Pulmonology is a branch of internal medicine that deals with the study, diagnostics and treatment of lungs, pleura and lower respiratory tract (bronchi, trachea) diseases. In some countries, there is no separate section of pulmonology in medicine; it is included in such medical areas as chest medicine or respiratory medicine. Pulmonologists work closely with resuscitators, thoracic surgeons, phthisiatricians, allergists, immunologists, oncologists, rheumatologists and other highly quolified specialists, since lung disease or injury often extends beyond just pulmonology.

Pulmonology Department of Tel Aviv Medical Clinic is an example of modern patient-oriented medical facility. For department’s employees, patient and his well-being come first. The department is equipped with only modern expert-class diagnostic and treatment equipment; all tests and procedures can be completed right here.

Treatment and diagnostic process can involve both pulmonologists and allergists, oncologists, immunologists, radiologists, functional diagnostic doctors, rehabilitation specialists, physical therapists, thoracic surgeons, phthisiatricians, rheumatologists and others. Such coordinated work of professional team ensures the continuity of providing highly qualified medical care. Assistance, starting from initial diagnosis stage and ending with a comprehensive treatment and rehabilitation program.

The main advantages of treatment in Pulmonology Department of TAMC:

Only modern treatment, according to world standards, as well as the active applicatonn of innovations and their rapid implementation into practice immediately after approval by relevant authorities.
The ability to undergo a comprehensive diagnostic program in the shortest possible time (3-5 days, depending on the diagnosis).
Individual approach to each patient, detailed explanation to person about the nature of his illness, necessary diagnosis and treatment options.
Medical support by a medical tourism employee for the entire period of stay in clinic, as well as free interpreter services.
Comfortable conditions in clinic, tasty and healthy hospital food, friendly and caring medical staff, ready to answer all patient’s questions.
Good pricing policy, payment upon receipt of services.
Highly qualified doctors with rich practical experience and excellent theoretical training.

X-ray examination. Skeleton radiology. Woman doctor surgeon holding film scan radiography diagnostic in hospital bone disease treatment.

Departments

At TAMC Pulmonology Department operates several highly specialized departments and clinics:

General pulmonology – doctors of this profile deal with general issues of pulmonology patients, diagnosis and treatment of the most common lung diseases (pneumonia, pleurisy, exacerbation of bronchial asthma and chronic obstructive pulmonary disease).
Clinic for diagnostics and treatment of bronchial asthma – pulmonologists in this area, together with allergists-immunologists, study, diagnose and treat patients with various types of bronchial asthma.
Oncopulmonology – specialists in this profile, together with oncologists, are involved in diagnostics and treatment of benign and malignant diseases of lungs, pleura, bronchi and trachea.
Intensive care unit – specialists in this profile, together with resuscitators, provide emergency medical care to patients with acute respiratory disorders (patients on oxygen therapy, artificial ventilation).
Diagnostic department – here there are all the necessary laboratory, instrumental and functional diagnostic methods in pulmonology clinic.

What diseases does Pulmonology Department treat?

Innovative method of treating small cell lung cancer

Contact us

Diagnostic methods in pulmonology

At the first stage, patient meets with pulmonologist of highest category for an initial consultation. Specialist collects complaints, anamnesis of life and illness, examines and study patient in detail, inspects medical documentation (preliminary examination and treatment data – if any). After this, a preliminary diagnosis is formed and a diagnostic plan is made up.

At the second stage, patient undergoes all tests and procedures prescribed by doctor at TAMC Diagnostic Department. The list of examinations can be very different (this depends on preliminary diagnosis):

Various laboratory tests of blood, urine, sputum.
Diagnostic allergy tests and tests (prick tests, patch tests, scratch tests, provocative allergy tests, etc.).
Various immunological studies.
Modern methods of medical imaging of lungs – digital radiography, CT, MRI, MSCT, angiopulmonography, PET-CT, scintigraphy.
Ultrasound of the lungs and pleural cavities. · Endoscopic examination of bronchi – bronchoscopy. Other endoscopic examinations: pleuroscopy, thoracoscopy.
Diagnostic pleural puncture under ultrasound control followed by cytological examination of fluid from pleural cavity.
Biopsy and histological examination of tissue samples if a malignant disease is suspected. After biopsy, we send all samples of materials for pathohistological examination to the best histological laboratories in Israel. Thanks to such checks, we are absolutely sure of diagnosis correctnes and appropriate treatment.
Computer spirometry – study of external respiration function.
ECG and ultrasound of heart.
Bacteriological studies – bacterial culture of sputum and contents of pleural cavities to determine causative agent of pneumonia.
Specific genetic tests, for example for diagnosis of cystic fibrosis.

Important!

An undeniable advantage of diagnostics in Pulmonology Department of TAMC is speed of all studies conducting and obtaining results.

The entire diagnostic process lasts 3-5 working days and consists of 3 stages.

At stage 3 of our diagnostic program, patient meets again with treating pulmonologist. Doctor studies all examination results, forms a final and detailed diagnosis, discusses all treatment options with patient and makes up an individual treatment plan.

Cardiopulmonary exercise test (CPET). This computerized test provides an analysis of respiratory and cardiac function at rest and during exercise that is gradually increased in intensity until symptoms limit testing. Information on air flow, oxygen consumption, carbon dioxide production and heart rate is collected and used to calculate important parameters and indices. Arterial blood gas samples may also be taken. Physical activity includes running on a treadmill or riding a bicycle ergometer.

CPET primarily determines whether patients have normal or reduced maximal exercise capacity (VO2max) and, if so, testing recognizes possible causes. This computerized test is used to determine which systems (cardiovascular or respiratory) contribute to a patient’s symptoms of exertional dyspnea and exercise intolerance and to what extent.

In TAMC diagnostic innovations also concern bronchoscopy (endoscopic examination of bronchi using a modern flexible bronchoscope). Specialists from Pulmonology Department use Super Dimension Bronchus system technology to examine patients using bronchoscopy. It allows us to perform targeted bronchoscopy using navigation using a 3D map of affected area of lungs. Map is created based on computer tomograms. Specialist finds desired area of lung using a special sensor. Thanks to this technology, doctor can perform a biopsy and take tissue samples for histological examination from hard-to-reach places without resorting to surgery.

Modern treatment methods in pulmonology

Israeli medicine’s peculiarity is rapid introduction of advanced treatment methods into practice. Pulmonology is no exception; every day our patients receive modern effective medications and procedures that allow them not only to maintain a good quality of life, but also to completely get rid of the disease.

Until recently, patients with severe forms of bronchial asthma who failed inhaled therapy were prescribed systemic corticosteroid hormones. As is known, such therapy is associated with many severe side effects (diabetes mellitus, obesity, arterial hypertension, osteoporosis, infections), which sometimes becomes an even heavier burden for a person than the underlying disease. In Pulmonology Department of TAMC, in such cases they resort not to hormones, but to modern immunobiological drugs.

Mepolizumab (“Nucala”) is a monoclonal antibody against inflammatory mediator interleukin-5 (released in large quantities from eosinophils in bronchial asthma). The drug is administered by subcutaneous injection once a month. This is enough to completely control bronchial asthma.

Roflumilast (“Daliresp”) is another modern immunobiological drug that can significantly reduce the number of exacerbations of COPD (chronic obstructive pulmonary disease). It is a phosphodiesterase-4 inhibitor that has a powerful anti-inflammatory effect and is used in severe forms of COPD when standard therapy is ineffective.

Until recently, it was impossible to somehow stop fibrosis of lung tissue, and the only effective treatment that relieves patient of symptoms is lung transplantation. But 2 drugs have appeared on pharmaceutical market that can affect fibrosis development and significantly slow it down. Naturally, TAMC patients have access to such treatments – Pirfenidon (Esbriet) and Nintedanib (Ofev).

If we are talking about such a serious disease as lung cancer, patients in Pulmonology Department with such a diagnosis are treated together with oncologists, thoracic surgeons, and radiologists. They are prescribed a comprehensive treatment program taking into account the main diagnosis, its stage, the presence of genetic mutations (mutations in EGFR, KRAS, ALK genes – this allows us to select effective biological drugs), and patient’s health condition. If patient requires surgery, then thoracic surgeons, even for lung cancer, are guided by principle of organ-preserving and minimally invasive surgical interventions, if clinical situation allows it. Surgeons perform wedge-shaped or segmental resection of part of lung, lobectomy.

Unfortunately, sometimes it is impossible to remove the tumor. In such cases, surgeons resort to palliative interventions to improve patients’ quality of life, such as placing intrabrachial stents to keep the airway open.

New methods of modern radiation therapy can significantly improve the prognosis and achieve a positive response to treatment in the majority of patients:

3D conformal radiation therapy. In this case, there are several radiation sources that converge at one point, which allows to minimise the negative impact on healthy surrounding tissues and to maximise efficiency in the area of tumor itself.
Intensity-controlled radiation therapy (IMRT). In this case, a model of tumor is first modeled in 3D mode, then irradiation is carried out taking into account the specific shape and size of the tumor.

Chemotherapy for lung cancer can be neoadjuvant (before surgery to decrease tumor’s size) or adjuvant (after surgery to destroy any cancer cells that may remain). TAMC uses only modern chemotherapy protocols. It is also mandatory to use modern immunobiological and targeted drugs: Dacomitinib (Vizimpro) is used to treat patients with non-small cell lung cancer whose cancer cells have an EGFR mutation. According to data, such treatment increases survival by more than 1.5 times than treatment according to standard protocol.

Lorlatinib (Lorbrena) is used to treat patients with non-small cell lung cancer whose cancer cells have an ALK mutation. The drug is 57% effective, meaning more than half of people with severe lung cancer who have stopped responding to standard treatment respond positively to Lorlatinib.

In each individual case, the decision on a combination of therapy methods is made by a whole team of specialists. Each organism and its disease are individual, so our doctors often go beyond standard treatment protocols, complementing and improving therapy taking into account the individual characteristics of the patient.