• The Best Clinic
    2017
  • The Best Clinic
    2018

    Cancer Treatment in Israel: Innovative Approaches and Effective Methods

    In modern structure of premature mortality, cancer ranks second, inferior only to cardiovascular pathologies. But, if you make certain efforts aimed at identifying cancer processes at an early stage, you can significantly influence this indicator and reduce the percentage of premature deaths from cancer pathology. After all, such a disease, detected and properly treated at an early stage, is absolutely compatible with a healthy and long life.

    Cancer treatment in Israel has some of the highest survival rates in the world. And all this is thanks to active development of oncology, generous government funding for this medical area, introduction of innovative therapy methods into practice and highly qualified personnel.

    Oncology Department of Tel Aviv Medical Center is engaged in study, diagnostics (including early diagnostics), treatment and prevention of all malignant and benign neoplasms in human body.

    Our department has a whole multidisciplinary team. Along with oncologists, general surgeons, gynecologists, mammologists, urologists, hepatologists, thoracic surgeons, radiologists, rehabilitation specialists, physical therapists and a large number of specialized specialists who can be involved in the complex treatment of each individual patient are actively working for the benefit of our patients.

    Spinal surgery. Group of surgeons in operating room with surgery equipment. Laminectomy. Modern medical background

    What diseases does Oncology Department treat?

    Departments

    Oncology is a very broad section of modern medicine, dealing with the study, diagnostics and treatment of benign and malignant neoplasms of all localizations. Therefore, for convenience, Oncology Department of Tel Aviv Medical Center has several specialized departments that deal with oncological problems of certain localization.

    Divisions of Oncology Department

    • Neuro-oncology – benign and malignant tumors of brain, spinal cord, spine, peripheral nerves.
    • Oncology ENT department – benign and malignant tumors of ear, nose and throat, and oral cavity.
    • Endocrine oncology – benign and malignant neoplasms of thyroid gland, adrenal glands and other endocrine glands.
    • Oncology of digestive organs – malignant diseases of esophagus, stomach, colorectal cancer, neoplasms of pancreas, gall bladder and biliary tract, metastases into abdominal cavity.
    • Hepatology-oncology – benign and malignant liver tumors.
    • Mediastinal tumors – germ cell tumors, mediastinal lymphomas and cysts, mesenchymal tumors, etc.
    • Cardiac neoplasms – sarcomas, myxomas, lipomas, teratomas, metastases and others.
    • Oncodermatology – benign and malignant malformations of skin and its appendages.
    • Oncogynecology – benign and malignant diseases of external and internal female genital organs.
    • Mammology – benign and malignant tumors of mammary glands.
    • Ophthalmic oncology – benign and malignant tumors of anatomical structures of eye, orbit, optic nerves.
    • Orthopedic oncology – benign and malignant neoplasms of musculoskeletal system (bones, cartilage), muscle and adipose tissue, blood vessels.
    • Urological oncology – benign and malignant diseases of excretory organs (kidneys, ureters, bladder and urethra), as well as male external and internal genital organs.
    • Pulmonary oncology – tumors of lungs and pleura.
    • Oncology proctology – neoplasms of rectum and anal canal.
    • Hematology-oncology – malignant diseases of blood and hematopoietic organs.
    • Chemotherapy department – here all patients receive the necessary courses of chemotherapy, targeted therapy, immunotherapy, etc.
    • Radiation therapy department – patients undergo the necessary courses of radiation therapy (distance or contact).
    • Diagnostic department is a modern department with all the necessary equipment for accurate diagnosis of oncological diseases.
    • Pathohistological laboratory – specialist pathologists work here who study tissue samples after biopsy and verify the diagnosis.

    In any of these departments, every patient can count on quality medical care. Tel Aviv Medical Center has a friendly team that interacts well and effectively with each other in interests of patient. Oncology Department has all necessary modern equipment, the latest diagnostic and treatment methods are being actively introduced into practice, and clinical research is constantly being conducted.

    Diagnostic methods in oncology

    If there is a suspicion of cancer, patient is sent for detailed diagnostics. Only the best specialists practice in our Diagnostic Department.

    When making up an examination plan, preliminary diagnosis, patient’s age, his gender, concomitant diseases presence, indications and contraindications for certain types of diagnostics, and the wishes of person himself are taken into account. The whole process takes place as quickly and comfortably as possible for patient. Diagnostics are carried out only on modern and safe expert-class equipment.

    If it is necessary to perform invasive diagnostics (for example, trephine biopsy, colonoscopy with biopsy, etc.), the procedure is performed under local or general anesthesia so that patient does not feel pain or other discomfort.

    Specialists in the field of oncology use all available biopsy methods, because this is the basis for diagnostics in Oncology Department. Along with standard procedures, such as ultrasound-guided puncture biopsy of thyroid nodule, we use unique and highly modern biopsy techniques. These include:

    • Mammotomy – precise stereotactic biopsy of breast tumors without any pain. Unlike standard procedure, it does not require anesthesia, it leaves no wound or scar on skin, and lasts no more than 30 minutes.
    • Fusion biopsy of prostate – the procedure is performed under dual ultrasound and MRI guidance. It is extremely accurate and allows you to avoid repeated biopsies.

    Punch biopsy for skin tumors – biological material is taken not with an ordinary needle, but with a specially designed DERMO-PUNCH instrument (a hollow cylinder with a sharp cutting edge) designed for this purpose. It is a tubular scalpel with which doctor quickly, accurately, painlessly and bloodlessly obtains a tissue sample for further histological examination.

    Important!

    Thanks to molecular genetic diagnostics, we can detect known mutations that lead to certain tumors at preclinical stage, that is, when tumor does not yet exist.

    Molecular diagnostics of cancer (molecular genetic studies) is an integral component of modern oncology. The direct cause of tumors is a mutation in a gene, due to which it begins to function incorrectly, and a cell with such a mutation acquires signs of malignancy and the ability to uncontrolled reproduction and metastasis.

    Based on results of these studies, we can select risk groups and carry out preventive treatment or monitor their health over time so as not to miss the initial stage of disease. Also, for patients with an existing disease, molecular genetic analysis of tumor cells makes it possible to select the most effective treatment regimens, because the type of mutation determines the response to action of certain drugs.

    The modern Foundation One oncology screening procedure is a full range of studies of genomic profile of identified molecular genetic changes in patient’s tumors for selection of individual targeted and immunotherapy. This allows us to select the most effective treatment for each individual person, taking into account tumor cells sensitivity to certain drugs. This treatment approach is very effective and is called personalized oncology.

    The Oncotype DX genetic test avoids unnecessary chemotherapy for women with breast cancer. Most of these tumors are non-aggressive and the risk of recurrence after surgery is very low. A genetic test makes it possible to determine with what probability, on a 100-point scale, cancer can recur. And only after this oncologist decides on the necessaty for a course of chemotherapy.

    All our patients have access to modern medical imaging techniques, for example, PET-CT and all its varieties:

    • 18F-fludeoxyglucose PET-CT is the most common test for malignant tumors, which is used to determine the exact location, type of tumor, its size and stage of disease.
    • PSMA PET-CT – this study is carried out to determine the extent of process in malignant neoplasms of prostate. There are varieties of this diagnostics using different isotopes, which are selected individually for each patient (GA68, 18F and 11C).
    • PET-CT with 18F-DOPA is the most accurate method for diagnosing neuroendocrine tumors, as well as malignant neoplasms of thyroid gland.

    The latest technology in medical imaging is PET-MRI machine. This study combines all advantages of magnetic resonance and positron emission tomography. Like PET-CT, PET-MRI is used to scan the entire body and determine the stage of cancer process, its spread and metastases presence. Clinical studies have shown that PET-MRI has more advantages and diagnostic capabilities compared to MRI, especially in study of head and neck organs, as well as in primary neoplasms of bones and soft tissues.

    Important!

    The main rule of Tel Aviv Medical Center Diagnostic Department is to get the most accurate results in shortest period of time.

    Modern treatment methods in oncology

    The principles of treatment in the oncology clinic are based on the following scheme: radical surgery (if possible, complete removal of the primary tumor) + chemotherapy + radiation therapy. These are the main treatment methods, which can be combined differently in each individual case and complemented by other methods of influencing the malignant disease (hormone therapy, targeted therapy, immunotherapy, bone marrow transplantation in oncohematology, etc.).

    Surgical operation robot. Robotic da vinci surgery.

    Modern surgical interventions for oncological diseases

    For example, in case of breast cancer, in 90% of cases it is possible to avoid a mastectomy and preserve mammary gland, which is extremely important for a woman.

    It is for this purpose that Oncology Department actively uses modern robotic surgical units – for example, the modern model of Da Vinci robotic surgeon. Such surgeries are performed for cancerous tumors of prostate, female genital organs, and stomach. Robot-assisted interventions have significant advantages over open and even endoscopic surgeries – they are less traumatic, are accompanied by less blood loss, and recovery is much faster.

    Also, the majority of surgical interventions are endoscopic; very rarely, surgeons resort to open surgery with large incisions. The main advantages of endoscopic surgery

    • reduction of hospitalization period;
    • fast recovery;
    • lower risk of all postoperative complications;
    • absence of large postoperative scars on skin – a good cosmetic effect.

    Varieties of such surgical interventions in Oncology Department of Tel Aviv Medical Center can be:

    • laparoscopic intervention for oncology of abdominal organs, prostate, internal female genital organs;
    • transurethral intervention for bladder and prostate cancer;
    • hysteroscopy for pathology of uterus and its cervix;

    thoracoscopy for malignant tumors of lungs, pleura, and mediastinal organs.

    Important!

    One of the basic principles of Israeli oncology is maintaining a high quality of life for patient after treatment. That is why all surgical interventions are organ-preserving whenever possible.

    Chemotherapy

    This is treatment method of malignant tumors when certain drugs are introduced into human body – cytostatics, which have the ability to stop the growth and reproduction of tumor cells. But, unfortunately, chemotherapy also negatively affects other healthy cells of body (blood, mucous membranes, skin, germ cells), which is what causes the main side effects of chemotherapy.

    To treat malignant tumors, Tel Aviv Medical Center uses only original chemotherapy drugs from well-known European, Israeli and American manufacturers. Due to the high quality of these medications, the risk of side effects is minimized.

    Chemotherapy is rarely used as monotherapy (only in palliative patients); as a rule, it is combined with surgery and/or radiation therapy.

    In addition to standard method of administering chemotherapy drugs – systemically into a vein, oncology clinics use other routes of administration to reduce the risk of side effects (intra-abdominal chemotherapy, chemoembolization).

    Immunotherapy

    Immunotherapy does not belong to classical chemotherapy, but is actively used in complex cancer treatment in modern medicine. As already noted, modern oncology centers use molecular genetic tests to select the most effective immunotherapy drug (personalized oncology). We use only modern immunotherapy drugs, such as pembrolizumab (Keytruda®), nivolumab (Opdivo®), avelumab (Bavencio®), durvalumab (Imfinzi®), pazopanib (Votrient®), imatinib (Gleevec®), rapamycin (Rapamu), palbociclib (Ibrance®).

    Targeted therapy

    Targeted therapy is a collective concept that combines various types of anticancer drugs, which also cannot be classified as classical chemotherapeutic agents. A targeted drug is aimed specifically at cells of a specific tumor. They are “trained” by genetic engineering to block signals that promote tumor growth, or “set a command” for self-destruction of all malignant cells in human body. Examples of modern targeted drugs are: trastuzumab, lapatinib, pertuzumab (Pertuzumabum), neratinib, nexavar (Nexavar®), lenvatinib (Lenvatinibum), pazopanib (Votrient®), sunitinib (Sutent®), sora), temsirolimus (Torisel®), everolimus (Afinitor), Keytruda(Keytruda®).

    Cancer treatment in a modern medical private clinic or hospital with a linear accelerator. Professional doctors team working while the woman is undergoing radiation therapy for cancer

    Radiation therapy

    This is a method of treating malignant tumors when they are trying to destroy them by irradiation with ionizing radiation. Radiation therapy can be remote, when radiation source is outside the body (a linear accelerator, for example), as well as contact, for example, brachytherapy, when radioactive material is placed in a capsule and implanted directly into tumor tissue. In second case, there are much fewer side effects, since surrounding healthy tissues are almost not affected by radiation.

    One of radiation therapy types is radioiodine therapy – treatment with radioactive iodine isotopes for thyroid cancer. The procedure has good efficacy and can be used as an alternative to surgical removal of thyroid gland.

    Diffuse alpha-emitting radiotherapy for malignant breast tumors and skin cancer (Alpha DaRT). This is a modern type of radiation therapy that uses alpha radiation. Alpha particles have a short range of action, so they do not negatively affect a large number of surrounding tissues. A specialist uses a special needle to insert radioactive grains into tumor, which subsequently emit alpha particles and help to destroy tumor.

    Thus, all patients of Tel Aviv Medical Center have access to modern and effective methods for diagnostics and treating any cancer. All procedures are selected individually, taking into account the main diagnosis and tumor characteristics. Each case is monitored not only by the attending physician, but also by an entire multidisciplinary team of specialists, so there is no doubt about the quality of the services provided.

    Doctor Irina Stefansky

    Oncologist, head of the oncology department of the day hospital

    Professor Ofer Merimsky

    Oncologist, Head of the Department of Bone and Soft Tissue Oncology

    Doctor Postovsky Sergey

    Director of the Department of Pediatric Hematology-Oncology

    Doctor Felix Bookstein

    Head of the neuro-oncology service of the medical center

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