Pancreatic Cancer Treatment in Israel
Due to high technology development and Israeli physicians’ extensive experience many pancreatic cancer patients are successfully treated in Israel. This pertains even to “advanced” stage tumors. Treatment comprises the modern “NanoKnife” technology, ablation and embolization techniques, complex surgeries and cutting-edge chemotherapy protocols (thanks to these treatment methods, pancreatic cancer survival rates in Israel increased threefold). Thus, the doctors are able to help even those patients who can’t get help in other countries.
The leading specialists of the Top Ichilov Clinic provide prompt pancreatic cancer diagnosis and treatment: the diagnosis starts on the day of your arrival in Israel.
According to our physicians’ experience, about 30% of “pancreatic cancer” cases in CIS nations are not confirmed. Israeli doctors have to re-examine these patients.
Diagnosis of Pancreatic Cancer
Reliable and accurate diagnosis is the first step in a pancreatic cancer treatment plan. The Top Ichilov oncologists will provide comprehensive diagnosis and determine the type and stage of the disease.
The diagnostic examination may include such procedures as laparoscopy, chest X-rays or bone scan. These methods help to determine whether cancer has already spread outside the pancreas. The examination results are used to develop a treatment plan corresponding to your individual needs and preferences.
Standard methods of pancreatic cancer diagnosis include:
A biopsy is an important tool of pancreatic cancer diagnosis. During the procedure the doctor removes a small sample of pancreatic tissue. If pancreatic cancer is suspected, the doctor may perform an ultrasound-guided endoscopic fine needle aspiration biopsy.
Comprehensive pancreatic cancer telemedicine package – $540.
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Endoscopic Retrograde Cholangiopancreatography (ERCP)
The ERCP method is used to remove cell or liquid samples for microscopic examination, to alleviate bile duct obstruction or to put in a stent designed for lumen reconstruction. Our doctors use the “SpyGlass” endoscope. This device is equipped with a fiber optic transducer connected to a camera. It helps to detect bile duct obstructions.
- Computerized tomography (CT). CT produces detailed images of pancreas with the help of X-rays.
“GE Discovery PET/CT 600 Scanner” – a four-dimensional CT scanner – produces cross-sectional X-ray images of internal organs and structures. The Top Ichilov radiologists analyze the images and develop treatment plans according to the patient’s breathing patterns.
- MRI. This technology produces detailed cross-sectional images of the pancreas. It uses radio waves.
- Ultrasound. An ultrasound examination of the pancreas implies using sound waves in order to receive echo signals from the pancreas. Tumor echo signals differ from healthy tissue echo signals. Some patients undergo a procedure called endoscopic ultrasound: the ultrasound probe is placed onto an endoscope which is inserted into the mouth, esophagus, and stomach. This technology not only provides high-quality visualization of the pancreas but also helps to immediately treat the malignant tumor.
- X-rays. X-rays produces images of the pancreas and other internal organs. These images may be used to determine the stage of the disease.
- Percutaneous transhepatic cholangiography. During the procedure the doctor injects special dye in the liver and checks whether the cancer has affected the bile ducts.
- Angiography. During angiography the doctor injects dye into an artery and checks whether the malignant tumor has affected the blood supply.
Lab tests help to determine levels of antigens connected to tumor growth. If pancreatic cancer is suspected, doctors check if CA 19-9 (carbohydrate antigen 19-9) is elevated. Increased bilirubin levels may suggest bile duct obstruction.
Other lab tests include:
- Advanced genomic testing. Genomic testing is a study of the tumor on the genetic level. Its results help to detect the DNA mutations responsible for cancer development. Knowing the mutations in the cancer cell genome, doctors determine the cause of cancer and prescribe proper treatment.
- Levels of nutrients. The doctor determines whether the patient suffers from the deficit of such nutrients as vitamin D and iron. After the test the doctor may recommend replacement therapy or supplements. All these measures help to improve the quality of life for pancreatic cancer patients.
During the procedure the doctor makes a small incision in the stomach and looks at internal organs for signs of damage. Laparoscopy is an effective tool used in the staging of pancreatic cancer. Besides, laparoscopy helps to see if pancreatic cancer has already spread into the liver.
The Pancreatic Cancer Diagnosis in Top Ichilov
On the first day the patient is seen by a diagnostician. The doctor examines the patient and all the medical documents and prescribes lab tests and instrumental examinations.
Within the next couple of days the patient undergoes lab tests and all the recommended instrumental examinations. A medical coordinator-interpreter accompanies the patient to ensure comfort and productive communication with doctors and nursing staff.
The patient undergoes the following procedures:
- Routine tests:
- Complete blood count and biochemical profile.
- Tumor marker tests.
- Genetic tests:
- K-ras mutation testing is necessary for the assessment of prognosis and disease management planning.
- BRCA1 mutation detection. This mutation predetermines inherited predisposition to pancreatic cancer in about 50% of cases. BRCA1 also ensures women’s genetic susceptibility to breast cancer and ovarian cancer. If there is a BRCA1 mutation, Israeli doctors recommend testing to all the women in the family. If necessary, steps can be taken to prevent cancer.
- Imaging studies:
- PET/CT is the major study which helps to assess the size of the tumor and the spread of cancer into the lymphatic system and other organs.
- Jaundice requires a fibroscan, or a liver function study.
- Endoscopic (transesophageal) ultrasound guides biopsies.
- Biopsy or pathology material revision helps to make a final histological diagnosis.
On the fourth day, an oncologist summarizes the results and develops a treatment plan.
Length of a complete diagnostic examination in Israel: 3-4 working days. Price: $2962.
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What is the difference between pancreatic cancer treatment in Israel and treatment in CIS countries?
- Diagnostic precision. As was already mentioned, about 30% of patients from CIS nations travel to Israel for pancreatic cancer treatment with a wrong diagnosis. Most often, the following situations come up:
- The tumor is not malignant. It is benign, and the patient needs an entirely different treatment program.
- The patient indeed has a malignant tumor, but the type of cancer cells has been misdiagnosed. This can lead to errors in assigning a treatment protocol.
- The patient brings test results the material for which was erroneously taken from another person.
- Wide use of PET/CT in pancreatic cancer diagnosis. This diagnostic method which is still rarely used in CIS countries helps to see the tumor in the earliest stages of cancer development. It also detects metastases and determines their locations.
- Use of IMRT. This highly precise radiation, like a lancet, affects only tumor tissue and does no harm to healthy cells.
- Biological therapy. These treatment techniques are the last word in medicine. They affect the patient’s immunity and help the body to fight cancer more efficiently.
The Physicians Specializing in Pancreatic Cancer Treatment in Top Ichilov
In Top Ichilov, diagnosis and treatment of pancreatic cancer patients is supervised by Israel’s leading oncologists:
Professor Moshe Inbar – leading Israeli oncologist, Head of Oncology Department in Ichilov Medical Center (since 1997), chief consultant in Oncology in Assuta Clinic. Author of more than 250 scientific papers.
Professor Joseph Clausner – internationally renowned surgeon, surgical oncologist, Head of Surgery Department in Ichilov Medical Center. Author of 196 medical publications, Professor of the Faculty of Medicine in Tel Aviv University, member of the editorial board in the international magazine “Annals of Surgical Oncology”.
Doctor Diana Matseevski – senior physician in the Oncology Department of Ichilov Medical Center. Author of scientific papers on cancer radiation therapy, member of the Israeli Society of Gynecologic Oncology, clinical instructor of the Oncology Department in Tel Aviv University.
Doctor Irina Stefanski – Head of Chemotherapy Department, Deputy Head of Oncology Department. Professional experience in oncology: over 27 years. One of the best Israeli experts in pancreatic cancer comprehensive therapy.
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Pancreatic Cancer Treatment Methods
The Top Ichilov Clinic’s leading oncologist will explain your diagnosis and offer various methods and technologies of treating a malignant tumor. The treatment plan will depend on your personal needs. A standard pancreatic cancer treatment plan includes such methods as chemotherapy, minimally invasive gastrointestinal procedures, interventional radiology and/or other innovative approaches.
Common pancreatic cancer treatment methods include:
If you’ve been prescribed chemotherapy, a medical oncologist will select an appropriate combination of chemotherapy drugs for you. Chemotherapy may be used alone or in conjunction with other cancer treatment methods, e.g. surgery or radiation.
Pancreatic cancer patients often undergo chemoradiation therapy. This is a combination of chemotherapy and radiotherapy.
Patients with liver metastases require intra-arterial chemotherapy (IAC), or direct infusion of chemotherapy agents into secondary tumors. This method ensures drug concentration inside the tumor. As a result, malignant tumor cells are destroyed, and healthy tissues receive minimal damage.
- Endoscopic retrograde cholangiopancreatography ensures visualization of bile ducts in the pancreas. During the procedure the doctor may also remove tissue samples for examination, alleviate a bile duct obstruction or place a stent into the narrowed bile duct.
- Endoscopic ultrasound produces high-quality images of the pancreas.
- Fiducial points are applied on the inside of the malignant tumor before radiation therapy. They ensure higher precision of the radiation and protection of healthy tissues.
- Celiac plexus neurolysis blocks the nerves of the pancreas and reduces pain.
- If necessary, our gastroenterologists also place stents and drain pancreatic pseudocysts.
Interventional radiology helps to visualize pancreatic tumors and perform interventional procedures under visual control in a real-time mode. We deliver therapeutic agents directly to malignant tumors, perform biopsies, recommend palliative treatment and monitor your body’s reaction to therapy.
If pancreatic cancer has spread into the liver, we use the following treatment methods:
- SIR-spheres (yttrium-90). Tiny beads (microspheres) deliver radiation directly to the liver metastases. Microspheres – one third of a human hair in diameter – contain yttrium-90, a radioactive element capable of destroying cancer cells. Microspheres enter the body through a catheter placed into the major hepatic blood vessel – hepatic artery. After that, they spread into smaller blood vessels feeding the liver metastasis and disrupt its blood supply. Then microspheres irradiate tumor cells and protect the healthy liver tissue at the same time.
- Chemoembolization. This is a method of delivering chemotherapy agents directly to the liver tumor. Chemoembolization reduces such side effects as nausea and vomiting while simultaneously increasing the drugs’ anti-cancer properties. During the procedure the doctor injects a chemotherapy agent directly into the tumor through a catheter. Chemoembolization is performed under visual control. Medications are mixed with the microspheres that disrupt the tumor’s blood supply. Without fresh blood, the tumor stops receiving the necessary nutrients and oxygen. Chemoembolization ensures long-term treatment with high doses of chemotherapy drugs. Thus, chemotherapy affects only the tumor (instead of the entire body).
- Radiation therapy. Advanced irradiation systems and new visual control technologies allow targeting pancreatic tumors in hardly accessible surgical locations. The Top Ichilov radiation oncologists aim high-dose radiation at cancer cells and simultaneously minimize the damage inflicted on normal, healthy pancreatic tissues. In Israel, pancreatic cancer patients are usually treated with a combination of radiation and chemotherapy. This approach is known as chemoradiation therapy.
- Surgery. The Top Ichilov physicians perform complicated and complex surgeries in cases when the pancreatic tumor can be removed entirely and safely. The nature and scale of surgical treatment depends on the size and location of the resectable tumor.
We offer the following surgical procedures:
- laparoscopic resection;
- Whipple procedure (pancreaticoduodenectomy);
- distal (partial) pancreatectomy;
- total pancreatectomy;
- surgery with the use of the “da Vinci” surgical system;
- palliative procedures.
The Top Ichilov specialists may also offer other treatment methods in addition to or instead of surgery. For instance, unresectable pancreatic tumors may be turned into potentially resectable ones. To do this, the patient must first complete a course of chemotherapy and/or radiation therapy.
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Pancreatic Cancer Treatment Methods Introduced in 2021
- Targeted therapy agent Lynparza (olaparib). Recently, this drug has been approved by FDA for the treatment of VI stage pancreatic adenocarcinomas with BRCA genetic mutation. It has been used in Israel since 2021. Clinical trials proved that this medication could be safely and effectively used in patients who had already been treated with platinum-based chemotherapy drugs.
- Three-component therapy COMBAT/KEYNOTE-202. The cutting-edge treatment scheme was developed in Israel. It includes 3 medications and helps achieve improvement in 77% of patients with pancreatic cancer. Clinical trials show that the COMBAT/KEYNOTE-202 protocol is 25% more effective than standard chemotherapy.
Pancreatic Cancer Myths
Myth: Pancreatic cancer is a deadly disease.
Fact: Pancreatic cancer can be treated. Early detection is the best protection against any cancer, but in the case of cancer of the pancreas, timely diagnosis can prove to be a difficult task. However, such treatment methods as surgery, radiation therapy and chemotherapy are oftentimes successful. At present, Israeli scientists conduct new clinical trials in order to increase the effectiveness of cancer treatment.
Myth: There is only one form of pancreatic cancer.
Fact: Doctors differentiate between two types of pancreatic cancer. In approximately 90% of cases the disease affects pancreatic ducts. Rarer malignant tumors form from the cells responsible for production of insulin and other hormones. Most growths of this type are benign.
Myth: A person can be screened for pancreatic cancer.
Fact: Unfortunately, there are no screening methods that would be able to help with pancreatic cancer detection. Instead, doctors recommend lab tests. Increased levels of certain tumor markers may indicate pancreatic cancer.
Myth: Young people shouldn’t worry about pancreatic cancer.
Fact: Rarely, pancreatic cancer is diagnosed in people under 30. Most cases, however, fall into the age group of 60-80 years. The pancreatic cancer risk rises significantly after 50. Experts recommend leading a healthy lifestyle at any age. This can help prevent various diseases, including pancreatic cancer.
Myth: Family history of pancreatic cancer is the most dangerous risk factor.
Fact: Even though some genetic mutations are actually passed down from generation to generation, only 10% of malignant pancreatic tumors form as a result of inherited predisposition. In 90% of cases, pancreatic cancer develops because of such factors as age, smoking, obesity, and diabetes.
What Is the Cost of Pancreatic Cancer Treatment in Israel?
|Minimally invasive partial pancreatectomy||Inquire about price|
|1 day in a day patient facility for systemic chemotherapy||1346|
|Gastroscopy with HP testing||892|
|Radiation therapy for pancreatic cancer (irradiation of 1 field)||190|
|Endoscopic retrograde cholangiopancreatography||Inquire about price|
*Attention! Payments are only accepted directly by the Ichilov-Sourasky Clinic. Avoid intermediaries.
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