Melanoma Treatment in Israel
Melanoma is one of the most dangerous tumors of the skin. It looks like a mole, or nevus, but is malignant in nature. Melanoma is different from a typical mole. Signs of melanoma include:
- uneven borders;
- mixed coloring;
- prominent nature (the growth is usually raised on the surface of the skin);
- change with time.
In the Israeli clinic “Top Ichilov” 85-90% of melanoma patients are cured after surgical removal of the tumor. Patients with metastatic melanoma are offered state-of-the-art immunotherapy drugs.
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- Tumor removal and testing
Initial melanoma diagnosis involves surgery: the doctor removes the suspicious growth and sends it to the laboratory for testing. If the diagnosis is confirmed, another surgical procedure is done. Additional surgery is called wide excision of the skin tumor.
- Sentinel lymph node biopsy
In some cases of melanoma the specialist performs sentinel lymph node biopsy. A sentinel lymph node is the first node out of a group of lymph nodes draining lymph from the melanoma. The results of this study indicate the stage of cancer and help develop a treatment program.
Melanoma Diagnosis Program in Top Ichilov
Day 1. Initial examination and consultation.
- Physical exam and consultation, health history in Hebrew, preparation of medical documents, referrals for laboratory tests and instrumental studies by Doctor I. Molchanova, Head of Diagnosis Department.
- Sending tissue samples (slides and/or paraffin blocks) to the laboratory.
*For revision, the patient must have a medical document identifying the slides/blocks.
Day 2. Laboratory testing and diagnosis.
Laboratory tests help evaluate the function of internal organs, study the disease and make an accurate diagnosis. Together with a coordinator responsible for medical translation and assistance, the patient undergoes recommended procedures:
- complete blood count, blood biochemistry test, urinalysis, tumor marker tests, etc.;
- MRI scan of the brain with contrast;
- PET/CT (positron emission tomography with computed tomography).
*This study is carried out: 1) not sooner than 2-2.5 weeks after completion of a chemotherapy course, steroid use or treatment with granulocyte colony stimulating factors (filgrastim, pegfilgrastim); not sooner than 5-6 weeks after completion of a radiation therapy course; 3) not sooner than 5-6 weeks after surgery.
Day 3. Consultation on the examination results and treatment planning
Examination and consultation with an oncologist – Professor J. Schachter, Head of the Melanoma Treatment Department, or a surgeon – Professor R. Shafir. The final consultation with Doctor Molchanova is dedicated to the examination results and referrals according to the treatment protocol.
Length of staying in Israel for complete outpatient examination: 2-3 working days.
Price for diagnosis and conservative melanoma treatment in Israel: $3,356.
Comprehensive telemedicine package for melanoma treatment: $540.
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It is important to correctly determine the type of the disease before starting treatment in the country of residence. Consult an Israeli physician right now, free of charge. Find out the prices for the necessary diagnostic procedures in Top Ichilov.
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What Are the Differences Between Melanoma Treatment in Israel and in the CIS Countries?
- Extensive experience in diagnosis and treatment of these diseases. Israel, like Australia, ranks among the countries with the most skin cancer cases. This is because these countries lead in the number of Caucasian people living in sunny regions. Therefore, treatment of all types of skin cancer is given utmost attention in Israel. The per cent of cured melanoma patients is also one of the largest in the world.
- Accurate diagnosis. 37% of patients that come to Israel for melanoma treatment happen to be misdiagnosed. Most of the time, Israeli physicians face the following situations: There is indeed a tumor but it is benign and requires different treatment. The tumor is malignant but the type of cancer cells was misidentified which led to wrong treatment recommendations. Sometimes patients bring skin biopsy material taken from another person who indeed has melanoma.
- Wide use of PET/CT in diagnosis. In the CIS countries, positron emission tomography combined with computed tomography (PET/CT) is often considered an exclusive method of diagnosis and is offered only by certain medical centers. In Israel, however, this method is used everywhere. A PET/CT scan detects even small tumors and helps evaluate the metastases if there are any.
- Use of IMRT. This method of radiation therapy, also called “radiation as a scalpel”, helps irradiate the tumor without damaging healthy tissues.
- Biological drugs. This state-of-the-art therapy used for melanoma treatment in Israel helps strengthen the immune system so it could fight the tumor.
Physicians Providing Melanoma Diagnosis and Treatment in Top Ichilov
The Top Ichilov specialist team for treatment of melanoma patients includes:
Professor Jacob Schachter – Director of Melanoma Institute. Developed a unique immunotherapy method for metastatic melanoma which may cure IV stage melanoma patients.
Professor Schlomo Schneebaum – surgical oncologist with 40 years of professional experience, Head of Breast Cancer Treatment Center. Professor at Tel-Aviv University; worked in leading US cancer centers. Provides surgical treatment of melanoma, including sentinel lymph node biopsy.
Professor Raphael Shafir – specialist in regenerative and aesthetic surgery with about 40 years of professional experience. Has been Head of Plastic Surgery Department for a long time. Worked in the leading clinics of plastic surgery in Israel, Switzerland and the USA. Provides surgical treatment of melanoma in its earlier stages.
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Common Melanoma Treatment Methods
In most cases, melanoma treatment is limited to surgery: removal of the growth and some of the surrounding healthy tissues. The type of surgery preferred by the Top Ichilov physician depends on the thickness and spread of the tumor.
- Melanomas smaller than 1 millimeter. Most often doctors perform wide local excision of the primary tumor. The surgeon carefully removes the melanoma within healthy tissue margins. The width of the removed skin flap and the degree of scarring depend on the tumor thickness. Tumors of such thickness are excised on the outpatient basis, under local anesthesia.
- Melanomas larger than 1 millimeter. Wide excision of the primary tumor remains the mainstay of treatment. The surgeon carefully excises the melanoma. If the surgery involves removal of a large skin fragment the doctor transplants skin from another area of the body to correct the defect.
In addition to wide excision of the melanoma, the surgical oncologist often performs the procedure called “sentinel lymph node biopsy”. This is a minimally invasive surgical procedure that involves removal of the regional lymph node (closest to the primary tumor) and its careful evaluation for cancer cells. If the sentinel lymph node doesn’t contain cancer, removal and evaluation of other lymph nodes is not necessary. If the sentinel lymph node contains melanoma metastases, the doctor decides what type of further surgical treatment and therapy the patient needs.
If the melanoma has spread into regional lymph nodes, the doctor performs the surgical procedure called lymph node dissection (lymphadenectomy). This procedure involves removal of lymph nodes in the tumor area. The intervention is carried out under general anesthesia; after surgery, the doctor puts in the drains to promote healing.
In 10-15% of patients the disease recurs after surgery. As a rule, this pertains to the patient who:
- were diagnosed with a relatively late-stage melanoma which started progressing;
- had a large, thick, or bleeding tumor.
In these cases, surgical removal of the growth does not always lead to complete cure, because at the time of surgery, the patient already has metastases which are impossible to detect with such imaging methods as CT, MRI or PET/CT. These microscopic metastases slowly grow to become macroscopic: either visible to the eye, or detectable with visual studies. In these cases, the patients are diagnosed with metastatic melanoma.
The highest recurrence risk is seen in patients with III stage melanoma and metastases in regional lymph nodes. In this group, the risk of recurrence is over 30% (depends on the number of involved lymph nodes).
In Top Ichilov, patients with a high risk of melanoma recurrence are offered adjuvant or preventative therapy. This therapy may prevent the recurrence of the disease. As a rule, the patient is prescribed immunotherapy drugs.
In the past, immunotherapy for melanoma involved use of interferon in high doses. The modern medication approved by the FDA also activates the immune system. For most patients, this is the vital therapy that decreases the risk of recurrence by dozens of per cent.
Radiation therapy may be used as a component of overall melanoma treatment. Radiation oncologists work closely with experienced medical oncologists.
This innovative melanoma treatment method involves use of:
- BRAF inhibitors;
- c-KIT inhibitors;
These state-of-the-art treatment methods intensify the natural immune response for fighting cancer.
Top Ichilov offers modern and the most effective chemotherapy protocols for melanoma treatment in Israel. If you have been diagnosed or you suspect you have melanoma, contact the clinic right now.
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Innovations: Treatment Methods Implemented in 2021
- The combination of drugs Braftovi (encorafenib) and Mektovi (binimetinib). This protocol combining 2 state-of-the-art targeted therapy drugs is indicated for metastatic melanoma with the BRAF gene mutation. The results of the clinical studies show that the new drug combination is more effective than vemurafenib monotherapy which was used before. Both drugs come as pills and capsules and are administered orally so treatment may be carried out at home.
- The combination of targeted therapy drugs atezolizumab, cobimetinib, and vemurafenib. Earlier, melanoma was treated with a combination of cobimetinib and vemurafenib. According to the results of clinical trials, added monoclonal antibody atezolizumab increases survival rates in patients with metastatic melanoma by a factor of 1.5.
The Cost of Melanoma Treatment in Israel
|Resection and testing of sentinel lymph nodes||starting from 3,900|
|Wide excision of melanoma with histological analysis||starting from 2,500|
|BRAF gene mutation test||1,126|
|Plastic surgery: reconstruction of the removed tissues||starting from 3,328|
How to Receive Melanoma Treatment in Top Ichilov
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