Breaking News: Israeli PM Netanyahu undergoing prostatectomy for UTI--and potentially could join 'the reluctant brotherhood'

Active Surveillance could even be in the cards, prostate cancer expert

By Howard Wolinsky

Israeli Prime Minister Benjamin Netanyahu is scheduled for prostate removal surgery Sunday after being diagnosed with a urinary tract infection, his office announced.

The 75-year-old PM’s plate was plenty full already, running the Israeli war with Hamas and other Iranian-backed organizations on multiple fronts, facing arrest warrants hanging over head for genocide from the International Criminal Court, and battling in court over charges bribery, breach of trust and fraud charges.

Now he’s now is tackling prostate issues during the Hanukkah season. Oy vey, right?

Netanyahu underwent a test at Hadassah Hospital on Wednesday, where he was "diagnosed with a urinary tract infection resulting from a benign prostate [hyperplasia (BPH)," the prime minister's office said in a statement.

"As a result, the prime minister will undergo prostate removal surgery [Sunday]," it added.

The PM’s office noted Netanyahu has been receiving antibiotics treatment to eliminate the infection, and it was then decided that he would undergo the procedure.

Urologic oncologist Brian Helfand, chief of urology at Endeavor Health Northshore University HealthSystem near Chicago, said, “This isn’t drastic. An indication to undergo an outlet procedure for the prostate (shaving BPH) [includes] urinary infections. So many different in treatment options and associated with few if any side effects.”

Urologic oncologist Adam Weiner, assistant professor and urologist at Cedars-Sinai Medical Center in Los Angeles, said, “While there is no direct connection between BPH and prostate cancer, the chances of finding prostate cancer at the time of a BPH surgery ranges from 3-17%.”

He added that he incidence of prostate cancer in men age 70 and older is about 1 in 11.

Weiner told me Netanyahu could be facing “a number of different procedures for BPH. In a BPH procedure, a surgeon either ablates prostate tissue with laser or steam or does a removal of prostate tissue. The latter can be done cystoscopically with a camera through the urethra - no incisions. It can also be done with an open incision or multiple small incisions in a laparoscopic-robotic approach.”

He suspects the PM will undergoing a “simple prostatectomy.” He said a simple prostatectomy is done for patients with really large prostates and BPH issues like severe urinary symptoms, urinary retention, or infections.

Weiner added: “If you think of a prostate as an orange, during a simple prostatectomy the surgeon removes just the fruit and leaves the peel behind. This opens the urine channel and helps patients urinate better after surgery. This is different from a radical prostatectomy during which both the fruit and peel are removed since the goal is to make sure to remove all sources of cancer.”

(Adam Weiner, MD)

He said the simple procedures are very common.

As part of the procedure, pathologists biopsy the tissue to look for possible prostate cancer,

Weiner said: “If they remove prostate tissue, as opposed to just ablate it, the tissue will routinely be sent off to be analyzed for prostate cancer. If they find prostate cancer, the surgery is not considered a cure. Patients with prostate cancer that is found during a BPH procedure have to be counseled on cancer treatements or surveillance afterwards.”

He said, “It id quite common after BPH procedures to start a patient on Active Surveillance after finding prostate cancer during a BPH procedure. But you can still offer radical prostatectomy or radiation in those situations.

Haaretz, the Israeli newspaper, noted that Netanyahu has been going through a series of medical issues:

—Last April, Netanyahu underwent hernia surgery under full anesthesia following a routine checkup.

—In July of the previous year, Netanyahu underwent a pacemaker implantation procedure a week after a heart monitoring device was fitted into his body.

MRI-invisible lesions: A good sign—like a Gleason 6?

By Howard Wolinsky

Did you know that it’s possible for prostate cancer can spotted by a pathologist but the lesion can be invisible in an MRI?

Is this a good thing? Many researchers think it is a good thing.

Dr, Mark Emberton, Professor of interventional oncology at University College London and Dean of its Faculty of Medical Sciences, will be speaking to the ASPI webinar on Saturday, January 25, 2025, from noon – 1:30 p.m. Eastern (5:00pm-6:30pm UK time), about MRI-invisible lesions. Emberton is a pioneer on the use of MRIs in diagnosing, classifying and monitoring prostate cancer.

Don’t be invisible. Register here: https://zoom.us/meeting/register/tJYldu-qqzojGNEzCkgPQuTOWYGhcL80Dhec'

MRI-invisible lesionms are considered a good thing, comparable to Gleason 6.

Professor Emberton’s clinical research is aimed at improving the diagnostic and risk stratification tools and treatment strategies for prostate cancer (PCa). He specializes in the implementation of new imaging techniques, nanotechnologies, bio-engineering materials and non-invasive treatment approaches, such as high intensity focused ultrasound and photo-dynamic therapy.

His research has been published in over 300 peer-reviewed scientific papers in journals including BMJ, Lancet Oncology and European Urology. He has also contributed to the development of guidelines for the management of PCa and lower urinary tract symptoms, published by the International Society of Geriatric Oncology and the European Association of Urology.

If you have questions, please send them to: contactus@aspatients.org

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Tick-tock. Do you want to attend the Jan. 4 AS year-in-review webinar, featuring four top prostate experts. You need a paid subscription: click below.

If you feel you can’t afford it, please contact me at Howard.wolinsky@gmail.com. I know a guy who can get you in.