Hi,
The tumor is showing itself to be aggressive and it's muscle invasive, that will always be a high grade tumor.
I wouldn't worry at all about the quality of care available in Israel as there is much good research and innovative treatments that originate there. I'm sure if you're at the national cancer center you will be seen by doctors qualified to perform any surgery or treatment your husband needs.
A PET scan could make the difference in approach. If there is no distant spread surgery maybe could be performed (bladder removal), if there's spread in the nodes or somewhere else then chemo is given first. If there's a good response to chemo, surgery might be done later. But your husband may not be a good candidate for surgery.
In a case like your husband's chemo is often recommended first. There's a new protocol using cisplatin or carboplatin and gemzar and it's supposed to be less toxic than most. Sometimes radiation is given at the same time, to improve response. If anything would give side effects it would be the chemo and not so much the radiation.
Even if there is not a chance for total cure, it could be worth getting treatment to sustain quality of life, to keep the symptoms of cancer to a minimum. The treatments are not always worse than the disease...although sometimes it does seem that way.
Please let us know how things go.
Wishing you and your husband all the best,
Wendy