Treatment of Ovarian Diseases in Israel

Professor Gilad Ben Baruch

Head of the Surgical Department of the Gynecology and Oncogynecology Department

Ovarian diseases can be successfully treated with the right timely approach. The Israeli Ichilov Clinic offers comprehensive diagnostics using state-of-the-art MRI and molecular genetic studies. Specialists use minimally invasive laparoscopic methods that minimize the trauma of surgeries. Robot-assisted interventions ensure maximum precision while preserving healthy tissues.

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Table of Contents

Treatment Methods

Diagnostics

Prices

Personalized therapy is tailored to the specifics of each case. A multidisciplinary team is formed from oncologists, reproductive specialists, and, if necessary, world-class chemotherapists. Modern treatment protocols allow for remission even in complex cases. Patients receive not only effective treatment but also psychological support at all stages of therapy.

About the Disease

Ovarian diseases include benign and malignant neoplasms, as well as functional disorders that affect the hormonal balance of the entire body. These pathologies require timely diagnosis as they impact a woman's reproductive health.

Causes of development include genetic predisposition and hormonal disorders, while inflammatory processes in the pelvic area and stress exacerbate the course of the disease. Age-related changes also provoke the development of neoplasms and functional disorders.

Discomfort manifests as physical and emotional symptoms that reduce the quality of life for women.

Main Symptoms

• Lower abdominal pain
• Menstrual cycle disturbances
• Bloating and heaviness in the pelvic area
• Pain during intercourse
• Weakness and irritability
• Conception problems

Treatment Methods for Ovarian Diseases

The choice of treatment methods for ovarian diseases is determined by the type of pathology, stage of the disease, the patient's age, and her reproductive plans. In modern oncogynecology, a combined approach is often used, combining several therapeutic techniques to achieve maximum effect.

Surgical Treatment

Surgical interventions are used for both benign neoplasms and malignant ovarian tumours at various stages of the disease. Modern surgery employs minimally invasive laparoscopic technologies using high-frequency electrosurgical devices and ultrasonic dissectors for precision removal of pathological tissues. Robot-assisted systems provide maximum precision in manipulations during cytoreductive surgeries. Intraoperative navigation and fluorescent diagnostics allow for clear delineation of the tumour tissue boundaries, achieving complete cytoreduction in 85-90% of cases.

Chemotherapy

Systemic chemotherapy is prescribed for malignant ovarian neoplasms in both neoadjuvant and adjuvant settings. Platinum-based drugs are used in combination with taxanes, administered intravenously according to specific protocols. Intraperitoneal chemotherapy with hyperthermia ensures high concentrations of cytostatics directly in the abdominal cavity. Targeted therapy with angiogenesis inhibitors and PARP inhibitors allows for prolonged remission in 70-80% of patients with platinum-sensitive tumours during primary treatment.

Radiation Therapy

Radiotherapy is primarily used as a palliative method for recurrent forms of ovarian cancer or when systemic treatment is not possible. Modern linear accelerators with intensity-modulated radiation therapy (IMRT) ensure precise delivery of radiation doses to the tumour focus. Stereotactic radiosurgery is used to treat limited metastatic lesions. Intracavitary brachytherapy using radioactive sources shows effectiveness in local recurrences, providing disease control in 60-70% of cases.

Hormonal Therapy

Hormonal therapy is used for hormone-dependent ovarian tumours, especially stromal neoplasms and as supportive treatment. Anti-estrogens and aromatase inhibitors are used to block the growth of hormone-sensitive cells. Gonadotropin-releasing hormone agonists provide medical castration when necessary. Selective estrogen receptor modulators are used in long-term therapy regimens. This approach allows for stabilization of the process and long-term disease control in 40-50% of patients with appropriate indications.

Immunotherapy

Immunological treatment methods are used for progressive forms of ovarian cancer, especially with high microsatellite instability of the tumour. Immune checkpoint inhibitors activate the body's own antitumor defense by targeting PD-1 and PD-L1 receptors. Adoptive cell therapy using modified T-lymphocytes shows promising results in clinical studies. Antitumor vaccines and cytokine therapy complement the main treatment, ensuring the formation of a long-term immune response and achieving remission in 20-30% of patients.

Targeted Therapy

Molecularly targeted treatment is applied when specific genetic mutations are present in the tumour cells, identified through molecular genetic testing. PARP inhibitors are effective in BRCA1/2 gene mutations and block DNA repair in cancer cells. Angiogenesis inhibitors prevent the formation of new blood vessels in the tumour. Monoclonal antibodies to specific receptors on tumour cells provide targeted action on pathological tissues. Combined targeted therapy allows for an objective response in 60-70% of patients with corresponding molecular markers.

Photodynamic Therapy

Photodynamic treatment is used for superficial tumour lesions of the peritoneum and as an adjunct method during cytoreductive surgeries. Special photosensitizers accumulate in tumour cells and are activated by laser radiation of a specific wavelength. Intraoperative photodynamic therapy is conducted using fiber optic systems to deliver light directly to the tumour foci. Selective action on cancer cells while preserving healthy tissues ensures local disease control in 50-60% of cases with minimal recurrences.

Radiofrequency Ablation

Thermal destruction methods are used for limited tumour foci in the ovaries and metastatic liver lesions in patients with ovarian cancer. Radiofrequency electrodes, guided by ultrasound or CT navigation, deliver high-frequency energy directly to the tumour tissue. Microwave ablation provides rapid heating of tissues to temperatures that cause coagulative necrosis of cells. Cryoablation using liquid nitrogen is applied for the destruction of small neoplasms. Local control is achieved in 80-90% of cases with proper patient selection.

Hyperthermic Intraperitoneal Chemoperfusion

HIPEC technology is used during cytoreductive surgeries for advanced forms of ovarian cancer with peritoneal carcinomatosis. Special perfusion systems ensure circulation of heated chemotherapy agents at 42-43°C in the abdominal cavity for 60-90 minutes. Hyperthermia enhances the penetration of cytostatics into tumour cells and increases their cytotoxic effect. Intraoperative monitoring of temperature and drug concentrations ensures optimal conditions for action. The combination of cytoreduction and HIPEC allows for prolonged remission in 40-50% of patients with peritoneal metastases.

Diagnostic Methods for the Disease

At the Ichilov Clinic, all diagnostic procedures for treating ovarian diseases are planned in advance and conducted within an average of three days, allowing for a prompt comprehensive understanding of the patient's condition and immediate development of an individual treatment plan.

First Day

Upon arrival at the clinic, the patient immediately meets with the attending physician, who carefully collects a detailed medical history, conducts necessary examinations, and provides recommendations for additional studies that help create a complete and comprehensive picture of the patient's health status.

Second Day

To obtain the most accurate data about the disease, the following studies are conducted:

• Blood tests (general, biochemical, hormonal, tumor markers)
• Ultrasound examination of the pelvic organs
• Colposcopy
• Biopsy with histological examination
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET-CT)
• Laparoscopy (diagnostic)

Third Day

On the third day, based on all the diagnostic data obtained, an individual therapeutic plan is developed, involving a multidisciplinary team of doctors, including gynecologists, oncologists, surgeons, chemotherapists, and radiologists. This approach ensures a comprehensive review of the case, taking into account the opinions of various specialists, allowing for the selection of the most effective and safe treatment strategy.

How Much Does Treatment Cost in Israel

Advantages of Treatment in Israel

1. Accurate diagnostics using advanced imaging and laboratory methods
2. Comprehensive treatment involving internationally trained physicians
3. The most advanced minimally invasive surgical interventions
4. Individual therapy plan considering age and reproductive goals
5. Comfortable accommodation and support at all stages of treatment

Even before arriving at the Israeli clinic, the patient can undergo an online consultation with a specialized expert. This allows for early recommendations, clarification of treatment details, and confidence in the chosen strategy.