For Cancer in Israel, characterized by a high level of diagnosis and treatment of cancer.
Early diagnosis of cancer by means of instrumental and laboratory studies. Apply tomography, endoscopy, radionuclide, ultrasound, magnetic resonance methods, diagnostic biopsy, and cytogenetic Cytomorphological investigations, determination of tumor markers.
For the treatment of the following methods of cancer: surgery, gamma - therapy, chemotherapy, immunotherapy, hormonal therapy and others.
Oncological Surgery in Israel
Surgery - a medical procedure designed to study the removal or repair of tissue. It is used, including as part of cancer treatment programs to:
- Prevent cancer.
- Diagnose and determine the stage of cancer.
- Remove the tumor.
- Relieve symptoms.
- Reduce the likelihood of relapse.
- Restore damaged tissue.
- The effectiveness of other therapies.
- Improve the performance of certain organs.
Below we consider the characteristics of the main types of operations on oncology, which is carried out in one of the largest private medical centers in Israel - Assuta .
Prevent the development of cancer
Preventive or prophylactic surgery is used to prevent or reduce the risk of developing certain types of cancer. This operation is carried out before the disease occurs. The surgeon removes healthy tissue at high risk of converting it into a malignant.
If there is a bad heredity, indicating a high risk of developing certain types of cancer, doctors at Assuta offer preventive oncology. Performed resection of a large number of tissue or whole body in order to reduce the likelihood of cancer. For example, women with a high risk of breast cancer selected prophylactic mastectomy, during which removes one or both breasts.
Assuta diagnostics and staging
Doctors use different types of surgery to diagnose cancer. Cancer surgery is used to determine the stage of the disease, which describes the amount of tumor in the body.
For example, surgery is performed for taking a sample of tissue - biopsy procedure to examine the sample under a microscope for the presence of abnormal cells. In addition, the removal of the tumor study to determine the stage of the disease and to develop the most appropriate treatment plan.
The pathologist examines segment neoplasm or a tumor and surrounding tissue extracted during the surgical intervention. It defines:
- the exact type of cancer;
- the degree of malignancy;
- the presence of cancer cells in the edges of the tissue removed - "positive margins";
- malignant cells in adjacent lymph nodes.
Once doctors get pathologist report, they will decide whether further treatment is needed, and what it was.
removal of the tumor
The main goal of cancer surgery - complete removal of the cancerous tissue. Surgery - the most effective method if the tumor at an early stage, localized and has not given secondary foci.
Surgery is also used to treat metastatic cancer when the primary tumor metastasizes to other body parts.
During such oncological surgery, the surgeon also removes a small amount of healthy tissue around the damaged - the so-called surgical margins. This is done with a purpose - as fully as possible to eliminate cancer cells. If they remain in the body, the disease will return. The type of tumor and its location the amount of healthy tissue depends extracted. Surgeons use special equipment - a microscope to make sure the cancerous tissue with a margin has been removed.
Depending on the type of tumor can be resected lymph nodes that are close to it. This is called lymph node dissection. They were also sent to the laboratory for further study. If the lymph nodes contain cancer cells, and they were left in the body, will develop new foci of the disease and to grow throughout the body.
Sometimes it is impossible to remove all of the malignant process, for several reasons:
- The tumor is too large.
- Localization of tumors makes it difficult to remove without damaging the blizprilegayuschih bodies.
- The tumor is too small, the surgeon can find it, and that its tests found.
- The general health of the patient makes surgery too risky.
In some cases, when all the malignant process can not be eliminated, the operation is still carried out in order to remove the maximum possible amount of abnormal tissue. This is known as cytoreductive oncosurgery aimed at reducing the number of cancer cells in the body. Such an operation increases the effectiveness of chemotherapy and radiotherapy.
Surgeons tend not to violate the integrity of the tumor during removal to reduce the likelihood of pathological cells in other structures. During a biopsy indicated the way in which the procedure was performed. It is removed during the primary operation.
Doctors will try to cause as little damage during surgery to remove tumors, it tends to reduce the amount of cancer surgery. For example, carried sentinel lymph node biopsy. If the cancer cells do not find it, it is possible to avoid resection of lymph nodes in a particular area.
Whenever possible, surgeons use minimally invasive approaches to performing surgery through small incisions - through laparoscopic cancer surgery. Also, their action aimed at reducing or preventing the side effects or complications by careful recovery of damaged tissues. Carefully sealed blood vessels, minimizing injury to surrounding organs.
relief of symptoms
Palliative oncosurgery at Assuta is used to relieve symptoms of the disease and improve quality of life. For example, surgery is sometimes used to bypass the blocked body. I also used to reduce pain or pressure caused by swelling.
The surgeon discusses the risks and benefits of surgery with the patient before making a decision, especially when the goal is - to control the symptoms of the disease and improve quality of life, not get rid of the disease.
Reduce the likelihood of relapse
In addition to the removal of a tumor located adjacent undamaged other structures may be resected, together with a margin of healthy tissue. These include muscles, nerves, and lymph nodes. They may be resected, even if there is no evidence that they contain cancer cells. According to the research, the removal of nearby structures may reduce the risk of recurrence.
This idea underlies the resection radical cancer surgery. Such an operation eliminates the organ affected by the cancer along with surrounding tissues which may contain abnormal cells. For example, radical mastectomy breast resected with pectoral muscle and lymph nodes. Radical neck dissection removes almost all of the lymph nodes on one side of the neck, veins, muscles and nerves. But nowadays in Israel, including in the Assuta, such transactions do not actually take place.
Restoration of damaged tissues
Reconstructive surgery is used to regenerate tissues damaged by cancer or by the treatment of cancer including surgery to remove the tumor. By requesting it to restore the functionality of the body or the old look and feel.
Surgeons using various methods - transplants, implants, prostheses , patchwork and other plastics.
Enabling other treatments
Oncosurgery used, for example to provide direct access to the blood vessel for supplying medication or other treatment in order to avoid the need to put a constant drip.
For example, a central venous catheter is set, through which can take blood samples, if necessary, administered chemotherapy, antibiotics, intravenous nutrition and so forth.
The surgery is performed to establish a special pump to deliver chemotherapeutic drugs.
Support body functions
By turning to surgery that improve the body's functions - breathing and nutrition.
Tracheostomy - an operation in which a hole is made in the trachea through the neck. The opening is placed airway tube.
Patients who can not take food or drinks, the operation is carried out under the name of gastrostomy. In the stomach, creating a hole so as to insert a tube into the body. It provides a flow of fluid or food inside.
Oncosurgery with other treatments
As part of the oncology surgery treatment programs are used along with other methods - chemotherapy and radiotherapy.
Neoadjuvant therapy is aimed at reducing the size of the tumor prior to surgery. Chemotherapy, radiation, or both methods may be used as such a treatment to reduce the amount of neoplasms.
Adjuvant therapy is performed after surgery. Cytostatics, irradiation, or both methods may be used as an adjuvant treatment to destroy abnormal cells remaining after surgery and reduce the risk of relapse after surgery for cancer. These procedures seek to destroy any cancer cells that may have spread to other parts of the body. Duration of disease due to the peculiarities. These methods treat after a while after the surgery, as they can affect the healing process.
How much does the operation in Israel in oncology?
We give prices for oncological surgery in Assuta:
- Laparoscopic resection of the uterus - 21 390 $.
- Laparoscopic partial nephrectomy - 31 750 $.
- Lumpectomy - $ 13 400.
- Craniotomy ( surgery to remove a brain tumor ) - $ 35 800.
- Radical hysterectomy - $ 24 400.
- Breast reconstruction - $ 34 800.
- Gastrectomy - $ 36 250.
- Mastectomy - $ 15 900.
Types of cancer surgery in Assuta
Many different types of surgery are used as part of cancer treatment plan. Some of them removed the tumor. For example, laryngectomy - an operation to remove part or all of the larynx. Other surgical interventions seek to make a hole in the body, for example, we are talking about colostomy surgery. Choosing the type of surgery due to:
- type of cancer;
- tumor size and location;
- stage of the disease;
- treatment purposes;
- general state of health and the patient's wishes;
- available capabilities and preferences of surgeons.
Physicians selected type of surgery to treat cancer. They determine the best approach to describe the method by which it is possible to reach the desired area or organ.
There are two main approaches - open surgery and minimally invasive.
Open surgery is performed through a large incision with which the doctor reaches studies removes and restores tissue. This approach is often referred to as conventional or traditional surgery.
Minimally invasive approach does not require a large incision. The surgeon performs several small incisions to place inside an endoscope and special tools. Recovery from such an operation is faster, less pain. But this type of surgery can not be used for all types of tumors.
Sometimes, surgery is performed through a natural orifice or cavity in the body. For example, the surgeon uses a transoral approach for removing the larynx tumor. In some cases, prostate cancer is treated by transurethral resection. The prostate is removed through the urethra.
Surgical techniques in Assuta
These are the steps and tools that are used to perform cancer surgery.
- Radiofrequency ablation uses a special probe to deliver radiofrequency waves that heat and destroy abnormal tissue.
- Cryosurgery uses extreme cold (liquid nitrogen or liquid carbon dioxide) to freeze, and destroy the malignant tumor.
- Electrosurgery uses high frequency electric current to fight cancer.
- Radiosurgery uses high doses of radiation to destroy oncology.
- Endoscopic surgery involves the use of an endoscope, which the surgeon places within the body through small incisions or natural orifices. This device is used to examine the structure or resect organs and tumor. There are different types of endoscopes.
- Operation Maus removes layers tumor. Each layer is examined under a microscope for the presence of malignant cells. Layers are removed until it will be completely removed the affected tissue.
- Stereotactic surgery using CT or MRI scan to locate the tumor. This technique is used to perform accurate biopsy removing tumors or deliver precise radiation doses.
- Percutaneous ethanol injection involves the use of ultrasound or CT for precise direction of the needle to the tumor reached an alcohol.
How is cancer surgery at Assuta?
Depending on the amount of interference field operations can be a doctor's office or operating room. Treatment is carried out on an outpatient basis or require hospitalization. Using local, regional, or general anesthesia. The patient can leave the clinic on the same day or stay in it for a longer time, depending on the type of surgery, the anesthetic used, and overall health.
How to prepare for an operation to general oncology?
The surgeon and the medical team will tell the patient:
- What training is needed.
- What happens during surgery.
- What to expect after surgery, some supervision is required.
Also, the patient will be put in the course of the potential side effects and complications that may occur after surgery. Explain the risks and benefits of treatment, provide for signing a consent form. The anesthesiologist will tell you what type of anesthetic is used during the operation.
The following tasks are performed before surgery. Some require several days or weeks before the treatment.
A number of people may have contraindications for surgery. It is certain health problems, including lung, heart, liver or kidneys. Therefore, before the oncology doctor collects history, conducting a physical exam and a series of tests that will tell about the work of the organs:
- Analysis of urine is required to check renal function.
- Blood tests determine the patient's blood type, set the number of blood cells was examined the liver and kidneys.
- Chest X-ray and ECG study the functioning of the lungs and heart.
- Other medical imaging tests - ultrasound, CT and MRI - may be performed to determine the amount and location of the tumor, the proliferation of malignant process on nearby organs or lymph nodes.
Range of necessary measures will depend on the type of operation. Most people need to do the following. The patient takes a shower in the evening before or the morning of surgery. You may need to shave the hair from the operated area.
Avoid eating food or drink after midnight before the surgery if doctors did not give specific instructions.
You should inform the doctor about the medications that the patient takes. They may be assigned additional medications, use of laxatives or enemas.
During cancer surgery
Surgery is performed under sterile conditions in the operating room. Before the start of the surgeon gives the anesthesia, the treated area is specially cleaned. The physician makes an incision in order to reach the desired area or organ being treated. In some cases, a natural opening in the body (e.g., mouth).
The surgeon removes the tumor along with a margin of healthy tissue around it. If necessary, the resected lymph nodes located nearby. The operation can be carried out with a view to take a sample of tissue for biopsy.
Reconstructive surgery is performed at the same time as the removal of the tumor. Sometimes later, during the next surgery.
To close the incision, the surgeon uses sutures or staples. In place of the treated area is put a bandage.
Rehabilitation after cancer surgery
Recovery and follow-up after surgery is an important part of the treatment process. Doctors and nurses carefully monitor the state of ptsienta.
Care cancer patients after surgery
Upon completion of the surgical process the patient is moved into the reduction zone (ICU if oncological surgery painful). Doctors carefully checked blood pressure, heart rate and breathing. Keep track of the signs of bleeding or other side effects of surgery.
If necessary, the patient is given medication, controlling pain, nausea and other symptoms. Change and check the bandage.
After resuscitation of the patient is moved into the ward. Doctors are convinced that there are no serious problems or side effects. Depending on the type of cancer surgery, general health of the patient the following medical devices can be set:
- The catheter is placed into the bladder to drain and collect urine. It is removed when the patient can go to the toilet.
- Drains are installed inside or near the slits, with their help remove excess liquid.
- The patient is put dropper to the body of the incoming fluid and medication.
Upon completion of the recovery process of the patient is discharged from hospital. It is normal, if the first time a person feels weak and tired.
Follow-up examination after cancer surgery is necessary to:
- The doctor saw the body recovers.
- Discuss the test results.
- Check how to heal the incision, remove the stitches if necessary.
- Come to a common decision about further treatment options.
Among the possible side effects and complications of cancer surgery note:
- nausea and vomiting;
- sore throat;
- problems with urination;
- the risk of infection;
- blood clots;
- post-operative pain;
- irregularities in the digestive tract;
- lung problems;
- divergence wound;
- nerve damage;
- limb swelling;
- scarring et al.