The competence and experience of doctors, the equipping of medical centers in Israel with modern equipment, and the implementation of innovative treatment methods into clinical practice allow for excellent results in the treatment of severe and rare oncological diseases. Esthesioneuroblastoma is a highly aggressive oncological pathology of the nasal cavity, accounting for about 3% of malignant tumors that develop in this area. Treatment of esthesioneuroblastoma in Israel follows a comprehensive scheme that includes the most progressive surgical methods and the latest chemotherapeutic agents. Therapy conducted according to international protocols significantly improves prognosis in more than 90% of cases, alleviates symptoms, and contributes to the normalization of the patient's condition.
As with other oncological diseases, the effectiveness of treatment must begin at an early stage of the disease. In esthesioneuroblastoma, at the initial stages of the pathological process, characteristic signs manifest weakly, resembling the manifestations of some other pathologies and do not cause significant discomfort to the patient. Moreover, foreign patients often come to clinics in Israel with an initially incorrect diagnosis, resulting in ineffective treatment conducted in their home country. The high-precision modern equipment used for examinations in Israeli medical centers allows for the detection of tumors at the earliest stages of development, establishing their characteristics, and selecting the most effective therapeutic methods. Patient reviews indicate that the accessible cost of treatment corresponds well to its quality and is much lower than in many other countries.
Treatment Methods for the Disease
In the case of esthesioneuroblastoma, the development of the primary tumor, the spread of the malignant process to the paranasal sinuses, and then to the cranial cavity occurs very rapidly. After a short time, metastases are detected in the regional lymph nodes of the neck and lower jaw, in the lungs, liver, and bones. Considering the high rate of spread and the degree of aggressiveness of the pathology, oncologists strongly recommend starting therapy immediately after diagnosis. The treatment program is based on the results of examinations and includes methods that complement each other, significantly increasing effectiveness.
Surgical Treatment
The most effective method of therapy, considered the primary approach and necessarily prescribed to most patients. The types of surgical operations used to remove the tumor are selected based on the localization and some other characteristics of the oncological formation.
- Transnasal surgery — an endoscopic procedure prescribed at the early stages of the disease. This method of intervention is permissible if the tumor is clearly localized and small in size, located in the paranasal sinuses, and there is no spread of the malignant process to the structures of the base of the skull. The minimally invasive surgery is performed without incisions, using nasal passages to access the pathological focus with an endoscope and microsurgical instruments. The operating surgeon monitors the procedure on a monitor that displays images from the endoscope's video camera.
- Open surgery — unfortunately, due to the difficulties of early diagnosis of the pathology, most patients with esthesioneuroblastoma are diagnosed at advanced stages, when the large size of the oncological formation and involvement of brain structures make endoscopic minimally invasive intervention impossible. In such cases, neurosurgeons are forced to resort to open surgery to remove the neoplasm. Accurate determination of the location of the malignant neoplasm, control of the precision of manipulations, removal of the maximum volume of tumor tissues, and ensuring the safety of healthy tissues are performed using the KINEVO 900 robotic microscope. Additionally, the condition of the surgical field is fixed by the O-Arm neuronavigation system.
- Robotic surgery — leading Israeli clinics use Da Vinci robotic surgical systems for the operative removal of oncological formations. In this case, all manipulations are performed by a robotic surgeon, which is remotely controlled by a qualified surgical operator. This achieves exceptional precision of actions, unattainable by humans, eliminates mechanical errors, significantly reduces the duration of the intervention and the postoperative period.
Stereotactic Radiosurgery
When there are reasons that make surgical operation impossible, an alternative option is considered to be the removal of esthesioneuroblastoma using a stereotactic radiosurgery procedure, or CyberKnife surgery. Radioactive beams of low doses are directed from multiple sources at different angles to the oncological formation, focusing directly in front of it. The destructive effect on the tumor is due to the high cumulative dose, while the low radiation load of an individual beam is insufficient to cause significant harm to the healthy tissues through which it passes. Numerous studies and clinical practice confirm the high effectiveness of the procedure — in 2-3 sessions, esthesioneuroblastoma can significantly decrease or even completely disappear.
Radiotherapy
Since it has been proven that radiation of tumor tissues significantly increases their sensitivity to the action of cytostatic drugs, radiotherapy is most often prescribed in combination with chemotherapy. Radiation sessions are indicated before surgical intervention (neoadjuvant radiotherapy) to reduce the size of the tumor, facilitating its removal. After surgical treatment, radiation is performed to destroy any remaining cancer cells in the patient's body. In cases of inoperability and at terminal stages of the oncological disease, radiation therapy is prescribed as the primary and independent method of treatment.
Chemotherapy
Chemotherapy is necessarily indicated to slow the progression of the disease, the spread of the malignant process, and eliminate distant metastases. Like radiotherapy, it is prescribed before and after the surgical removal of the tumor. In Israeli clinics, chemotherapy courses are conducted using the latest generation of chemotherapeutic agents, which have low toxicity, do not cause the traditional side effects of chemotherapy, and are easily tolerated by patients.
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How the Disease is Diagnosed
Accurate early diagnosis of this type of oncopathology requires high professionalism and experience from doctors. In Israeli medical centers, the necessary diagnostic examination takes about three days.
After arriving at the clinic, the patient must visit the treating neurosurgeon-oncologist. During the appointment, the doctor reviews the patient's medical history and the results of previous examinations provided by the patient, listens to the patient's complaints, and clarifies the symptoms that are concerning them. After neurological and physical examinations, the specialist prescribes the necessary examinations.
The prescribed examinations include:
- Rhinoscopy — the primary method for diagnosing esthesioneuroblastoma, where examination of the nasal cavity using special mirrors can almost always reveal the tumor;
- Cytological examination of nasal discharge — conducted to detect malignant cells;
- Biopsy — sampling of pathological tissue for histological analysis to establish the histotype of the oncological formation;
- Visual methods (X-ray, CT, MRI) — examination of the nasopharynx and nasal sinuses aimed at identifying the oncological formation, accurately determining its size and localization. MRI can determine the involvement of distant organs in the malignant process and the presence of metastases in them.
A council, which includes the treating neurosurgeon and specialized experts, studies the results of the conducted examinations, makes a final diagnosis, and develops a treatment plan.
How Much Does Treatment Cost
To determine the final amount, doctors need to conduct the necessary examinations and prescribe treatment procedures. In any case, the cost of treatment in Israel allows patients to save approximately 30-50% compared to the prices set in Western European and American clinics of similar levels.
Advantages of Treatment in Israel
- Qualified doctors with extensive experience in treating such oncological diseases.
- Availability of modern equipment.
- Professional performance of endoscopic neurosurgical operations.
- Application of progressive treatment methods.
- Affordable prices.
With timely therapy using modern progressive methods and drugs, remission can be achieved in most cases. Therefore, without wasting time, contact the clinic and start treatment with leading oncologists as soon as possible.