Prostate Cancer Treatment in Israel

[Shai]

My sources in the health insurance sector tell me that more Israeli patients travel over-seas for PROSTATE CANCER SURGERY than for ANY other medical treatment.

Can anyone care to comments about this issue?
What does it say about patient confidence in the Israeli health system?

[Arnon Krongrad, MD]

Well, so far one patient, Ehud Olmert, is not traveling outside the country for health care.

[E. Michael D. ("Mike") Scott]

Sounds to me as though there's a major opportunity for a talented young Israeli urologic surgeon who wants offices and surgical privileges in Jerusalem, Haifa, and maybe a couple of other places!

[Lenny Hirsch]

You are dealing with two separate issues.

1. The Israeli Health System, from what I have read, is a lot better than many other places in the world.All citozens have to belong to a health fund at a relativily low cost. These funds cover most expenses. I have been active in having medicines included in the basket of approved medicines, our latest success is having Taxoterre included. For the sum of less than $100 per month I get all my medications free, do not pay a cent for doctors of which I have a selection to choose from. Besides the bureaucracy it is a pretty sound system.

2. Until recently prostate cancer was very much on the back burner here. There are only two support groups. The Israeli Cancer Ass. who do a tremendous amount of good work, hardly feature pca awareness. This is one of the reasons for forming the Amuta. I will not go into all the horror stories that have come about because of this lack of awareness. This lack of awareness applies a lot to the family physicians.

There are a few top surgoens who have excellent results and of course there are butchers
There is one main center for Brachy Therapy. The results are fair to good.
Until recently radiation was like playing Russian Roulette. To-day most institutions have modern equipment and their technicians are well trained
HIFU is being preformed with excellent results, but one has to pay privately for this treatment. I hope that this will change in the near future.
Cryotherapy is hardly done and I do not recommend it here.
There is talk of robotic surgery for pca, but there is not the funds available. Come home Arnon and set up office here
Unfortunetly there are not many oncologist who specialize in pca. This a major problem. One in six will be diagnosed with pca. Last year 385 men died of the disease. I feel that this figure is low as I know of cases where the secondary cancer appeared on the death certificate and not the primary one, pca.
I know of may be ten people who travelled overseas for treatment.
One has to bear in mind that most Jewish mothers want their sons to be a doctor or lawyer. This means that the doctor is put on a pedestal and is hardly questioned. A second opinion, until recently was almost unheard of. This is one of my major battles

Over the last seven years that I have been activelly involved I have definitely seen an improvement in attitudes and awareness, but there remains a lot of work to be done

[Shai]

Thank you Lenny. Very informative.

[Arnon Krongrad, MD]

Lenny, did you see my editorial that mentions Ehud Olmert's diagnosis? It was published in the Miami Herald a few weeks ago and got great responses. It's all about prostate cancer screening. You may want to link to it from your site.

[phil]

I'd like to know more about the numbers. How many people travel overseas for this surgery? What are some of the reasons?

[Lenny Hirsch]

Phil, I receive between 10 to 15 telephone calls a week from newly diagnosed men. In the last year, yesterday was the first time that I spoke to some one who was thinking about going overseas for treatment. The reason he gave was as follows, Dr Roberts Meyers, of Mayo Clinic, gaurantees 97% erectile recovery after surgery. Here he was told that the success rate is around 60%, a more realistic figure. I suppose if you have the insurance or the money to cover a minimum expense of $50,000 then you should go.That is the only input that I can give you

[E. Michael D. ("Mike") Scott]

Hey Lenny ... I have a really hard time believing that Dr. Meyers told anyone that he could "guarantee a 97% erectile recovery rate" post surgery. It sounds so "not" the Mayo Clinic.

Do you think it's possible that what Dr. Meyers told your caller was more like, "Given your clinical stage and pathology, and [some other stuff too], I can 97% guarantee that I can spare both nerves." That at least sounds like a possibility to me.

[E. Michael D. ("Mike") Scott]

Now I'm mis-spelling his name too ... :O). It is actually Robert Myers, MD.

[Kathy Meade]

Gee Mike I followed your lead. Apologies to Dr Myers.

[Kathy Meade]

Lenny,

The question to ask Dr Meyers is how he defines erectile recovery and over what time frame? Is he talking about natural recovery or recovery with aides? Is he talking about a stuffable erection or a pretreatment erection? Terminology and expectation is a major problem.

[Lenny Hirsch]

Kathy

I am not interested in how Dr Myers defines erectile recovery. I was answering a question that Phil asked. I personally do not see any reason for a man to invest his life savings in travelling to the States for surgery on the off chance that the results will be better than he could achieve here.

Medical insurance is very comprehensive here and covers all the expense involved with treatment. I know that the person in question would not be covered by any insurance if he went overseasand would have pay out of his own pocket almost all his life savings.