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Bladder Cancer – Diagnosis, Treatment and Costs

Thu, 12/06/2012 - 11:16 Urology
Bladder Cancer

It's believed that the main cause of bladder cancer is exposure to carcinogenic substances released in the urine in the bladder mucosa. The main risk factors for bladder cancer are:

  • Work in close contact with plastic, paint, aluminum, and other materials;
  • smoking

Bladder cancer may be suspected due to a number of symptoms and confirmed by cystoscopy with biopsy of the tumor. The time factor is crucial in diagnosing the disease.
Diagnostic measures include the following procedures:

  • Lab tests – extended blood tests, including oncomarkers, general and microscopic urinalysis, urine culture - $770
  • CT urography before and after administration of FDG - $950
  • Radioisotope test of the kidneys (DMSA, MAG-3) - $850
  • Consultation of onco-urologist – $550

The diagnostic process lasts 4 working days. It is done at Assuta Hospital.
After completing the non-invasive phase of diagnostic, we begin intravesical diagnosis (combined with removal of tumor sites within the bladder) and subsequent remedial measures.

Option 1.
Providing the tumor is localized in the bladder and does not penetrate the walls, therapeutic interventions include surgery to remove the tumor followed by subsequent, 6 weeks, intravesical therapy.
The cost of TUR-T surgery + express Bladder biopsy - $9,650, including 2 days of hospitalization, at Assuta Hospital.
The patient has to remain in Israel for 5 days, following his release from hospital.
Intravesical therapy includes 6 BCG injections, or Mitomycin injections. The injections are performed at Assuta Hospital (ambulatory department). The cost of therapy including injections - $ 5,880.
The therapy can also be performed at home, at a local hospital, under professional supervision.
Option 2.
Providing bladder wall have been penetrated by tumor and metastasis in the small pelvis is suspected, the TUR-T surgery is followed by a full course of chemotherapy. At the end of the course a checkup is performed to determine the results of chemotherapy; where necessary the second surgery (radical Cystectomy and Urinary Diversion by Ileal Conduit) is performed. During this operation, reconstruction of the bladder (usually from patient's small intestine) is performed.

  • TUR-T surgery + express Bladder biopsy - $9,650, including 2 days of hospitalization.
  • 4-6 courses of chemotherapy; each course 21 days. One course of chemotherapy costs $ 3,600 – the medicine is administered on the 1st and 8th day of the course.

    The therapy can also be performed at home, at a local hospital, under professional supervision.
  • Radical Cystectomy and Urinary Diversion by Ileal Conduit - $ 42,000, including 9 days of hospitalization, express biopsy during operation and final histology, post surgical monitoring by uro-oncologist.

The patient has to remain in Israel for 5 days, following his release from hospital.

Option 3.
Providing tumor does not penetrate small pelvis, but is distributed along the ureter, during surgery the tumor is removed and retrograde bladder ureteropyelography is performed; biopsy of the tumor is also performed.
If possible TUR-T + Bladder Biopsy + Distal Ureterectomy + Re-implantation are performed during the same surgery.
If there is a risk of spread of the tumor into the pelvis, the operation is limited to the removal of cystic tumors; then a 6-week intravesical chemotherapy is performed, followed by radical surgery and plastic restoration of ureter.
Cost of TUR-T + Bladder Biopsy + Distal Ureterectomy + Re-implantation surgery - $ 30,500, including 5 days of hospitalization, post surgical monitoring by uro-oncologist,  and express biopsy during operation.
The patient has to remain in Israel for 10 days, following his release from hospital.

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