Glioblastoma Treatment in Israel

Glioblastoma is one of the most common and aggressive brain tumors, classified as Grade 4 malignancy according to the WHO classification. In the medical literature, it is also referred to as Grade 4 astrocytoma or Grade 4 glioma.

The tumor has no clear boundaries, grows rapidly, and spreads to healthy brain areas, compressing nerve tissue. Glioblastoma originates from neuroglial cells—supportive brain tissue that plays a crucial role in the function of neurons.

This tumor can develop in any part of the brain and affect patients of all ages. However, it is more common in people over 40. In rare cases, glioblastoma can also occur in young adults, teenagers, and children.

If you have been diagnosed with glioblastoma or suspect the presence of this disease, do not waste precious time! Seek specialized medical help as soon as possible. It is crucial to find a specialist with practical experience in treating patients with these brain tumors, as a correctly chosen treatment strategy and modern comprehensive therapy can save lives. Highly qualified specialists at the Tel Aviv Medical Clinic Oncology Department are exactly the experts you need.

We offer our patients:

• Highly skilled doctors with extensive experience in treating brain glioblastomas.
• Specialists who follow modern clinical guidelines and international treatment protocols.
• A personalized approach to each clinical case, as no two patients or tumors are identical.
• A multidisciplinary team that includes oncologists, neurosurgeons, neurologists, radiation oncologists, chemotherapy specialists, psychologists, and other specialists if necessary.
• Comprehensive, rapid, and modern diagnostics, including innovative genetic tests.
• Advanced and safe neurosurgical procedures for glioblastoma treatment, including awake craniotomy, confocal laser endomicroscopy, optical coherence tomography, and magnetic imaging systems.
• Non-surgical treatment options such as stereotactic radiosurgery (CyberKnife).
• Laser neurosurgery using the Visualase system.
• Effective systemic chemotherapy (Temozolomide) and localized chemotherapy with Gliadel wafers.
• Immunobiological therapy (Bevacizumab).
• Participation in clinical trials for new drugs and treatment methods.

Causes of Glioblastoma

Currently, the exact causes of glioblastoma remain unknown. However, specialists identify several risk factors that increase the likelihood of developing this pathology:

• Age: The older a person, the higher the risk of developing this brain tumor.
• Genetic syndromes and inherited diseases: Such as Neurofibromatosis Type 1, Turcot Syndrome, Li-Fraumeni Syndrome, Lynch Syndrome, and Cowden Syndrome.
• History of brain tumors: Previously diagnosed astrocytoma (Grade 1, 2, or 3), which may progress to glioblastoma.
• Radiation exposure: For example, prior radiation therapy to the head for another malignant condition.
• Certain viral infections.
• Toxic substance exposure.

Glioblastoma can be primary, developing from initially healthy brain tissue, or secondary, arising from a pre-existing tumor (such as astrocytoma).

Glioblastoma is always aggressive and malignant, but depending on its histological subtype (three known subtypes), the malignancy degree may vary, affecting the treatment approach. Based on histopathological examination, glioblastomas are classified into giant cell glioblastoma, multiform glioblastoma, and gliosarcoma.

Symptoms of Glioblastoma

In the early stages, the disease is almost asymptomatic, making early diagnosis challenging. Symptoms appear as the tumor grows and progresses.

General brain-related symptoms are associated with increased intracranial pressure and tumor-induced intoxication:

• Severe headaches, worsening when lying down and in the morning after sleep.
• Nausea unrelated to food intake and vomiting that does not bring relief.
• Persistent dizziness.
• General weakness, increased fatigue, and drowsiness.
• Slowed cognitive function, memory impairment.
• Apathy, depression, and irritability.

Focal neurological symptoms depend on the tumor location and may include:

• Speech, hearing, and vision impairment.
• Seizures.
• Paralysis or sensory disturbances in the limbs.
• Coordination disorders (vestibular syndrome).
• Respiratory suppression.
• Auditory and tactile hallucinations, etc.

Because the neurological symptoms resemble those of a stroke, misdiagnosis is sometimes possible.

Modern Diagnostic Methods

At Tel Aviv Medical Clinic, we use only state-of-the-art diagnostic equipment to ensure precision and safety.

The diagnostic process starts with a consultation with a leading neurosurgeon and oncologist, along with a detailed neurological examination and patient history review. This helps evaluate symptoms, overall health, previous conditions, and risk factors. The neurological examination assesses brain function, including memory, vision, hearing, muscle strength, balance, coordination, and reflexes.

To detect tumors, assess their size, and determine affected brain areas, medical imaging techniques are used:

• CT scan, MSCT, and MRI (with and without contrast). These help visualize the tumor, measure its size, and plan surgery.

To confirm the diagnosis and determine the tumor subtype, a biopsy is performed.

Tissue samples from biopsy procedures (stereotactic puncture biopsy or intraoperative biopsy) are sent for examination to top-tier pathology labs in Israel, where renowned specialists in CNS tumors analyze them.

Genetic Diagnostics

In some cases, patients at Tel Aviv Medical Clinic undergo molecular-genetic testing of tumor cells. This helps:

• Identify specific genetic mutations.
• Find treatment “targets” for personalized therapy.
• Determine the most effective treatment protocols.

Tissue samples are analyzed in top genetic laboratories in the Israel and U.S.

Some modern genetic tests include:

• Loss of heterozygosity (LOH) at 10q.
• EGFR amplification.
• TP53 mutation.
• p16INK4a homozygous deletion.
• PTEN mutations.

Glioblastoma Prognosis

The prognosis depends on:

• Histological type of glioblastoma.
• Tumor location.
• Overall health condition.
• Timely and appropriate medical intervention.

With correct complex treatment, patients can significantly extend life expectancy, and some achieve long-term remission exceeding five years.

Modern Glioblastoma Treatment

Glioblastoma patients must be treated in specialized oncology and neurosurgery centers, such as Tel Aviv Medical Clinic, where:

• High-level experts apply advanced, comprehensive therapies.
• Treatment is aimed at curing while minimizing side effects.
• Patients can participate in clinical trials and experimental protocols.

Standard treatment begins with neurosurgical tumor removal, followed by:

• Radiotherapy (IMRT).
• Chemotherapy (Temozolomide).
• Local chemotherapy (Gliadel wafers).
• Targeted therapy (Bevacizumab).
• CyberKnife radiosurgery.
• Laser neurosurgery (Visualase).

Each case is reviewed by a multidisciplinary team to tailor the best treatment plan. This approach enhances survival rates, even in the most challenging cases. Constant specialist communication ensures rapid treatment adjustments if needed.