Treatment of Tonsil Cancer in Israel

Reviews confirm that a full range of services is provided for international patients: rapid diagnosis, coordination of all stages of therapy, support throughout the stay, comfortable accommodation, and attention to organizational issues. The high qualifications of doctors with extensive experience in treating head and neck tumors, as well as reasonable service costs, make Israel one of the most sought-after destinations for medical tourism.

About the Disease

Tonsil cancer is the most common form of oropharyngeal cancer, but it is not diagnosed very often. Currently, the true causes of the malignant transformation of healthy cells are unknown, but recent studies have shown that the risk of developing tonsil cancer significantly increases with infection by the human papillomavirus (HPV).

Risk factors include:

• tobacco smoking (this applies not only to traditional cigarettes but also to electronic cigarettes);
• excessive alcohol consumption;
• weakened immune system (in patients with HIV, when taking immunosuppressants during organ transplantation).

Clinical signs of tonsil cancer may resemble symptoms of other, less serious ENT diseases, which is why an accurate diagnosis is often made only at an advanced stage of the pathology. A characteristic symptom is persistent throat pain and an enlarged tonsil, visibly larger than the other.

The most common symptoms include:

• ear and oral cavity pain;
• bad breath;
• blood in saliva;
• difficulties with swallowing, speech, and chewing;
• non-healing ulcers in the back of the mouth;
• enlargement of cervical lymph nodes (cervical lymphadenopathy).

Overall, tonsil cancer has a favorable prognosis, with more than 80% of patients achieving sustained long-term remission.

Treatment Methods for the Disease

The treatment program at the Ichilov clinic is tailored individually for each patient and includes minimally invasive surgeries, robotic surgery, radiation therapy, chemotherapy, and the latest medications. The therapeutic strategy depends on the size of the tumor, its stage of development, involvement of cervical lymph nodes in the malignant process, and the presence of HPV association.

One of the key components of anti-tumor therapy is the surgical removal of the affected tonsils. The main goal of surgical interventions is to maximize the removal of tumor tissues while preserving critical swallowing and speech functions for the patient. The Ichilov clinic professionally performs various types of minimally invasive surgeries, characterized by minimal risk of complications and a short, uncomplicated recovery period. Robotic surgical procedures are also frequently performed, during which all manipulations are carried out by a robotic surgeon.

Robotic Transoral Surgery (TORS)

This method of surgically removing tonsil cancer is the most advanced and gentle. At the Ichilov clinic, TORS is included in the anti-tumor therapy program as a standard of organ-preserving treatment in the early stages of the disease.

The method involves access to the affected tonsil through the mouth using the DaVinci robotic surgical system. With TORS, it is possible to successfully remove the tumor with minimal impact on surrounding tissues. This surgery also has the following advantages:

• high precision of manipulations;
• enhanced 3D imaging;
• micro-access that allows work in hard-to-reach areas of the throat;
• minimal invasiveness;
• rapid recovery;
• shorter hospitalization;
• reduced risk of speech and swallowing impairment.

Transoral Laser Microsurgery (TLM)

This organ-preserving endoscopic method of removing tonsil tumors through the mouth does not involve external incisions. It is widely used in Israeli clinics due to its high precision and good results.

For TLM, the following are required:

• surgical microscope or endoscope providing magnification of the surgical field;
• CO2 laser, acting as a surgical scalpel;
• special micro-surgical instruments for layer-by-layer removal of tumor tissues.

The CO2 laser emits light in the infrared range, which is well absorbed by cells. The laser beam simultaneously performs two actions: it precisely excises tissue and cauterizes damaged blood vessels, preventing bleeding. One of the advantages of laser surgeries is their low invasiveness, due to the minimal area of tissue damage around the beam.

Advantages of the method include:

• preservation of swallowing and speech functions;
• high precision;
• minimal blood loss due to the coagulating effect of the laser;
• rapid recovery;
• an alternative to extensive open interventions;
• the possibility of repetition in case of recurrence.

Open Surgery

Open surgical interventions are rarely performed. Indications for their execution include deeply infiltrating tumors of large size and the need for simultaneous removal of affected lymph nodes. During open surgical intervention, the following actions are performed:

• partial or complete removal of the affected tonsil (tonsillectomy);
• resection of adjacent tissues;
• reconstruction of the resulting defect with local or free flaps of soft tissues.

Lymphadenectomy

In tonsil cancer, cervical lymphadenectomy is performed—removal of lymph nodes involved in the malignant process and surrounding soft tissues of the neck that may contain cancer cells. The operation aims to remove metastases, reduce the risk of recurrence, and enhance the effectiveness of subsequent radiation or drug therapy.

Radiation Therapy

Radiation therapy (radiotherapy) is one of the main anti-tumor methods. In tonsil cancer, it is used alone or in combination with chemotherapy. These methods contribute to the destruction of tumor cells and the prevention of the spread of the malignant process while preserving the functions of swallowing, speech, and breathing.

At the Ichilov clinic, the treatment program for tonsil cancer includes irradiation using the modern IMRT (Intensity-Modulated Radiation Therapy) technique. The advantage of this method is the high precision of irradiation of the tumor focus with minimal impact on surrounding normal tissues. IMRT is also valued for its ability to safely irradiate complexly shaped neoplasms and metastatic foci in lymph nodes.

Stereotactic Radiotherapy

This method involves high-precision irradiation of the tumor focus with a high dose of radiation. It differs from classical radiotherapy in having fewer sessions and a higher dose of exposure. This approach leads to a pronounced cytotoxic effect in a short time.

The radiation is delivered simultaneously from several dozen directions. Each individual beam has a relatively low dose and minimally affects healthy tissues. As the beams approach the focus, they intersect, and their doses sum up, forming the maximum high dose that has a therapeutic effect.

Chemotherapy

This method is based on the destructive action on malignant cells of a number of anti-tumor drugs. In the case of tonsil cancer, it is usually used in combination with radiation therapy to enhance the effectiveness of irradiation. Chemotherapy is indicated for advanced and recurrent tumors. It is administered both before surgical treatment (to reduce the size of the neoplasm) and after the surgical removal of the neoplasm (to destroy remaining cancer cells).

At the Ichilov clinic, modern chemotherapeutic agents with low toxicity that do not cause severe side effects in patients are used.

Immunotherapy

This progressive anti-tumor method involves stimulating the patient's own immune system. The introduction of drugs based on specific monoclonal antibodies activates anti-tumor immunity, aiding in the recognition and destruction of malignant cells.

Targeted Therapy

This method is based on the precise recognition of malignant cells and the impact on specific molecules and signaling pathways that ensure their growth, division, and survival. Targeted drugs help to dismantle the camouflage, making cancer cells recognizable to immune cells. Healthy cells are not damaged, and the patient does not experience side effects.

Diagnostic Methods for the Disease

At the Ichilov clinic, a combination of advanced instrumental and laboratory methods allows for an accurate diagnosis, on average, within three days.

First Day

Upon arrival at the clinic, the patient is directed to a primary consultation with the treating oncologist. During the appointment, the doctor reviews the medical history, listens to complaints, conducts a superficial examination, and orders additional tests.

Second Day

Undergoing examinations:

• ENT examination using a fiberendoscope;

• video laryngoscopy;

• biopsy with subsequent histological analysis of the obtained tumor tissues;

• imaging studies (CT, PET-CT, MRI);

• ultrasound of lymph nodes;

• Molecular and immunohistochemical analysis to identify HPV-positive tumors and select effective targeted drugs.

Third Day

The medical council reviews the obtained results, collectively establishes the final diagnosis, and formulates a therapy program.

How Much Does Treatment Cost

Advantages of Treatment in Israel

• Professionalism and experience of doctors.
• Advanced methods of anti-tumor therapy.
• Equipped clinics with the latest technology.
• Individualized program development.
• Affordable prices.

International patients can have an online consultation with an Israeli specialist without leaving home. To do this, they should contact the clinic consultant, request a consultation, and at the agreed time connect with the doctor. The doctor answers the questions posed, evaluates the ongoing treatment, and recommends further actions.