Head and Neck Oncology

Head and Neck Oncology in Israel — Diagnosis and Treatment at TAMC

Head and neck cancers are never simple. They sit close to vital nerves, vessels, speech and swallowing centers — so every decision has to be precise.
That’s why treatment isn’t about one doctor or one step; it’s about coordination.

At Tel Aviv Medical Clinic (TAMC), we start fast but think carefully.
A patient usually comes in, sees our ENT-oncologist, sometimes the same day we do an endoscopy or a quick ultrasound.
CT or MRI follows, and if we need a biopsy, it’s done under local anesthesia — no waiting weeks for answers.

After that, we all sit down — the ENT surgeon, the oncologist, the radiotherapist, the pathologist.
Everyone brings their piece of the puzzle.
Within a few days, the patient already knows the full picture and the plan — clear, personal, and realistic.

What Conditions Do We Treat?

Lip Cancer

Usually related to prolonged sun exposure or tobacco use.
Treatment focuses on function and appearance preservation — precise surgery with reconstructive options if needed.
In early stages, organ-preserving excision is enough; in advanced cases, plastic reconstruction restores both form and function.

Oral Cavity Cancer

Includes tumors of the mouth floor, cheeks, palate, and inner lips.
Diagnosis starts with clinical exam and biopsy, followed by MRI/CT to determine the spread.
Treatment combines surgery with clear margin control, neck dissection if lymph nodes are at risk, and IMRT/VMAT radiotherapy for high-risk cases.
Speech and swallowing rehabilitation start early to prevent long-term complications.

Thyroid Cancer

Differentiated thyroid cancers (papillary, follicular) often require thyroidectomy with selective lymph node dissection.
Depending on pathology, radioiodine therapy is used afterward to eliminate residual tissue.
For medullary or anaplastic variants, the focus shifts toward targeted therapy or systemic options, combined with radical surgery.
Intraoperative nerve monitoring helps preserve the recurrent laryngeal nerve and reduce voice complications.

Ear Cancer

A rare but challenging group of tumors affecting the ear canal or temporal bone.
Diagnosis requires early biopsy and high-resolution CT.
Treatment includes oncologic resection (up to subtotal temporal bone removal), often followed by radiotherapy.
The main goals: radical tumor control and hearing preservation whenever possible.

Throat and Pharyngeal Cancers

Symptoms often include hoarseness, pain while swallowing, or the feeling of a “lump in the throat.”
Israeli protocols focus on organ-preserving techniques:

• TLM (Transoral Laser Microsurgery) and robot-assisted approaches for early stages;
• combined radiotherapy and systemic therapy for locally advanced disease.
  For HPV-associated oropharyngeal tumors, Israel leads in de-escalation protocols — minimizing toxicity while keeping high cure rates.

Salivary Gland Tumors

Includes pleomorphic adenocarcinomas and mucoepidermoid carcinomas.
Treatment balances radical surgery with facial nerve preservation.
Parotidectomy with intraoperative nerve monitoring is standard; if the tumor is aggressive, adjuvant radiotherapy follows.
Reconstruction is performed immediately, during the same operation.

Tongue Cancer

Front-tongue tumors are usually treated surgically, with lymph node assessment.
If pathology shows aggressive features, radiation or chemoradiation may be added.
Speech therapy and oral care begin before radiotherapy to maintain quality of life.

How Treatment Is Performed in Israel

Diagnosis
ENT-oncology consultation with endoscopy, neck CT/MRI, ultrasound, fine-needle aspiration, and full pathology with immunohistochemistry.
When indicated — PET-CT for staging.

Surgery
From organ-preserving resections to extended operations with immediate reconstruction (forehead, radial, or microvascular flaps).
The aim is not just to remove the tumor, but to preserve speech, swallowing, and breathing function.

Radiotherapy
Modern techniques like IMRT and VMAT precisely target the tumor while sparing salivary glands and taste buds.
In certain cases, stereotactic radiosurgery is used for recurrent or limited lesions.

Systemic Therapy
Chemotherapy when indicated, targeted drugs for specific mutations (e.g., RET, NTRK in thyroid cancer), and immunotherapy for selected patients.

Support and Rehabilitation
Dental preparation before radiation, early nutrition support, speech therapy, and oral care are integral parts of the plan.
We manage pain, prevent mucositis, and monitor long-term complications like xerostomia.

Why Patients Choose Israel and TAMC

• Fast scheduling: Full diagnostic workup and treatment planning take days, not weeks.
• Team approach: Every case discussed by head & neck surgeons, oncologists, radiologists, and pathologists.
• Technology: Robotic surgery, intraoperative nerve monitoring, microvascular reconstruction, IMRT/VMAT, and radioiodine therapy when indicated.
• Personalized care: Based on tumor histology, molecular markers, and patient preferences.

For a private consultation with Dr. Inbar Finkel or Dr. Orit Gotfild:

Phone: +972-73-374-6844
Email: [email protected]
WhatsApp: +972-52-337-3108

FAQ: Dr. Inbar Finkel — Oncologist, Head of the Head & Neck Oncology

 1. How is radiotherapy combined with other treatments in head and neck cancer?

It’s rarely used alone. In most cases, radiotherapy works best together with surgery or chemotherapy.
The goal isn’t just to destroy tumor cells — it’s to protect what matters: speech, swallowing, and taste.
We plan radiation fields with millimeter precision, using IMRT or VMAT, so that healthy tissues stay functional.
It’s a delicate balance, and every plan is built around the person, not the diagnosis.

 2. Can all head and neck tumors be treated while preserving function?

Not always, but we try whenever possible.
Our main principle is preserve, if safe.
I’ve seen patients return to normal speech and eating just weeks after surgery and radiation.
That’s why early diagnosis is everything — the earlier we act, the more we can save.

 3. What’s special about the way TAMC manages complex head and neck cancers?

Coordination. Everything happens fast, but nothing is rushed.
ENT surgeons, radiation oncologists, and medical oncologists sit together, discuss scans, pathology, and options — in one room.
That’s how we avoid delays and give patients a clear, confident plan within days.

FAQ: Dr. Orit Gotfild — Director, Institute of Radiotherapy

 1. What does modern radiotherapy look like for head and neck cancers?

Very different from what people imagine.
It’s not about “burning” the tumor anymore — it’s about sculpting the dose.
With IMRT and VMAT, we shape the radiation beam around critical structures like salivary glands or vocal cords.
Patients keep their ability to speak and taste. That’s the progress of the last decade.

 2. When is radioiodine therapy used for thyroid cancer?

Only when it’s truly needed. Radioiodine is very effective for differentiated thyroid cancers, but it’s not for everyone.
We base that decision on pathology and molecular markers — if there’s microscopic disease left or lymph node involvement, then yes, we do it.
The idea is to treat enough, but not more than necessary.

 3. Is radiotherapy in Israel painful or difficult to go through?

It’s not painful, but it can be tiring. The sessions are short — about 10–15 minutes each — and patients come daily for several weeks.
We support them through nutrition, pain management, and oral care.
Most people continue to live their normal lives during treatment, just a bit slower, and that’s okay.