Treatment of Kaposi Sarcoma in Israel

Professor Ofer Merimski

Head of the Department of Bone and Soft Tissue Oncology

When the need arises to find the most reliable direction for combating Kaposi sarcoma, the natural inclination is towards centers where innovation is combined with experience, and technology works towards results. This is why the appeal of the Ichilov Medical Center is so high. Here, an excellent combination of advanced diagnostic methods, modern treatment protocols, and deep expertise of specialists is ensured. All stages of treatment at the center are carefully thought out and planned. Special attention is paid to patient comfort: the accommodation conditions are created to help them focus on the recovery process. Thanks to the high professionalism of its team, the Ichilov Center enjoys trust and is considered a reliable alternative among international medical institutions.

>80%

of patients choose online support from our clinic's medical consultants even before arriving in Israel

>30%

of patients received innovative treatments unavailable in domestic clinics

24

- hour support in Russian

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Table of Contents

Treatment Methods

Diagnosis

Prices

Reviews

About the Disease

Kaposi sarcoma is a malignant vascular neoplasm associated with infection by human herpesvirus 8, and includes types such as classic form which develops slowly, endemic form prevalent in Africa, epidemic form associated with HIV, and iatrogenic form occurring due to immunosuppression.

Causes

• HHV-8
• Immunodeficiency
• Organ transplantation
• Chronic inflammatory processes

Symptoms

• Spots and nodules on the skin
• Swelling of the limbs
• Mucosal lesions
• Enlargement of lymph nodes

Treatment of Sarcoma in Israel - Review

Treatment Methods for Kaposi Sarcoma

The choice of treatment methods for Kaposi sarcoma at Ichilov is determined by the molecular-genetic profile of the tumor, the extent of the process, and the immune status of the patient, allowing for the creation of a therapeutic strategy that takes into account the individual characteristics of the body.

Systemic Chemotherapy

In advanced forms of the disease, when lesions affect internal organs or multiple skin areas, systemic chemotherapy becomes the cornerstone of treatment. Liposomal anthracycline drugs are delivered directly to tumor cells thanks to a special coating that protects healthy tissues from toxic effects. This approach minimizes side effects and allows for outpatient therapy. Dosages are calculated using computer modeling systems that take into account body weight, kidney, and liver function.

Antiretroviral Therapy

When Kaposi sarcoma develops in the context of HIV infection, restoring the immune system through antiretroviral therapy can lead to regression of tumor lesions without additional interventions. Combinations of drugs from the protease and reverse transcriptase inhibitor groups are selected based on virus genotyping, ensuring maximum effectiveness. Viral load is monitored using highly sensitive PCR methods, allowing for tracking dynamics every four weeks and adjusting the regimen as needed.

Local Cryotherapy

Single small skin lesions are effectively eliminated by cryodestruction in the early stages of the disease. Liquid nitrogen at a temperature of minus one hundred ninety-six degrees is applied with an applicator precisely to the tumor boundaries, causing immediate freezing of pathological cells. The procedure takes a few minutes and does not require anesthesia, as the cold itself has an analgesic effect. After destruction, the tissue gradually sloughs off, and healthy epithelium forms in its place with minimal cosmetic defects.

Radiation Therapy

For patients with localized lesions in the facial area or mucous membranes, where surgical intervention may disrupt function or aesthetics, radiation therapy offers an alternative solution. Modern linear accelerators using intensity-modulated radiation therapy (IMRT) technology create a complex three-dimensional dose distribution that accurately replicates the shape of the tumor down to the millimeter. Dose fractionation allows for delivering the maximum amount of energy to the neoplasm while preserving surrounding structures. The entire course usually concludes within two to three weeks with daily sessions.

Interferon Immunotherapy

In the early stages of the disease, especially in skin forms without internal organ involvement, immunotherapy with alpha interferon drugs activates the body's own defense mechanisms against tumor cells. These biological molecules enhance the activity of natural killers and macrophages, which recognize and destroy altered tissues. Injections are administered subcutaneously several times a week, and the effect develops gradually over several months. This method is particularly relevant for individuals with preserved immune function.

Targeted Therapy

In cases of resistance to standard regimens or aggressive disease progression, targeted therapy opens new possibilities for controlling the tumor process. Drugs from the angiogenesis inhibitor group block the formation of new blood vessels that nourish the sarcoma, depriving it of resources for growth. Molecular diagnostics identify specific markers on the surface of tumor cells that become targets for targeted action. This personalized approach allows for achieving remission even in complex clinical situations.

Photodynamic Therapy

For superficial multiple lesions of Kaposi sarcoma, photodynamic therapy provides selective destruction of the tumor without damaging healthy skin. A photosensitizer is administered to the patient, which selectively accumulates in pathological tissues over several hours. The affected area is then irradiated with a laser of a specific wavelength, activating the drug and initiating a cascade of oxidative reactions leading to the death of tumor cells. This method is particularly valued for its excellent cosmetic result and the possibility of repeated application as needed.

Surgical Excision

When tumor nodules have clear boundaries and are located in accessible anatomical areas, surgical removal becomes the method of choice for achieving rapid results. The operation is performed using high-frequency electrosurgical instruments that simultaneously cut tissues and coagulate vessels, minimizing blood loss. The boundaries of resection are determined based on dermatoscopic mapping, ensuring complete removal of altered areas. Histological examination of the material confirms the radicality of the intervention and helps plan further monitoring.

Intralesional Chemotherapy

For individual large nodules, especially located on the limbs or torso, intralesional administration of chemotherapeutic agents creates a high concentration of the active substance directly in the tumor. Vinca alkaloid drugs are injected with a thin needle under ultrasound control, preventing the spread of the solution beyond the lesion. This method avoids systemic side effects and ensures regression of the lesion after just a few procedures. Patients tolerate this treatment significantly better, maintaining their usual level of activity.

Supportive Therapy

At all stages of treatment for Kaposi sarcoma, supportive therapy helps the body cope with the burden and maintain quality of life. Medications to protect mucous membranes prevent the development of ulcerative lesions during chemotherapy, while modern antiemetic agents from the serotonin receptor antagonist group alleviate nausea within an hour after administration. Nutritional support with individual calculations of caloric and protein content helps maintain muscle mass. Psychological support is integrated into the treatment process from the first days, creating a resource for overcoming difficulties.

Diagnostic Methods for the Disease

Accurate diagnosis of Kaposi sarcoma is critically important, performed on precise equipment, and procedures at Ichilov are planned in advance and conducted quickly.

First Day

Upon arrival, the patient undergoes a consultation with the attending physician, who clarifies the medical history, conducts an examination, and prescribes necessary tests for a complete assessment of the condition.

Second Day

Diagnostic procedures prescribed by the attending physician are conducted:

• Clinical blood test
• Biochemical blood test
• PCR for HHV-8
• Biopsy
• Dermatoscopy
• CT
• MRI
• PET-CT

Third Day

The team of specialists jointly analyzes the diagnostic results, assesses the prognosis, and selects the most effective therapy strategy. This approach allows for considering nuances of the disease course and increases the likelihood of achieving optimal clinical outcomes.

How Much Does Treatment Cost in Israel

Advantages of Treatment in Israel

1. Experienced oncology team of world-class
2. High-precision expert-class diagnostics
3. Individual therapy protocols
4. Modern clinic infrastructure
5. Comfortable accommodation conditions

The patient can pre-order an online consultation with a specialized specialist to receive personalized recommendations, answers to pressing questions, and information about available modern treatment technologies.