Nasal Cancer Treatment in Israel

Doctor Orit Gotfeld

head of the head and neck department of the oncology institute

Thanks to a combination of scientific research, clinical experience, and technological infrastructure, Israel has become one of the key locations for head and neck cancer therapy. Nasal cancer treatment in Israel is conducted through a comprehensive individualized program that includes advanced surgical and conservative methods. Israeli oncologists perform precise tumor verification, analyze its molecular markers, determine the anatomical features of the nasal cavity and sinuses, and predict the behavior of the neoplasm. Thus, with early-stage tumor diagnosis and comprehensive anti-tumor therapy, a positive prognosis is often reported.

>80%

of patients choose an online consultation with an Israeli expert even before arriving at the clinic

>30%

of patients received innovative treatments unavailable in local clinics

2384

patients have utilized comprehensive medical services

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Table of Contents

Treatment Methods

Diagnosis

Prices

Israeli clinics also have a well-structured organization of the treatment process. The patient undergoes a comprehensive examination within a few days, with a multidisciplinary medical commission responsible for diagnosing and developing a therapy program, allowing for the determination of the optimal strategy. Feedback indicates that comfortable treatment conditions, assistance from the clinic in resolving organizational issues, and reasonable costs are very important for international patients.

About the Disease

Nasal cancer refers to malignant neoplasms that arise in the nasal cavity or paranasal sinuses. The disease is relatively rare, and its timely diagnosis is complicated by the fact that the initial symptoms resemble those of common ENT inflammation. The tumor can form from different types of cells – glandular, squamous, neuroendocrine – and the characteristics of each type vary.

The peculiarity of nasal cancer is that the tumor develops in an anatomically complex area where vital structures that ensure breathing, vision, and smell are located. Therefore, even minor changes require precise assessment.

There is no single exact cause for the occurrence of malignant neoplasms in the nose, as is the case with most cancers. It has been proven that various types of mutations occurring in the cells of the nasal mucosa and sinuses act as triggering mechanisms. Known factors significantly increasing the risk of developing the disease include:

• occupational hazards (wood dust, leather, textile dust, flour production waste, chemical solvents);
• chronic inflammatory processes (rhinosinusitis, septal deviation, polyposis);
• infection with the human papillomavirus;
• smoking.

In the early stages, the disease successfully masquerades as common ENT pathologies. For this reason, the diagnosis is often made late, when symptoms become pronounced and the malignant process spreads throughout the body.

The most characteristic clinical signs include:

• persistent nasal congestion, difficulty breathing;
• discharge from one nostril (often with blood);
• headaches;
• reduced or lost sense of smell;
• sensation of pressure in the area of the paranasal sinuses;
• recurrent nosebleeds;
• pain in the area of the eye socket and upper jaw;
• constant tearing;
• swelling of the eyelid or cheek;
• sensation of a foreign body in the nose.

In the late stages of the disease, the following symptoms may manifest:

• vision impairment (double vision, decreased sharpness);
• change in the shape of the nose;
• enlargement of cervical lymph nodes;
• difficulties in opening the mouth.

Treatment Methods for the Disease

At Ichilov Clinic, a multi-level, personalized approach is used for treating tumors of the nose and paranasal sinuses. Thanks to an effective combination of methods, excellent results can be achieved even in advanced stages of therapy and in clinically complex cases.

Surgical Treatment

The primary therapeutic method remains surgical removal of the tumor. The type of surgery and the extent of resected tissues depend on the location and stage of the neoplasm. In cases where the tumor is detected on one side of the nasal cavity, partial rhinosectomy may be permissible. If the tumor focus is located in the nasal septum, as well as in cases of significant tumor size, a decision may be made for complete rhinosectomy, i.e., removal of all tissues of the nasal cavity. Often, surgical intervention is not possible when the tumor grows and malignant cells spread.

Key features of surgery at Ichilov Clinic include:

• endoscopic endonasal surgery – a standard method that allows for tumor removal through natural pathways, without external incisions, using HD endoscopes and 3D visualization systems, characterized by effectiveness and minimal trauma;
• extended endoscopic access – often performed even in cases where traditional open surgeries are conducted (when the eye socket and base of the skull are involved in the pathological process);
• combined access – a combination of endoscopy and microsurgery allows for tumor removal even in hard-to-reach places with maximum preservation of healthy tissues;
• reconstructive surgery – to eliminate cosmetic defects that arise, a reconstructive plastic surgery is performed using the patient's own tissues and 3D-printed implants within the same intervention.

Radiation Therapy

Radiotherapy sessions are usually part of a comprehensive anti-tumor program but may replace surgical intervention in the early stages of the disease. Typically, radiation therapy is conducted after surgery (neoadjuvant radiotherapy) to destroy any remaining viable cancer cells post-intervention. If, for any reason, surgical treatment is not possible, therapy begins with simultaneous chemotherapy and radiation.

At Ichilov Clinic, IMRT – intensity-modulated radiation therapy is most commonly used, allowing for the adjustment of the dose and direction of the radioactive beam. The primary impact is on the pathological focus, with minimal involvement of surrounding healthy tissues. Sessions are conducted on modern linear accelerators capable of operating in various modes.

Chemotherapy

At Ichilov Clinic, chemotherapy drugs are selected after histological analysis of tumor tissues and molecular-genetic analysis.

Chemotherapy can be of two types:

• neoadjuvant – prescribed before surgery to reduce tumor size and facilitate future resection and alleviate painful symptoms;
• adjuvant – conducted after surgical removal of the neoplasm to destroy remaining malignant cells.

Israeli clinics use low-toxicity, next-generation chemotherapy drugs that have the least impact on the weakened patient’s body and do not cause severe side effects. To enhance the therapeutic effect, a combination of several chemotherapy drugs (polychemotherapy) is used. Schemes with dose modification based on the patient's genetic characteristics are also employed, for which pharmacogenetic testing is conducted.

Targeted and Immunotherapy

The extensive molecular-genetic diagnostics of the tumor conducted in Israel allows for the identification of targets for:

• targeted drugs that block growth receptors or vascular factors – proteins without which the growth and division of malignant cells are impossible;
• immune drugs that help the patient's own anti-tumor immunity find and destroy cancer cells.

These methods are used in the late stages of the disease, when other treatment methods are ineffective, as part of comprehensive programs for localized tumors with a high risk of recurrence.

Diagnostic Methods for the Disease

The high qualifications of specialists and modern equipment at Ichilov Clinic allow for diagnostic examinations to be conducted within three days, determining the correct diagnosis.

First Day

On the first day of their stay at the clinic, the patient must attend a primary consultation with the treating oncologist. During the appointment, the doctor reviews medical documentation, familiarizes themselves with complaints, conducts a superficial examination, and prescribes additional examinations.

Second Day

Undergoing examinations:

• endoscopic examination of the nasal cavity;
• CT of the paranasal sinuses and base of the skull;
• MRI of the brain, sinuses, and neck;
• biopsy (obtaining a sample of tumor tissues for cytological and immunohistochemical analysis);
• determination of the molecular-genetic profile of the tumor (NGS diagnostics);
• laboratory blood tests (general and biochemical analyses, detection of tumor markers, immunological tests, analysis for certain viral infections).

Third Day

The medical council reviews the obtained results, based on which the diagnosis is determined and effective anti-tumor methods are selected.

How Much Does Treatment Cost

Advantages of Treatment in Israel

• High level of physician training.
• Clinics equipped with modern technology.
• Use of the latest medications and advanced diagnostic and therapeutic methods.
• Comfortable conditions.
• Reasonable prices.

International patients can undergo an online consultation with an Israeli doctor without leaving home. To do this, it is necessary to contact the clinic's consultant, provide the required medical documentation, and connect at the agreed time. The specialist will assess the reviewed conclusions and test results and recommend further treatment.