Treatment of Hodgkin's lymphoma in Israel (Hodgkin's disease), as a rule, very successfully, a high percentage of people recover fully.
Assuta Hospital has achieved great success in the treatment of Hodgkin's lymphoma in Israel - more than 80% of applicants to the services of doctors patients gain health and the opportunity to forget about the terrible disease. It contributes to the professionalism of the medical staff, new technologies in the therapeutic process, the latest generation of drug formula. Assuta Hospital is equipped with expensive equipment. Private complex is investing a lot of money in the development of the technological base. The cost of equipment is often in the millions of dollars.
We offer treatment of cancer pathologies in Israel from international experts. Turning to us, you can choose a doctor, who without fear entrust their health. Many patients receiving a disappointing outlook in Russia, traveling to the Middle East. As practice shows - it's a real chance in the struggle for life. As an official representative of the clinic in questions of medical tourism, maintenance of Russian-speaking patients, we offer reasonable prices for services.
The cost of treatment depends on the individual plan drawn up by a doctor. To obtain more accurate information, send documents through a form on the website or by e-mail. Below are the rates for some services:
- Consultation oncologist - $ 600
- Revision biopsy - $ 610
- PET-CT - 1670 $
- Chemotherapy - from $ 2080
- Blood tests from - $ 80
procedures cost less than 25-30% of the cost of treatment in Europe or the United States. The official conclusion of the contract - a guarantee that the interests of people who applied to us. Call for details and procedures for registration of treatment in the clinic.
With the patient in the clinic Assuta interacts multidisciplinary team of doctors:
- Specialist stem cell transplantation.
- Radiation oncologist.
- Pharmacist, psychologist, and a number of other doctors.
For the treatment of Hodgkin's disease in Israel methods use not associated with surgery. The main measures are radiation and chemotherapy. However, possible to carry out an operation to remove lymph nodes for the purpose of a biopsy, taking tissue samples.
Under the influence of general or local anesthesia, the doctor removes an enlarged lymph node and send to the lab. A pathologist examines it under a microscope for the content of Hodgkin lymphoma cells. It's a small operation. Usually after that there are bruises, swelling, stitches. After 10 days, the state is completely normal.
Radiation therapy in the treatment of Hodgkin's lymphoma in Israel
Radiotherapy restrictions apply. Small area is subjected to irradiation - one or two lymph nodes where cancer cells are found in one part of the body, 1 or 2 steps. Radiotherapy Hodgkin's lymphoma is used to reduce large lymph nodes for metastatic malignancy. Basically when it is conducted after cytostatic preparations.
Hodgkin's disease treatment is carried out at the Institute for radiotherapy and radiosurgery at the medical center, five times a week. Duration determined by the area of treatment.
Radiotherapy Hodgkin lymphoma precedes careful planning using advanced computer: determined dose localization. CT is performed, visualizing the tumor and surrounding structures. Instead CT can be an MRI or PET scan. irradiation region is marked by special symbols.
In the treatment of Hodgkin's disease using special masks and form that provide a body immobility.
Lymphoma at an early stage in most people radiotherapy is performed on a small area of lymph nodes, which are called fields involved (IFRT). If the lymph nodes occupy a large area, they are called advanced fields (EFRT). The procedure itself takes a few minutes, does not cause pain, does not make a person radioactive.
Potential side effects
The most common undesirable effects are:
- Redness of the skin in the treatment area. The skin can get sunburned hue. It is not recommended to use creams and lotions without a prescription. Advise the patient in detail about care.
- Fatigue, as a rule, comes to the end of treatment. It disappears completely after a few weeks of therapy.
- Hair loss in the treatment area.
Other side effects vary depending on what part of the body exposed to radiation. If this was the area of the abdomen, there may be diarrhea. When extended fields fatigue and nausea are the most problematic side effects.
Possible long-term adverse effects
Most people have not noted such side effects. Perhaps their appearance after many years. Constantly innovating new methods that reduce the risk of such consequences.
In most cases, there are changes in the skin - it acquires a permanent tan tint, or a network arises of tiny blood vessels near the surface. Increased sensitivity to the sun.
For other possible problems include:
- The risk of other types of cancer. Upon irradiation of the chest cavity, there is the likelihood of developing breast cancer.
- Heart problems. Radiation therapy of Hodgkin lymphoma in the chest cavity area increases the risk of heart and vascular diseases. Now Israeli doctors use reduced the field of treatment of Hodgkin's disease, to reduce the effect on the heart. To reduce the risk, it is recommended to eat right, exercise regularly and do not smoke.
- Changes in the thyroid gland. After radiotherapy in the neck area may develop hypothyroidism. The thyroid gland stops producing adequate amounts of hormones, it is necessary to accept a thyroxine.
- The risk of infertility. If radiotherapy is carried out in the pelvis or groin, noted the risk of infertility.
- Irradiation chest cavity can cause pneumonitis.
Chemotherapy in the treatment of Hodgkin's disease in Israel
Basically do intravenously, appointed several cytostatic drugs in Hodgkin's lymphoma chemotherapy. Some of chemotherapy combinations include steroids course. Often used in this disease chemoradiotherapy.
cytostatic treatment is carried out in the following cases:
- As primary therapy, with or without radiation.
- In relapsed or refractory lymphoma.
- In order to control the symptoms of metastatic disease.
Chemotherapy consists of a series of cycles. Treatment can take place in 1-3 days, determined by the designated medications. This is followed by a break, which lasts a few weeks. It is necessary to let the body recover from the effects of therapy. Then resume treatment. The number of such cycles is determined by several factors: drugs; and step type lymphoma; diagnostic results; reaction to the treatment.
Chemotherapy Hodgkin's lymphoma in the majority of cases is performed on an outpatient basis, it may require 1-2 days of hospitalization.
A catheter or IV Portacath used as a chemical for administration. drugs.
High-dose chemotherapy with Hodgkin's lymphoma
This type of chemotherapy affects the bone marrow. Therefore, after this procedure is necessary to restore his recovery and stem cells. This is done by grafting. New blood begins to produce stem cells that are transplanted into the bone marrow.
For the treatment used treatment protocols Hodgkin's lymphoma in Israel:
- CBV (TSBV)
- BEAM or miniBEAM
There are many different combinations of cytotoxic drugs used in Hodgkin's lymphoma. A doctor in the clinic Assuta select a treatment regimen, which will best fit the stage and type of lymphoma. Such combinations are referred to as schemas.
Most patients at an early stage of disease is assigned from 2 to 4 cycles ABVD:
- doxorubicin (adriamycin)
- bleomycin (Blenoxane)
- vinblastine (Velbe)
- dacarbazine (DTIC)
In metastatic process some patients recommend to 8 cycles of ABVD.
Other protocols (circuit) treating Hodgkin lymphoma:
- stanford V
If cytostatic drugs do not have the desired effect, or lymphoma returned, some patients administered chemoradiotherapy with stem cell transplantation.
Possible unwanted effects
For all chemotherapeutic agents are characterized by certain side effects, they are developing differently in different people. The doctor prescribes medication, controlling and reducing such effects. Most of the side effects - temporary. The doctor at the clinic Assuta detail tells the patient what unwanted effects may develop.
- Low number of red blood cells.
- Disorders of the gastrointestinal tract.
- Inflammation in the mouth.
- Thinning and hair loss.
- Fatigue, weakness.
Potential long-term side effects
Cytotoxic drugs can provoke long-term adverse effects. Are more likely to infertility occurs. If the patient / patient is young, has not yet had children, the doctor will try to pick up the drugs that will not cause loss of fertility. Other long-term effects are much less common - heart disease, lung damage, the risk of other types of cancer.
Unfortunately, certain chemotherapy drugs that are used to treat lymphoma in Israel, Can cause damage to the ovaries or testes, leading to infertility. Doctors difficult to definitely say it will happen or not. On the loss of fertility is influenced by such factors as:
- Assigned chemotherapy.
- The total drug dose.
- Age, if the patient - a woman.
It is possible to preserve sperm and eggs.
In women, chemotherapy can cause early menopause. It is treated with hormone replacement therapy.
Chemotherapy can increase the risk of developing other types of cancer in the future. Cytostatic drugs exerting a therapeutic effect, damage not only cancer cells but also healthy. Such damage triggers the development of cancer a few years later. Studies show that 1 out of 10 people 10 years later there is another oncology. However, new methods reduce this risk.
After chemotherapy for Hodgkin's lymphoma observed probability of developing leukemia - 1-3% of patients in the future.
Doctors do not know exactly how much increased risk of cancer in the future just because of the treatment. Patients who have had lymphoma, have an increased likelihood of developing cancer in the future. Doctors assess the treatment benefit against the long-term risk of other types of cancer. The patient will need to go to the hospital for check-ups for years. Doctors will check for any signs of cancer, to identify them and treat as early as possible.
Some medicines used to treat Hodgkin's lymphoma, can provoke heart problems. The patient has an increased risk of heart attack or other irregularities in the work of the Authority. Assuta Hospital doctors will do everything possible to effectively cure the disease, trying to protect the patient from the risk of long-term therapy.
Certain cytotoxic drugs, such as bleomycin, can cause inflammation of the lungs that develops during therapy in many cases. Such a state is called pneumonitis. If it occurs, doctors stop treatment with bleomycin, and the state is normalized.
Steroids in the treatment of Hodgkin's lymphoma in Israel
Steroids - are substances which are synthesized naturally by the body, have a high biological activity. Their manufacture and use as medicaments.
Doctors prescribe steroids for many different reasons. Steroids can be part of a chemotherapeutic treatment of Hodgkin lymphoma in Israel. They come in tablets or injections. Most often it is - prednisolone.
Steroid injections can be administered in the same time as chemotherapy drugs and injections. This helps to control nausea, which causes cytotoxic agents, such as dexamethasone.
Possible side effects
Steroids patient will not take a long time without a break, so, most likely, serious side effects will be. However, the following effects can be observed:
- Increased appetite.
- Increased energy.
- Difficulty sleeping.
Steroids can cause water retention. If a person takes these drugs for some time, excess fluid in the body can provoke swelling of hands, feet or eyelids. Possible weight gain.
The physician will examine the condition of the presence of other side effects of steroids. It can be:
- Increasing the risk of infections.
- Sugar in the urine and increased blood sugar.
These side effects are unlikely to occur, if the drugs are not taken for a long time. They are temporary, steroid use is stopped, the symptoms go away.
Since the resistance to infection is reduced during the treatment, it is best to avoid contact with patients (influenza, common cold) people. It is prudent to do and chemotherapy.
Stem cell transplant
In the treatment of Hodgkin's disease, many patients assigned high-dose chemotherapy. This eliminates the disease for many people. doctors usually conduct such intensive treatment, when the disease comes back after the first course of therapy. Oncologist may offer transplant, if the lymphoma does not respond to standard treatment.
The procedure of bone marrow and stem cell transplantation
Bone marrow transplantation and stem cells - are technologies that produce the replacement of dead cells under the influence of high-dose therapy. The main task of these cells - the production of blood cells. New bone cells enter the bloodstream through an IV to replace, through the bloodstream, they penetrate into the bone marrow. After that, the production of blood cells. Stem cells taken from the patient (before chemotherapy) or from a donor.
Perhaps transplant from a donor, which often acts as a relative, because they will be more likely to match. And less likely that the body will reject them. This type of transplant has many side effects and risks, the patient must have a general good health.
The doctor at the clinic Assuta sees foreign transplant of stem cells in the following cases:
- Hodgkin's Lymphoma returned after autologous transplantation (autologous stem cells).
- The disease progresses.
Biological therapy in the treatment of Hodgkin's disease in Israel
Biological drugs affect the cells, they can:
- Stopping the division and growth of malignant cells.
- Identify abnormal cells and destroy them.
- Strengthen the immune system, prompting it to fight cancer cells.
Monoclonal antibody - Brentuximab drug is used in a number of cases in the treatment of Hodgkin's lymphoma in Israel, which recurred after treatment or has not responded to treatment.
Rituximab (MabThera) is intended for the treatment of Hodgkin's disease (a type of lymphocyte predominance). It demonstrates high efficiency. Rituximab is a monoclonal antibody. It attaches to a specific protein by stopping cell division and growth. This drug can control lymphoma for a long time, enhance survival when given type of lymphoma does not respond to standard chemotherapy or recurs. Side effects of its application include - flu-like symptoms, nausea, diarrhea, itching, rash, change in blood pressure, feeling of weakness and fatigue.
Treatment of relapses or refractory Hodgkin lymphoma
Relapse of disease return means after the treatment, the term refractory lymphoma - resistant to treatment.
In both cases, further treatment. The plan will depend on the localization of the disease before the treatment.
It can be offered chemotherapy scheme: ABVD, Stanford V, BEACOPP and various combinations of drugs - gemcitabine, dexamethasone, cisplatin.
High-dose chemotherapy treatment protocols include the following Hodgkin's lymphoma in Israel - CBV, BEAM.
If the body does not respond to two (minimum) regimens, or relapse after autologous stem cell transplantation may be recommended brentuximab vedotin (Adcetris).
External radiation therapy is used in relapsed and refractory lymphoma, if the initial treatment was chemotherapy, and lymphoma remains or returns in only one area. Irradiation is recommended as monotherapy or with chemotherapy. Radiotherapy can be used with chemotherapy in preparation for a stem cell transplant.
Transplantation of stem cells is carried out at relapses which arise for several months after initial treatment or refractory form of the disease.
Prognosis of Hodgkin's disease. How many live after treatment of Hodgkin's lymphoma?
Please be aware that 5-year survival rate - is a medical term. This is the number of people participating in the studies who were alive 5 years after diagnosis.
Available statistics intended for general guidance only.
Treatment of Hodgkin's lymphoma in Israel, often very successfully cured many patients. There are the following data:
- 90% - survival rate for 5 years or more after diagnosis.
- 80% - survival of 10 years and more.
Results by stage:
- 1 and 2 stage - 91-94% - survival of five years or more.
- 3 and step 4 - 59-90% - 5 or more years.
Successful treatment of lymphoma affects the type, age (young better trend). 5 year survival rate for people aged 15-39 years - 95% older than 80 - 30%.
Even if Hodgkin lymphoma returns after treatment, it again being treated, including by stem cell transplantation. In such a situation somewhat less likely to recover, but the treatment is often keeps the disease under control for many years.
How reliable statistics? Statistical information will not say exactly what will happen in each case. The same type of cancer that develops at different rates in different people. Some procedures are effective for some people, and less effective in others. There are many different factors that affect prognosis and treatment. To get information about the possible outcome of a particular case, to deal directly with the doctor who owns the full information.
Research has shown that participation in clinical trials to improve the prognosis.