Bone Cancer Treatment in Israel

Primary bone cancer is a rare disease: it accounts for less than 1% of all malignant tumors. Much more often, the bones contain metastases of other cancers, such as breast, prostate or lung cancer. These are treated according to the rules for the main disease, so doctors always first establish where the tumor is growing from.

There are three main types of primary bone tumors:

• Osteosarcoma – the most common type, usually in teenagers and young adults, most often in the bones around the knee or shoulder.
• Ewing sarcoma – occurs in children and young adults and responds well to chemotherapy and radiation. More about it on the page Ewing sarcoma treatment.
• Chondrosarcoma – grows from cartilage tissue, more often in people over 40, and responds poorly to chemotherapy, so surgery plays the main role. This type has a separate page, chondrosarcoma treatment in Israel.

There are also rarer tumors: chordoma, undifferentiated sarcoma, giant cell tumor. Each of them has its own treatment approach.

Bone cancer diagnosis in Israel starts with a review of what has already been done at home. The doctor looks at the images on the disc, not only the reports, and decides what information is missing. Usually the following are needed:

• X-rays and MRI of the whole affected bone to see the borders of the tumor and its relation to blood vessels and nerves;
• chest CT, because the lungs are a common site of metastases in sarcomas;
• PET-CT or a bone scan (a test with a small dose of a radioactive substance that shows lesions in all the bones);
• biopsy – taking a small piece of the tumor to examine under a microscope.

With sarcoma, it matters where and how the biopsy is done. A poorly chosen needle path can later make it harder to save the limb, so doctors try to perform it at the center where the surgery will take place. If a biopsy has already been done, the clinic often asks for the slides and blocks so that a pathologist (a doctor who makes the diagnosis from tissue samples) can review them.

Treatment methods are chosen according to the type of tumor. The decision is made by a tumor board, not by a single doctor.

Surgery. This is the main method for almost all bone sarcomas. The surgeon removes the tumor in one piece with a margin of healthy tissue. If blood vessels and nerves are not involved, limb-sparing surgery is performed: the removed segment is replaced with a modular endoprosthesis, a bone graft or a combination of both. In children, expandable endoprostheses that are lengthened as the child grows are sometimes used. Amputation is considered when it is impossible or unsafe to preserve the function of the limb.

Chemotherapy. In osteosarcoma and Ewing sarcoma it is given before surgery to shrink the tumor, and after it. Based on how many tumor cells have died after the first cycles, doctors assess the tumor’s sensitivity and adjust the plan.

Radiation therapy. It is important in Ewing sarcoma and in cases where the tumor cannot be removed completely, for example in the bones of the pelvis, spine or skull base. For tumors close to vital organs, doctors discuss proton therapy, which delivers the dose to the tumor more precisely.

New-generation drug treatments. Targeted drugs and immunotherapy are used only to a limited extent in bone sarcomas: mainly for relapse or within clinical trials. Whether they suit you is decided by oncologists after analyzing the tumor.

For a sarcoma bone cancer Israel is chosen above all for its experience with rare tumors. Bone sarcomas are uncommon, and small hospitals do not see them often. Large Israeli medical centers such as Sourasky (Ichilov), Sheba, Hadassah and Rambam have orthopedic oncology departments where such operations are performed regularly. For children, there is the specialized Schneider clinic.

For a patient from another country, it also matters that a tumor board opinion can be obtained remotely: doctors study the records and propose a plan before the trip. The methods of bone cancer treatment in Israel are discussed with you in advance. This helps you understand which stages can be done in Israel and which, for example maintenance chemotherapy, can sometimes be continued at home under the supervision of a local oncologist.

The cost of bone cancer treatment in Israel is made up of several parts: additional tests, surgery with an endoprosthesis, chemotherapy cycles and, if needed, radiation. Sarcoma protocols are long, so the final amount depends heavily on the type of tumor and on which stages the patient completes abroad.

To avoid comparing random figures, it is better to get a program tailored to your situation. After reviewing your records, we request offers from several Israeli clinics and show you what each one includes: consultations, tests, surgery, days in hospital, rehabilitation. This makes it easier to understand how much money you will need and what exactly you are paying for.

Bone cancer treatment in Israel does not end at discharge. After limb-sparing surgery, rehabilitation begins: exercise therapy, work with a physiotherapist, gradual loading of the limb with the endoprosthesis. The first sessions take place at the clinic, and then the patient continues at home following the doctor’s recommendations.

After treatment is completed, regular follow-up is needed: lung CT scans and images of the operated area at the intervals set by the oncologist. The Israeli clinic provides a discharge summary with a follow-up plan, and the coordinator helps you contact the doctor if any questions arise.

We publish patient reviews of bone Cancer Treatment in Israel only with the patients’ consent. Ask the coordinator whether you can talk to a patient who has already been treated in Israel.

To start bone cancer treatment in Israel, submit a request and send your scans, biopsy report and discharge summaries. The coordinator will pass them on to oncologists, you will receive the doctors’ opinion and clinic programs, and then together we will choose an option and plan the trip.