Treatment of melanoma at Ichilov Clinic (Sourasky), Tel Aviv

Melanoma is the most aggressive form of skin cancer, where time is often measured in weeks: the speed of diagnosis and the correct choice of therapy directly affect survival. At the Ichilov (Sourasky) Medical Center in Tel Aviv, a multidisciplinary team — dermatologic oncologists, surgeons, pathomorphologists, specialists in immunotherapy and radiotherapy — guides patients with melanoma from initial dermatoscopy to long-term follow-up after remission.

Diagnosis begins with digital video dermatoscopy and mapping of all suspicious nevi, excisional biopsy with histological and molecular genetic testing (BRAF, NRAS, c-KIT, PD-L1). If regional spread is suspected, a sentinel lymph node biopsy — the gold standard for staging — is performed, along with PET-CT and MRI of the brain to rule out distant metastases.

Treatment is tailored according to the stage and molecular profile of the tumor. In early stages, conservative surgery with adequate margins and plastic reconstruction is sufficient. For locally advanced and metastatic melanoma, modern protocols are used: immunotherapy with checkpoint inhibitors (nivolumab, pembrolizumab, ipilimumab), targeted therapy with BRAF/MEK inhibitors, combination regimens, and stereotactic radiosurgery (Gamma Knife, CyberKnife) for brain metastases. Patients at Ichilov have access to international clinical trials and new drugs even before their widespread registration.

Specific areas include uveal melanoma, acral lentiginous melanoma of the soles and nail beds, and facial melanoma with reconstructive plastic surgery. Below are materials on diagnosis, modern protocols, patient stories, and specialized doctors at the Sourasky Clinic who manage this type of cancer.