What you should know about prostate cancer, treatment options
and your quality of life…

By Yvette Manard, MPH

Deciding what kind of prostate cancer treatment to get is a critical decision.  “Every man is different. But do your research and get all the facts,” says Donald Tavie, a lead singer with Lakeside. “I’m happy that I explored all options before deciding on a new procedure.”   

 Donald Tavie, 53, a Los Angeles resident, is known for his high-energy performances with the long-running R&B funk group Lakeside.  What this keyboard and lead singer and father of six isn’t known for is his prostate cancer treatment and his passion for getting the word out on ‘High Intensity Focused Ultrasound’ or HIFU, a minimally invasive treatment for prostate cancer that isn’t yet available in the United States. 

 During National Prostate Cancer Awareness Month in September, Donald Tavie is not only encouraging men to get their annual screening but also is telling his story so that prostate cancer patients understand the importance of researching various treatment options.  Tavie’s story on how he found out about HIFU and his decision to pursue this treatment option outside of the United States is an interesting story of fate and timing.

 As one of the lead singers for Lakeside for 29 years, Tavie has a busy schedule of performances throughout the United States and abroad.  In February 2008, with some gentle nudging by his mother,  Tavie scheduled an annual physical, which included a prostate cancer exam. To his surprise, Tavie was told by his family physician that his prostate-specific antigen (PSA) test was elevated and his prostate was enlarged.  He underwent a biopsy and was diagnosed with prostate cancer.

“I was told that I had a slow growing type of prostate cancer so I took the time and went into research mode,” says Tavie.  He took three months to research and to confer with his first urologist to decide on a course of action to treat his prostate cancer. 

 Tavie’s uncle had prostate cancer and he had opted for the surgical removal of his prostate so Tavie was aware of the risks and complications from traditional surgery. He carefully compared treatment options - surgery or radiation.  If surgery, what type, traditional or the newer robotic-assisted laparoscopic radical prostatectomy?  If radiation, what are the odds of a successful treatment and how extensive are the side effects?  The statistics show that approximately 30% of men undergoing a traditional radical prostatectomy experience incontinence and 50 – 70% develop impotence.  Both were very worrisome complications but doing nothing was not an option he would consider.

 Tavie decided on a 43-day course of radiation.  But a morning television show and fate intervened.  On the morning of his first scheduled radiation treatment, Tavie was getting dressed and casually listening to a local television show, which featured a segment about using HIFU – High Intensity Focused Ultrasound - to treat prostate cancer.  Tavie hadn’t heard of HIFU.  His doctors never mentioned HIFU as a treatment option and he was perplexed as to why he hadn’t learned about this procedure while he was doing his research.  He watched with great interest and when the urologist stated that HIFU wasn’t yet offered in the United States he wondered why.

“I was trying to figure out what to do when the phone rang,” says Tavie.  “It was a call from the hospital radiation therapy department to reschedule my appointment as their equipment stopped t working that day.”

Tavie then immediately placed a call to International HIFU in Charlotte, NC to learn more and to find out if he could see a HIFU certified urologist in Southern California.  “I was thrilled that I found out about HIFU and that Dr. Robert Pugach, Medical Director of Pacific Coast Urology Medical Center in Los Alamitos, CA, had treated many cancer patients with HIFU,” continues Tavie. 

After his consultation with Dr. Pugach, studying the risks and benefits of the procedure and speaking with other HIFU patients, Tavie thought that HIFU sounded too good to be true.  “The fact that HIFU is minimally invasive, with faster recovery time, and fewer complications of erectile dysfunction and bladder control problems were big factors in my decision to select HIFU,” says Tavie.

Dr. Pugach has been treating prostate cancer patients with HIFU for 4 years and is one of only four US physicians certified to train urologists in HIFU.   “I understand the concerns many of my patients may have about undergoing a procedure that is not yet approved by the FDA in the United States,” says Dr. Pugach.  “However, the truth is that there are many advanced medical procedures available throughout the world that we still don’t have in the US.” 

Developed and refined by two companies in Europe and the United States, HIFU is administered through a trans-rectal probe and relies on heat developed by focusing ultrasound waves into the prostate to kill the tumor. These treatments are performed under constant, real time ultrasound imaging guidance, which allows for precise treatment planning. 

According to Dr. Pugach, HIFU offers a powerful advantage over radiation treatment as it provides the control and precision needed to accurately target the tissue to be destroyed without injuring adjacent tissue.   "HIFU is emerging as a remarkable treatment option for patients who are both physically and sexually active.  It provides excellent cancer cure rates while preserving normal urinary continence and erectile function in the vast majority of patients,” advises Dr. Pugach.

Promising results have been reported in a large series of prostate cancer patients and HIFU is currently undergoing Phase III clinical trials in the United States.  “Prostate cancer can be a very treatable cancer, if detected before it has spread to other organs, but many patients are not given complete information on minimally invasive treatment options,” he continues.   “I encourage all of my patients to be their own advocates and learn as much as they can about treating their prostate cancer.”   

On September 20, 2008, Tavie, with the emotional and financial support of his family, traveled to a modern hospital in Puerto Vallarta, Mexico where Dr. Pugach, working with a local urologist and the International HIFU professional team, performed his HIFU procedure.  HIFU is not automatically covered by health insurance and patients undergoing this treatment must pay out of pocket and travel to Europe, Mexico, Canada, Japan, China, Bahamas, or Latin America for the procedure.  However, there are some patients who have received reimbursement from their insurance company after the procedure.

Tavie recovered rapidly though he does like to point out that he is in the record books for one of the longest HIFU procedures.  “Typically the procedure takes two to three hours, says Dr. Pugach. “But due to the thickness of his rectal wall the procedure actually took longer than usual.”   Nevertheless, Tavie has no complaints.  “I was up the same day and discharged from the hospital the very same day.”  Tavie credits his fast recovery time to his preparations to be in prime physical and health shape before the procedure.    

Tavie is cancer free, performing with Lakeside and leading an active healthy lifestyle.  “I’m so pleased that I selected HIFU and wouldn’t hesitate to recommend this procedure.”  Dr. Pugach concurs as he is a strong advocate for HIFU.  In fact, Dr. Pugach says, ‘if I am diagnosed with prostate cancer HIFU is the treatment I will choose.”

 Dr. Robert Pugach has performed more minimally invasive prostate procedures than any other urologist in California and is actively involved in training physicians. Dr. Pugach is one the most experienced Sonablate^® HIFU physicians on the west coast.  For a consultation and to see if you qualify for HIFU, contact Dr. Pugach by calling 888.735.4336. 

The Sonablate^® 500 is not approved for use in the U.S and  remains investigational in the U.S. and is being studied for the treatment of prostate cancer in clinical trials in the U.S. FDA has made no decision as to the safety or efficacy of the Sonablate^®500 for the treatment of prostate cancer.  Visit www.internationalhifu.com