Israel has a very high incidence of melanoma. Every year, 300-400 new cases of this disease are diagnosed here. Due to the long experience of patients diagnosed with melanoma, this can be detected in patients with liver failure and successfully treated.
However, even in the later stages, the treatment of melanoma in Israel brings results. The leaders were assisted by patients from all over the world, offering new methods of treatment developed in Israel.
Examination for melanoma
HOW THE DIAGNOSIS IS GOING ON IN ASSUTA
Diagnosis takes 3-4 days.
confocal microscopy. With this innovative technology, a virtual biopsy can be performed optically. This procedure is more gentle, instead of cutting the skin, the doctor uses infrared rays of weak strength. They illuminate the superficial layers of the skin. The light that is reflected from them, the doctor sees as an image on a computer screen.
The method is similar to ultrasound technology, but light waves are used instead of sound waves. Confocal microscopy allows you to see the cellular structure of skin neoplasms. Based on this, it is possible to understand without a biopsy whether the formation is benign or malignant. Thus, the doctor does not have to take a piece of tissue and send it to the laboratory – the study can be carried out on the spot, which speeds up the diagnostic process.
An example of a diagnostic program for melanoma
Day 1 — Initial inspection
10:30
Arrival and registration at the Assuta clinic.
14:00
Consultation with a diagnostician. Physical examination of the patient, examination of medical documents and previous examinations. Drawing up an anamnesis in Hebrew, issuing referrals for tests and diagnostic procedures.
15:30
Transfer to the laboratory for the revision of glasses / blocks of the previously performed biopsy (if any).
Day 2 — Diagnostics
09:00
Detailed clinical and biochemical blood tests.
10:00
Urinalysis, which reveals a number of physical and chemical characteristics.
15:00
Confocal microscopy.
18:30
PET-CT (positron emission tomography).
Day 3 — Treatment plan
13:30
Consultation of an oncologist. The doctor makes a diagnosis, determines the tactics of treatment.
14:30
Consultation of an oncosurgeon (if necessary).
17:30
Making recommendations, issuing prescriptions according to the treatment protocol.
18:30
For patients continuing treatment at home: purchase of medications. For patients continuing treatment at Assuta Top Clinic: appointment and operation / start of radiotherapy / targeted therapy / chemotherapy / immunotherapy the next day.
The price of the melanoma diagnostic program in Assuta is $2650.
Who diagnoses and treats melanoma
How much does melanoma treatment cost
Name of the treatment
Цены (USD)
Standard diagnostic program
от 2650
Consultation with an oncodermatologist using dermatoscopy
от 520
Neoplasm biopsy
от 640
PET-CT
1600
Removal of melanoma at the 1st stage
от 3900
Resection and biopsy of sentinel lymph nodes
от 6000
Antimetastatic vaccination in advanced disease
от 13000
Melanoma treatment methods in Israel
The following methods of melanoma treatment in Israel can be applied:
Surgical
The operation is performed when the tumor is located on those parts of the body where it can be removed. With multiple foci of melanoma, surgery is unrealistic.
Surgical removal of melanoma in Assuta is usually performed on an outpatient basis, under local anesthesia. General anesthesia is usually used when the patient requires a sentinel lymph node biopsy. This procedure is carried out in order to assess how much the tumor has spread throughout the body, and to properly plan treatment.
Biological treatment
This method directly or indirectly uses the body’s immune system to fight cancer. Melanoma is treated with a wide range of biological agents. Their choice may depend on the results of molecular genetic testing of the tumor. Depending on the results of this study, the patient may be prescribed:
- Interferon alpha (Interferon alpha) and interleukin 2;
- BRAF inhibitors (vemurafenib, dabrafenib, encorafenib);
- MEK inhibitors (trametinib, bimetinib);
- Monoclonal antibodies – immune drugs ipilimumab, pembrolizumab, nivolumab.
- Biological treatment is offered on an outpatient basis.
Chemotherapy
Thanks to the development of personalized oncology and the emergence of a large number of biological drugs, in recent years in Israel, chemotherapy has been used less and less for the treatment of melanoma. However, recently, the Assuta clinic began to introduce an innovative chemotherapy protocol in Temozolomide tablets. The protocol is used for the treatment of advanced melanoma with brain metastases.
In most cases, the procedure is performed in a day hospital.
Isolated limb perfusion
For recurrent melanoma in a limb, a doctor may suggest a treatment called “isolated limb perfusion.” This innovative procedure makes it possible to carry out chemotherapy in only one arm or leg. The treatment is carried out under general anesthesia and involves hospitalization for several days.
During the procedure, the blood vessels of the affected limb are temporarily isolated from the general circulation. After that, they are washed with a solution of a chemotherapy drug.
Radiotherapy
The goal of radiation therapy for melanoma can be:
- Stopping or slowing the progression of the disease;
- Relief of local pain, mainly due to bone metastases.
The patient is usually prescribed external beam radiation therapy, for which a special device is used – a linear accelerator. Modern models of linear accelerators, which are available in the Assuta clinic, can significantly reduce the exposure time and reduce the number of treatment sessions.
As a rule, irradiations are performed daily for 6 weeks.
TIL-therapy
The purpose of this method is to strengthen the patient’s immune response against cancer cells. This treatment is based on a new technology based on the implantation of the patient’s own lymphocyte cells, whose function is to fight melanoma cells. The treatment is combined with chemotherapy and interleukin 2 therapy. During TIL therapy, lymphocytes are removed from the tumor tissue, restored and grown in the laboratory, and then they are reintroduced into the patient’s body along with interleukin 2.
How to get treatment in Israel?
You can ask any questions about treatment at the Assuta clinic using the application on the website or by phone. +7495-7899230 (your call will be forwarded free of charge to the international department of the clinic in Israel). Our consultant doctor will call you back within 1-2 hours. The consultation is completely free. Privacy is guaranteed.
Stages of melanoma
Melanoma in situ is very early stage melanoma where the cancer cells are in the top layer of the skin. Treatment at this stage is usually the surgical removal of the affected area and the skin around it. If the thickness of the neoplasm is less than 1 mm, then the risk of recurrence is low, and removal of the melanoma leads to complete healing.
A patient with melanoma with a penetration depth of more than 1 mm in Israel undergoes a biopsy of the sentinel lymph node. If only this lymph node is affected, then stage 2 is diagnosed. The patient then undergoes a larger operation to check other lymph nodes. If it is found that they are also affected, the 3rd stage of the disease is diagnosed. Patients with stage 3 melanoma have a higher risk that the melanoma will return as metastases.
Melanoma can spread to various organs, including the liver, lymph nodes, and brain. In such a situation, they speak of an advanced stage of melanoma – the 4th stage. This stage is also called metastatic cancer. Treatment will depend on which organs the tumor has spread to, as well as the general condition of the patient and the treatment received earlier. The goal of treatment for stage 4 melanoma is to slow the spread of the tumor and relieve symptoms.
Israel is one of the few countries in the world where sentinel lymph node biopsy is performed for melanoma. The initial treatment for melanoma is its surgical excision. In some cases, we also examine the sentinel lymph node. This is the name of the node, which is the first in a line of lymph nodes that drain melanoma. If the melanoma has already metastasized, signs of this may be found in the sentinel lymph node. For this, it is removed and analyzed. This approach to treatment allows us to prevent recurrence of melanoma after surgery in 85-90% of patients.
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FAQ
The main treatment for melanoma is the surgical removal or excision of the primary melanoma on the skin. The extent of the operation depends on the thickness of the melanoma. Most melanomas are found when they are less than 1.0 mm thick, and often the only treatment needed is outpatient surgery.
Larger excisions, or those on the arm or face, may require a skin graft to close the wound. A skin graft is a very thin sheet of healthy skin taken from another part of the body to replace the removed skin. The operation usually takes up to an hour. You will probably be heading home soon after.
In an Israeli study published in the Journal of Clinical Oncology, scientists reported a 3-year overall survival of 63% among 94 patients treated with this drug combination. All patients had stage 3 or 4 melanoma that could not be removed surgically.
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