Thorough examination and accurate diagnosis is the first step in the development of a brain cancer treatment in Israel plan. The multidisciplinary team of experts at the Top Ichilov Clinic in Israel explores the pathology using such modern medical visualization technologies as MRI and PET, and develops a treatment plan according to each patient’s individual case.
Neurosurgeons perform the most complex procedures to remove brain tumors, including awake craniotomy. Brain cancer is treated with the newest drugs that significantly improve survival rates in patients with gliomas and other aggressive tumors.
The Evaluation Program In Top Ichilov
Day 1: Initial examination of the patient.
On the first day in the Top Ichilov Clinic, the patient is seen by Doctor I. Molchanova, Head of Cancer Diagnosis Department. The appointment includes health history analysis, physical exam and consultation, preparation of all medical documents and referrals for the necessary laboratory and instrumental studies.
If the patient brought tissue samples (slides), they are immediately sent to the clinic’s laboratory for revision. Experts verify the tumor type, determine tissue receptor sensitivity and analyze immunohistochemical reactions.
Day 2: Diagnostic procedures.
When the patient undergoes recommended procedures, they are accompanied by a medical coordinator.
Tests and studies used to diagnose brain cancer include:
- Complete blood count.
- Blood biochemistry with testing for tumor markers.
- MRI of the brain (helps visualize the cancerous tumor and identify affected brain tissues).
- Positron emission tomography, or PET/CT (detects the spread of the abnormal process and metastases in the brain).
- Spinal tap. Spinal tap is performed when leptomeningeal cancer is suspected. During the procedure, the doctor takes a small sample of spinal fluid.
- Biopsy (if wasn’t performed earlier).
Biopsy may be taken in two different ways:
- Surgical biopsy. A tissue sample is taken for testing directly during surgery.
- Stereotactic biopsy. This minimally invasive technique helps puncture the necessary area of brain tissue with highest precision. This is a CT-guided biopsy.
Day 3: Development of the Treatment Plan.
On the third day, the patient receives results of all diagnostic procedures and is referred to a dedicated expert (Professor Zvi Ram, Professor D. Blumenthal) for consultation. A plan of future treatment is developed.
After that, the patient goes through the process of final consulting by Doctor I. Molchanova, Head of Cancer Diagnosis Department. The process also includes referrals, verification and certification of medical documents.
The diagnostic program takes 3-4 days. Price for complete evaluation: $2,393.
Comprehensive telemedicine package for brain cancer treatment: $540.
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Brain Cancer Diagnosis In Israel
In the Top Ichilov Clinic, imaging studies are carried out during the entire course of therapy: they help monitor tumor characteristics and control the body’s response to the drugs or procedures prescribed by the doctor. If necessary, doctors modify the treatment plan accordingly.
Conventional methods of cancer diagnosis include:
Whenever possible, doctors recommend surgical resection of cancerous tissues. If the resection threatens the neurologic function, doctors perform a less extensive procedure, or a biopsy.
During biopsy, the doctor takes out a small piece of malignant tissues. Then the sample is analyzed. The treatment plan is usually based on the results of this testing. If the tumor is located in a hard-to-reach or vital area of the brain, a needle biopsy is used.
- Laboratory tests
The main laboratory test used in brain cancer is called advanced genomic testing. This is genomic profiling of the tumor aimed at detection of DNA mutations that promote tumor growth. Having determined the nature of mutations (changes) in the cancer cell genome, doctors come to better understand the tumor’s behavior and develop a personalized treatment plan.
- Bone scan
Bone scan is an imaging study that creates bone images on film or computer. These images help determine the location of the tumor and check whether brain cancer has spread into bones. Before the procedure, a small dose of radioactive substance is injected into the patient’s vein. The radioactive substance accumulates in the bones and appears on the images created with a special scanner.
This technique uses X-rays. Angiography creates multiple detailed three-dimensional images of blood vessels in the brain. This procedure may be carried out before surgical resection of a tumor located near numerous blood vessels. In some cases, angiography is performed before surgery in order to embolize (seal) blood vessels feeding the tumor.
- Other imaging studies
Scans received after a brain imaging study help determine the location and the grade of the tumor. Doctors use a contrast agent to differentiate between abnormal and healthy tissues.
Imaging studies used to diagnose brain cancer include:
- MRI (magnetic resonance imaging). MRI is often used in brain and spine tumor diagnosis. In comparison with computed tomography, this method yields more detailed images. On the other hand, MRI does not provide appropriate quality of skull and bone imaging and – unlike CT – cannot show how the tumor affects the skull.
- CT (computed tomography). Thanks to the CT technology doctors receive detailed soft tissue scans. This procedure is indicated when MRI is impossible (for instance, if the patient suffers from obesity or claustrophobia). Computed tomography provides more precise visualization of bony structures next to the tumor.
- PET (positron emission tomography). PET is used for fast-growing, high-grade brain tumors. This procedure is also performed when finishing treatment: PET helps detect remaining cancerous tissues.
Physicians Treating Brain Cancer In Top Ichilov
Treatment and evaluation of patients with brain cancer in Top Ichilov is provided by Israel’s leading oncologists:
Professor Zvi Ram – leading neurosurgeon, has been heading the Neurosurgery Department of the Ichilov Medical Center for 14 years. Professional experience: approximately 45 years. Chairman of the Israel Neurosurgical Society. One of the most sought-after oncologists in Israel.
Doctor Dvora Blumenthal – neurologist, neuro-oncologist, Head of the Neuro-Oncology Department in the Ichilov Hospital. Has been treating brain tumors for more than 32 years. Uses state-of-the-art cancer treatment methods.
Doctor Irina Stefanski – oncologist, Head of Chemotherapy Department, Deputy Head of Oncology Division. Professional experience in oncology: about 27 years. One of the best experts in comprehensive brain cancer therapy in Israel.
Methods Of Brain Cancer Treatment In Israel
The comprehensive neuro-oncology program in Top Ichilov includes a wide range of treatments for primary and metastatic brain tumors. We offer such treatments as conventional surgery (for instance, tumor resection), radiation therapy, chemotherapy and/or immunotherapy.
Surgery is the primary method of brain cancer treatment. In Top Ichilov, the procedure is performed by an experienced neurosurgeon. During surgery, the doctor removes the entire tumor or, if the complete removal may negatively impact brain function, takes out as much abnormal tissue as possible.
Depending on the size, location and grade of the tumor the patient may undergo either surgery alone or surgery in combination with radiation therapy and/or chemotherapy. In selected patients, surgical intervention improves some symptoms associated with tumor growth, especially if these symptoms are caused by increased intracranial pressure.
Such symptoms include headaches, nausea, vomiting and blurry vision. If the patient suffers from seizures, surgery may improve the effectiveness of antiseizure medication therapy.
Indications for surgical treatment depend on the type of cancer, location of the tumor and patient’s overall health.
- Minimally invasive surgical techniques
Brain surgery mostly means complete tumor removal. In the past, surgeons removed cancerous growths through long excisions. Nowadays, doctors use minimally invasive surgical techniques.
If possible, we use endoscopic tumor resection. This surgical procedure involves removal of the tumor through small incisions. Tumor imaging is provided by a special camera. Potential benefits of the endoscopic approach include:
- faster recovery;
- less pain during rehabilitation;
- prompt completion of treatment;
- faster return to everyday activities.
- State-of-the-art brain mapping tools
Advanced brain mapping tools improve surgical precision and safety. They ensure removal of tumors earlier considered inoperable and preserve neurologic function:
- Intraoperative neuronavigation involves use of an advanced MRI system to map brain areas responsible for vital functions. Using the map, doctors plan the surgical procedure in minute detail. This helps avoid damage to critical areas of the brain.
- Intraoperative electrophysiological mapping (mapping of the areas responsible for the motor and language functions) is like GPS of the brain. The doctor places small electrodes on the external tissues of the brain in order to stimulate the function of the areas near the tumor. This approach determines which areas are responsible for speech and movements. Further medical manipulations are based on the fact that these areas must receive minimal damage.
- Anti-cancer therapy during surgery.
Some therapeutic procedures are performed during surgical resection. For instance, the chemotherapy drug called BCNU (bis-chloroethyl-nitrosourea) is indicated for local treatment. It is injected into the tumor and the area of resection in order to improve side effects of the systemic chemotherapy (for instance, make nausea and vomiting less intense).
Researchers are exploring one more promising cancer treatment method, intraoperative radiation therapy (IORT). This technology helps irradiate the area of resection directly during surgery. The approach also prevents excessive damage to healthy structures, such as scalp.
- Radiation therapy
Highly precise radiation therapy destroys malignant cells and improves symptoms caused by tumor growth. Radiation therapy in the Top Ichilov Clinic involves use of last-generation linear accelerators. The highly accurate targeting simultaneously helps increase the radiation dose and reduce damage to nearby healthy tissues.
Radiation therapy is mainly used either after biopsy or after surgical resection of the tumor. Radiation destroys remaining microscopic tumor cells. Radiotherapy is also used in patients with unresectable or metastatic brain tumors.
Brain cancer is traditionally treated with external beam radiation therapy. This technology helps irradiate the tumor and nearby healthy tissues. If the brain contains metastatic tumors, whole-brain radiotherapy may be used.
Considering that lung cancer often spreads to the brain, some lung cancer patients are offered prophylactic whole-brain irradiation. This approach helps prevent formation of metastases.
Chemotherapy is traditionally used in patients with high-grade brain tumors. This method may be used either alone or in combination with other cancer treatments including surgery and radiation therapy.
- Systemic chemotherapy
Systemic chemotherapy drugs enter the bloodstream and penetrate different organs and tissues. Treating brain cancer with systemic chemotherapy is problematic because the doctor must select drugs that are able to penetrate the blood-brain barrier (natural protective barrier of the brain) in order to reach tumor cells. Experienced specialists of the Top Ichilov Clinic can solve this problem.
Chemotherapy drugs are administered either orally or intravenously. Some medications are injected directly into the cerebrospinal fluid in the brain or spinal column. For this purpose, a special reservoir is implanted under the scalp. This reservoir is connected with a tube leading into a ventricle of the brain.
- Local chemotherapy
Local chemotherapy drugs are injected into the affected area of the brain during surgical resection. After complete or partial removal of the tumor the doctor implants a biodegradable wafer containing a chemotherapy drug into the emptied space. The wafer stays in the empty tumor bed or near the inoperable segment of tumor. Slowly, within a few days, the drug penetrates nearby tissues.
This technique increases the concentration of the chemotherapy drug around the tumor and simultaneously prevents intensive side effects characteristic of systemic chemotherapy.
- Targeted therapy
Targeted therapy drugs affect specific abnormalities that promote growth and division of cancer cells. Targeted therapy is often combined with other cancer treatments, for instance, chemotherapy. It is mainly used in case of tumor recurrence.
Brain Cancer Treatment Methods Implemented In 2024
- Alternating electric field therapy for glioblastoma. TTF (tumor treating fields) is a state-of-the-art glioblastoma treatment method developed in Israel. In 2021, it was implemented into countrywide clinical practice. Treatment is non-invasive and is carried out with the help of a special helmet-like device. The patient wears it on the head for 18 hours a day. The device emits alternating electric fields which interfere with the process of cancer cell division.
- Laser interstitial thermal therapy (laser-induced thermotherapy, or LITT). This method sometimes serves as an alternative to brain surgery. The MRI-guided procedure is performed through a 3mm-diameter opening in the skull. The growth is destroyed with a laser.
|Consultation with a neuro-oncologist
|MRI of the brain
|Stereotactic biopsy of the brain
|Radiosurgery for brain tumor
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