric MRI, to evaluate the extent of your cancer.

Experience does matter! HIFU is not a simple procedure. It requires knowledge of how to use real time ultrasound in the operating room. It also requires integration of multiple ultrasound images, temperature and heat data every 3 seconds to allow your HIFU urologist to constantly direct the treatment computer so that you have the best possible outcome. Our medical director at Western States HIFU, Dr. Robert Pugach, has been performing HIFU procedures for more than 12 years. He is acknowledged to be one of the most experienced HIFU practitioners in the world! He is also one of a handful of urologists certified to teach other urologists how to perform this remarkable procedure! What Is My Next Step for Treating my Prostate Cancer?

Dr. Robert Pugach, a Los Angeles and Orange County, CA urologist and prostate cancer specialist, is recognized as an international and national expert in treating prostate cancer patients with High Intensity Focused Ultrasound (HIFU). He has been successfully treating patients with HIFU since 2006 and is the most experienced HIFU physician west of the Mississippi.

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 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.