Treatment of bladder cancer in Israel

Israeli oncologists, together with the world’s leading researchers, have reached a complete understanding of the effectiveness of the treatment of bladder cancer (BC). Therefore, Israeli specialists are considered the most in demand for patients around the world who are diagnosed with this disease.

Bladder cancer is an oncological disease, in which the growth of abnormal tissue, a tumor, develops in the mucous membrane of the organ. In some cases, the cancer has spread into the muscle of the bladder.

According to the degree of spread, the disease is classified according to the following criteria:

1. If abnormal cells are found inside the lining of an organ, doctors describe it as non-invasive bladder cancer (early stage). This is the most common type of this disease.
2. When cancer cells spread outside the mucosa into the surrounding muscle of the organ, it is called muscle-invasive bladder cancer. This is a less common variant of the disease.
3. If the tumor has spread to other parts of the body, the disease is called metastatic bladder cancer.

In order to carry out effective treatment, the malignancy of bladder cancer is determined in the leading Israeli clinics. For this, tissue samples are examined under a microscope. This information helps doctors determine exactly which therapy would be most appropriate in a particular case.

To draw up an individual plan for the treatment of bladder cancer in Israel, specialists use modern diagnostic methods. Therefore, if patients do not have the opportunity to undergo high-quality examinations at their place of residence, they will be offered the full range of necessary examinations in the hospitals of Tel Aviv, Jerusalem, and Haifa.

Comprehensive diagnostics may include the following procedures:

• Urine cytology. This is a laboratory test for the presence of cancer cells in the urine.
• Complete blood count. Specialists check all deviations in the volume of blood elements, in particular the number of immature cells.
• Antigen analysis. UBC antigen (Urinary Bladder Cancer) is a specific tumor marker in bladder cancer. The amount of soluble fragments of cytokeratins in the urine is determined with this analysis.
• Ultrasound of the bladder. In 80% of cases, according to the results of an ultrasound examination, a tumor in the bladder can be detected.
• This is a method of plucking a tissue sample from the wall of the bladder. The material is examined under a microscope.
• Under local anesthesia or general anesthesia, the patient is injected through the urethra with a special instrument with a camera and a cystoscope. This allows to examine the body from the inside. This study helps the doctor evaluate the invasiveness of the tumor in the bladder mucosa. During a cytoscopy, the doctor may take tissue for later examination for the presence of cancer cells.
• Intravenous urography (IVU). This is an X-ray examination of the urinary tract using a contrast medium. The contrast enters the kidneys, ureters, and bladder, which helps the doctor to identify an atypical focus.
• MRI or PET-CT. These studies help to determine the exact size and extent of the spread of the tumor, not only in the bladder but also in other structures of the body.

Modern medical devices make it possible to detect a tumor and make an accurate diagnosis. In the process of treating bladder cancer in Israel and monitoring the postoperative condition, they also help to identify:

• fistulas;
• complications after surgery;
• sclerotic changes;
• congenital anomalies of the organ.

Detailed diagnostics allow professors of Israeli clinics to comprehensively solve all problems with the bladder so that the patient can achieve a full recovery.

The tactics of treating the disease will depend on the results of the tests, instrumental diagnostics, and the general state of health of the patient. The following options may be considered:

• In cases of non-muscle-invasive bladder cancer, the tumor is usually removed, leaving the normal part of the organ intact. This is done by transurethral resection of the bladder tumor (TUR). This is followed by a dose of chemotherapy drugs directly into the bladder to reduce the risk of cancer coming back.
• In cases with a higher risk of recurrence, a drug known as Bacillus Calmette-Guerin (BCG) may be injected into the bladder. This reduces the risk of recurrence of the disease.
• Treatment for high-risk, non-muscle-invasive bladder cancer may involve complete removal of the organ. This operation is called a cystectomy.
• In some cases, patients will have a choice between surgery or radiation therapy.
• Once the bladder is removed, the patient will need another way to collect urine. To do this, holes are created in the abdominal cavity so that urine can pass into the outer bag. Or there is a variant of the operation to form a new bladder from the intestine. This will be performed at the same time as the cystectomy.

In some cases, people with invasive bladder cancer who do not want to have surgery to remove the organ may try a combination of treatments. This is called trimodal therapy. It combines TUR, chemotherapy, and radiation therapy.

The surgeon performs the TURBT procedure to remove the cancer from the bladder while preserving the organ’s function. After TUR, the patient undergoes a course of chemotherapy along with radiation therapy. For radiation therapy in Israel, the latest generation units are used, which do not damage healthy tissue and do not harm the entire body.

If, after trimodal therapy, the cancer is not completely eliminated or the patient has a recurrence of the disease, the doctor may recommend a radical cystectomy.

Depending on the stage of bladder cancer and the severity of symptoms, doctors use various combinations of treatment for the disease. Surgery is the main treatment for bladder cancer. The type of surgery will depend on where the tumor is and how big it is. In addition to surgery, other types of treatment may be prescribed, including preoperative therapy (neoadjuvant) or adjuvant therapy (to reduce the risk of recurrence).

In leading Israeli clinics, doctors perform the following types of interventions:

1. Transurethral resection with fulguration

During TUR with fulguration, a doctor inserts a cystoscope (a thin, lighted tube) into the bladder through the urethra. An instrument with a small wire loop at the end is used to remove the tumor or cauterize it with high-energy electricity (the fulguration process).

2. Partial cystectomy. A partial cystectomy is an operation to remove a segment of the bladder. This operation is performed on patients with a low-grade tumor. The neoplasm grows into the wall of the bladder but is limited to one area of ​​the organ. As only part of the bladder is removed, patients can urinate normally after recovery. This is also called a segmental cystectomy.
3. Radical cystectomy with urinary diversion

Radical cystectomy is an operation to remove the bladder, lymph nodes, and nearby organs with signs of cancer (metastases). This surgery may be performed when the bladder cancer has grown into the muscle layers or when a non-invasive bladder cancer is affecting a large part of the organ. Wherein:

• in men, nearby organs are removed: the prostate gland and seminal glands;
• in women, the uterus, ovaries, and part of the vagina are removed.

Whenever possible, Israeli oncosurgeons perform interventions using the Da Vinci robotic system. This is a gentle type of surgery (minimally invasive), but this is possible only for certain indications and is not used universally.

One of the key benefits of treating bladder cancer in Israel is access to innovative medicines. The result of treatment and the well-being of the patient depends on the quality of the drugs. Anti-cancer drugs, which are often prescribed in hospitals in Eastern Europe and Central Asia, cause severe side effects. In Israel, you can get a therapy that will be effective and non-toxic for the body of a patient with oncology.

Non-surgical methods of treating bladder cancer in Israel include:

1. Radiation Therapy

Radiation therapy may be used as part of treatment for early-stage bladder cancer or after surgery that does not remove the entire organ (for example TUR). Radiation therapy may be the primary treatment for people with early-stage cancer who are not eligible for surgery or chemotherapy. This therapy is also effective in the treatment of advanced bladder cancer (when the cancer has spread outside the bladder).

Radiation therapy is often given along with chemotherapy to improve the effects of radiation. This is called chemoradiation therapy.

2. Multiple chemotherapy options

In chemotherapy, drugs that can stop the growth of cancer cells or completely destroy them are used. Chemotherapy can be given alone or in combination with other treatments. How chemotherapy is given (in the form of tablets or injections) depends on the type and stage of treatment for bladder cancer.

Systemic chemotherapy for bladder cancer is the injection of chemotherapy drugs into a vein. With this method of administration, the drugs enter the bloodstream and reach cancer cells throughout the body.

For bladder cancer, chemotherapy may be intravesical, meaning it is given into the bladder through a tube inserted into the urethra. Intravesical treatment flushes the lesion in the organ and kills the remaining cancer cells after the operation. This reduces the likelihood of recurrence of the disease.

4. Immunotherapy

Immunotherapy helps the human immune system fight cancer. An Israeli oncologist may offer biomarker tests to a patient to pre-determine an individual’s response to certain immunotherapy drugs.

Leading Israeli cancer centers use systemic immunotherapy. Systemic immunotherapy drugs are used to treat urothelial cancer (the tumor can develop at the level of the pyelocaliceal system of the kidney, ureter, bladder, and urethra).

Innovative drugs act not only on the immune system of a person with oncology. They are also considered targeted therapies because they target specific changes or substances in cancer cells.

5. Targeted therapy

Special substances to block the action of certain enzymes, proteins, or other molecules involved in the growth and spread of cancer cells are used in the targeted therapy. An oncologist performs biomarker tests on a patient in order to prescribe an effective targeted drug for a specific type of bladder cancer.

6. Intravesical immunotherapy

BCG (Bacillus Calmette-Guerin) is an intravesical immunotherapy drug used to treat bladder cancer. The BCG vaccine is given directly into the bladder using a catheter (thin tube). This procedure reduces the chance of cancer coming back.

Doctors prescribe the number of courses of this or that therapy individually. During the treatment of bladder cancer in Israel, intermediate monitoring is mandatory. This allows to adjust the tactics of therapy in time.

Among the best hospitals that effectively treat bladder cancer in Israel are the following:

• oncology department of Sheba Medical Center in Tel Aviv;
• network of Assuta clinics in Tel Aviv, Ashdosh, and other cities;
• Hadassah Medical Complex in Jerusalem;
• Sourasky Clinic (formerly Ichilov) in Tel Aviv.

You can learn about the benefits of these clinics from the coordinators-doctors of Experts Medical. Leave a request on this site and get a free consultation. On the pages of the clinics, you can find reviews about the treatment of bladder cancer in Israel.

Depending on the stage of the cancer being treated, doctors will prescribe one or more courses of drug therapy. The same goes for radiation therapy.

The operation with the help of the Da Vinci robot will cost approximately $20,000. The average price for radiation therapy in Israeli clinics is $10,000 per course. Cancer immunotherapy can cost as much as $60,000.

For comparison, the cost of the same procedures in hospitals in Germany and Italy will be about 30% more expensive with the same quality of medical care.

Reviews about the treatment of bladder cancer in Israel are most often the following:

• there is no language barrier, doctors speak Russian and English, in some cases they provide an interpreter;
• when monitoring the cost of treatment in clinics in Europe, it was determined that medicine in Israel is more affordable;
• conditions in hospitals, staff attitude, and post-operative care are at a high level.

Israeli medical centers with which Experts Medical cooperates are medical institutions accredited by world standards. They have distinctions confirming the quality of therapy and service for international patients. Therefore, Experts Medical employees receive only positive feedback about the treatment of bladder cancer in Israel from those people who chose to go to this country.

Contacting Experts Medical specialists will allow to quickly find a suitable doctor and clinic in Israel. The coordinator doctor of the company will send your medical documents to the clinic and help with booking tickets for the desired date.

Each patient who travels to Israel for bladder cancer treatment will receive informational support from a specialist of Experts Medical at all stages until returning home.