Professor Michal LuntzHead of the Department of Ear Surgery and Rehabilitation and Hearing Pathologies
Israel today is the most developed country in terms of medical tourism. This rapid development of medicine in Israel, particularly medical tourism, can be explained very simply: financial investments from the state budget, high-class doctors, whose skills and virtuosity are legendary, and clinics equipped with the latest advancements in science and technology. These are the three proverbial pillars on which the country's healthcare system firmly stands.
In Israel, even the rarest and most complex diseases are diagnosed and treated.
The level of medical care here is high, and the prices for treatment are lower than in Europe and the USA. In addition, various discount and benefit programs often operate for patients from the CIS who have been diagnosed with severe oncological diseases requiring expensive treatment.
Chemodectoma is Treatable in Israel
The numerous advantages of Israeli medicine attract a huge number of patients from other countries every year, who come to Israel seeking a miracle: at home, they were refused treatment due to the incurability of the disease or could not receive a correct diagnosis.
Doctors at Top Ichilov often face the problem of misdiagnosis, especially concerning such a rare oncological disease as chemodectoma.
- Embolization. Embolization is used to treat chemodectoma. This modern method helps to reduce the tumour and decrease bleeding, significantly simplifying surgical removal.
- Surgical treatment. Even malignant chemodectomas are poorly responsive to chemotherapy. The only effective method of therapy is surgery. The operation to remove chemodectoma, whether benign or malignant, should only be performed by a highly skilled surgeon with refined expertise. Since chemodectoma is located very close to the vessels and nerve endings of the neck, it must be operated on very carefully, skillfully separating the chemodectoma from the nerves and vessels in the area of the carotid artery. If the chemodectoma is benign, the neck vessels are not ligated. In the case of malignant chemodectoma, it is often necessary to perform vessel resection with subsequent plastic reconstruction. Such a complex operation can only be performed by a team of professional doctors, including a highly qualified vascular surgeon. To reduce bleeding during surgery, embolization of the chemodectoma is performed, meaning substances that provoke blockage of the vessels supplying blood to the neoplasm are introduced into the tumour's vessels. During the surgical intervention, it is necessary to monitor the condition of the patient's vessels, and in the postoperative period, to observe the patient's condition, as complications such as stroke or bleeding may arise. In the distant postoperative period, complications develop quite rarely.
- Radiation therapy. Radiation is performed only if surgery is impossible, for example, for life-threatening indications. The latest generation linear accelerators – Novalis and TrueBeam – are used for radiation therapy. A high-focus beam is precisely directed at the area of chemodectoma localization. The navigation system installed on the accelerators, which is a completely new technology for medicine, allows for very precise adjustments even for the respiratory movements of the body and changes in the shape of the tumour. The probability of cure with radiation therapy is 90% or higher.
Other Cancer Treatment Methods
- Radiation therapy
- Radiosurgery methods in Israel
- Chemotherapy
Chemodectoma in Israel: High Diagnostic Accuracy at Top Ichilov
Chemodectoma is very difficult to diagnose, especially challenging to differentiate it from neuroma or metastases from other cancer locations. To recognize chemodectoma, one must possess exceptional knowledge and experience, as well as access to the latest diagnostic equipment. For the surgery to be successful, the doctor must clearly establish the localization of the tumour, its size, shape, and degree of adhesion to the nerves and vessels. In Israel, such diagnostics take 3 days – this time is sufficient for the highly qualified specialists at Top Ichilov.
Day One – Doctor's Examination
On the first day of the patient's stay at the clinic, they are seen by a leading diagnostic physician. The specialist conducts a general examination of the patient to determine their overall condition, studies the medical history and the results of tests and studies brought along. The doctor then orders the necessary examinations and issues referrals for tests.
Day Two – Diagnostic Studies and Tests
- Laboratory tests. A urine test shows a high level of catecholamines, indicating the hormonal activity of the chemodectoma.
- Angiography of the neck vessels. In CT or MRI studies, the vessels are poorly visualized. Therefore, the latest method – angiographic study with contrast material – is used to assess their condition. This method allows for the detection of any deformities, dysfunctions, or tumours in the vessels. Angiography can be used to study any vessels in the body – small capillaries and large vessels, vessels of the heart and brain, upper and lower extremities. In our case, it involves studying the condition of the carotid artery, one of the largest vessels in the body. The data from angiography is processed using computer technologies and reproduced as a three-dimensional image on X-ray or MRI scans. The technique involves inserting a vascular catheter through the femoral vein, through which contrast material is injected, and images are taken.
- Ultrasound of the neck vessels allows for the identification of the section of the carotid artery located close to the tumour, the tumour itself, its exact location, and to assess the condition of the neck vessels and the presence of various dysfunctions and deformities within them.
- CT, MRI, PET-CT. These methods are highly informative for diagnosing oncological diseases and vascular pathologies. These studies provide volumetric images that allow for the detection of the slightest changes in the structure of internal organs and vessels, as well as to study the structure of internal organs and pathological neoplasms layer by layer. Since chemodectoma is localized in a very dangerous area – adjacent to the carotid artery, it is essential to carefully study its location, shape, and degree of adhesion to the vessel before performing surgery.
- Biopsy with subsequent cytological examination. A biopsy allows for distinguishing a malignant tumour from a benign neoplasm, as well as determining the type of oncological disease, the degree of malignancy, and the stage of development. Material is taken using a needle by aspiration (fine-needle aspiration biopsy) and sent for cytological examination to study the cells contained in the aspirate. Studying the morphology of the cells helps to accurately determine the type of tumour and choose the correct and adequate treatment, as different tumours with varying cellular structures respond differently to therapy.
Day Three – Expert Group Conclusions
On the third day, after receiving the results of all examinations and tests, an expert group is assembled, consisting of an oncologist, radiologist, and vascular surgeon. The doctors collectively make a decision on the individual treatment program for the patient with chemodectoma.
- Biopsy and histological studies
Chemodectoma – A Deceptive and Cunning Disease
What is chemodectoma and why is it so dangerous? The fact is that chemodectoma is located in the neck area – at the bifurcation of the carotid artery. Chemodectoma arises from specific tissue localized in the area of the carotid sinus (sinus of the carotid artery) – from the carotid glomus, or body. Its close proximity to such an important vessel as the carotid artery significantly complicates surgical treatment and requires unparalleled skill from the surgeon when excising the chemodectoma.
Chemodectoma is a rather rare tumour that is poorly understood. According to a study of 700 patients with this tumour, it was found that chemodectoma more frequently affects women aged 20 to 50 years, with malignant chemodectomas detected in only 15-20% of cases. Patients' complaints typically include the appearance of a firm nodule on the neck, headaches, dizziness, and loss of consciousness when pressure is applied to the tumour.
Chemodectoma differs from other tumours in that it can be displaced horizontally but cannot be displaced vertically. Additionally, upon palpation, the tumour cannot be separated from the carotid artery, and the pulsation of the artery is transmitted to the chemodectoma. Rapid growth, invasion into adjacent tissues, and the presence of metastases indicate the malignancy of the chemodectoma.
Chemodectoma: Treatment Only in Israel
- At the Israeli clinic Top Ichilov, the study and treatment of chemodectoma are conducted only by doctors of the highest qualification with extensive experience in performing surgical interventions on vessels. Doctors in Israel undergo internships at the best clinics in the world and rightfully bear the title of professors and world luminaries, as they have proven their high skill in practice.
- To accurately establish the diagnosis of such a rare disease as chemodectoma, innovative equipment must be utilized alongside experience and skills. It would be impossible to accurately diagnose chemodectoma without the latest methods and technologies such as positron emission tomography with CT, angiography, and biopsy, which are performed on the most modern equipment of the latest models. Modern linear accelerators allow for targeted radiation of the tumour without harming healthy tissues and the body as a whole.
- The priority method for treating oncological diseases in Israel is medication therapy with ultra-modern drugs. However, in this case, for the treatment of chemodectoma, medication treatment is ineffective.
- The only effective method for treating chemodectoma remains surgery – a highly complex intervention. The surgical intervention is performed by the most experienced surgeon, skillfully excising the tumour while preserving the integrity of the carotid artery or reconstructing it after the removal of the neoplasm.
- Chemodectoma: price in Israel. The cost of treating chemodectoma in Israel is much lower than in Germany or the USA – by 30-50%, respectively. At Top Ichilov, there is no prepayment; patients are offered to pay for medical services after receiving them. Additionally, thanks to the individual approach that underlies the therapeutic and diagnostic process in Israel, patients only pay for the procedures that are necessary in their case. Moreover, at Top Ichilov, discount and benefit programs are periodically available for patients from the CIS who require expensive examinations and treatments.
- To ensure that foreign patients feel comfortable in a foreign country, they are cared for by staff from the International Department. These are certified medical specialists who act as translators, guides, and accompany patients everywhere from the moment they arrive in the country until their discharge from the clinic. They handle all patient issues that arise during the diagnostic and treatment process and also organize postoperative care and monitoring.
- Medical errors in Israel are unacceptable and intolerable; doctors highly value their reputation and that of their clinic. The Association of Medical Tourism oversees the provision of high-level and high-quality medical services and strictly punishes healthcare facilities and doctors for negligence in their work. The Top Ichilov Clinic holds a certificate from the Association, which guarantees the provision of medical services at the highest level.