Various forms of duodenal cancer often can be asymptomatic and lack specific markers for early diagnosis. The disease is frequently discovered during a routine examination by a gastroenterologist – about 70% of patients had previously been under observation for duodenal ulcer disease. However, there is no need to lose hope – this type of neoplasm has a relatively mild course, and specialists at Top Ichilov use non-surgical treatment methods in more than 42% of cases. The secret to success lies in the application of the latest advancements in pharmacology and radiotherapy. The use of diagnostic panels allows for the selection of a drug to which the tumor cells are sensitive.
Interstitial radiotherapy enables targeted irradiation within the pathological focus, without affecting healthy tissues. Effectiveness, safety, and results – this is why you should trust the specialists at Top Ichilov.
Methods of Treating Duodenal Cancer in Israel
Effective treatment of duodenal cancer in Israel, whose reviews speak for themselves, is conducted only according to individually developed protocols. After determining the cellular composition of the neoplasm, the following treatment methods are available to the patient:
Chemotherapy
- Intra-arterial administration of drugs: due to the rich arterial network in the area of the duodenum, intra-arterial administration of chemotherapeutic agents through a long-term port system is effective. The advantage of the method is the absorption of a larger portion of the drug by the tumor and practically insignificant transformation of the active substance in the liver. It is often used to reduce tumor size in cases of bile and pancreatic duct compression syndrome.
- Administration via a venous catheter: the standard chemotherapy regimen, most commonly used for non-invasive tumor growth. Through intravenous infusion (controlled administration via an infusion pump), a combination of platinum drugs, cytostatics, and mitosis blockers is administered.
Radiation Therapy
- Stereotactic radiation therapy: the Top Ichilov clinic is equipped with the latest technology, which eliminates the possibility of radiation burns to surrounding tissues. The True Beam STx linear accelerator used has a laser navigation system. Its presence eliminates the possibility of displacement of the radiation beam from the intended target. Before the session, the radiologists at Top Ichilov perform a control scan, allowing for the creation of a three-dimensional model of the tumor and tracking its movement amplitude depending on the act of breathing. Now, the patient does not need to hold their breath during the procedure, which adds comfort to this important stage of treatment.
- Interstitial brachytherapy: a small capsule containing a supply of radioisotopes is implanted into the tumor or adjacent tissues using an endoscope. As the isotopes decay, they release ionizing radiation, which is maximally absorbed by the tumor cells (contact method). As a result, the maximum therapeutic effect is concentrated in the pathological focus, without affecting surrounding tissues and organs.
Surgical Treatment
- Radio-surgical intervention using a CyberKnife: a new technique successfully applied by surgeons at the Top Ichilov clinic. The operation is based on a combination of surgical excision of the malignant area and simultaneous sterilization of the surgical field with high-dose ionizing radiation. The robotic navigation system of the CyberKnife allows for precise removal (up to 0.5 mm) of even deeply infiltrating tumors, while the radiation destroys even single cancer cells hiding within the tissues.
- Laparoscopic removal of the focus: used in cases of polypoid neoplasm or pronounced compression syndrome of the bile duct and pancreas. With the video recording system, it is possible not only to delicately remove the tumor but also to simultaneously assess the surrounding tissues and lymph node packets. The advantage of the method is its minimally invasive nature – after the operation, three small holes remain, healing naturally.
- Combined operation according to Billroth: applicable when the focus is represented by an ulcer defect and its length exceeds 20% of the surface area of the intestine itself. A combined operation is performed, during which part of the intestine is removed, and an end-to-end or “Y” shaped anastomosis is created. The operation for duodenal cancer – in Israel, the Billroth operation has excellent patient reviews.
- Whipple procedure: if duodenal cancer invades the head of the pancreas – a pancreaticoduodenectomy is performed. Part of the pancreas is removed, and its duct is brought out and fixed in the formed anastomosis with the ileum.
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Duodenal Cancer: Diagnosis in Israel
The diagnostic process begins with an examination by the chosen specialist. Collecting the medical history, ordering various tests, examinations, and making a 100% accurate diagnosis at Top Ichilov takes no more than three days. It is important to note that if the patient wishes to hear a “second opinion” on their diagnosis, this type of consultation is available even without coming to Israel. By simply describing their problem to a consultant on the official Top Ichilov website and providing copies of existing medical reports, the patient will have the opportunity to quickly connect via Skype with a Top Ichilov specialist. The video consultation is conducted at a convenient time, the doctor thoroughly answers the questions posed and provides an expert assessment of the existing diagnosis. If the patient later decides to undergo treatment at Top Ichilov – the first in-person consultation with the supervising physician will be completely free.
First Day – Consultation
During the conversation with the patient, the doctor collects the life history (bad habits, previously existing gastrointestinal diseases), asks about the initial complaints and the nature of the disease's course. Then, a list of necessary studies is compiled, many of which can be conducted on the same day.
Second Day – Conducting Studies
Laboratory Diagnostics
- General studies (blood, urine, duodenal contents)
- Determination of gastrin and somatostatin levels in the blood
- Blood biochemistry
- Biochemical study of tumor secretions (mucus, detritus)
- Histological examination of the tumor structure
Instrumental Diagnostics
- Esophagogastroduodenoscopy with biopsy
- Tomography with contrast
- Ultrasound of the liver and retroperitoneal space
- PET-CT
- ECG
Third Day – Diagnosis Announcement
After receiving the study results, a commission of three specialists announces the diagnosis and suggests possible treatment tactics. During the consultation, a Russian-speaking attendant with a medical background provides simultaneous translation of the medical conclusion. The patient can actively participate in the discussion, asking questions about the diagnosis, treatment, and rehabilitation.
Treatment of Duodenal Cancer in Israel: Cost
Despite the high level of technical equipment, the total cost of treating duodenal cancer in Israel is 30-50% lower compared to clinics of similar level in Europe, Canada, and the USA. By contacting Top Ichilov, the patient receives not only a high level of medical care but can also be fully assured of the absence of shadow payments: all prices for treatment at Top Ichilov are controlled by the Ministry of Health of Israel.
Advantages of Duodenal Cancer Treatment in Israel
- The latest laboratory equipment, helping to conduct 100% accurate diagnostics in the shortest possible time.
- Determination of the degree of radiosensitivity and the level of absorption of chemotherapeutic agents by the patient's tumor cell culture. As a result, an individual treatment scheme with maximum effectiveness can be developed.
- The application of advancements in pharmacology and radiology in more than 42% of cases makes it possible to treat without surgery.
- The cost of treating duodenal cancer in Israelis approximately half of that in clinics of similar level in the USA, Europe, and Canada.
- A personal Russian-speaking attendant who handles all arising everyday and organizational issues.