carcinoid Treatment in Israel

Carcinoid tumors (carcinoid) - is one of the types of neoplasms of the neuroendocrine system:

  • 65% of these tumors have tract ( esophagus , Stomach, small intestine, large and rectum);
  • 25% - in the lungs;
  • 3% - on the pancreas;
  • 2% - on the kidneys, ovaries and testes.

There are many different types of therapy for this disease in Israeli medical centers.

Medical service en.thebestmedic.com offers treatment for carcinoid in Israel in the best clinics, where the accumulated huge experience correction of cancer pathologies. Working in the market to assist oncology patients over 12 years, we have helped many patients from Russia and CIS countries.

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To find out the cost of treatment from the best doctors in the Israeli health care system, call or write us at the contacts on the site. In up to 48 hours we will contact medical practice experts for advice on your questions. And after a short time we will offer you to get acquainted with the treatment plan and the amount of your stay in the Israeli hospital.

Do not waste your vain days, weeks and months to independently clarify the details, wasting it in vain. We work professionally, accurately, quickly, so that you restore your health as soon as possible. The exact cost of the treatment of carcinoid be known after you contact us. After the diagnosis is made the plan, which may include different types of treatment depending on the type and stage of disease. Below is the cost of services for the programs, an indicative list:

  • Medical consultation - $ 500
  • Laboratory tests - $ 630
  • PET CT - 1650 $
  • Biopsy - $ 610
  • MRI - $ 1350
  • US - $ 420

carcinoid Treatment in Israel

Carcinoid tumors develop at different rates, but often grow very slowly. Sometimes, no progress is observed in a few months or years.

In case where notes carcinoid development or disease symptoms occur, apply surgery to remove the tumor. When contraindications for surgery using other methods, often a combination thereof, for example - somatostatin analogues, radiotherapy and chemotherapy.

In addition, it employs a method such as radiofrequency ablation to remove tumors in the liver. Also arterial embolization in order to reduce tumor size.

As with other types of cancer, the earlier the diagnosis, the easier it is to control the disease and the greater the chances of cure. The doctors plan treatment program carcinoid in Israel in accordance with the following factors:

  1. Localization of the primary lesion.
  2. The spread of the tumor.
  3. The presence of symptoms.
  4. The degree of malignancy.
  5. General state of health.
  6. Is there a carcinoid syndrome.

Operation in the treatment of carcinoid in Israel

If the tumor is in only one area and does not spread, the surgeon will remove it completely. When you can not do this, perform operations on the maximum amount of resection of the tumor mass - cytoreduction.

In the case where the intestine neoplasm blocks may be offered surgery to bypass the lock. This will ease the symptoms. The team of highly qualified doctors, who works with the patient, discuss with them the best options. To make a choice is influenced by:

  • Location carcinoid.
  • Its size.
  • The presence of the lock.
  • Metastases.

Surgery with carcinoid tumors in the intestine

This type of cancer can affect the small intestine, large intestine or rectum. Consideration of options for surgery due to the size of the tumor and its localization. Types of operations:

  1. Removal of the tumor during colonoscopy. If carcinoid less than 1 cm and is low in the intestine, the physician may resect it during colonoscopy. This operation is called - Endoluminal resection. After that, you need regular monitoring.
  2. Local excision. This removal of the tumor together with a margin of healthy tissue and surrounding lymph nodes. In most cases, the operation is performed through the abdominal incision in the abdominal cavity. The indication is a tumor of the small intestine in less than 1 cm and less than 2 cm - in the colon. Resection of the healthy tissue and lymph nodes reduces the risk of relapse.
  3. Removal of part of the intestine. If katsinoid too large for the operation of local excision, resection is performed and removed area containing the tumor. Then the surgeon will connect the ends of the body within the body - will create an anastomosis. How much tissue is resected, depending on the volume of tumors and its location. This will also remove lymph nodes, since cancer cells can spread to them. It may require the creation of a colostomy or ileostomy after removing part of the intestine, but this is rare and usually temporary.
  4. Laparoscopic surgery on the intestines. In recent years, Israeli surgeons began to carry out laparoscopic surgery to remove colorectal cancer in its early stages, including carcinoid. This type of surgery is called laparoscopic resection. The operation is carried out through several small incisions (0.5-1.5 cm) instead of a single cavity (laparotomy operation). Surgical treatment is performed using a laparoscope, it lasts 40 minutes (longer than the standard operation). However, the patient subsequently recovers faster, and less feel the pain.
  5. Creating a colostomy after removal of intestinal carcinoid. Stoma is usually temporary. It is needed until the intestine has healed to function normally. Temporary stoma closed after a few months. Very rarely a need for a permanent stoma, since there is no possibility to connect the ends of the intestine together or tumor is too low to the anus. Surgeons are taking all possible steps to avoid it.
  6. The operation to remove or bypass the blockage. Sometimes, carcinoid tumor completely blocks the bowel (intestinal obstruction creates) begin to accumulate waste of digested food. There are symptoms such as bloating and overcrowding, cramping, nausea, vomiting, constipation, gas. Maybe an operation to unblock the intestines and relieve the symptoms.

Surgical treatment of carcinoid in Israel: the pancreas

Carcinoid of the pancreasCarcinoid tumors of the pancreas are often called neuroendocrine. It conducts operation surgeon who specializes in the treatment of pancreatic and liver. It removes the maximum amount of tumors and lymph nodes throughout the gland. It may require resection of the whole body or its parts.

Surgical treatment of carcinoid in Israel: the stomach

Treatment will be determined by the type of tumor. Physicians grouping them by type - 1.2 or 3 depending on the risk of proliferation in other body parts.

  • 1 type of gastric carcinoid unlikely to metastasize. Perhaps, the operation will not be necessary, require regular inspection. Or the doctor can remove the tumor using an endoscope.
  • Type 2 gastric carcinoid tumors are likely to spread to other parts of the body after some time. If the tumor less than 1 cm in diameter, it is removed using an endoscope. If larger, it will need surgery to remove the tumors with a margin of healthy tissue and surrounding lymph nodes.
  • 3 type of carcinoid tumors of the stomach is able to spread already at the time of diagnosis. Even if the tumor is small, you will need an operation to remove part of the stomach or the entire body completely with the surrounding lymph nodes.

Surgical treatment of carcinoid in Israel: the liver

If there is a 1 or 2 tumors within one lobe of the liver may conduct operations for their removal. For some patients, this procedure will cure cancer.

When the tumor process involving more than one share body, surgery can relieve symptoms and slow the progression of the disease.

If carcinoid spread to the liver from another part of the body, can be an operation to remove them. When multiple tumors conducted wedge resection. In addition, the used radiofrequency ablation.

Surgical treatment of carcinoid in Israel: light

Thoracic surgery is performed or cardiothoracic surgeon. The choice of surgery depends on the size and position of a carcinoid tumor.

Sometimes the tumor detected by chance during surgery for other lung diseases. carcinoid is often at the earliest stages, and possibly further treatment of carcinoid is not required.

If you are diagnosed with lung cancer , The tumor is localized, surgery may be needed to remove the tumor and a margin of healthy tissue, sometimes surrounding lymph nodes to reduce the risk of recurrence.

Type of surgery depends on the size and location of tumors. For small kardinoidah in the early stages is conducted wedge resection or segmentectomy. When larger - lobectomy (removal of the lobe of the lung), or the entire organ - pneumonectomy. But the latter two operations are not often used in the treatment of carcinoid tumors.

Somatostatin in the treatment of carcinoid in Israel

Somatostatin - a protein that is naturally produced in the body by the hypothalamus, stomach, pancreas, intestine.

Its functions are:

  1. It slows down the production of hormones, including intestinal hormones.
  2. Reduces the rate of emptying of the stomach and intestines.
  3. Controls the synthesis of hormones produced by the pancreas, including insulin.
  4. It slows or stops the production of growth hormones.

When kartsionoidnom syndrome somatostatin applied as a treatment used drugs:

  • Octreotide (Sandostatin)
  • Lanreotide (Somatuline)
  • Pasireotid (Signifor)

Symptoms of carcinoid syndrome include diarrhea and flushing. Hormones produced by the tumor, are the cause of these symptoms. Somatostatin analogs work by slowing down the production of hormones, including growth hormone and serotonin. Reducing the levels of these hormones help control diarrhea and skin flushing. They can also reduce the amount of tumors. Drugs enter the body by injection.

Side effects of somatostatin analogs

they usually do not cause a large number of undesirable effects, note the following:

  • loss of appetite;
  • nausea;
  • swelling;
  • abdominal pain;
  • fatigue;
  • an increase in diarrhea;
  • tenderness at the injection site.

It can be raised or lowered blood sugar levels. If the patient is suffering from diabetes, it is necessary to check blood sugar levels frequently. You may need less diabetes pills and insulin.

If octreotide has been used for many months, may have gallstones. Before treatment, an ultrasound scan of the gall bladder, and then every 6-12 months. In 10-50% of people after the application of octreotide develop gallstones.

Radiation therapy in the treatment of carcinoid in Israel

Radiation therapy for carcinoidRecommend radiotherapy in metastatic carcinoid, which causes the symptoms.

Target Radiotherapy

All cells have receptors that cause changes when triggered. For example, they can give a signal:

  • create more cells;
  • release agents;
  • to stop the synthesis of substances.

Special scan can show whether carcinoid tumor specific receptors, which doctors can use with the target radiotherapy. Radioactivity transferred to substances that activate the receptors. Destroyed only carcinoid cells.

131 I-MIBG (131 I-meta-yodbenzilguadinin) therapy

MIBG - a substance that is treated tumor cells. To this is attached a radioactive iodine. Abnormal cells absorb it and become radioactive. Based on studies it is known that this treatment controls the symptoms in 80% of patients. After treatment, carcinoid in Israel a few days need to be in hospital, while continuing therapy. The patient is isolated, since the interaction with it is unsafe for others. The level of radiation is reduced in a few days, and he can leave the hospital. After treatment decreases the number of erythrocytes, leukocytes and platelets. A person feels tired, increasing the risk of infection. But most people recover quickly after treatment.

Octreotide 90 Y

Octreotide 90 Y - a new type of targeted radiotherapy. Octreotide - an analogue of the natural hormone - somatostatin, doctors refer to it as an analog samotostatina. The combination of octreotide and the radioactivity destroys the carcinoid cells.

Just octreotide is used in the treatment of karitsinoidnogo syndrome, as well as before the operation.

In studies, 90 Y reduces octreotide carcinoid size in 30% of patients, 60% - reduces symptoms.

Possible side effects:

  • Fullness;
  • nausea;
  • diarrhea;
  • reduction of blood cells;
  • rarely renal failure.

For effective treatment of carcinoid in Israel, further research is needed to determine the long-term side effects of octreotide 90 Y. Some doctors have reported damage to the bone marrow, which leads to a condition known as myelodysplastic syndrome.

Selective Internal Radiation Therapy (SIRT)

Radiation therapy of carcinoid in IsraelThis method is used for radionuclide therapy in treatment of liver metastases. The procedure is similar to the hepatic artery embolization. But instead to block blood flow in blood vessels administered radioactive microspheres coated substance yttrium-90. They enter into the capillaries kratsinoidnoy only within the tumor and kill cells by radiation. Radiation works primarily the first two weeks after injection. A month later, the radiation is scattered.

The doctor makes a small incision in the groin and inserts a catheter into the femoral artery. CT-guided, he promotes it to the liver where the tumor is located. Then enters the microspheres and places them in the vessels. After the procedure, you must stay overnight in the hospital.

According to the research, 40% of patients experience complete or partial response after treatment in Israel.

Side effects SIRT include:

  • abdominal pain;
  • nausea;
  • loss of appetite;
  • fever;
  • inflammation of the stomach, small intestine, pancreas and gall bladder, caused by radiation;
  • liver failure (very rare).

This type of treatment is carcinoid in Israel is carried out not in all clinics.

External-beam radiation therapy

Very rare carcinoid spreads to the bone or brain. In these cases, an external radiation therapy. It is particularly effective in controlling pain. Side effects are usually mild. Upon irradiation of the head can be hair loss, which grow back a few months later.

carcinoid treatment in Israel: radiofrequency ablation

This method destroys cancer cells by heating. RFA is applied in the following cases:

  • swelling less than 4 cm in diameter;
  • carcinoids number does not exceed 4;
  • the tumor can not be surgically removed.

Early studies showed the following results: RFA controls carcinoid tumors for some time, they usually begin to grow again. Also, this method controls the symptoms in most people.

6 hours before the procedure, you can not eat or drink. Patient is given a sedative medication, apply a local anesthetic in the liver region. To control the RFA using CT or ultrasound. A special probe or needle is introduced through the skin into carcinoid, heating it and destroying. In healthy tissue the ability to withstand heat up as the ability to recover. The treatment takes from 30 minutes to 1 hour.

After radiofrequency ablation are possible pain in the shoulder area. About 20% of patients have flu-like symptoms that occur within 5 days after treatment and last up to 5-7 days. Very rarely observed bleeding from the liver.

Radiofrequency ablation - a specialized treatment in Israel carcinoid available only in some hospitals of the country.

Chemotherapy in the treatment of carcinoid in Israel

Treatment with cytotoxic drugs is generally not a primary therapy. Chemotherapy is carried out:

  • if there is no possibility of using the surgery;
  • if the carcinoid tumor is rapidly growing;
  • when it is necessary to reduce the volume of tumors prior to surgery;
  • after surgery.

Chemotherapy may be combined with other treatments for carcinoid in Israel, including somatostatin analogues.

Treatment with cytotoxic drugs more effective in some types of carcinoid tumors. Based on studies it is known that the carcinoid, which responds to somatostatin analogues, can not respond to chemotherapy.

Chemotherapy in the treatment of carcinoid in Israel

The choice of cytostatic agents is due to the localization of carcinoid tumor. If the tumor is located in the digestive system, doctors use a combination of the following preparations:

  • streptozotocin
  • dacarbazine
  • fluorouracil
  • Doxorubicin (adriamycin)
  • cyclophosphamide
  • Capecitabine (Xeloda)

If it affects the lungs following chemotherapy is recommended:

  • Cisplatin or carboplatin
  • etoposide

Common side effects include: nausea, alopecia, a lack of blood cells, fatigue, problems with the kidneys.

carcinoid treatment in Israel: embolization of hepatic vessels

Embolization of blood vessels in liver IsraelThe main problem of this method - block the blood flow to the malignant tumor in the liver , Leading to its destruction.

The doctor may recommend embolization in the following situations:

  1. Diagnosed with carcinoid tumor that has spread to the liver.
  2. There are contraindications to surgery for tumors in the liver.
  3. Carcinoid produces large amounts of hormones.
  4. Other treatments do not control the symptoms of the tumor.
  5. There is one primary carcinoid tumor.

Embolization may reduce liver neoplasms half in 60% of patients. it also reduces the amount of produced hormones that help control symptoms in 70-90% of patients. Therapy can be repeated again if the tumor grows.

embolization procedure is as follows. The doctor makes a local injection in the groin area, and makes a small incision in the femoral artery catheter insertion. Under ultrasound or CT sends it into the hepatic artery, reaching it introduces a combination of drugs. One of them is blocking the blood supply, the second is a chemotherapy drug.

Possible side effects of hepatic embolization:

  • Flu-like symptoms.
  • Nausea.
  • Heat.
  • Pain in the liver or shoulder.

They can last a few days. More rarely develop serious side effects - infection of the kidneys or liver abscess.

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