How much does prostate cancer treatment cost in Israel

Prostate cancer treatment in Israel

Most often, patients seek prostate treatment late, when symptoms appear that clearly indicate Prostate cancer. Successful treatment for cancer is possible when the tumor has not yet grown beyond the prostate area. However, modern treatment methods can curb the development of prostate cancer and improve the patient's well-being.

Israeli specialists have developed a special program for the diagnosis and treatment of prostate cancer. It consists of 2 stages - a complete examination of the patient and further treatment of prostate cancer in Israel.

In Israel, it usually takes about three days to diagnose cancer and examine the prostate gland, but the results of some tests will have to wait up to 10 days. At the stage of examination and confirmation of the diagnosis of prostate cancer, the patient is waiting for:

• consultation of a urologist-oncologist (price 550);
• blood, urine tests, including testosterone and PSA, urine culture (price 970);
• revision and histopathology of a previous prostate biopsy - if available (price 680);
• Ultrasound of the genitourinary system (price 490);
• optional: radioisotope bone examination (price 820), computed tomography (price 1150), PET/CT with choline (price 2300).

Sometimes, after a prostate examination in Israel, specialists do not give an unequivocal answer on the type of cancerous tumor and cannot prescribe treatment. This happens when a previous biopsy of the prostate was done poorly or the patient did not provide its results. Then a new biopsy of the prostate is performed in Israel, under ultrasound control (the cost is 2310). The result of the study is ready in a week or two (in case of surgery).

If, after the diagnosis, Israeli specialists have established the type of prostate cancer, then further treatment tactics are determined. There are several treatment options for prostate cancer in Israel, for convenience they are divided into three treatment plans

Plan one: removal of the prostate (prostatectomy)

In Israel, the cost of the operation includes:

• preoperative preparation and examination (price 270);
• surgical intervention and subsequent hospitalization at the Department of Urology of the Israeli clinic "Assuta" (price 17400);
• consumables (price 1200);
• prostate biopsy and histopathology (price 2300).

In Israel, the removal of the prostate gland with nearby tissues and lymph nodes is carried out in several ways:

1) removal of the prostate through an incision in the abdominal wall (the incision is made in the lower half of the abdomen)

2) removal of the prostate gland through an incision between the anus and the scrotum

3) laparoscopic removal of the prostate. Unlike the first two types of surgery, laparoscopy allows you to preserve the nerve endings as much as possible and reduce the risk of possible complications (urinary incontinence, erectile dysfunction, and others). Surgical instruments are inserted through small incisions in the abdominal wall, and the surgeon uses a laparoscope (a special video camera) to monitor the progress of the operation. After laparoscopy, rehabilitation is quick, no long-term hospitalization and stay in Israel are required.

4) Operation with the help of a medical robot. The intervention is carried out laparoscopically, but the instruments are fixed on a special robot controlled by a doctor. The robot allows the surgeon to manipulate instruments more accurately during prostate removal.

The patient is discharged from the hospital 4 days after the operation, but after discharge and completion of prostate cancer treatment in Israel, he will have to stay for another 10 days. This is due to the fact that the urologist will remove the catheter installed during treatment only two weeks after prostate surgery.

Plan Two: Brachytherapy

Brachytherapy - internal irradiation of a cancerous tumor, in which radiation sources (radioactive granules) are implanted into the prostate tissue - is carried out at the Israeli Sheba clinic. After the introduction of the emitter into the prostate tissue, the patient is allowed to leave Israel for home and return to extract it, after undergoing a course of local treatment.

The cost of the procedure includes:

• preliminary preparation and examination (price 770);
• surgical intervention and hospitalization day (price 19080);
• consumables (price 5100).

Third plan: remote radiotherapy in combination with hormonal drugs

Surgical intervention often becomes impossible in the advanced stages of prostate cancer and when the patient feels unwell. Then the specialists of the Israeli Assuta clinic, where this treatment is carried out, choose one of the advanced radiation therapy protocols.In Israel, prostate cancer treatment using the latest radiation technology has fewer side effects and reduces the likelihood of prostate cancer recurrence. The main point of hormonal treatment is to reduce the production of testosterone to slow down the growth of a cancerous tumor. Its increase depends on the concentration of testosterone in the blood: the higher it is, the faster the development of a malignant formation.

The traditional course of radiological treatment of prostate cancer consists of 30 sessions of 10 fields per session (the price of 1 field is 190). An appointment with a radiation oncologist in Israel will cost 650, and a simulation of an irradiation program will cost 1540.

An alternative treatment for prostate cancer in Israel

Israeli specialists are actively introducing another effective method of cancer treatment, the name of which is hidden behind the short abbreviation HIFU. Non-surgical treatment consists in exposing the cancerous tumor to high-power sound waves. High-intensity ultrasound focuses on the prostate as precisely as possible, and this "targeted" treatment allows you to save healthy tissues and nerves around the affected organ. This means that at the end of cancer treatment in Israel, the patient will quickly return to everyday life without any side effects.

In Israel, HIFU is a new treatment technology that is currently used only in the Israeli Assuta clinic.

Prostate cancer treatment in Israel

When a man is first diagnosed with prostate cancer, an Israeli clinic will offer him a choice of several treatment options. What factors should be considered before making a decision?

Identification of risk groups

Most men develop so-called localized prostate cancer. This means that the pathology is at an early stage and has not spread beyond the gland. While some patients can live long lives and end up dying from something other than cancer - even in the absence of any treatment - in others, the disease is often much more aggressive and therefore requires more aggressive therapy.

The following clinical parameters are used to divide patients into risk groups and thereby determine oncological tactics:

• serum PSA level;
• Gleason index based on biopsy results;
• Disease prevalence as assessed clinically, from rectal examination and imaging studies.

Based on these parameters, we build a prediction system, in accordance with which a therapy plan is developed. Consult TopClinic

Diagnosis of prostate cancer in Israel: the latest developments

In some cases, prostate cancer is characterized by a high risk and aggressive course, and in other cases, a less likely outcome. A biopsy reveals a malignant tumor, but diagnostic tools provide minimal information about the degree of aggressiveness of the disease. Therefore, most men decide to immediately begin treatment. At the end of therapy, many patients experience serious side effects for a long time.

Immediate treatment is not always necessary, but there is currently no way to know if action should be taken immediately or if treatment can be delayed.

Now Israeli scientists are developing an innovative test to answer this question. By analyzing primary tumor biology and using genes from a variety of biological pathways, the test predicts the aggressiveness of prostate cancer at the time of diagnosis, allowing men to make more informed treatment decisions with confidence.

Prostate cancer tests may include:

• Digital rectal examination (DRE). During DRE, the doctor inserts a lubricated index finger into the rectum to examine the prostate. If any abnormalities are found in the structure, shape, or size of the gland, you may need further tests.
• Prostate specific antigen (PSA). A blood sample is taken from a vein in your arm and tested for PSA. PSA is a tumor marker that is naturally produced by your prostate gland. It is normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, then this may indicate a prostate infection, inflammation, enlargement, or cancer.

PSA analysis combined with PRI helps to detect prostate cancer at the earliest stages. Consequently, the debate continues around prostate cancer screening. Find out the price of diagnostics

How is a prostate cancer screening done?

If the DRE or PSA test finds an abnormality, further tests will be recommended to determine if you have prostate cancer, for example:

• Ultrasound.If other tests are of concern, your doctor may use a transrectal ultrasound (TRUS) to further evaluate your prostate. A small tube the size of a cigar is inserted into the rectum. The probe uses sound waves to create an image of your prostate.
• Prostate tissue sample collection. If the initial test results indicate prostate cancer, your doctor may recommend a procedure to collect a sample of cells from your prostate (prostate biopsy). A biopsy of the prostate is often done using a thin needle that is inserted into the prostate to collect tissue. A tissue sample is analyzed in a laboratory to determine if cancer cells are present.

At TopClinic clinics, urologists and radiologists collaborate on the use of MRI-assisted biopsy technology, which provides the best fusion picture available for the treatment of prostate cancer.

When a biopsy confirms the presence of cancer, the next step is to determine the aggressiveness (grade) of the cancer cells. A laboratory pathologist examines a sample of your cancer to determine how many cancer cells differ from healthy cells. A higher level of aggressiveness indicates a cancer that will spread quickly.

The most common scale used to evaluate prostate cancer cell levels is called the Gleason score. The Gleason score combines two numbers and can range from 2 (non-aggressive cancer) to 10 (very aggressive cancer).

In addition, genomic testing is increasingly being used to more accurately assess risk and detect aggressive prostate cancer.

Treatment tactics for patients with prostate cancer

According to the results of research, Israeli oncologists divide patients with prostate cancer into 3 risk groups for progression of the pathology:

Low Risk Group

If the patient is at very low risk for disease progression, active surveillance is recommended. This means that the patient will have to regularly come for examinations and take tests for PSA levels. If necessary, a biopsy is ordered. If prostate cancer has begun to progress, more aggressive methods are required.

In certain cases, low-risk patients can choose between active surveillance, radiotherapy, and radical prostatectomy.

Moderate risk group

Patients with moderate-risk pathology should not rely on active surveillance. Basically, they choose between radiation therapy and surgery. When choosing radiotherapy, they are also prescribed a course of androgen deprivation therapy for 6 months.

High risk group

Patients with high-risk tumors are threatened by the rapid progression of the disease and the occurrence of metastases. They are most often prescribed a prostatectomy. If the patient refuses the operation in favor of radiation exposure, he will have to undergo an additional 2 or 3 years of androgen deprivation therapy. Find out the cost of prostate treatment

Surgery or radiotherapy?

The criteria for choosing between surgery and radiation depend on the patient's risk profile. If the patient is contraindicated for surgery due to any other comorbidities or risk factors - for example, heart disease, diabetes, or simply old age - most likely, he will be prescribed radiation with or without concurrent hormonal therapy.

A younger patient - say 50-55 years of age - who is in good physical shape and does not suffer from other diseases, except for a very aggressive prostate tumor, the doctor will recommend immediate surgery. According to patients, minimally invasive surgery for prostate cancer by a qualified specialist is the best way to solve the problem.

With regard to surgery, it is very important to preserve the nerves that mediate sexual function to ensure an optimal quality of life. Therefore, the question arises before the surgeon: can he preserve these nerves and at the same time remove all traces of the pathology? The specialist discusses this issue with the patient before the procedure. Depending on the degree of risk, the doctor may also have to remove the lymph nodes in the pelvic area, which can cause swelling later.

If the doctor damages the sphincter of the bladder during surgery, the patient may develop urinary incontinence after surgery.

Most of the listed side effects go away with time. If you look at the results of various scientific studies, 30 to 50% of patients report a decrease in the intensity of side effects 2 years after surgery. It should be noted, however, that these adverse events are not initially severe.For example, sickle cell dysfunction is treated with implantation and drug therapy.

Patients who treat prostate cancer with radiation suffer from more severe side effects. These include irritable bowel syndrome, because the intestine, like the prostate, is included in the irradiation field.

Symptoms of irritable bowel syndrome are:

• imperative urge to defecate;
• diarrhea;
• rectal bleeding.

However, these side effects disappear within 1-2 years after treatment.

The phenomena associated with the function of the urinary tract are caused by the so-called radiation cystitis. Patients complain of frequent urge to urinate and a burning sensation, but all this passes with time.

Sexual dysfunction is a side effect that increases during the 1st year or 2 years after exposure. However, in most cases, the side effects observed after 2 years after the end of radiation therapy are almost the same as the undesirable consequences of surgery. Therefore, the choice of treatment method depends on the presence or absence of concomitant diseases.

Treatment of prostate cancer by the leading Israeli urologist Professor Matskin

Director of Urology

In patients from the CIS countries who are treated at Top Ichilov, the diagnosis is not confirmed in 43% of cases.

The cost of the examination to obtain a 100% accurate diagnosis and treatment protocol is 3115.

In the treatment of prostate cancer in Israel, preference is given to minimally invasive organ-preserving operations, thanks to which the quality of life of a man is preserved and there are no inconveniences. The Top Ichilov clinic uses the DaVinci Xi surgical robot, the latest model of the Da Vinci surgical robot, to perform prostate cancer surgeries. The operations are performed by Dr. Meyer David Gershbaum, one of the world's leading specialists in robotic-assisted urological operations.

When contacting Top Ichilov for cancer treatment in Israel, the patient is at the center of attention of a multidisciplinary team of leading Israeli specialists. This group includes:

• Oncologist ( Prof. M. Inbar )
• Surgeons ( Prof. H. Matskin and Dr. A. Tsivyan )
• Oncourologist-Radiologist ( Head of Department Dr. E. Ghez )
• Urologist-andrologist ( Prof. Yu. Heng )

What methods of prostate cancer treatment are used in Israel

Radiation therapy

The radiation method is often used to treat prostate cancer in Israel. At an early stage of the disease, patients have the choice between surgery and radiation with comparable results. For larger or more aggressive tumor types, radiation therapy may be used in conjunction with Hormone therapy. Radiotherapy is also used to treat malignant tumors of the prostate gland, which could not be completely removed, or when the disease recurs.

The latest methods of radiation therapy allow Top Ichilov specialists to conduct focused irradiation of the tumor more accurately, providing the maximum amount of radiation at the calculated point, with the least damage to surrounding healthy cells. Request a quote for prostate cancer treatment Top Ichilov provides the most advanced methods of radiation therapy for prostate cancer. Among them:

1. Brachytherapy - placement of about 60 grains with radioactive material in the tumor tissue of the prostate. Thus, a weak internal irradiation is produced, which differs from the external minimal impact on other organs of the patient. Brachytherapy is performed as a one-time one-day procedure and does not require hospitalization. The procedure lasts about an hour and is performed under local anesthesia. In Israel, brachytherapy is performed by an oncourologist together with a nuclear physicist.

This technique has the lowest side effect and a 93% success rate. The procedure is carried out personally by Professor H. Matskin, a leading specialist in the treatment of prostate cancer in Israel.

2. Intensity Modulated Radiation Therapy (IMRT) - focusing the maximum number of beams on the tumor, without the side effect of radiation on healthy tissues.

Urological surgeon Dr. A. Tsivyan, a specialist in laparoscopic prostate surgery, works as part of the Top Ichilov team, which offers the most advanced, personalized methods of treating prostate cancer.

Radical prostatectomy

Radical prostatectomy is a surgery that involves the removal of the entire prostate, both seminal vesicles, the short segment of the urethra that passes through the prostate.

In some patients, one or more groups of lymph nodes in the pelvic area are also removed (lymphadenectomy, or lymph node dissection).In more advanced prostate cancer, one or both neurovascular bundles are removed, affecting, among other things, erectile function.

The operation takes about 1 hour.

• Surgery with the Da Vinci Robotic Surgical System. A lot of experience has been accumulated in the treatment of prostate cancer with the help of the da Vinci robot in Israel. Due to the novelty of this method of surgical treatment and its fundamental difference from the usual surgical interventions, the quantity and quality of operations performed by specialists using this device is very important. In Israel, the Da Vinci robot has been working for 8 years. Now Top Ichilov specialists are working with the latest model of the robot - DaVinci Xi. This robot is designed to perform more complex prostate cancer surgeries than previous da Vinci robots.

2. Laparoscopic (minimally invasive) technique:

Endoscopic instruments are inserted through punctures in the abdominal wall. A miniature video camera and surgical arms are attached to the end of the endoscope. Top Ichilov's surgeons are experts in nerve-sparing surgery techniques, which allows the patient to fully rehabilitate the genitourinary function of the patient. This technique has a number of obvious advantages:

• Less blood loss
• Shorter postoperative hospital stay
• Less complications during surgery

The experience of the surgeon is extremely important in carrying out such interventions and will affect the outcome of the treatment more than any set of tools.

Get a treatment program and an exact price

Hormonal therapy

Most prostate tumors are dependent on the hormonal background of androgens. The most significant is testosterone. About one third of patients with prostate cancer require hormone therapy (also called "androgen deprivation"), which blocks the production of testosterone that interacts with tumor cells. This reduces the size of the tumor or slows down its growth. While hormone therapy can help fight prostate cancer, it cannot cure it.

Hormone therapy is most commonly used for high-grade advanced disease (Gleason scores of 8 or higher) or in patients with cancer that has spread beyond the prostate. However, doctors have different opinions about the length and timing of hormone therapy. Types of hormone therapy for prostate cancer:

Antiandrogens are drugs that block the synthesis of testosterone. They are taken daily. Antiandrogens are most often used in combination with LHR agonists. LHR antagonists are drugs that stimulate the pituitary gland to produce luteinizing releasing hormone (LRH). Significant release of this Professor Moshe Inbar at the reception in Ichilov

The hormone gives a signal to reduce the synthesis of testosterone. The treatment consists of injections or subcutaneous implants in the form of granules that gradually release the drug. The course lasts from 1 to 6 months. Orchiectomy is the surgical removal of the testicles. Orchiectomy is an effective and convenient way to lower testosterone, but after this operation, most men cannot have an erection. Chemotherapy Most doctors recommend chemotherapy for prostate cancer that has spread to other organs and is not responding to hormone therapy.

• Docetaxel is one of the standard chemotherapy drugs for the treatment of prostate adenocarcinoma
• Cisplatin-based chemotherapy is used to treat small prostate cancers.

Gene therapy

A special genetic analysis of the tumor will help you choose the most effective and gentle treatment in Israel.

Cryotherapy

With this treatment, the tumor is destroyed by exposure to low temperatures. Exposure is carried out using a long thin probe under the control of x-rays or other medical imaging methods.