Prostate cancer is one of the most common malignancies in men over 50. The Ichilov urology department hosts a dedicated minimally invasive uro-oncology centre equipped with the latest da Vinci Xi surgical robot.
Diagnostics
- Prostate MRI with fusion-guided biopsy (real-time MRI and ultrasound fusion);
- PSMA-PET — precise staging when metastases are suspected;
- Molecular profiling of biopsy tissue (NGS, 300+ genes) for targeted therapy selection;
- Gleason score and ISUP risk grouping.
Robot-assisted prostatectomy (da Vinci Xi)
A radical procedure performed through six small ports. According to the institute, 99% of procedures are technically successful; average blood loss is under 100 ml, discharge is on day 3–5, and continence is restored in most patients within 3 months. Cost — from $32,000 (including hospitalisation and follow-up).
Non-surgical methods
- Brachytherapy — implantation of I-125 radioactive seeds directly into the prostate. Ideal for low- and intermediate-risk disease. Cost — from $24,000.
- TOOKAD — vascular targeted photodynamic therapy for low-risk cancer: a laser combined with a photosensitiser selectively destroys the tumour while preserving urinary and erectile function.
- ExAblate (HIFU) — MRI-guided focused ultrasound for localised cancer.
- SBRT — stereotactic radiation in 5 sessions on CyberKnife and Linac MRI UNITY.
Metastatic and castration-resistant disease
- Lu-177 PSMA — a radioligand therapy that accumulates in prostate cells;
- Enzalutamide, apalutamide, abiraterone;
- Immunotherapy for MSI-H tumours;
- Olaparib for BRCA1/2 mutations.
Method comparison
| Method | Indication | Recovery | From |
|---|---|---|---|
| Radical da Vinci prostatectomy | Localised, intermediate/high risk | 2–4 weeks | $32,000 |
| Brachytherapy | Low and intermediate risk | 1 week | $24,000 |
| TOOKAD | Low risk, unilateral | 2–3 days | $22,000 |
| SBRT | Localised, surgery declined | Outpatient | $18,000 |
| Lu-177 PSMA | Metastatic CRPC | Outpatient | $15,000 / session |
The final plan is selected by a uro-oncology tumour board based on histology re-review, PSMA-PET and comorbidities.