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?

[Kathy Meade]

Lenny I brought the definition up because it is important for men to realize that they need to question statements like the one Dr Myer made. To travel based on an apples/oranges definition is one of the problems that we have. Happens here also when people travel based on hype they hear rather than knowing the facts. I hear of men borrowing large amounts of money to get treatment that they could get locally. My objective was to help keep him local based on the reality of the information that he heard.

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

I'm going to say this again for clarity. I have a very hard time believing that Dr. Myers ever made such a statement. That may well be what the patient in question thought that he heard, but I doubt that it was what was actually said. And Kathy you are correct, making the decision to travel anywhere to get care on the basis of such a statement (whether heard correctly or incorrectly) would be unwise.

[Arnon Krongrad, MD]

Lerry: I agree with you. These are two unrelated issues. The problem of erection studies starts with the problem of term standardization. This is a subject I addressed in Erection Season, one of our earliest blog entries. Until we start to speak the same language we will not be able to assert that erections are better preserved in place A than in place B.

As for 97% -- I chuckled at the concept of a "97% guarantee." I like my guarantees 100%, not a probablity. Semantics, but I chuckled nonetheless. Secondly, the only population in which I would reasonably cite such a high figure is in very young men. For example, 100% of my patients under age 40 have regained and/or are now regaining erections. caveat emptor.

Phil: based upon discussions with Israeli international insurance companies it would seem that 200-300 Israeli men travel outside their countries for radical prostatectomy. In this Israelis are not unique. The reasons are surely similar as what we see in men from Chile, Canada, and elsewhere. We can speculate on what those reasons might be.

A price tag like the one cited is usually very problematic. This is where international health insurance policies deliver coverage that can eliminate and/or markedly reduce the financial burden, often better than we see commonly with domestic policies here. Among the Israeli carriers that offer policies that may fit the quality description are Dikla, Clalit Mashlim-Mushlam, Harel, DavidShield, Macabbi Zahav, and Migdal Overseas. Shai knows more about it than I do but I think I have it straight.

[Itzy Be'er]

The reason why PCa patients, from Israel, consider getting treatment oversea (especially in the US) is because the most of the oncologists MD, in Israel, are general oncologist.
General oncologist treats many cancer diseases (There are about 100 different cancer diseases) and so he can't have enough knowledge in each of one of these cancer diseases.
It is especially true for advanced and complicate PCa situation where the most knowledgeable specialist is needed to get better, than the standard, outcome.
I know that there are some expertises, in the US, which their professional life time are dedicated only to PCa.
Itzy
Hilla, Israel

[Shai]

Shalom Itzy,
Welcome to the forum. Your comments are interesting and valuable. As stated by Dr. Krongrad, the reasons are not unique to Israel. In my experience, the depth of sub-specialty expertise is a global barrier to offering patients state of-the-art medical care. I must say that even in the USA, a/k/a "the land of the sub-specialists", the outcomes in treating PCa are NOT even. The bottom line is that in PCa, as in many other areas of medicine, "an educated consumer" has a far better chance at successful outcome then a consumer who did not do his homework.

The Prostate Cancer Info Link is a source, a tool and a home for those seeking targeted knowledge about PCa. For me, it is the bible of PCa information..

When it comes to the Israeli patient, the supplemental insurance policy that cover overseas elective surgery clearly makes for more - patient driven - treatment options. Nevertheless, for patients without the "elective over-seas policy", global package price are offered. I will be happy to discuss this off line with you. Please e-mail me to: [e-mail]

Be well.
Shalom from Miami
Shai

[Arnon Krongrad, MD]

Shai, I thought about your question in light of today's article in Ha'aretz. The article cites a general deterioration in surgical quality. I am not sure how one measures that in the first place. Secondly, I have to wonder how much of this is posturing meant to support coming requests for funding. Third, I wonder how much is reporters trying to sensationalize and sell newspapers. Finally, I am not sure how useful it might be to group surgical specialities. I am sure that some are better than others.

[Shai]

No doubt there is some posturing due to the "politics of funding". Nevertheless, the numbers don't lie. There are simply not enough specialists in Israel. There are only 70+ Urologists for a population of 7M (1:100,000). Can anyone provide data about quality of outcomes in metro area hospitals Vs. non-metro area hospitals? Wait lists and average time to treatment? (Oncology or surgery)?

[Rabbi Ed]

Hi, Shai,

My sister is a nurse in Tel Aviv. I'll forward your inquiry to her to see if she has any answers to your concerns. Either way I'll get back to you within the next two weeks as I wait for her reply.

Rabbi Ed

[Shai]

Greetings from Miami and thank you Rabbi Ed for your assistance in this matter.

Shai

[phil]

My impressions up until now are that the services provided are at a high standard but there's a lot of Israeli folklore about the poor quality of local services. The accessibility of foreign services- with costs largely covered by the local health system- probably sends many people to seek treatment overseas just for the "prestige."

I'm among the more unknowledge I must say...don't have any idea how to make a case for having treatment overseas, if I should decide that's what I'd like.