Rectal Cancer Treatment in Israel

The rectum lies in the pelvis, next to the bladder, the reproductive organs and the muscles responsible for holding stool. That is why rectal cancer is treated differently from tumors in other parts of the large intestine: radiation before surgery is used more often, and the surgeon needs to preserve the nerves and the sphincter. General information about colorectal cancer is available on the page colon cancer treatment in Israel.

Three things matter for choosing the approach: the stage of the tumor on MRI, the distance from its lower edge to the anus and the molecular features of the tumor.

Diagnosis in Israel is built around a pelvic MRI. It shows how deeply the tumor has grown into the wall and whether the lymph nodes and the mesorectal fascia (the thin layer around the rectum that the surgeon removes together with the tumor) are involved. This determines whether treatment starts with surgery or with chemoradiation.

In addition to MRI, the following are usually needed:

• colonoscopy of the whole large intestine with biopsy;
• CT of the chest and abdomen, and PET-CT if necessary, to look for metastases;
• a blood test for the CEA tumor marker (carcinoembryonic antigen);
• molecular tests of the tumor: MMR/MSI, KRAS, NRAS and BRAF mutations.

If the tests have already been done at home, doctors study them in advance and say what needs to be repeated. Most often the MRI is repeated if it was not performed according to the special rectal protocol.

Treatment methods depend on the stage.

Early cancer. A small superficial tumor can sometimes be removed through the anus without abdominal incisions – by the transanal approach.

Locally advanced cancer. Treatment most often starts with chemoradiation or a short course of radiation. Total neoadjuvant therapy is becoming more and more common: chemotherapy and radiation are given in full before surgery. This shrinks the tumor and increases the chance of preserving the sphincter.

Surgery. The standard is total mesorectal excision: removal of the rectum together with the surrounding fatty tissue and lymph nodes. It is performed laparoscopically or with a robot. With a very low tumor, it is sometimes necessary to remove the sphincter and create a permanent stoma.

Monitoring without surgery. If the tumor has completely disappeared after treatment, active monitoring with frequent examinations and MRI is discussed in some cases.

Drug treatment. For metastases, chemotherapy, targeted therapy based on the results of molecular tests and immunotherapy for MSI-H tumors are used. Metastases in the liver or lungs are sometimes removed surgically.

Rectal cancer treatment in Israel takes place in large medical centers such as Sourasky (Ichilov), Sheba, Rambam, Hadassah and Assuta. For an international patient, it matters that a tumor board opinion can be obtained in advance: doctors study the MRI, histology and discharge summaries and propose a plan before the trip.

Long stages, such as chemotherapy, are sometimes completed partly in Israel and partly at home under the supervision of a local oncologist. How best to divide the treatment is discussed with the Israeli doctors. If you are also considering other countries, there is a page on colon cancer treatment in Turkey.

The cost is made up of additional tests, chemoradiation cycles, surgery and recovery. The option with surgery straight away and the option with a full course of treatment before surgery differ in duration and scope, so the final price differs from patient to patient.

That is why how much rectal cancer treatment in Israel will cost can only be said after your records are reviewed. We request programs from several clinics and show you what each one includes: tests, surgery, days in hospital, treatment cycles. This shows what the treatment is made up of: the prices of individual stages, the timing and what is paid separately.

After surgery, the bowel needs time to adapt: in the first months, bowel movements may be frequent. This is called low anterior resection syndrome, and diet, medication and pelvic floor exercises help to cope with it. If there was a temporary stoma, it is closed a few months later.

Follow-up after rectal cancer treatment in Israel includes examinations, CEA tests, CT and colonoscopy at the intervals set by the oncologist. The clinic provides a discharge summary with a follow-up plan.

We publish patient reviews of rectal Cancer Treatment in Israel only with the patients’ consent. Ask the coordinator whether you can talk to a patient who has already been treated in Israel.

To start, submit a request and send your pelvic MRI, histology and discharge summaries. The coordinator will pass them on to oncologists, and you will receive the doctors’ opinion and clinic programs.