Professor Tzvi Ramleading neurosurgeon
The increasing popularity of Israel among medical tourists each year is explained not only by the clinics being equipped with modern facilities and comfortable conditions for diagnosis and treatment. Israeli doctors are recognized worldwide, regularly exchanging experiences with specialists from other countries, and possess immense experience in treating rare diseases, including ganglioneuroblastoma. This malignant neurogenic neoplasm is most often diagnosed in children under ten years of age, accounting for approximately 45% of oncological pathologies of the sympathetic nervous system on average. Treatment of ganglioneuroblastoma in Israel includes a comprehensive set of progressive methods, including professional execution of neurosurgical interventions. Israeli surgeons utilize all possibilities for performing minimally invasive surgeries, which are easily tolerated by young patients.
To select effective treatment methods capable of normalizing the patient's condition and ensuring a favorable prognosis, timely comprehensive diagnostics is required. The latest equipment presented in Israeli clinics allows for obtaining the most accurate information, describing the characteristic signs of neoplasms even of the smallest size. Reviews from relatives of children who underwent treatment in Israel confirm that comfortable conditions for children are created in the clinics, and effective treatment is conducted using methods that are safe for the developing child's body. An important factor is also the cost, which is accessible for medical tourists and significantly lower than in the USA and Western Europe.
Treatment Methods for the Disease
Ganglioneuroblastoma is a transitional stage between benign ganglioneuroma and the highly aggressive malignant neuroblastoma. Despite numerous studies, the exact causes of the disease remain unclear. Since the likelihood of malignant transformation of ganglioneuroblastoma into neuroblastoma is quite high, timely diagnosis and adequate treatment of the pathology at an early stage are necessary.
The characteristic symptoms of the disease vary depending on the location of the neoplasm. Typically, the oncological formation is found in the brain, mediastinum, or retroperitoneal space. When the brain is involved in the pathological process, the patient complains of dysfunctions for which the affected areas are responsible; when a tumour develops in the mediastinum, cough and difficulty breathing are noted. If the neoplasm is localized in the retroperitoneal space, pronounced clinical signs do not manifest, except for disturbances in bowel function (usually diarrhea), a feeling of heaviness in the abdomen, and in some cases, intestinal obstruction.
This type of oncopathology is characterized by an increase in catecholamine levels, which externally manifests as symptoms that are almost always observed in the advanced stages of ganglioneuroblastoma. These include facial flushing, increased heart rate (tachycardia), sweating, fever, elevated blood pressure, and noticeable weight loss up to anorexia.
The necessity for prompt treatment is also due to the fact that ganglioneuroblastoma rapidly develops distant metastatic foci. In cases where the primary tumour develops in the brain, metastases are diagnosed in the nerve fibers; if the oncological formation arises outside the brain — in the lymph nodes, bones, and liver.
The comprehensive treatment program necessarily includes surgical removal of the neoplasm, and the method of surgical intervention is chosen based on the location and size of the neoplasm.
Surgical Treatment
In Israel, the treatment of oncological diseases involves a multidisciplinary approach, where the types and scope of treatment procedures are determined by a medical council. In the case of ganglioneuroblastoma, if the neoplasm is localized in the brain, its surgical removal is performed by a team of neurosurgeons; in the retroperitoneum and mediastinum — by abdominal and thoracic surgeons.
If an accurate diagnosis was made at the initial stage of the disease, provided the neoplasm is small and there is no spread of the pathological process to surrounding tissues, radical removal of the tumour is permitted. However, in most cases, ganglioneuroblastoma is detected at a late stage when the oncological formation has reached large sizes and pathological changes in healthy tissues are noted. In such patients, the neoplasm is removed along with a fragment of adipose tissue and regional lymph nodes. If the patient exhibits pronounced painful symptoms caused by compression of adjacent organs by a significant-sized neoplasm, and there are contraindications to the removal of the entire volume of the tumour, palliative or partial resection is recommended.
During the surgical intervention, the patient is under general anesthesia; after the procedure, they initially remain in the intensive care unit. If the condition is satisfactory and there are no postoperative complications, the patient is transferred to the postoperative ward.
Other Therapy Methods
A significant increase in treatment effectiveness is achieved through the combination of several methods, particularly the administration of a course of adjuvant (postoperative) chemotherapy. Under the action of chemotherapeutic agents, individual pathological cells that remain in the patient's body after the surgical removal of the oncological formation are destroyed. This significantly helps to prevent the development of recurrence. Patients over ten years of age may be prescribed sessions of radiotherapy.
For severely ill patients diagnosed with terminal stage ganglioneuroblastoma, surgical removal of the neoplasm is combined with high-dose chemotherapy and subsequent bone marrow transplantation. This procedure helps restore the suppressed hematopoietic function.
How the Diagnosis of the Disease is Conducted
A comprehensive diagnostic examination necessary for identifying the pathology and selecting the most effective treatment methods takes, on average, no more than three days in Israeli clinics.
First Day
During the initial consultation, the treating oncologist reviews the patient's medical history, studies the available results of previous examinations, and clarifies complaints. After conducting a physical examination, the specialist prescribes the necessary tests.
Second Day
Completion of the prescribed examinations, including:
- general and biochemical blood and urine tests — to confirm the diagnosis, the level of catecholamines (prostaglandins, dopamine, norepinephrine) in the blood is determined;
- visual methods of investigation (X-ray, CT, MRI) — these methods can identify the oncological formation, accurately determine its location, size, and structure, diagnose distant metastases, and assess the condition of surrounding tissues and organs;
- liver ultrasound — indicated for examining the organ and diagnosing the presence of metastatic foci;
- biopsy of lymph nodes or liver — in cases of enlarged painful lymph nodes and liver function disturbances, samples of pathological tissues are obtained through puncture and sent to the laboratory for histological analysis;
- bone scintigraphy — this radiological examination identifies metastases in bone tissue.
Third Day
A medical council, consisting of the treating physician and several narrow-profile specialists, reviews the results of the conducted examinations, makes a final diagnosis, and develops a treatment program.
How Much Does Treatment of the Disease Cost
The final amount depends on the size, location, stage of development of the pathology, and several other factors, and is determined after the patient undergoes examination and the appointment of treatment procedures. In general, the cost of treatment in Israeli clinics is 30-50% lower than in medical centers of the same level in Western Europe and the USA.
Advantages of Treatment in Israel
- High qualifications and many years of experience of doctors.
- Availability of high-tech medical and diagnostic equipment in clinics.
- Application of a comprehensive treatment program that includes modern methods.
- Comfortable conditions for undergoing diagnostics and treatment.
- Affordable prices.
In the case of oncological diseases, recovery of health is possible with the prompt initiation of treatment. Therefore, do not waste time, contact the chosen clinic, and start treatment with high-class specialists.