About The Urologic Oncology Department
Urologic Oncology involves the treatment and prevention of cancers of both the male and female urinary systems as well as the male reproductive system. The treatment of female reproductive system cancers fall under the category of gynecologic oncology.
At Sheba Medical Cancer Center the Department of Urologic Oncology is a division of the Department of Urology as a whole. This department is affiliated with the Sackler School of Medicine at Tel Aviv University, and each one of our senior staff holds a faculty position at Sackler.
Without expert, dedicated staff, we would not be able to provide our patients with outstanding care. Each of our clinicians is an expert in their field, and we recruit the best physicians and surgeons from around the world. In caring for our patients, we offer tailor made medicine by having a full team consult on every case, including surgeons, urologists, radiation oncologists, urologic oncologists, nursing staff, and pathologists.
The Department of Urology is led by Prof. Jacob Ramon, a 1983 graduate of the School of Medicine at the Hebrew University in Jerusalem. Prof. Ramon is a former Israeli Air Force pilot and a specialist in urinary tumors, reconstructive surgery of the urinary tract, and laparoscopic surgery, a less invasive approach than traditional, open surgery. He has studied and practiced around the world, including at Duke University in the United States.
Cancer Types Treated
Cancer Treatments Available
Sheba Medical Center offers the latest in cutting edge, integrative treatment for urologic cancer. Below are some of the treatment types we provide, including ongoing urological cancer research:
- Fortunately, kidney cancer is now often discovered in its initial stages, thanks to modern detection methods. Early stage, local kidney cancer can usually be removed with surgery, either of the traditional abdominal type or through less invasive laparoscopic surgery.
- We also provide treatment for kidney (renal) cancer in advanced stages, including abdominal and laparoscopic surgery, immunotherapy with biologic drugs, radiation therapy, targeted chemotherapy, conventional chemotherapy, and combinations of the above. We use the latest, most effective drugs in our chemotherapy treatments for kidney cancer.
- Bladder cancer, the fifth most common type of cancer in Israel, disproportionately affects men over women. Surgery is often sufficient to address bladder cancer in the event that the disease has not spread. For metastatic bladder cancer, we provide chemotherapy using the latest generation of drugs under strict standards of safety.
- Testicular cancer, or cancer of the male testes, is rarer than many other urologic cancers. Fortunately, testicular cancer is often highly treatable. Treatment may include surgery, chemotherapy, radiation therapy, and immunotherapy. Sheba Medical Center has several top experts in the treatment of testicular cancer on staff.
Prostate Cancer Treatment
Prostate cancer is extremely widespread. In fact, it is the most common cancer among American men. There are several treatment types that may be appropriate at differing stages of prostate cancer, including surgery, chemotherapy, and radiation therapy. Furthermore, Sheba Medical Cancer Center offers advanced brachytherapy treatment. This involves the implantation of small amounts of radioactive material near the cancer. Brachytherapy often has the advantage of fewer side effects than traditional treatments.
Molecular Imaging for Prostate Cancer
Sheba Medical Cancer Center is also proud to provide high tech molecular imaging for our patients. Molecular imaging goes beyond traditional diagnostic imaging techniques that only present a view of the patient’s anatomy, such as CT, MRI, and x-rays. Instead, molecular imaging shows what is occurring inside the patient’s body at a cellular and molecular level. This permits the treatment team to be able to personalize a patient’s treatment to their exact situation. It is another way in which we offer tailor made medicine.
Molecular imaging allows precise localization of tumors and cancer cells. Furthermore, it shows cellular changes much earlier than they would be detected on other forms of imaging, like CT or x-ray. Molecular imaging also allows our physicians to quickly determine a patient’s response to treatments like chemotherapy or brachytherapy.
These advanced imaging techniques typically involve the injection of a radiotracer, a radioactive compound that will bind to certain substances in the body. The radiotracer acts as a sort of highlighter, allowing the amount and locations of these substances to be determined. Molecular imaging is thus part of the discipline known as nuclear medicine.
A type of molecular imaging known as positron emission tomography (PET) scans are used in prostate cancer patients to evaluate the extent and location of the cancer. The radioisotope gallium-68 (68Ga) is bound to protein prostate-specific membrane antigen (PSMA), a substance that is often produced in cases of prostate cancer. Once the 68Ga-PSMA is injected into the patient, it begins to decay and give off particles. The PET scanner will detect these particles, where they will show up as “hot spots” or areas of greater concentration.
These hot spots allow the treatment team to determine the exact spread of the cancer, including whether it has infiltrated bones or lymph nodes. 68Ga-PSMA scans are particularly useful when checking for the recurrence of prostate cancer or to survey suspicious lesions, especially when traditional blood tests, like prostate-specific antigen (PSA), are normal. 68Ga-PSMA scans can also be utilized when the patient has had a prostatectomy, or surgical removal of the prostate.
Like any nuclear medicine procedure, 68Ga-PSMA scans carry some risk. However, the rate of adverse effects is low, and the benefits outweigh the risks. The scan is performed in a single day and results are available within 24 hours.
The Advantage of 68Ga-PSMA Scans at Sheba Medical Cancer Center
This particular form of medical imaging has been yet been approved by the FDA, therefore it is not available in the United States. However, over 450 scans have been conducted during the past two years at Sheba. As a result, our staff has invaluable experience and expertise in this procedure and we are proud to be able to offer it for our patients.
Prof. Simona Ben-Haim is the director of the Department of Nuclear Medicine.