Lung Cancer Treatment in Israel

When a bronchopulmonary system malignancy is suspected, it is vital to confirm the diagnosis as quickly as possible and assess the extent of the involvement of the respiratory tract and whether the disease has metastasized. Presented below is the lung cancer treatment in Israel program.

Causes and Symptoms

Specialists identify two types of lung cancer based on the tumour’s location: central and peripheral. Central cancer develops in the bronchi, while the peripheral variant develops in the lung tissue. The first symptom of central cancer (also called bronchus cancer) is usually dry cough, with coughing up phlegm and haemoptysis appearing at a later stage. Peripheral cancer is often asymptomatic during the early stages (it is often discovered by chance during routine screening). Strong pain, coughing and elevated temperature are seen when the tumour invades either the bronchi or the pleura.

You are advised to promptly seek treatment if you experience some of the aforementioned lung cancer warning signs.

Common causes of pulmonary carcinoma include:

• Cigarette smoking (lung carcinoma is 15 to 25 times more common among smokers than non-smokers)
• Chronic pneumonia
• Chronic bronchitis
• Scarring of lung tissue d/t tuberculosis
• Exposure to asbestos

Diagnosis

Following a PET/CT scan, a biopsy is performed to determine the tumour’s morphological characteristics. Depending on the mass’ location, either a punch (under US/CT guidance) or bronchoscopic biopsy is indicated. The obtained material is then sent for various studies (including histopathology, histochemistry, cytology and bacteriology, and, if required, EFGR mutation test). These will help determine the immediate treatment plan, and will help the treating physicians select the most appropriate chemotherapy protocol later on.

Investigations included in the lung cancer treatment in Israel program:

• Full blood workup (CBC, CMP, electrolyte levels, coagulation factors, lipid profile and tumour markers)
• PET CT to evaluate the size of the tumour and assess metastases
• Lung function tests (spirometry, diffusion capacity and blood gas analysis at rest and following exercise)
• Pulmonary biopsy (punch or bronchoscopic) and subsequent histopathological and immunohistochemical studies
• Optional: Expedited histopathological study
• ECG
• Pulmonary oncologist consultation

Duration of program: 7 business days. Workup will take place at Tel-HaShomer and Assuta Tel Aviv hospitals.

Treatment

Usually, if the mass is small in size, the recommended treatment is a lobectomy. The cost of the operation includes:

• Routine preoperative investigations including an ECG, chest X-ray and an anesthesiologist consultation
• Operative procedure and 6 days of hospitalization
• Disposable surgical materials and equipment
• Express biopsy and definitive histopathological study

The surgery will take place at the Department of Thoracic Surgery at either Tel HaShomer or Assuta.

It is advised you remain in Israel for 10 days following your discharge from the hospital.

Chemo and Radiotherapy

Chemotherapy is indicated in the event of metastases into lymph nodes and/or other organs. The treatment protocol will be determined by an oncologist from Assuta. You can choose to undergo the therapy either in Israel or in your country of residence (according to the Israeli protocol). The cost of chemotherapy for lung cancer depends on agents and dosages used.

In cases when the cancer affects more than 1 lobe but has not spread beyond the lungs, a cutting-edge radiation therapy IMRT RapidArc® (integrated boost) technology is applied alongside chemotherapy. It allows maximizing the radiation dosage delivered to the tumour while minimizing the harmful effect to the surrounding healthy tissues. The tumour’s size is continuously monitored by means of dynamic CT-scans. This technique has increased the intensity of radiation applied to the tumour cells by approximately 30 to 40 per cent, and, as a result, significantly improved both the efficiency of radiation therapy and treatment tolerance in patients.