esophageal cancer in Israelesophageal cancer called malignant tumor of the esophagus. Typically, there are three main forms of esophageal cancer: squamous cellular carcinoma, adenocarcinoma and carcinoid. Among cancer tumors active type of cancer is not common: about 5 - 7% of the total. In this case, among other kinds of diseases of the esophagus cancer is the leading positions - about 70%. It is known that in the early diagnosis and adequate treatment of esophageal cancer can be cured. Thanks to the active support of the state is considered to be the most effective treatment for esophageal cancer in Israel.

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Risk factors for esophageal cancer

Because the causes of cancer in the esophagus is not yet reliably established, should pay special attention to the factors that increase the risk of disease.

  • esophageal achalasia.
  • Smoking, alcoholism.
  • Frequent consumption of very hot food.
  • Poor diet, lack of vitamins.
  • Abuse of pickled products.
  • Plummer-Vinson syndrome.
  • Disease "Barrett's esophagus".
  • Esophageal mucosal injury.
  • Polyps and papillomas in the esophagus.
  • Frequent radiation exposure.

Symptoms of esophageal cancer

There are certain symptoms of cancer of the esophagus:

  • Trouble swallowing;
  • Heartburn;
  • Gastric disorders;
  • Pain and discomfort in the back and chest;
  • Weight loss;
  • Vomiting (sometimes with blood);
  • Belching food;
  • Hoarse voice;
  • A bad odor from the oral cavity.

In order to establish a definite diagnosis should undergo a special set of surveys. Israeli cancer clinics have impeccable technical facilities for this purpose.

In 2014 Israel was visited by over 80 thousand foreign patients, most of whom were cancer patients.

Diagnosis of esophageal cancer in Israel

Treatment of esophageal cancer in Israel begins with the quality of diagnostics on the advanced equipment. Comprehensive survey includes the following types of activities:

  • Consultation and medical examination;
  • Roentgen barium (barium solution is introduced into the gastrointestinal tract before scanning X);
  • Esophagoscopy (thin hose attached to the end of the chamber is introduced directly into the esophagus, the picture displayed on the monitor);
  • Biopsy (taken from the esophageal wall puncture);
  • CT scan;
  • Endoscopic ultrasound (introduced into the esophagus thin hose ultrasound scanner at the end, the degree of swelling is determined by germination in tissue and lymph node status);
  • Laparoscopy (estimated extent of lesions adjacent organs);
  • PET-CT (detection of secondary tumors).

With the help of the above studies genuinely unable to establish whether the esophagus really amazed dangerous tumor. If cancer is confirmed by the presence, further tests help determine the type of tumor, the coordinates of its location, the presence of metastasis, etc.

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Treatment of esophageal cancer in Israeltreatment of esophageal cancer in Israel

Effective treatment of cancer in Israel is based on the most modern techniques. Hospitals in the country are well-equipped high-tech equipment. Very high is the level of training of doctors. For the treatment of esophageal cancer in Israel Use the following types of therapy, and combinations thereof.

  • Surgery . Removal of the tumor can take place in several ways:
    • incisions in the chest and the abdomen;
    • transkhiatalnoe removal through incisions in the neck and the abdomen;
    • mini-invasive esophagotomy.
  • Chemotherapy. The use of anti-cancer medications help reduce the size of the tumor before surgery and prevent the occurrence of relapse after it. Chemotherapy is successfully combined with radiation therapy. Also it is the main way to fight metastasis. The following medications are used most often: Aporobisin, Xeloda, cisplatin, 5FU. The dosage for each patient is evaluated individually. Thus, the side effects minimized.
  • Radioterapiya.Primenyaetsya radiotherapy outer and inner, i.e. brachytherapy. Radiation therapy is used as an independent treatment or in combination with chemotherapy and surgical removal. External irradiation is usually carried out five days a week. Conducting brachytherapy involves administering radiation source in the esophagus, in the tumor site. radiation source may be inside the esophagus from several minutes to several days.

Let us consider approaches to esophageal cancer treatment in Israel.

Chemotherapy for esophageal cancer

Chemotherapy - methods used cytotoxic drugs in the treatment of cancer. In most cases, a systemic therapy, where drugs circulate throughout the body and destroy cancer cells, including those that could break away from the primary tumor.

Chemotherapy is commonly used in the treatment of esophageal cancer in Israel. Cytotoxic agents enter the body intravenously.

It is recommended in the following cases:

  1. With radiotherapy as the primary treatment. Sometimes assigned separately.
  2. With radiation before surgery to reduce the amount of malignancy, and reduce the likelihood of the disease returning.
  3. After surgery to remove the remaining abnormal cells and to reduce the risk of recurrence. Chemotherapy that is given both before and after the operation, called the peri-operative.
  4. To ease the pain and other symptoms common in the body of tumor.

chemotherapy drugs in esophageal cancer

Often in the treatment of esophageal cancer using 5-fluorouracil (Adrucil, 5-FU), leucovorin, cisplatin (Platinol AQ).

Less commonly used chemotherapy drugs:

  • paclitaxel (taxol)
  • irinotecan (Camptosar, CPT-11)
  • mitomycin (Mutamycin)
  • mitoguazone
  • doxorubicin (adriamycin)
  • vindecine (Eldesine)
  • vinorelbine (Navelbine)
  • bleomycin (Blenoxane)

The most common scheme of cytostatics:

  1. 5-fluorouracil and cisplatin - the standard treatment for esophageal cancer in Israel.
  2. ECF: epirubicin (Pharmorubicin), cisplatin and 5-fluorouracil. In most cases, it is indicated for esophageal adenocarcinoma, or cancer of the gastrointestinal junction. The circuit may be assigned to and after surgery. Epirubicin and cisplatin given every three weeks, 5-fluorouracil enters the body continuously and on a daily basis through the device (port) vascular access. The catheter is placed into a large artery in the arm, chest or neck. To control the admission rate of the drug pump is used. capecitabine (XELODA) Tablets (form 5-fluorouracil) can be recommended instead vnutrivennogo5-fluorouracil. It is given in combination with epirubicin and cisplatin.
  3. Docetaxel (Taxotere), cisplatin and 5-fluorouracil.

Other combinations of chemotherapy drugs that are sometimes used to treat cancer of the esophagus in Israel:

  1. Paclitaxel and cisplatin. They can also be combined with 5-fluorouracil.
  2. Irinotecan and cisplatin.
  3. Irinotecan and 5-fluorouracil. Leucovorin may be added to enhance the effectiveness of 5-ftoraratsila.
  4. Irinotecan and capecitabine.
  5. Oxaliplatin (Eloxatin) and 5-fluorouracil. Sometimes complement circuit leucovorin to increase the effectiveness of 5-FU.
  6. Oxaliplatin and capecitabine.
  7. Mitomycin, cisplatin and 5-fluorouracil.
  8. Docetaxel and capecitabine.

When chemoradiation therapy for esophageal cancer in Israel is most often used 5-fluorouracil and cisplatin. This combination, along with radiation is the standard treatment of squamous cell esophageal cancer. Drugs given every 3-4 weeks at a time with radiotherapy for five weeks.

In early stages of cancer rate recovery after treatment in Israel reaches 90%.

Among the potential adverse effects of chemotherapy in esophageal carcinoma note:

  • bone marrow suppression;
  • vomiting and nausea;
  • diarrhea, constipation;
  • alopecia;
  • inflammation of the oral mucosa;
  • fatigue;
  • loss of appetite;
  • skin irritation;
  • flu-like symptoms (fever, sore throat, chills, pain in muscles and joints);
  • peripheral neuropathy;
  • vision problems.

Radiation therapy in esophageal cancer

To fight the malignant process Radiotherapy uses ionizing radiation.

Radiation therapy in the treatment of esophageal cancer in Israel may be recommended:

  • As a separate method and a base, in combination with or without treatment with cytostatics.
  • Before surgery to reduce the amount of tumors. Usually combined with chemotherapy.
  • After surgery to remove the remaining abnormal cells and to reduce the likelihood of a return of the disease.
  • Metastatic cancer of the esophagus in order to facilitate disease symptoms - pain and other symptoms.

Remote radiotherapy

For the treatment of this disease in most cases apply external radiation. Linear accelerators direct radiation to tumor formation and some adjoining tissues. Sessions (fractions) are held on weekdays for a number of weeks, often in combination with cytostatic agents.

Radiologists team is very carefully planned radiation therapy in esophageal cancer in Israel. Close to this body are located - a liver, kidney, lung, spinal cord and heart. A high dose of radiation required for treatment of a disease can cause damage to these organs. Create special screens to protect them and apply as much as possible.

The effectiveness of cancer treatment in Israel due to the following factors - a high-precision diagnostics; correct selection of a treatment program based on the biological characteristics of the tumor; oncological surgery; virtuosity Israeli doctors to prolong the life of seriously ill patients; the rapid introduction of the world's innovation and development.

Internal radiation therapy for esophageal cancer (brachytherapy)

The radioactive isotope is placed directly into a malignancy or near, and sometimes in a place where the tumor (bed) was removed. Radiation kills cancer cells over time. Iridium - the most common radioactive substance used in radiation therapy of esophageal cancer. Brachytherapy may prescribe either before or after external radiotherapy.

In the treatment of esophageal cancer using intraluminal brachytherapy (transluminal) located inside the body of the implant. To install it, doctors use an endoscope or a probe. This type of brachytherapy is often combined with a remote radiotherapy.

Internal radiation therapy can be administered at low or high doses:

  1. Low-dose radiotherapy and provides a continuous low dose of radiation is usually within a few days. Requires hospitalization and special precautions for surrounding people from the effects of radiation.
  2. High-dose - a single and a large dose of radiation in a short period of time. I need one treatment, which usually takes a few minutes.

Brachytherapy is sometimes used as a palliative treatment for esophageal cancer in Israel. Its purpose - to slow down the progression of the disease or reduce the amount of tumor to alleviate difficulty in swallowing or stop the bleeding.

Among the potential undesirable side effects noted:

  • skin reactions (redness, dryness or pruritus);
  • fatigue;
  • vomiting and nausea;
  • kserotomiyu (dryness in the mouth due to damage of the salivary glands);
  • difficulty swallowing;
  • stomatitis;
  • diarrhea;
  • narrowing of the esophagus;
  • lung problems (cough, phlegm, shortness of breath);
  • fistula formation (abnormal opening between the esophagus and trachea).

photodynamic therapy

Photodynamic therapy (PDT) destroys cancer cells by using a photosensitizer, enhancing their sensitivity to light. The procedure is performed through the endoscope.

PDT in the treatment of esophageal cancer in Israel may be recommended:

  1. As the primary disease therapy stages Tis and T1, when the process of tumor has not spread beyond the mucosa.
  2. To ease the symptoms of advanced cancer and control the disease.
  3. Photodynamic therapy may be given in combination with remote radiotherapy, laser surgery or stenting.

PDT is carried out in two stages:

  1. First, the photosensitizer is administered, it is absorbed by cells in the body. Through time, the healthy cells get rid of him, but he remains in malignant.
  2. Approximately 48 hours later the cancer cells containing the photosensitizer, exposed to low-intensity laser radiation. The photosensitizer absorbs it, and starts a chemical reaction that destroys the abnormal cells.

Photodynamic therapy destroys only the cancer cells are located near the mucous membrane, which are processed by radiation. FTD does not apply if the cancer has spread to deeper layers or distant parts of the body.

After photodynamic therapy requires careful monitoring to ensure that the disease does not return. Endoscopy of the upper gastrointestinal tract.

Special precautions in connection with skin sensitivity and eye for 4-6 weeks or more after treatment should be taken.

FTD is not available in all hospitals and clinics in the country.

Possible unwanted effects of therapy include:

  • skin reactions (redness or discoloration, sensitivity to the sun);
  • eye sensitivity to ultraviolet radiation and other sources of bright light;
  • difficulty swallowing or disease (inflammation, swelling, pain or scarring in the esophagus);
  • esophageal narrowing (stricture);
  • lung problems (difficulty or painful breathing, cough);
  • pain in the stomach if it gets into the treatment (cause - inflammation, swelling, and scarring);
  • nausea;
  • metallic taste in the mouth.

Laser surgery in the treatment of esophageal cancer in Israel

Laser surgery utilizes intense, narrow laser beam to destroy malignant cells. In the treatment of cancer of the esophagus using a laser type of an yttrium-aluminum garnet with neodymium. The procedure is performed using the endoscope.

Laser surgery can remove large tumors, however, refer to it:

  1. To ease the pain and control the symptoms of metastatic process. This method can be designated in combination with external beam radiation therapy or PDT.
  2. Remove the blockage in the esophagus, in order to facilitate swallowing. 1-2 days after the procedure the patient is exempt from these problems.

After laser surgery can be mounted stent to prevent narrowing of the esophagus, and to ensure the passage of food and liquids.

Laser surgery it is possible to spend again, if the tumor grows and begins to cause difficulty in swallowing. Such treatment of esophageal cancer in Israel may be repeated every 4-6 weeks.

Potential adverse effects of therapy include:

  • temporary swelling of the esophagus;
  • stomach discomfort;
  • perforation (hole) in the wall of the esophagus;
  • bleeding;
  • fistulas (abnormal openings) between the esophagus and the trachea.

Endoscopic treatment of esophageal cancer in Israel

Several therapies are carried out by means of an endoscope.

Endoscopic mucosal resection

This type of removal involves resection of malignant tumors with a margin of healthy tissue around it. This is an option for the smaller tumors in the early stages, which are in the borders of the mucous layer. The resection is performed using general anesthesia. If the malignant cells are found in the removed tissue edges may be carried out another operation or recommended treatment of esophageal cancer in Israel by chemotherapy, irradiation or FTD to completely eliminate cancer.

FTD

It is recommended as a primary treatment for Tis and T1 stages for localized cancer within mucosa. As photodynamic therapy is used to alleviate symptoms of the disease in advanced cancer. It can be administered in conjunction with remote radiotherapy, laser surgery or stenting.

Laser surgery

It is recommended to facilitate the control of pain or symptoms of the disease in the presence of secondary foci. Also eliminates the blockage in the esophagus.

radiofrequency ablation

RFA - a procedure that uses high-frequency electrical current destroys the tumor. It is indicated for the treatment of esophageal cancer in Israel at stage 0.

By the end of the endoscope is connected cylinder is supplied to the part of the esophagus to be treated. After the stacks are supplied with current cylinder. The balloon is moved to the treatment of other parts of the esophagus.

Electrocautery and argon plasma coagulation

Electrocoagulation in the treatment of malignant disease uses electric current argon-plasma coagulation - Argon gas and electric current. These procedures are not available in all hospitals in Israel.

Palliative endoscopic treatment

His task - to ease the symptoms of advanced esophageal cancer, improve the patient's condition and quality of life, to eliminate problems with swallowing.

Esophageal dilatation and stenting

These procedures are used to eliminate the narrowing or blockage of the esophagus caused by the tumor. This eliminates the complexity in the process of swallowing. To accommodate the expander or stent use endoscope.

esophageal dilation may be preceded by stenting. It happens that the procedure must be repeated several times over a number of weeks before the area opens. Expansion may be temporary, since the repeat blocking. It is a relatively safe procedure. The main risk - a perforation (hole) in the wall of the esophagus is a rare side effect.

A stent is a tube that is installed in the esophagus to keep it open. The procedure prevents blocking. The stent may also seal the leaks caused fistulas (abnormal openings) between the trachea and the esophagus. The device is made of metal or plastic. Before you place it, you may need an extension of the esophagus to make a hole through the lock. After the procedure is performed x-rays to make sure that the stent is in the correct position. Major risks - growing tumor through the stent or stent movement, requiring removal or replacement. The stent allows the patient to swallow food, but requires adherence to a special diet to prevent it from blocking. To minimize the risk of the patient should:

  • chew;
  • avoid eating fibrous foods such as beef and chicken;
  • drink carbonated beverages during the meal.

feeding tube

Feeding tube is set to provide the patient with esophageal cancer capable of receiving supply liquid to maintain weight. Surgery conducted under the name eyunostomiya, during which the tube is placed into the small intestine through the opening (fistula) in the peritoneal cavity. If surgery is planned, the feeding tube can be inserted into the stomach using an endoscope.

When metastatic esophageal patient may need such a tube before surgery, during it or after the recovery process. It is also used when other methods do not eliminate the tumor blocking.

rehab is the final stage of treatment. During this period, the body actively restored. Doctors constantly monitor the healing process, to avoid the possibility of recurrence.

The cost of diagnosis and therapy

Purpose of treatment is preceded by diagnostics. Pre-screening program for suspected cancer of the esophagus is the next price range:

  1. Consultation with a specialist - $ 600.
  2. Gastroscopy - 1080 dollars. The price includes the text check for Helicobacter pylori.
  3. Complete blood count - 260 dollars.
  4. PET-CT - 1670 dollars.
  5. Blood Biochemistry - 280 dollars.
  6. Biopsies - 680 dollars.
  7. Testing for tumor markers - 240 dollars.

Total: 4810 USD.

Aside from the standard diagnostic procedures can assign additional:

  1. Esophagoscopy - 370 dollars.
  2. US - 340 dollars.
  3. Study Target Now - 9250 dollars. On the basis of the test results to develop individual care plan, taking into account the genetic and biological parameters of the tumors. Target Now helps establish the most correct treatment approaches for the specific case of the disease.

on conservative treatments Rates:

  1. Chemotherapy - 1180 dollars. Cytostatic preparations - 360 dollars.
  2. Radiotherapy (one field) - 140 fraction.

The cost of operations for esophageal cancer in Israeli hospitals:

  1. Esophagectomy - from 59 000 dollars.
  2. Radical resection of the esophagus - 75 thousand dollars.
  3. Partial resection - 59 thousand dollars.

The prices laid down payment of logistics services, wards, operating and work of surgeons. To get a more detailed and specific information, fill out the application form on the website.

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