The Endocrinology Department of Ichilov is a leader in its field in Israel and performs a wide range of diagnostic and therapeutic procedures for patients suffering from endocrine diseases, including adrenal tumours. The surgeons on the team have received specialized training in this field, have extensive experience, and perform hundreds of surgeries annually.
Interdisciplinary collaboration and a comprehensive approach are practiced at the clinic. The department's team works closely with experts from other departments, including oncology, metabolic, and imaging departments, making decisions and providing assistance to patients to achieve optimal outcomes. Reviews of treatment at the clinic can be found in the relevant section of the website.
Treatment Methods for Corticosteroidoma
Treatment of corticosteroidoma involves both conservative and surgical methods; for oncological forms, chemotherapy is also indicated for patients.
Active Monitoring and Control
Adrenal neoplasms smaller than 4 cm that are non-functioning, meaning they do not produce hormones and do not raise any suspicion of cancer in imaging methods, are usually included in the monitoring protocol. Monitoring is conducted at regular intervals (6-12 months) using routine blood tests, urine tests, hormone levels, and imaging methods.
Hormone Replacement Therapy
Hormone therapy allows for the regulation of hormone production and is used before surgery or if the patient is not a candidate for surgery. This is usually a treatment course lasting several weeks.
Surgery
Adrenal tumours that are functional, meaning they cause significant complaints due to excessive hormone production or are larger than 4 cm, are surgically removed. This protects against serious long-term health problems such as uncontrolled high blood pressure, heart attack, weight gain, diabetes, and kidney issues. Since adrenal neoplasms larger than 4 cm are highly likely to be cancerous, surgical treatment is still required regardless of whether they are functioning or not. Surgery either removes only the entire mass of the adrenal gland or removes the entire adrenal gland along with the mass. Complete adrenalectomy is usually preferred for malignant adrenal tumours and in cases where cancer from other parts of the body has spread to the adrenal glands. Complete removal of one adrenal gland usually does not cause cancellation if the function of the other adrenal gland is normal. In all other cases, partial removal of the adrenal gland is preferred. The operation is performed using either an open or minimally invasive laparoscopic (closed) method.
Minimally Invasive Technique
Laparoscopic methods, especially robotic surgery, are more preferred in adrenal surgery. When technological capabilities are available, robotic adrenalectomy provides better visualization of the tumour and technically more precise exploration. Adrenalectomy with classical laparoscopic and robotic intervention ensures faster recovery and shorter hospital stays compared to open surgery.
Open Surgery
Open surgery is preferred if there is no technological infrastructure or if there has been a history of previous surgeries on abdominal organs. It may still use open surgery to remove diffuse adrenal tumours of large volume.
Chemotherapy
Chemotherapy may be prescribed after surgical intervention for confirmed cancerous forms of the tumour. The Ichilov clinic uses modern chemotherapeutic agents that effectively destroy cancer cells, with minimal side effects associated with these medications.
- Chemotherapy
Diagnostic Methods for the Disease
For the diagnosis of adrenal tumours, advanced technologies are typically utilized. Medical history, systematic medical examination, and measurements of blood pressure and body (weight, height, etc.), routine laboratory tests, hormone levels, and some complex hormone level measurements determine if there is an elevated hormone level and deviations from normal through imaging tests such as CT, MRI, and whole-body PET, where a tumour is detected. Diagnosis at the clinic is conducted in a compressed timeframe, averaging three days.
On this day, the attending physician examines the patient, reviews their medical history, collects a complete medical history, and orders the necessary diagnostic tests to establish a diagnosis and rule out other pathologies in the patient.
Possible types of laboratory tests:
- Blood and urine tests: some simple and complex hormone level measurements that may be caused by adrenal tumours are used. In some cases, a 24-hour urine collection and measurement of hormone waste from the adrenal glands excreted with this urine may be required. In these laboratory tests, levels of potassium, sodium, and renin in the blood are important for diagnosing aldosteronoma. Measurement of cortisol levels, one of the adrenal hormones, is crucial for diagnosis, and high cortisol levels may indicate Cushing's syndrome. Dopamine, norepinephrine, and epinephrine are measured in the blood, and the waste of these hormones (metanephrine) is determined in urine, with high levels potentially indicating pheochromocytoma.
- A biopsy may help confirm the diagnosis if necessary.
Imaging methods:
- Ultrasound: tumours larger than 1 cm can be detected with a standard ultrasound examination; this is a very simple and inexpensive method accepted as a diagnostic tool.
- CT (computed tomography): tomography using contrast material can provide clear visualization of adrenal tumours.
- Magnetic Resonance Imaging (MRI): this imaging method provides insight into the structure of the mass. This is important in terms of demonstrating the extent of this tumour in adrenal cancer. This method uses radio waves. Again, contrast material is used.
- PET scan: this radioisotope nuclear medicine study is important for cancer diagnosis, showing us whether the adrenal tumour is cancerous or not, whether it has metastasized, or if another known cancer has spread to the adrenal glands. It also provides insight into how intense and active the cancer is.
Once the examination results are ready, a medical council is convened. A collegial approach to diagnosis and treatment method selection helps improve the overall prognosis.
How Much Does Treatment Cost in Israel
The cost of treatment is calculated individually and depends on the complexity of the case. The final price is announced after the therapeutic plan is approved. The preliminary cost is discussed before arriving at the clinic. Call our International Department for a consultation regarding prices. A medical consultant will ask you a series of questions and send you the current price list for possible procedures.
Reasons Why Patients Choose Ichilov
- Ichilov Clinic is a multidisciplinary medical institution with an impeccable reputation.
- The clinic's doctors are recognized experts at both national and international levels.
- Medical equipment – the clinic is equipped with modern therapeutic and diagnostic equipment that enhances the effectiveness of the therapeutic process.
- Affordability – the cost of treatment at Ichilov is often lower than in other medical institutions in Israel and high-class foreign clinics.
- First-class support services – patients are provided with translator services, personal companions, and psychologists.
If you or your loved ones have signs of the disease and wish to consult an Israeli doctor, please contact us in any convenient way. A medical consultant will help organize direct communication with the necessary specialist.