Prime Minister Benjamin Netanyahu revealed Friday that he was diagnosed with prostate cancer and underwent targeted radiation therapy. The disclosure came in his annual health report, which was released after a significant delay.
Prof. Aron Popovtzer, head of the Sharett Institute of Oncology at Hadassah Medical Center, said the cancer is very common among men over 70 and was discovered incidentally during routine follow-up. The treatment was successful, but several key questions remain unanswered.
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Prime Minister Benjamin Netanyahu at a press conference during Operation Roaring Lion
(Photo: Shalev Shalom)
What exactly did doctors find?
According to Netanyahu and the official report from Hadassah Medical Center, he was diagnosed with prostate adenocarcinoma, the most common form of prostate cancer, accounting for about 95% of cases. The tumor was very small, measuring just 0.9 centimeters (0.35 inches), with no metastases. It was described as an incidental finding, meaning it was not detected due to symptoms but during an MRI scan conducted as part of routine monitoring following surgery for benign prostate enlargement on Dec. 29, 2024.
What is prostate cancer?
Prof. Amnon Zisman, head of urology at Shamir Medical Center (Assaf Harofeh), said a significant proportion of men have prostate cancer, whether diagnosed or not. “Even among those diagnosed, it is often not clinically significant, likely as in this case,” he said. Dr. Daniel Keizman, a senior oncologist specializing in urologic cancers, noted that prostate cancer is the most common cancer among men in Israel, with about 3,300 new cases annually.
Dr. Orit Raz, head of urology at Assuta Ashdod, said prostate cancer spans a wide clinical spectrum, from disease with no impact on overall health to more aggressive forms that can spread, cause symptoms and in some cases lead to death.
How is prostate cancer detected?
Keizman said prostate cancer is usually detected after age 50 and is often identified at an early stage without symptoms. When symptoms do occur, they may include difficulty urinating or blood in the urine or semen. Diagnosis typically involves a physical urological exam, a blood test for prostate-specific antigen (PSA), prostate MRI, a biopsy and, in some cases, a PSMA PET scan to detect or rule out metastases. Sometimes tumors are discovered incidentally during pathological examination following surgery for benign prostate enlargement.
Is it dangerous?
Popovtzer emphasized that this is a very common disease, particularly among men over 70. Medical literature often notes that many men in their 70s and 80s die with prostate cancer rather than from it: about 50% of men at age 70 have cancerous cells in the prostate, rising to about 80% by age 80. Netanyahu’s case is considered very low risk, and active surveillance without treatment was presented as an option.
How is prostate cancer treated?
Keizman said most cases are diagnosed without metastases. At that stage, the tumor’s risk level is determined based on its local extent, PSA levels and the Gleason score from biopsy. Low-risk tumors may be managed with active surveillance rather than immediate treatment, while higher-risk cases typically require intervention.
The two most common treatment options are prostatectomy or radiation therapy. “Prostate removal is usually performed with robotic assistance,” he said. “Radiation is modern and precise, sometimes MRI-based, and may target only the prostate or, in higher-risk cases, also nearby lymph nodes. Hormonal therapy may be added to reduce testosterone levels.” In more advanced stages with metastases, symptoms such as bone pain may occur, but a range of treatments can still allow patients to live for years.
How did Netanyahu’s age and tumor size affect decisions?
Raz said Netanyahu’s age, 76, places him in a range where decisions are not clear-cut and must consider factors such as prior surgeries and underlying conditions. While tumor size on MRI is important, the key indicator of aggressiveness is the biopsy result, along with its proportion relative to prostate size, location and progression over time.
Which treatment did Netanyahu choose?
According to Popovtzer, Netanyahu was offered two options: active surveillance or radiation therapy. He chose radiation, which was carried out at Hadassah about two and a half months ago. Following imaging and blood tests, Popovtzer said the findings indicate the disease has disappeared. Netanyahu will continue routine follow-up.
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Prime Minister Benjamin Netanyahu, his wife and Minister Miri Regev at the Independence Day torch-lighting ceremony
(Photo: GPO)
Despite these reassurances, several key questions remain unanswered.
What type of radiation therapy was used?
Radiation can be delivered in several ways, from daily treatments over six weeks to stereotactic body radiation therapy (SBRT), a focused approach involving five to six sessions. Another option is brachytherapy, in which radioactive seeds are implanted directly into the prostate, requiring general or epidural anesthesia. The official statement did not specify which method was used, how many sessions were performed or whether anesthesia was required.
Did Netanyahu experience side effects?
The medical report did not address this. Raz noted that patients receiving radiation after prostate surgery may face a higher risk of side effects. She added that such treatment typically indicates a clinically significant condition and requires long-term monitoring with periodic tests to assess success and rule out residual disease.
Was an acting prime minister appointed?
Treatment requiring general anesthesia would legally require appointing an acting prime minister. It is unclear whether such a designation was made, or whether anesthesia was not required.
Why was an MRI performed as part of follow-up?
After surgery for benign prostate enlargement, standard follow-up usually includes PSA blood tests rather than MRI. The use of MRI raises questions about whether PSA levels had changed or whether a more extensive monitoring protocol was used.
Where was the cancer found if surgery was performed two years ago?
Zisman explained that surgery for benign enlargement removes the inner tissue blocking urine flow, not the entire gland. Most adenocarcinomas develop in the outer region of the prostate. Thus, a negative biopsy from the earlier surgery did not rule out cancer elsewhere. In Netanyahu’s case, the tumor was later detected by MRI, likely in tissue not sampled during the original procedure.
The key question: Why disclose it only now?
Netanyahu said he asked to delay publication of the report by two months so it would not coincide with the height of the war, to avoid what he described as Iranian propaganda. Still, the timing raises questions about why the public is only now being informed — and not fully.