Skin cancer treatment in Israel

Treatment of melanoma in Israel, as well as non-melanoma skin cancer, is distinguished by the use of innovative techniques and drugs. For example, patients of Israeli clinics, including foreign ones, have access to:

• combined personalized, targeted therapy and new-generation immunotherapy;
• innovative radiation therapy – DaRT brachytherapy for recurrent squamous cell skin cancer;
• TIL cell immunotherapy for metastatic melanoma.

In the most difficult cases, in the absence of effect from second-line therapy, skin cancer treatment in Israel allows patients to participate in clinical studies of experimental techniques. For example, in patients with progressive melanoma, Israeli oncodermatologists use:

• personalized mRNA vaccine;
• intratumoral administration of the immunodrug Tavo and the oncolytic virus T-VEC;
• transplantation of intestinal microbiota, which enhances the therapeutic effect of immunotherapy.

  According to Israeli clinics, the overall 5-year survival rate of patients with melanoma is 94%. This is the highest rate in the world, which is currently achievable only in the treatment of melanoma in the USA, Israel, and Germany. At the same time, the cost of treating melanoma and other skin tumors in Israel is significantly less.

Skin cancer treatment in Israel is a guarantee that the patient will receive the most modern therapy available in global oncology.

The use of various combinations of immuno-oncological and targeted drugs of the latest generation in the treatment of skin cancer in Israel, which are not used in many other countries, provides a significant advantage for patients:

• with stages II-IV melanoma and its relapses;
• with advanced stages of basal cell and squamous cell skin cancer;
• with rare skin cancers, such as Merkel cell carcinoma.

Immunotherapy and targeted therapy in Israel give patients with metastatic melanoma a chance of recovery. These treatments have been scientifically proven to be more effective for melanoma than chemotherapy. This causes fewer side effects. Therefore, it can be used in patients for a long time and maintain a good quality of life.

Melanoma, unlike non-melanoma – basal cell or squamous cell carcinoma, is an aggressive malignant tumor. Despite improvements in diagnostic and treatment methods, the incidence of melanoma is increasing.

However, treatment of melanoma in the early stages is not a problem: surgery ensures complete recovery. However, according to the World Health Organization (WHO), less than half of patients consult doctors with stage I of this cancer.

Successful therapy for melanoma, starting from stage II, includes immunotherapy and targeted therapy, which is carried out in full only in clinics abroad, primarily in the USA and Israel. At the same time, the price of melanoma treatment in Israel is significantly lower, and the medical services are the same quality.

Israeli oncodermatologists, experts in dermatology and oncology, examine all suspicious skin lesions using a dermatoscope. You can also attach a camera to the “skin microscope” with a built-in light source and a magnifying glass with 10-20x magnification. Therefore, dermatoscopy makes it possible to take pictures and study them on a computer monitor.

Using the latest generation digital dermatoscopes, Israeli specialists:

• perform epiluminescence microscopy of neoplasms – examination using polarized light of deep layers of skin that are not visible during regular examination;
• Carry out computer digital analysis of images of all suspicious formations on the skin.

The qualifications and experience of Israeli oncodermatologists, advanced equipment, and computer technology allow us to identify in 100% of cases:

• precancerous skin conditions;
• non-melanoma cancer (most often basal cell carcinoma (basal cell carcinoma) and squamous cell skin cancer;
• melanoma;
• others, including rare skin neoplasms.

After dermatoscopy, the doctor performs an excisional biopsy – excision of the tumor using special instruments. Using laboratory microscopic examination, the histology of the obtained tissues, the type of malignant cells, and the stage are determined, including thickness, depth of tumor penetration into the skin, and several other indicators of cancer aggressiveness. Diagnosis of melanoma as the most malignant skin tumor has several features.

Melanoma quickly metastasizes: with a tumor thickness of up to 1 mm, they are detected in 2% of patients. For tumors more than 4 mm thick, metastases are found in 45% of patients. In 95% of cases, the first metastases appear in regional lymph nodes.

Therefore, in Israel, diagnosis of this type of cancer includes the following studies:

• search for metastases using MRI, PET-CT;
• sentinel lymph node biopsy.

The sentinel lymph node is the first node to develop metastases when malignant cells spread beyond the primary tumor. It is visualized by injecting a radiopharmaceutical into the tumor area. A biopsy of such a lymph node makes it possible to determine the stage of the disease as accurately as possible.

Also, in Israel, an immunohistochemical examination of cells is performed to detect melanoma biomarkers, such as the mitotic index. Innovative oncotests InVitae and FoundationOne CDx can detect the presence of mutations in the BRAF, MEK, and C-KIT genes in order to prescribe targeted therapy.

The main treatment method for non-melanoma skin cancer in Israel, which is usually detected in the early stages, is surgery. The doctor chooses a tumor removal technique depending on the following:

• size, thickness, level of invasion (germination), and other characteristics of the tumor;
• location;
• condition and age of the patient;
• expected cosmetic result.

Skin cancer treatment in Israel may include the following types of surgery:

• excision and micrographic Mohs (Mohs);
• laser;
• electro- and cryosurgery.

If patients have contraindications to surgery, non-melanoma skin cancer can be treated with modern radiotherapy, which is as effective as surgery.

In the treatment of skin cancer in Israel, photodynamic therapy, local chemotherapy (chemo- and immunotherapeutic ointments and gels), and electrochemotherapy are also used.

Several targeted drugs of the latest generation are successfully used in Israel for the treatment of locally advanced and metastatic basal cell carcinoma and its relapses, for the treatment of advanced squamous cell carcinoma, a treatment protocol that includes targeted and immunotherapy is used. An effective immunotherapy drug currently used in Israel provides a partial or complete cure in 50% of patients with advanced squamous cell carcinoma.

Mohs surgery (Mohs) is considered the gold standard treatment for non-melanoma skin cancer and some superficial melanomas in Israel. It is recommended for tumors located near the eyes, nose, lips, ears, scalp, fingers, toes, and genitals. Treatment of skin cancer in Israel using Mohs surgery is also carried out for large, ill-defined, rapidly growing recurrent tumors.

Mohs micrographic surgery is:

• safe outpatient surgical procedure under local anesthesia;
• simultaneous histological examination of all layers of the tumor, which guarantees the most complete removal of malignant cells;
• layer-by-layer removal of the tumor, which preserves healthy tissue and leaves a minimal scar on the skin;
• the highest cure rate is 99% for primary non-melanoma skin cancer, up to 94% for relapse (according to data from Israeli and American clinics).

The exact cost of treating melanoma and other types of cancer in Israel using Mohs surgery can be obtained from the coordinating doctors of Experts Medical.

Israeli oncodermatologists completely cure stage I melanoma using a surgical procedure. The main methods of treating stage II-III melanoma in Israel are surgery, immunotherapy, and targeted therapy.

Melanoma surgery is a wide excision of the primary tumor without or with the removal of regional lymph nodes when malignant cells are detected in the sentinel lymph node. Patients with BRAF mutations, who account for 50% of cases, are treated with targeted therapy and immunotherapy. Patients without a BRAF mutation receive immunotherapy only.

Treatment regimens may include different classes of targeted and immuno-oncology drugs: interferons, interleukins, monoclonal antibodies, BRAF/MEK, and immune checkpoint inhibitors.

Although many patients with stage IV melanoma have the primary tumor removed, the mainstay of treatment is immunotherapy, including cell-based (TIL) and targeted therapy.

Chemotherapy is used in selected patients: most often, it complements the main course of treatment or is prescribed as second-line therapy. Conventional radiation therapy is not used to treat the primary tumor. Metastases in the brain, bones, and other body areas are treated with stereotactic radiotherapy and radiosurgery (Gamma Knife, CyberKnife).

In advanced cases, oncologists perform chemoembolization of liver metastases, chemotherapy-isolated perfusion of the limb affected by the tumor, and other high-tech methods of treating metastatic cancer.

At the same time, the price of melanoma treatment in Israel is significantly lower than in the USA and Germany, which have similar treatment success rates.

TIL (tumor-infiltrating lymphocytes) technology allows you to use your own “tumor-infiltrating lymphocytes” to destroy cancer cells. In melanoma patients, in the removed tumor, they often find single cells of their own immune system, which appeared in it to fight cancer. In laboratory conditions, a cell clone is grown from them, prepared for the destruction of melanoma cells. A huge amount of TIL is injected into the patient’s blood along with an immunodrug from the interleukins group.

Treatment of melanoma in Israel using TIL cell immunotherapy is carried out in several clinics.

Treatment of melanoma in Israel, as well as non-melanoma skin cancer, is successfully treated by qualified oncodermatologists in the Sourasky, Assuta, Rambam, and Beilison clinics. Israel also has outstanding world-class specialists:

Professor Yakov Schechter, who directs the Institute of Immuno-Oncology and Melanoma Research at the Sheba Clinic and collaborates with the American National Cancer Institute (NCI) and the MD Anderson Cancer Center;

Professor Michal Lotem, head of the Melanoma Research and Treatment Center at Hadassah Medical Center, specializes in treating this disease with oncolytic vaccines.

Experts Medical will help organize consultations with professors, as well as treatment of melanoma in Israel, by receiving an application on the website.

The final cost depends on many factors, including the number of necessary diagnostic and treatment procedures, the immunotherapy protocol, and targeted therapy, which is prescribed only after a complete examination and clarification of the stage of the disease. It also depends on the clinic’s status (private and public).

For example, dermatoscopy costs in Israeli clinics vary from $100 to $220. The estimated average price of melanoma treatment in Israel is $29,000-34,000.

Therefore, it is best to discuss the cost of melanoma treatment in Israel with the Experts Medical coordinating doctor, who will recommend a clinic and doctor taking into account the patient’s financial capabilities.

Leave a request on the Experts Medical website. Service specialists will quickly select a clinic and oncodermatologist for you with good reviews from patients, provide a treatment plan, help you create a travel budget, and organize comfortable conditions for your stay in the country. And also during treatment for skin cancer in Israel they will assist with any questions.