Widely known as a pioneer in robot-assisted colorectal surgery, Pigazzi performed the world’s first robot-assisted tumor removal for rectal cancer more than 20 years ago. He has continued to advance the colorectal surgery field with his expertise in robot-assisted, laparoscopic and open surgical techniques to treat complex colorectal conditions such as recurrent and metastatic colorectal cancer.

Pigazzi brings to Cedars-Sinai a rich history of surgical leadership. Most recently, Pigazzi was division director of Colorectal Surgery at New York-Presbyterian/Weill Cornell Medical Center. He also was executive director for Surgical Services, vice chair of Clinical Network, and professor in the Department of Surgery at City of Hope Orange County.

In his new role at Cedars-Sinai, Pigazzi will concentrate on developing the academic colorectal practice, opening novel clinical trials and advancing translational research.

“Cedars-Sinai’s new Faculty Division of Colorectal Surgery will continue to build best-in-class, patient-centered care by staying on the forefront of the latest surgical techniques, clinical trials and clinical practices,” said Cristina Ferrone, MD, chair of the Department of Surgery at Cedars-Sinai. “Under Dr. Pigazzi’s esteemed leadership, we will also enrich our training programs as we develop the colorectal surgical leaders of tomorrow.”

In addition to his clinical practice, Pigazzi is involved in many significant research initiatives, including a translational research effort investigating the role dietary sugars play in the development of colorectal cancer. His extensive publication record includes more than 150 peer-reviewed articles and 16 book chapters. 

“Dr. Pigazzi’s innovative clinical work and research discovery for colorectal cancer aligns perfectly with our commitment to providing leading-edge expertise and care for our Cedars-Sinai Cancer patients,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer.  

Pigazzi earned both his medical and doctoral degrees at Boston University School of Medicine. He then completed his general surgery residency at New York-Presbyterian/Weill Cornell Medical College, followed by advanced fellowship training in minimally invasive surgery at Hackensack University Medical Center and in colorectal surgery at the University of California, Irvine.

“I’m grateful for the opportunity to bring my passion to this leadership role in the Department of Surgery at Cedars-Sinai,” Pigazzi said. “I look forward to growing the division to be the best in the region in terms of clinical, research and academic excellence.”

Read more on the Cedars-Sinai Blog: Taking the Fear Out of Colon Cancer Screening

Robert Figlin, MD, interim director of Cedars-Sinai Cancer and professor of Medicine and Biomedical Sciences at Cedars-Sinai, sat down with the Cedars-Sinai Newsroom to answer common questions about the disease and options for patients.

What does it mean to have stage 4 prostate cancer?

All cancers are diagnosed by stage. Stage 4 is when the disease has spread from the primary area or organ—in this case, the prostate gland—to other areas. The most common place that prostate cancer spreads is to the bone, although it can spread to other organs such as the lungs, lymph nodes or liver.

How is prostate cancer treated?

The standard of care for prostate cancer, by and large, when newly diagnosed, is to turn off the stimulation of the prostate cancer cell by blocking androgens, including testosterone, either where they are made or where they act with the cancer to cause cancer to grow. So, androgen suppression through treatments that reduce testosterone levels is the treatment of choice, primarily for hormone-sensitive prostate cancer. Having said that, recent evidence suggests that you can add chemotherapy to hormone treatment for men with prostate cancer that improves both their progression-free survival and their overall survival.

What is the expected prognosis for a patient with stage 4 prostate cancer?

Prostate cancer, when metastatic, whether it's aggressive or nonaggressive, is not currently a curable disease. So, what we can expect is that control of the cancer should be easily obtained using hormone ablation. This will certainly improve what's called progression-free survival, meaning that it'll slow the growth of the cancer to other areas, it will prolong survival, but it will not be curative.

What are the screening recommendations for prostate cancer?

The standard screening recommendation for men is a digital rectal examination and a PSA blood test on an annual basis. The PSA test measures a hormone called prostate-specific antigen, which may indicate prostate cancer when found at high levels. But currently, it's not recommended that men beyond the age of 70 have routine screenings, because in population studies, there's been no evidence that screening elderly men improves overall survival. Having said that, that should still be a discussion between the physician and the patient to see whether screening is appropriate.

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