Dr. Gal Keren Paz

Dr. Gal Keren Paz

Urinary Specialist - Surgical Oncologist,Urosurgeon

  , Tel-Aviv, Israel

  20 Years of experience

BIOGRAPHY

Qualification and Experience

Dr. Gal Keren Paz is a distinguished urosurgeon who is currently serving at the Tel Aviv Sourasky Medical Center (Ichilov Medical Center), Tel-Aviv, Israel. He has over 21 years of experience in his field of medicine. He obtained his medical education from the Ben-Gurion University of the Negev, Beer-Sheva. He has also done a specialization in Urology at Tel Aviv Sourasky Medical Center, Tel Aviv. He Specialises in Robotic and open surgeries for prostate cancer, bladder cancer' testicular cancer, and kidney cancer.

Contribution to Medical Science

Dr. Gal has been a part of many different research projects published in many renowned medical journals. He has also attended the Urologic Oncology at Memorial Sloan-Kettering Cancer Center, New York, USA. Dr. Gal is also a part of many associations such as the American Urological Association, Israeli Urological Association, and the Israeli Medical Association.

Past Experience

  • 2003-2004 Internship at Chaim Sheba Medical Center, Tel Hashomer
  • 2004-2011 Urology at Tel Aviv Sourasky Medical Center, Tel Aviv
  • 2011-2014 Urologic Oncology at Memorial Sloan-Kettering Cancer Center, New York, USA

Qualifications

  • Medical School - Ben-Gurion University of the Negev, Beer-Sheva, 1996-2003
  • Urologic Oncology at Memorial Sloan-Kettering Cancer Center, New York, USA, 2011-2014
MEMBERSHIPS (4)
  • European Association of Urology
  • Israel Medical Association
  • Israel Urological Association
  • American Urological Association
RESEARCH PAPERS AND PUBLICATIONS (4)
  • Comparing Open Radical Cystectomy and Robot-assisted Laparoscopic Radical Cystectomy: A Randomized Clinical Trial.
  • Does minimally invasive surgery for radical cystectomy provide similar long-term cancer control as open radical surgery?
  • The role of phosphodiesterase type 5 inhibitors in the management of premature ejaculation: a critical analysis of basic science and clinical data.
Procedures
Prostate Cancer Treatment

The prostate is a gland in the male reproductive system, which makes fluid that forms an essential part of the semen. Prostate cancer starts when cells of the prostate glands begin to grow abnormally

Prostate cancer is one of the leading cancers in men above the age of 60. In most of the cases, it is slow growing and may even go undetected and do not cause any problem. However, in some cases, it could be aggressive and cancer cells can spread to other parts of the body (metastatic prostate cancer)

Prostate cancer is a very slow growing disease and starts with tiny alterations in the shape and size of the prostate gland cells. The prostate cancer risk increases with age and it is rarely observed before the age of 40. That is the main reason why many men die of old age, without ever knowing that they had prostate cancer.

Prostate Cancer Causes

There is no direct prostate cancer causes. However, there are some factors that can increase the risk of prostate cancer, including the following:

  • Consumption of diet rich in red meat and high fat dairy products
  • Less consumption of vegetables and fruits
  • Obesity
  • Family history of the disease
  • Smoking and alcohol consumption
  • Sexually transmitted infections

Types of Prostate Cancer

Usually, prostate cancer means the cancer of prostate gland cells called prostatic intraepithelial neoplasia (PIN). Almost all the prostate cancers are adenocarcinomas, but there are some other types of prostate cancer as well, including the following:

  • Sarcomas
  • Small-cell carcinomas
  • Neuroendocrine tumors (other than small cell carcinomas)
  • Transitional cell carcinomas

Prostate Cancer Classification

Based on how abnormal the patterns of cancer cells look, prostate cancers are classified as:

  • Low-grade PIN: In this, the pattern of prostate cells appears almost normal
  • High-grade PIN: In this, the pattern of cells looks a bit abnormal

Signs of Prostate Cancer

There are no warning signs of prostate cancer. The symptoms of metastatic prostate cancer usually appear first in the region that the cancer cells have invaded.

After cancer causes the prostate gland to swell, the following signs of prostate cancer may be experienced: 

  • Frequent urination, especially at night
  • Difficulty starting or stopping the stream of urine
  • Weak urine stream and inability to urinate
  • Pain and burning sensation during urination and ejaculation
  • Blood in urine or semen

In prostate cancer stages, the following symptoms may also be there:

  • Pain in spine, pelvis or ribs
  • Leg weakness
  • Urinary incontinence
  • Fecal incontinence
Prostatectomy

The prostate gland is present below the urinary bladder in men. It surrounds the urethra and produces fluid that helps in the movement of the semen. Prostatectomy is a surgery that involves total or partial removal of the prostate gland. It is commonly performed as a part of treatment for prostate cancer.

Types of Prostatectomy

Radical prostatectomy: This surgery involves the removal of the entire prostate gland along with the surrounding lymph nodes. The surgical techniques used to conduct radical prostatectomy include the following:

  • Robot-assisted surgery: In this technique, several small incisions are made in the lower abdomen to remove the prostate gland.
  • Open surgery: In this technique, an incision is made in the lower abdomen between the anus and scrotum to remove the prostate gland.
  • Laparoscopic: In this technique, special surgical tools are inserted in the lower abdomen to remove the prostate gland.

Open simple prostatectomy: This surgical procedure involves removal of just the affected part of the prostate gland and is recommended for men with the cancerous prostate gland or benign prostatic hyperplasia (BPH).

Indications

  • Prostate cancer
  • Urinary tract infection
  • Bladder stones
  • Hematuria
Trans Urethral Resection of Bladder Tumor (TURBT)

Cancer in Bladder can be found to vary depending on the type of its origins. It can arise from the lining of the epithelium which is the inner lining of the urinary bladder or the urothelium. Rare forms of cancer are not of epithelial origins like the sarcoma or lymphoma. Tumours in bladder is found to be the 9th leading type of cancer in United States as per a survey conducted in 2012 with 430,000 new cases and mortality of 165000 deaths annually.

About Trans Urethral Resection of Bladder Tumor

The first and foremost question to ask is where is your bladder located? The sac like muscular urinary bladder is located in the pelvis region above the pelvic bone. It is connected to the kidneys through the two ureters that transfer the urine from the kidney to the bladder for storage. An abnormal growth of cells in the inner lining causes a tumour requiring diagnosis and then followed by a turbt surgery.

In most cases the tumour cannot be assessed in the primary stages. There are hardly any notable evidences found when the patient is harbouring a primary tumour.

The next stage is designated as Oa and categorized as a non invasive type papillary cancer.
In the stage next of the stage 0 or the carcinoma in situ the inner lining of the bladder is affected and is still considered non invasive.
In stage I the cancer has spread into the lining of the bladder further but has not affected the muscular wall of the bladder.
While in Stage II the inside part gets affected including the muscles of the bladder making it now invasive.
And when the cancer has spread enough in muscles and the tissues around the bladder like the reproductive organs it is considered to be in stage III.
And in the final or stage IV the cancer will spread to the lymph nodes affecting the organs around it as well.

Causes of developing a tumour in bladder

The causes of tumour in bladder are not always very clear and well defined but it has been linked with smoking, chemical exposure and radiation or a parasitic infection. The abnormal cells undergo some mutation that allows them to multiply in a non orderly fashion and goes beyond control and they do not die thus giving rise to the tumour.

Symptoms of the TURBT

A person suffering from a tumour will experience mild sensation of burning and discomfort in the times of urination for quite a few days. The force of the urinary stream may also undergo significant changes which can be observed for a week to a fortnight. Usually there could be none of the symptoms and in certain cases all symptoms even if experienced may not lead to the conclusion that it is a bladder cancer. There can be blood or clots of blood in the urine along with a tendency of urinating too frequently. Tendency of urinating at night may be felt more but there can be general problems in urine passing. Associated along with this the patient can experience pain on either side of the body.

What is transurethral resection of bladder tumour?

This procedure aims at removing bladder tumours at an early stage by inserting a scope through the urethra leading to the bladder. In the TURBT procedure bladder cancer can be detected by the urologist and potentially allow the urologist to treat various other kinds of bladder related disorders. But 75% of the cancer of bladders that are detected are superficial in nature causing growth only on the surface of the walls of the bladder and does not get very deep. So this facilitates the surgeon to have the tumour removed at the bladder wall level causing no damage to the deeper layers of the organ. The information that is collected while executing the procedure will help the surgeons to decide the type of the abnormality of the tumour and the extent of the tumour. This later allows the urologist surgeons to decide whether further treatments will be required or not.

What are the alternatives for TURBT procedure?

Some of the other treatment alternatives for TURBT are being worked upon while some of them have tremendous side effects

Blue light fluorescent cystoscopy : Enhanced tumour visualization is possible and detection of tumour chances are increased by almost 20 to 25% with this method where an ultraviolet blue light is used. A dye is injected an hour prior to the procedure.

Adjuvant bladder cancer therapy: TURBT is not suitable for many who have high chances of suffering a recurrence within 12 months from the treatment. In this case adjuvant therapy is recommended. It includes intravesicle chemotherapy. Chemotherapy for bladder cancer includes giving medication to curb the abnormal growth of cells. But it also has its sets of side effects like experiencing irritation in bladder and loss of hair, nails and feeling debilitated for a very long period of time.

Trans Urethral Resection of Prostrate (TURP)

The enlarged prostate gland can become a subject of concern after a certain age in men. It causes trouble while urinating and that is one of the main reason why such men are advised to undergo trans urethral resection of prostate (TURP) surgery.

What is Trans-Urethral Resection of Prostate (TURP)?

The prostate gland goes through two phases as a man grows old. The growth phase occurs during puberty when the gland assumes double its size. The second phase of growth takes place after a man has attained the age of 25. This final size at this stage continues to remain the same throughout the life. But when men suffer from benign prostatic hyperplasia, the prostate gland gets further enlarged.

When the gland enlarges, it squeezes the urethra and as a result, the wall of the bladder grows thick. With time, the bladder grows weak and loses its ability to empty the urine completely. This allows some urine to stay back in the bladder at all times. Along with this, the urethra also narrows and hence, all the problems associated with urination keep coming back.

As of now, it is not totally clear why most men develop BPH but it mainly indicates an imbalance of hormones and sexual activities with advanced age. Apart from that, there can be urinary tract infection, narrowing of the urethra known as urethral stricture, inflammation of the prostate, bladder or stones in the kidney, nerve problems in controlling the bladder, or scarring in the neck of the bladder as a result of previous surgery.

The following are some of the symptoms of BPH:

  • Frequent urge to urinate

  • Difficulty in initiating urination
  • The urine stream that flows is weak and stops and starts in the session
  • At the end of urination, dribbling is often experienced
  • Straining is felt at the time of urination
  • Blood in the urine
  • Inability to completely empty the bladder
  • Infection in the urinary tract

Some of these above symptoms can occur even in men whose prostate has not enlarged significantly.

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Dr. Gal Keren Paz

Frequently Asked Questions
How many years of experience does Dr. Gal Keren Paz have being an urosurgeon in Israel?

Dr. Gal has over 12 years of experience in his field of surgery.

What are the primary treatments and surgeries does Dr Gal Keren Paz as an urosurgeon? He Specialises in Robotic and open surgeries to prostate cancer, bladder cancer' testicular cancer, and kidney cancer.

He Specialises in Robotic and open surgeries for prostate cancer, bladder cancer' testicular cancer, and kidney cancer.

 
Does Dr. Gal Keren Paz provide Online Consultation?

Yes, Dr. Gal Keren Paz provides online consultation through MediGence.

What associations is Dr. Gal Keren Paz part of?

Dr. Gal is a part of the following associations

American Urological Association

Israeli Urological Association

Israeli Medical Association

When do you need to see an urosurgeon such as Dr. Gal Keren Paz?

Surgical oncologists are specialized doctors who help in curing and treating various cancers with the help of medicines and surgery. Many different cancers and tumors need to be removed surgically from different parts of the body and surgical oncologists are experts in these procedures.

How to connect with Dr. Gal Keren Paz for Online Consultation through MediGence?

He can be easily consulted by registering your profile with MediGence and writing down your inquiry. A meeting with the surgeon will be scheduled. Following which the consultation can be done.

What area of specialization does Dr. Gal Keren Paz have?
Dr. Gal Keren Paz is specialized in Israel and of the most sought after doctors in Urinary Specialist.
Does Dr. Gal Keren Paz offer Telemedicine Consultation through Medigence?
No, this doctor dose not offer telemedicine via MediGence
How many years of experience does Dr. Gal Keren Paz have?
Dr. Gal Keren Paz is one of the most sought after specialists in Israel and has over 20 Years years of experience.
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