Liver Cancer Treatment in Israel

Liver cancer is a malignant disease, which is common in countries with high rate of viral hepatitis infection. While symptoms may include weight and appetite loss, nausea, abdominal pain and/or swelling and fatigue, it is usually discovered accidently during abdominal US or CT scans. Every suspicious hepatic lesions must be thoroughly investigated in order to provide timely and appropriate liver cancer treatment, should it be confirmed.

Diagnosis

The diagnosis stage of the program includes:

• Extensive blood tests (CBC, CMP, lipid profile, electrolytes, tumour markers, pancreatic enzymes, liver function tests and coagulation factors)
• PET/CT scan
• Abdominal MRI scan
• Revision of liver biopsy (provided one was previously performed)
• Optional: New CNB liver biopsy under CT or US guidance
• Urgent histopathology and histochemistry (results will be ready within 4 business days)

Once the pathology results are ready, you will be evaluated by an abdominal surgeon specializing in gastrointestinal oncology.

Treatment

Usually, in cases when the malignant process has not spread beyond the liver, the best method of liver cancer treatment is surgery. Routine preoperative preparation includes an ECG, chest X-ray and an anesthesiologist consultation.

Surgery

Cost of surgery includes the following:

• Preoperative laparoscopic navigation and intra-abdominal US scan
• Partial liver resection, up to 7 days of hospitalization and postoperative care
• Surgical materials
• Intraoperative express biopsy of liver tissue and lymph nodes (to establish negative surgical borders in order to ensure maximum tumor removal)
• Definitive histopathology and histochemistry studies

It is advised you remain in Israel for approximately 14 days following your discharge from the hospital for outpatient follow-up and care. During this period you will undergo a follow-up gastro-oncologist evaluation, during which he will determine further course of treatment (monitoring, chemotherapy, radiotherapy etc) and a clinical nutritionist’s consultation.

Hepatic cancer surgery will take place at Tel Aviv's Assuta Medical Center.

Neoadjuvant Liver Cancer Treatment

If the disease has spread beyond the liver into other organs and/or the omentum, treatment will begin with neoadjuvant chemotherapy. Your treatment protocol will depend on the type of tumour. The chemotherapy protocol will be drawn up by Assuta’s oncologists, who are among the top specialists in their field in Israel.

A PET or CT scan and abdominal surgeon’s exam will be scheduled following 6 cycles of chemotherapy to evaluate response to treatment and assess the possibility of a surgical intervention.

Radiofrequency Ablation

RFA (radiofrequency ablation) is indicated in cases when a partial hepatectomy has been performed, but there are still tumour foci that need to be treated present in other lobes. Cost of procedure includes:

• Operative procedure and 2 or 3 days of hospitalization
• Surgical materials

SIRT Therapy

The innovative SIRT therapy is quickly becoming the inoperable liver cancer treatment of choice. Its cost includes:

• Oncologist consultation
• Radioactive microspheres
• Blood tests
• CT scan (according to specialized protocol)
• Invasive radiologist consultation
• 2 hepatic angiography procedures (diagnostic and therapeutic)
• Hospital stay and post-treatment care

Please note that the first (diagnostic) angiography procedure may show that SIRT therapy is contraindicated.

Provided there are no contraindications, your treating specialists will order the radioactive microspheres required for your treatment. They normally take around 10 days to arrive, and you don't need to be in Israel during this period. You will need to remain in isolation for 3 to 5 days following treatment with SIRT. Additionally, you will need to remain in Israel for 10 days following your discharge from the hospital for outpatient follow-up and care.