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New Oncology Treatments

There are innovative tests and treatments in the field of oncology, Hematology, which exist only in Israel and the United States.

The price in Israel for these tests and treatments is cheaper than in usa.

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New - Smart Biopsy Testing Directed MRI to Prostate Cancer Detection

How is it done ?

This is a "focused" biopsy using technology that combines an image from an MRI simulation.

The MRI-guided biopsy enables a computerized fusion of the MRI-related findings with the image on the ultrasound device, allowing the biopsy needle to precisely target the cancerous area and sample it.

The advantages of the test: accuracy of biopsies (biased and non-random biopsy), improvement in detection percentages.

Thyroid cancer surgery: Thyroidectomy without scars and neck scars

Removal of a tumor using a modern method that does not include a cut in the neck and leaves no scar at all. The operation is performed through a tiny incision in the mouth using a new technology that inserts a camera and surgical instruments through the inside of the mouth - beneath the lower gums. The surgery inserts a tiny camera and surgical instruments through a tiny incision in the mouth - beneath the lower gums, leaving no external scars. The camera transmits to the monitor where the doctor and the operating room staff are watching the operation.

The effectiveness of the operation is equal to that of the traditional surgery, but its great advantage is that there is no external scar on the neck, whose presence may have a psychological and emotional

 effect - especially among young women.

This method of surgery has been practiced for some time in the United States - where patients who undergo the procedure are discharged to their home that day.   

https://www.ynet.co.il/articles/0,7340,L-5176044,00.html

TIL  FOR YOUR MELANOMA TREATMENT

3  REASONS TO CONSIDER TIL FOR YOUR MELANOMA TREATMENT

(TIL) immunotherapy treatment turns your body’s lymphocytes into elite cancer-killing soldiers.

TIL  is very effective in patients with metastatic melanoma that have had little or no benefit from conventional therapies.

Only about 1% of all skin cancer cases are melanomas. However, melanoma is by far the deadliest form of skin cancer. Until recently, patients had limited options in melanoma treatment, especially if their melanoma was metastatic, meaning it had begun to spread throughout the body.

Thanks to recent advances in cancer treatment research, there is now another promising option – tumor-infiltrating lymphocyte (TIL) immunotherapy. This groundbreaking technique provides hope for many patients with even very advanced melanoma.

HOW DOES TIL MELANOMA TREATMENT WORK?

Everyone has cellular components within their immune system. One type of immune cells is white blood cells, also called lymphocytes. These lymphocytes will attack tumor cells, but in metastatic melanoma patients, the lymphocytes are not strong enough to make much progress against the tumor. This is where TIL comes in.

After removing part of the tumor, healthcare personnel isolate the lymphocytes. They then genetically engineer the lymphocytes to seek and destroy tumor cells, effectively turning the lymphocytes into elite cancer-killing soldiers. After being allowed to grow for a few days in the laboratory, doctors inject the lymphocytes back into the patient.

In this short video, Dr. Michal Besser and Prof. Jacob Schachter explain what TIL Immunotherapy is and its effectiveness treating patients with advanced metastatic melanoma.

 “Usually, within 4 weeks, we see the beginning of the clinical results. In the CT scans you see the metastasis getting smaller and smaller, and some of the metastasis finally disappear. If you achieve complete response, its durable, and you actually cure patients with advanced melanoma”

WHO CAN RECEIVE TIL TREATMENT IMMUNOTHERAPY?

TIL  is intended for malignant metastatic melanoma patients. This means that the cancer has penetrated through the outermost layers of the skin and may have moved into distant organs like the lungs. Conventional therapies, like chemotherapy, must have failed before TIL is tried.

WHAT ARE THE ADVANTAGES OF TIL TREATMENT IMMUNOTHERAPY?

This new therapy has several distinct advantages, including:

TIL uses the patient’s own white blood cells, so there is little risk of infection or allergic reaction.

TIL offers hope for patients whose cancer has not responded to traditional treatment methods.

TIL  can be very effective. Roughly half of all patients show improvement with TIL, with about 25% completely cured.

WHERE CAN I RECEIVE TIL IMMUNOTHERAPY TREATMENT?

Because of its advanced nature, TIL is not available everywhere. Only a few healthcare facilities in usa and in israel offer this therapy. 

Doctors at Sheba have participated in TIL research from the very beginning, and Sheba has a number of advantages when it comes to TIL immunotherapy and melanoma treatment in general:

Sheba has received full accreditation from the Joint Commission International (JCI), the foremost international healthcare accrediting authority.

MD Anderson Cancer Center in the US and Sheba Medical Center are close partners and sister institutions.

The Ella Lemelbaum Institute for Immuno-Oncology at Sheba is the largest and most advanced melanoma institute in the region.

Sheba has both advanced treatment and laboratory facilities. At Sheba, patients receive every aspect of their TIL treatment in a single facility. Even the lymphocyte genetic engineering is conducted in-house.

 

Til treatmet for ovarion cancer

In Israel, the world's first medical center has been selected for TIL treatment for ovarian cancer

It was decided to apply this promising treatment to patients with metastatic ovarian cancer, in which other treatments failed

Sheba Medical Center is the first medical center in the world to be approved to start a clinical trial of TIL in patients with ovarian cancer. Active recruitment of patients began in January 2018 following a preclinical study (which proved that we can grow TILs)

Study population: Ovarian cancer of any type that was chemically tolerated or after previous treatment lines failed, but no more than 3 previous treatment lines

  • Independent patient in functioning
  • Affected lesion for excision

Ovarian cancer is a highly aggressive disease in which the vast majority of patients face a poor prognosis. Although most patients initially respond to chemotherapy, the vast majority experience recurrence and develop increased resistance to existing therapies. Resistance to chemotherapy is a major obstacle in the treatment of ovarian cancer patients and new approaches are needed to try to extend the short life span and improve the quality of life of these patients.

Ovarian cancer, which ranks fifth in cancer deaths among women, is the most fatal gynecological malignancy. Today, clinical trials offer the best hope for developing new treatment paradigm for the persistent disease.

Lutetium-177 PSMA Therapy

Lutetium-177 PSMA Therapy, or Prostate-Specific Membrane Antigen Therapy, is treatment that is increasingly being used for people with advanced prostate cancer. Lu177 PSMA   therapy aims to reduce the size of the tumor  and stop them from multiplying, also to ease the symptoms and pain related to bone metastases. It is most often used when the disease has metastasised and when other therapies are poorly tolerated or have failed. 

How Does Lutetium-177 PSMA Therapy Work?

PSMA is a type of protein located on the surface of a cell and is naturally found on the prostate gland. In someone with prostate cancer, an increased amount of PSMA cell surface receptor is over expressed. If the prostate cancer has spread to other parts of the body ,  the PSMA will also appear in those areas. Lutetium-177 PSMA Therapy uses a molecule which attaches itself to the PSMA receptors on the cancer cells. the PSMA molecule is bound with Lutetium-177, which emits beta radiation, a destructive type of radiation that damages the cancer cells. The PSMA molecule acts as a means of transporting the radiation to the tumor site, so that the whole body does not get exposed to the radiation. This is often referred to as Peptide Receptor Radionuclide Therapy (PRRT) 

Treatment of radioactive iodine for patients with thyroid cancer

Who can be treated? 
The treatment of radioactive iodine is intended for patients with thyroid cancer, whether their disease was widespread or whether the disease was located in the neck.  The treatment is given after surgery to completely remove the thyroid gland, and its purpose is to harm all malignant cells left in the body.

How treatment works: 

  • The thyroid gland produces the thyroid hormone responsible for regulating the body's substances. Its chemical structure includes the iodine molecule.
  • The uniqueness of the thyroid gland is that it consumes a high rate of iodine, even during the presence of common malignant diseases of the gland.

This unique feature of the thyroid gland enables us to perform very effective treatment in cases of malignant tumors.Instead of supplying the body with active iodine, they provide a maximum amount of radioactive iodine. The thyroid cells absorb the radioactive iodine, which is actually a "trojan horse," and when it is absorbed into the cell, it destroys the cancer cells. It is absorbed at a very low rate in other tissues in the body so its damage there is quite marginal.

Course of treatment:
The treatment itself is given by swallowing a capsule. The capsule is absorbed in the body and is concentrated mainly in the thyroid cells. Radioactive iodine emits primarily beta radiation that does not endanger the environment. However, 8% also has gamma radiation emission, and can be dangerous.

Therefore, actions are required to reduce the exposure to radiation during the first few days: keeping a distance of 2-3 meters, ensuring urination (the iodine, most of which is secreted in the urine), etc.

The treatment of radioactive iodine is simple and effective, and the oncology community, happy if there was in our arsenal, would treat such diseases with other malignancies.

Prof. Rahamim ben Yosef

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Treatment of radioactive iodine for hyperthyroidism 

Hyperthyroidism is a condition in which the thyroid gland works fast and produces a large amount of thyroid hormone (hyperactivity). This hormone regulates the body's metabolism, pulse, breathing, nervous system, weight, body temperature and more.

Treatment:
Treatment of hyperthyroidism can be done by drugs that interfere with the production of hormones (but can cause side effects, and are not always effective), or surgery to remove the gland (involves the risk of surgery and damage to blood vessels and nerves, including paralysis of the vocal cords.) Another option is radioactive iodine therapy which destroys the cells that produce the hormone.

What is radioactive iodine?
Radioactive Iodine I-131 is used to treat hyperthyroidism from 1940. It is often used as a first line treatment - before surgery or other drugs. The radioactive iodine is absorbed into the thyroid gland and destroys the cells in the gland. It causes the gland to shrink, and reduces the amount of hormone produced by the gland.

Lyud has the best chance to cure hyperthyroidism for good. It is often used by doctors after treatment with drugs that block the gland, and can also be used after surgery of the gland if repeated activity.  Sometimes it is necessary to take medication to slow the heart rate.

Treatment: 
The radioactive iodine is given in a capsule, which is swallowed with water. After treatment, you should be in solitary confinement for a few days and avoid contact with infants, children and pregnant women. Rarely, additional treatment is needed. Two thirds of patients will develop hypothyroidism. This condition is more common during the first year after treatment, but can also happen later. The gland usually returns to normal function after 8-12 weeks.

Where are the therapists?

Prof. Lorberbaum is a specialist in nuclear medicine,  director of a nuclear medicine institute in a large hospital,  and has extensive experience in treating patients with  thyroid cancer and patients with hyperthyroidism.  A special  course in this field at Cornell Hospital in New York.

Anti-cancer Formula with International Patent Approval

 This formulation have been tested and proven in more than 40 scientific experiments in the laboratory and in hospitals as effective treatments for cancer diseases Anti-Cancer Number One, Composition for Treatment of Malignant TumorAnti-Cancer Number One, Composition for Treatment of Malignant Tumor Chinese medicine, Anti-Cancer Number One (ACNO) is new anti-neoplastic drug developed from Traditional Chinese Medicine. It has been used more than 20 years in Israel. Thousands of cancer patients were treated with ACNO. The efficacy of ACNO was 69.7% and ACNO combined with western medicine group was 84.3%.The clinical results showed that ACNO can improve immune system, inhibit cancer cells, improve blood circulation to suppress the growth and metastasis of tumor, increase the sensitivity to other therapies, diminish toxic and adverse effects of other therapies and drugs, improve sleep, increase appetite, alleviate pain and stress, improve liver and kidney function, and prevent leukopenia caused by radiotherapy and chemotherapy.It also elevates the body's anti-tumor capacity to reduce the relapse and metastasis and improve patient quality of life. 

Israeli technology revolutionizing brain cancer treatment

Optune, a skullcap developed in Israel that fights cancer using electric frequencies, has extended the lives of patients with glioblastoma, the most aggressive form of brain cancer, by months or even years.

There is no more accurate description of "thinking outside the box" than when talking about Optune, the Israeli innovation that fights glioblastoma (GBM), a particularly aggressive form of brain cancer.

Glioblastoma is the most common and aggressive primary brain cancer.

The average survival time after surgery combined with radiotherapy and chemotherapy (the standard treatment to date) is only 70 weeks. In most patients, the tumor will return after treatment.

Optune emerged from this despair. The technology, conceived by Israeli Prof. Yoram Palti, creates electromagnetic fields that interfere with cancer cells' ability to divide and multiply, causing them to stop growing. Fighting brain cancer from the outside

The idea behind the development is that molecules in the body have an electrical charge that can be manipulated. The transducers are attached to the patient's head and deliver alternating electric currents. The result of the electric field leads to abnormal division of cancer cells, and when the new cells divide improperly, they die.

https://www.ynetnews.com/articles/0,7340,L-5404104,00.html

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Innovative laser treatment for epilepsy

An innovative procedure at the Israel Medical Center suggests ablating the epileptic focus with a laser inserted into the skull during a minimally invasive procedure. Israeli patients are the first ones who were treated outside the USA.

  From now on, Israelis can also benefit from the new technology from the United States, which allows the ablation of the epileptic focus during a minimally invasive procedure, instead of opening the skull. Dr. Strauss says that the operation is intended for epileptic patients who, as noted, are resistant to drug treatment and to those with one and only epileptic focus, from where the seizures begin. "This is a friendly, minimally invasive alternative that significantly shortens the length of hospital stay and recovery," stresses Dr. Strauss.

This technological innovation that previously was performed in the USA only now is available in Israel thanks to Prof. Yitzhak Fried, the director of the Unit of Functional Neurosurgery in Ichilov..

Fried holds the same position at the UCLA Medical Center in California, where he was first exposed to the method. "This procedure, which is common only in some hospitals in the United States, requires a narrow subspecialization. It has been in use only for the last two years and so far it has been a great success," says Prof. Fried, "When I realized the tremendous potential of this advanced technology, I decided to import it to Israel for the benefit of the Israeli patients."

How is the procedure performed?

"The new treatment is performed with the LITT – laser interstitial thermal therapy, and is done in two stages: the patient is led to an operating room, given anesthesia, and an optic fiber is inserted into the center of the affected area through a small hole in the skull, up to four millimeters in diameter. Then starts the second stage: when the patient is still anesthetized, under the strict supervision of an anesthesiologist the patient is being inserted in an MRI device, where the laser beam is ablating certain focus in brain during continuous real-time monitoring, including of brain temperature. In this way nearby brain areas of critically important functions can be monitored and the heat of the laser beam removed from them", says Dr. Strauss.

This is a procedure that requires a multi-disciplinary team, the experts in neurosurgical anesthesia, the epilepsy imaging unit experts and more. "This multi-disciplinary team is focused on carrying out the operation that takes quite a long time, one hour for the insertion of the fiber and about an hour and a half for the brain ablation." After the ablation the patient is returned to the operating room where the optic fiber is removed out of his brain. The patient wakes up, is monitored for a while and the next day is sent home."

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Innovative laser treats kidney cancer without surgery

Cancer in the renal system so far required complete removal or removal of a large part of the urinary system. Now in Israel an innovative laser treatment is being introduced at the Sheba Medical Center, Tel-Aviv. The laser sends rays at two different wavelengths, removes the tumor without excision, minimizes patient's future risks and significantly shortens the recovery time..

The innovative and powerful laser device, developed to treat tumors in the upper urinary tract, currently is being used only at Sheba and in a few other leading medical centers in the world. In Israel, Dr. Nir Kleinman, a senior urologist, performs the procedure. His expertise in innovative procedure was acquired during his training at a leading medical center in Philadelphia..

"The kidney consists of two tissues, one that filters the blood and produces the urine, and the other is the collecting system, which is responsible for collecting the urine and delivering it to the bladder," Dr. Kleinman explains. "In each of these tissues, a different type of cancer may develop  "The innovative laser treats patients who have cancer of the urinary collecting system". 

The innovative laser replaces the surgery and preserves the kidney. "In fact, we're talking about two lasers in one machine, with two different wavelengths, which complement each another." This is the real innovation, because so far laser devices had a laser with only one wavelength..

So, how does it work?

"The patient is transferred to an operating room, is anesthetized and put on his back with his legs raised in lithotomy position, the surgeon stands between the patient's legs and inserts into the patient's urethra a thin optical fiber with a tiny camera. When the tumor location is discovered, a laser fiber, approximately 0.2 millimeters in diameter, is inserted through the endoscope. The fiber is connected to the generator, the doctor presses one of the two pedals, corresponding to the two different wavelength, and activates the energy of the laser. By the first laser the doctor hits the tumor and destroys it, and then the additional laser comes into action, cuts the tumor and completes the work," explains Dr. Kleinman.

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PRRT - An innovative treatment for oncology neuroendocrinology

(Peptide Receptor Radionuclide therapy) 
Targeted treatment of neuroendocrine tumors.

PRRT is the abbreviation of Peptide Receptor Radionuclide Therapy. This therapy is used for patients with neuroendocrine tumors (NET). NET is a rare form of cancer. By administering the radioactive protein lutetium octreotate to the patient, it is possible to treat the tumors with precision. The quality of life of the patient improves with this treatment in many cases.

PRRT and NET- is an abbreviation for Neuro-Endocrine Tumor. These tumors develop from the neuroendocrine cells that are present in every human body. In order to treat this form of cancer, we use Peptide Receptor Radionuclide Therapy (PRRT) at our treatment center..

The Peptide Receptor, located on the outside of the tumor cell, can bind peptides (=proteins). On neuroendocrine tumors (NETs) the peptide receptor is called the somatostatin receptor. It binds the body’s own protein somatostatin. For PRRT treatment we bind a radioactive particle (lutetium) to this protein. The somatostatin, with the lutetium attached to it, is then bound to the tumor cells by the receptor, and is thus transported inside. In this way, the radioactive lutetium octreotate can treat the tumor cell from the inside. This is a proven method which often has good results.

Preceding PRRT -The patient can only be treated if he or she has had a positive OctreoScan preceding the treatment, and if he or she meets other specific requirements. A positive scan shows that the radioactively marked octreotide is incorporated well at the NET site and at possible metastases. A scan is therefore important, as it gives a good indication of the results

https://netrf.org/prrt-approved-by-u-s-food-and-drug-administration-fda

https://www.cancercenter.com/treatments/peptide-receptor-radionuclide-therapy 

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Treatments for eliminating benign breast tumors and cancerous kidney tumors - by freezing and with no surgery

IceCure is an Israeli medical device company that has developed technology for eliminating benign and cancerous tumors in the breast and other parts of the body by freezing the tumor during treatment in a clinic and without surgery, uses the ProSense system, 

Treatment using ProSense is based on a system that streams liquid nitrogen is a closed circuit and then freezes with a unique needle developed by IceCure, benign and malignant tumors while protecting the healthy tissues surrounding the tumor and eradicating the entire tumor. The treatment of breast tumors uses a minimally invasive approach that allows swift recovery with no scars. The treatment lasts about 20-40 minutes in a medical clinic, without surgery, hospitalization or stitches and without changing the shape or size of the breast. Consequently after treatment the patient is able to return quickly to daily activities and follow-up of the lesion is similar to follow-up after surgical removal.

https://en.globes.co.il/en/article-icecure-begins-eliminating-cancer-by-freezing-in-israel-1001250194

 

 

Advanced Radiation Treatment with MRI-Guided Linear Accelerator (MRI-LINAC)

For the first time, cancer patients in Israel and from other countries in the world will have a cutting-edge option for radiation treatment, known as MRI-Guided Radiation Therapy (MRI-RT). There are few devices in the world of this model.

Magnetic Resonance Imaging Guided Linear Accelerator (MRI-LINAC) uses magnetic resonance imaging, or MRI, together with radiotherapy to treat cancers throughout the body, with specific advantages for soft-tissue tumors. The radiation delivery on the MRI-LINAC is fully integrated with the MRI. This means the system can deliver treatment radiation beams and monitor the target area at the same time. The unique combination of technologies gives our physicians greater control over the delivery of radiation because they can see the internal anatomy and tumor. They can fine-tune the radiation treatment plan and personalize and adapt each treatment in ways they never could before.

What are the advantages of having an MRI scanner integrated into a linear accelerator (device used to deliver external beam radiation therapy)?

MRI-based imaging on a linear accelerator offers superior high-definition image quality, especially for some soft tissue cancers, as compared to traditional linear accelerators which use x-ray-based imaging to visualize the target area and adjacent anatomy for treatment setup and delivery.

Are there fewer side effects for MRI-guided radiation therapy compared to tradition radiation therapy?

The MRI image will allow your doctor to target the tumor with increased accuracy and precision with the ultimate goals of reducing the amount of radiation exposure to surrounding organs and reducing potential side effects.

Why is MRI-guidance on a linear accelerator a technological breakthrough?

Seeing is Adapting. Tumors and organs move. The MRI-LINAC can adapt the radiation treatment plan based on movement of the tumor or your organs, and also track the motion of the tumor.

When you breathe, swallow or digest food, your internal organs move and even the smallest movement can affect the position of a tumor, which makes accurate targeting of radiation therapy difficult.

The MRI-LINAC uses continuous MRI, capturing multiple images every second, to see the soft tissue and organs moving and then to compensate for these movements during treatment.

The MRI-LINAC also includes advanced software that allows your doctor and treatment team to adapt your radiation treatment plan based on what they see each day. This level of personalization of radiation therapy has not been previously possible.

What can I expect during the MRI-LINAC treatment?

Treatment on the MRI-LINAC is a non-invasive procedure and most patients can return to their normal routine after treatment.

The Alpha DaRT Treatment

There are many types of cancer treatments, with differing levels of effectiveness. However, all existing treatments include substantial health risks or damage to the patient.

Alpha DaRT enables a highly potent and compliant radiation treatment for solid cancer. Directly inserted into the tumor, the Alpha DaRT seed releases high-energy doses over a range of a few millimeters enabling a treatment that spares the surrounding healthy tissue. In addition, research has not shown systemic side effects.

Alpha DaRT has several significant advantages:

Highly potent and conformal - The Alpha DaRT seed releases short-lived Alpha emitting atoms. These atoms emit high-energy Alpha particles which destroy the tumor. Since the atoms hardly diffuse into healthy tissue, Alpha DaRT mainly affects the tumor, sparing the healthy tissue around it.

No negative systemic effects - Promising preliminary clinical results showed no systemic side effects and minimal damage to healthy tissue.

Proven efficacy for all solid tumors tested - Preclinical studies have found the technology to be effective and safe for various indications, including tumors considered to be resistant to standard radiotherapy. The size of Alpha DaRT seeds is similar to fiducial markers enabling the treatment of small tumors and metastatic lesions.

Effective regardless of tumor oxygen level - Alpha radiation has proven efficacy independently of cell cycle stage and oxygenation level of the tumor. Hence, the Alpha DaRT treatment can be applied to hypoxic tumors which show great resistance to gamma radiation.

Short half-life - quick clinical outcome - Thanks to the short half-life of Radium-224 (3.7 days), Alpha DaRT achieves quick clinical results within a few days only.

Single-session treatment - Alpha DaRT can be applied under local anesthesia in a short single session.

Enables combination with other therapies - Proven in preclinical trials, efficacy and overall survival rate can be further improved by combination treatment of Alpha DaRT with other modalities such as chemotherapy and immunotherapy.

Stimulates systemic anti-tumor immunity - Tumor destruction by Alpha DaRT has been shown to stimulate anti-tumor immunity which is responsible for the elimination of distant metastases.

Safer for caregivers - The level of exposure to gamma radiation during and after treatment has proven to be negligible. This ensures higher safety for both the patient and the physicians.

Ultra-minimally invasive applicators - The company has developed ultra-minimally invasive applicators that can be utilized for various types of tumor within different anatomic areas.

Cost-effective - Since Alpha DaRT applicators are available and the treatment does not require capital equipment or special shielding, Alpha DaRT will be available to millions of patients worldwide.

The relevant cancers are and the areas are relevant:

Breast Cancer, Skin Cancer, Oral Cavity Cancer, Skin Metastases

 SCC Squamous Cell Carcinoma, BCC Basal Cell Carcinoma

  MCC או Merkel Cell Carcinoma ,Melanoma

Oral cavity (tongue, lips, ...), cheek, ear, nose, forehead, scalp, limbs

LITT - a new technique to treat brain tumors

LITT Innovative American technology in Israel as well

Laser interstitial thermal therapy (LITT) is a new technique to treat brain tumors that can’t be removed through surgery. It may also help patients whose tumors don’t react to radiation therapy. It is commonly used to treat gliomas and brain metastases.

Laser interstitial thermal therapy (LITT, also called MRI-guided laser ablation) is a minimally invasive surgical technique that allows surgeons to precisely target and ablate tumor tissue.

LITT uses laser energy to heat up and destroy tumor cells. It is a minimally invasive procedure with a faster recovery than craniotomy (open brain surgeries). LITT is most effective on smaller tumors.

Laser interstitial therapy can be used to remove brain tumors

LITT is a minimally invasive therapy that uses a thin laser fiber (arrow) guided with real-time MR imaging to precisely destroy tumor tissue.

Because this technique only requires a small incision and hole to guide the laser fiber through, the treatment does not involve a craniotomy and is considered minimally invasive. The procedure typically last 3-4 hours; much of it is spent carefully positioning the laser fiber, while the laser treatment itself takes minutes. Most patients are discharged the next day.

Tumor types that may be treated using LITT include gliomas and brain metastases. However, use of LITT also depends on a number of factors including tumor size, shape, and location. For example, LITT is most effective on tumors that are less that 3 cm in diameter and have a spherical shape.

Laser interstitial thermal therapy (LITT) is an emerging technique to treat primary and metastatic brain tumors that can be hard to reach with conventional surgery. LITT is  performed by implanting a laser catheter into the tumor and heating it to temperatures high enough to kill the tumor.

The catheter is implanted using advanced computer imaging techniques. The laser is guided through the catheter with real-time MRI, allowing neurosurgeons to limit thermal energy delivery only to the tumor. Most patients can go home the day after treatment and can quickly return to normal activities.

Laser interstitial thermal therapy is minimally invasive. It typically requires only a 2-millimeter incision in the scalp, and takes only a few minutes to perform.

LITT can also help patients who do not respond to stereotactic radiosurgery or have radiation necrosis tissue death caused by.


 Proton treatment

FDA-cleared, in-room diagnostic quality 4D CT is integrated with an adaptive therapy workflow, and combined with pencil beam scanning, ensuring the treatment plan is always updated and delivered to the patient with unprecedented precision.
 
The benefits of treating patients in the seated position include more precise proton beam delivery, better clinical outcomes, as well as greater patient comfort, less internal organ movement, better saliva drainage and a easier breathing for asthmatic and other patients experiencing impaired breathing.
It may also deliver less collateral radiation to sensitive organs while enabling greater accuracy in proton beam delivery. Adult and pediatric patients who will initially benefit from this clinical breakthrough will be those treated for cancers of the lung, breast, chest, head and neck, and lower torso.
 
Greater comfort, less organ movement, with potentially reduced collateral radiation to sensitive organs.
Clinical Efficacy; aims to shift treatment efficacy to a new, unprecedented level – a quantum leap forward in reducing the magnitude of internal organ motion and markedly improving imaging resolution.
Clinical Safety; treatment solution is expected to yield improved dose distribution, thereby exposing healthy tissues and organs to significantly less radiation.
 
Head & Neck Treatment
The first clinical application for proton therapy was for cancers in the head. The precise nature of proton therapy makes it an excellent option for the treatment of head and neck cancers.
 
Lung Cancer Treatment
Until now, lung cancer patients undergoing CT scanning and proton therapy normally lie flat on their backs. Research shows that when patients are imaged in an upright position compared to a supine position, motion within the lung was reduced and absolute lung volumes were much larger.
 
Breast Cancer Treatment
Breast cancer is a leading cause of cancer death, surpassed only by lung cancer. Although proton treatment is relatively new for breast cancer, clinical trials have already shown excellent signs of disease control and minimal side effects compared with traditional forms of treatment.
 
Chest Cancer (Mediastinum) Treatment
The seated position offers distinct advantages because the upright position for both treatment planning and treatment delivery permits more precise targeting of the tumor for placement of the proton beam.
 
Liver Cancer Treatment
Liver metastases are cancerous tumors that originate elsewhere and spread to the liver. Because the liver is the central filtration point for all the blood that circulates through your body, cells from many types of cancer that begin in other parts of your body — such as the colon, breast, pancreas, skin and lungs — can spread to the liver and metastasize, or grow into secondary cancerous tumors.
 
Pancreatic Cancer Treatment
The nature of pancreatic cancer, combined with the location of the pancreas and its proximity to other sensitive tissues, can make the disease challenging to treat.
 
Abdominal Treatment
Treatment for GI tract tumors often requires a combination of radiation therapy and either chemotherapy or surgery.
 
Prostate Cancer Treatment
Proton therapy has shown remarkable advantages over conventional therapy – especially in the treatment of prostate cancer. 

Microbiome transplantation for the treatment of melanoma at Sheba Tel Hashomer Hospital.

 Sheba Medical Center offers Fecal Microbiota Transplant (FMT) for metastatic melanoma patients .

Microbiome transplantation is a procedure that involves changing the gut microbiota of a patient by introducing bacteria from a healthy donor. The gut microbiota plays an important role in the immune system and its response to cancer treatments, such as immunotherapy. By altering the microbiota, the goal is to enhance the effectiveness of immunotherapy and improve the outcomes for patients with metastatic melanoma.

Sheba Medical Center is one of the few hospitals worldwide that offers fecal microbiota transplant for metastatic melanoma patients who have exhausted other lines of treatment. The procedure is performed by colonoscopy or oral stool capsules, after the patient receives antibiotics to deplete their native microbiota. According to preliminary studies, the procedure, followed by immunotherapy, can cause a reduction in the size of metastases and even lead to complete remission in some cases.

By eradicating the microbiome of a melanoma patient who is unresponsive to immunotherapies and replacing it with bacteria taken from patients who have responded to the treatment, a patient’s responsiveness to cancer immunotherapy can be significantly improved. According to preliminary studies, the procedure, followed by immunotherapy, is indicated to cause a reduction in the size of metastases and even lead to complete remission in some metastatic melanoma patients.

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