AT Assuta a multidisciplinary team of experts : urologists,oncologists,radiation oncologists , pathologists And radiologists , will review all of your treatment options and suit the effective treatment for you.
Using cutting edge technology with highest resolution of imagining devices.
What is prostate cancer?
Prostate cancer is the most common malignancy among men in Israel and the Western world (matching similar statistics to breast cancer in women). Every year, about 2,000 Israeli men develop prostate cancer.
Prostate cancer is a malignant growth, a group of cells in the prostate gland that has begun to divide uncontrollably, taking the place of the healthy tissue cells and interfering with normal tissue functioning.
How is prostate cancer diagnosed and its stage determined?
Physicians diagnose prostate cancer and determine its stage using three main indicators:
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A physical assessment of the local disease, as determined by a rectal examination. The doctor feels for prostate enlargement and the tumor. In some instances, the doctor can determine if the tumor is confined to the prostate or spread beyond it.
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A simple prostate-specific protein (PSA) blood test
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The degree of malignancy from the biopsy, as measured by the Gleason score, a numeric rating from microscopic evaluation of the tissue. The result of a biopsy is unequivocal and decisive.
Fusion biopsy: The smart prostate exam
At Lev Naot, patients can undergo an innovative test to diagnose prostate cancer when the disease is suspected. The fusion biopsy (nicknamed the “smart biopsy”) is performed using an MRI scan followed by the biopsy. The preceding MRI helps the clinician accurately target the tumor and perform an ultrasound-guided biopsy, which increases the chances of disease detection.
Prostate cancer treatment in Israel
Oncological medicine today has a variety of treatment options for prostate cancer, including:
The choice of treatment depends, among other things, on:
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Patient age
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The nature and characteristics of the tumor, as defined by the Gleason score
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Tumor size
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Disease stage: local or metastasized
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PSA protein level in the blood
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The patient's general health and medical history
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The patient’s personal preferences
Radical prostatectomy
Radical surgery – removal of the entire prostate – is one of the most common treatments for early stage disease. The practice of medicine has accumulated considerable clinical knowledge and experience with this alternative, and hundreds of such surgeries are performed in Israel every year.
This open-access surgery, which is usually performed under general anesthesia, is designed to remove the prostate gland, along with all the cancer cells found in the biopsy.
Many prostate cancer patients suffer from an enlarged prostate, unrelated to the disease. Surgical prostate removal simultaneously resolves the problem of frequent urination caused by prostate enlargement.
Choosing surgery leaves open the possibility of performing external radiotherapy as a complementary treatment if the disease recurs. Patients who undergo radiation therapy are not able to undergo subsequent surgery if the disease recurs because of scarring created in the radiated area.
Robot-assisted laparoscopic radical prostatectomy: the minimally-invasive, state-of-the-art approach
Robot-assisted laparoscopic radical prostatectomy is the most advanced prostate surgical technique, performed by the surgeon using a sophisticated robot called da Vinci. The procedure is not an automatic operation, but performed by the surgeon using this technological tool.
The benefits of the robot-assisted surgery include:
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Reduced surgical trauma at the incision point across the abdomen: The surgery leaves tiny holes that can be closed with a simple adhesive bandage)
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Improved medical procedure safety: The robot’s sophisticated arms boost the surgeon's abilities, giving him/her four arms to perform movements such as 360-degree rotations or reaching narrow spaces.
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Accelerated patient recovery rate
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Reduced pain
External radiotherapy
External radiotherapy treatments are performed in a linear accelerator, which directs high-energy photon beams to the cancerous tissue, damaging the DNA of the malignant cells, which kills the cells.
Radiation beams can also damage healthy tissues located near the tumor, so accuracy is essential. For this reason, radiotherapists perform personalized, sophisticated, high-precision pre-treatment simulations with the patient using CT and imaging-based guidance to precisely plan the therapy with maximum accuracy of a few millimeters, while protecting nearby organs.
The duration of the actual radiation therapy is brief – lasting only one minute to five minutes. Additional time (about 20 minutes to half an hour) is allocated for the radiotherapy technician to accurately position the beams using real-time imaging (image guidance), usually by CT scan.
Internal radiotherapy (brachytherapy)
Brachytherapy is an innovative therapeutic method in which radioactive material is inserted into the prostate to deliver local radiation from within the body to cure the prostate cancer. While radiotherapy is not painful, just as X-rays are not painful, it can sometimes have mild side effects, such as fatigue and disturbance in urination or bowel movements.
In a one-time procedure, the radiotherapy specialist inserts about 80 to 100 radioactive granules into the prostate gland, under ultrasound guidance, in an operating room.
Brachytherapy advantages and disadvantages
The procedure’s main benefits are that it is less invasive than surgical resection, and it is a one-time procedure, unlike external radiotherapy, which requires a series of treatments.
Brachytherapy’s main disadvantages are that when performed under anesthesia, it involves risks, similar to any invasive procedure, and during initial recovery phases, the patient can occasionally experience changes in urination, which usually passes within several weeks.
Radiotherapy side effects
Just like surgery, radiotherapy can have side effects, which occur in a small percentage of patients: