Bob's Story: Every man is at risk for prostate cancer. Even your urologist.

Robert Pugach, M.D., of Los Angeles, Calif., was diagnosed with prostate cancer late in 2016. His annual exam included a PSA blood test that was abnormal so a biopsy was done which showed an early prostate cancer.

Dr. Pugach faced the same dilemma that many of his patients face: What to do about a small, moderately aggressive prostate cancer?

“Some would do nothing. I am a candidate for ‘surveillance.’ Some patients have cancers that never progress to the point where they pose a danger. My concern with that approach is that no one really knows what we are waiting for. There is no PSA level and no imaging study that says when we must treat prostate cancer,” continued Dr. Pugach. “MRI exams of the prostate do not show many prostate cancers. In fact, I’ve had 3 MRIs and none show my cancer.”

Surveillance can allow small cancers to become larger so that the potential for a cure is reduced. “I am not a gambler, especially when it comes to my health. I plan to live a long, active, healthy life and enjoy time with my family and friends.”

Dr. Pugach, one of the most experienced HIFU doctors in the world, will have his prostate cancer treated with a urethral sparing HIFU procedure by fellow HIFU expert Dr. Michael Lazar.

“I won’t have radical surgery due to the potential of permanent urinary incontinence and erectile dysfunction. I won’t have radiation due to the possibility of a future recurrence,” said Pugach. “I look forward to having the same cancer free, normal, uninterrupted quality of life my patients typically have after HIFU. And, I’ll be able to return to work 2 days after my procedure to continue to helping my patients.”