"It's definitely a different society. In America, physicians are much more open with their patients in discussing diagnosis and progress," Lotan said. "In Israel, physicians don't lie, but we usually don't volunteer statistics or a bad prognosis.

"It's interesting to see because patients here are obviously able to deal with it and seem very well-informed and inquisitive. Maybe it's easier on the patients and on the physicians when they know the whole truth," she said.

Israel has followed the American lead in providing support groups for patients and their families, she said. "It is an American model that has come through internationally."

Like America, Israel is incorporating alternative healing methods into cancer care. There is a clinic for alternative medicine in Jerusalem's Hadassah Hospital, for example.

"Physicians are realizing they don't always have the ultimate answer. These alternatives may help patients with their well-being and daily routines," Lotan said. "We don't deny them to patients. But we have to make sure this will not replace conventional medicine and will not compromise their health."

Lotan received her medical degree from Tel Aviv University and a doctorate in chemistry from Hebrew University in Jerusalem, where she lives. She is married and has two adult children and a 6-year-old.

During her visit to the UCSF/Mount Zion Cancer Center, Lotan attended physician-patient conferences and a tumor board meeting and reviewed innovative programs such as Art for Recovery, which provides an artistic outlet for patients.

As a visitor to the United States, Lotan said she was struck by health-care cuts currently taking place here.

"It's noticeable. One is very aware of funding. In Israel, medicine is socialized so health-care professionals are less aware of costs." Even though this attitude is changing, she said, it is not happening at the same pace as here.

As a result, Israelis do not share Americans' fears that ill health might become a financial burden.

Despite the U.S. budget cuts and the impact of managed care, however, Lotan observed that cancer treatment in the two countries is very similar.

"We have the same approaches. The world is very small," she said.

For more than 10 years, the annual Billie Zemel Fellowship has allowed Israeli physicians to study U.S. health care. The fellowship was named after the late wife of Peninsula businessman Arthur Zemel.

During her West Coast visit, Lotan has been a guest in the home of UCSF/Mount Zion oncologist Dr. Ernest Rosenbaum and his wife, Isadora.