From all over the world, the Ichilov Medical Center attracts doctors who are experts in their fields and have extensive practical experience. The clinic provides comprehensive treatment for acral lentiginous melanoma in Israel, combining the latest advancements in surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.
The Ichilov Clinic adheres to strict international standards of medical practice and safety. Each patient is approached individually. The medical center is equipped with the most modern medical equipment and technologies, actively participates in research, and provides patients access to the latest drugs and therapeutic approaches.
To serve international patients, Ichilov employs staff who speak multiple languages. The clinic emphasizes quality of service and patient comfort, offering comprehensive support in organizational matters. In addition to direct medical treatment, Ichilov provides psychological support services, assistance in rehabilitation after surgeries and other procedures.
About the Disease
Acral lentiginous melanoma is one of the subtypes of melanoma. It is an aggressive form of skin cancer that originates in melanocytes – the cells that produce the pigment melanin. The peculiarity of the pathology is its localization: it most often appears on acral surfaces of the body, such as the palms, soles, or under the nails. This type of melanoma is the most common among dark-skinned individuals but can occur in people of all races.
The exact causes of acral lentiginous melanoma are not known. It is believed that, as with other forms of melanoma, genetic mutations in melanocytes play a major role, causing their uncontrolled division and the formation of malignant conglomerates.
The main symptoms of acral lentiginous melanoma include:
- the appearance of pigmented areas on the skin of the palms, soles, or under the nails, which may be brown, black, or multicolored;
- gradual increase in the size of pigmented areas;
- change in color of an existing mole or pigmented spot;
- asymmetry of shape, unclear or jagged edges of the pigmented area;
- subjective changes in the affected area, such as itching or bleeding;
- thickening or peeling of the skin in the area of the spot, and in rare cases – tenderness.
Treatment Methods for the Disease
Treatment of acral lentiginous melanoma may include a combination of interventions, depending on the stage of the disease, the size and location of the tumour, as well as the overall health of the patient.
Surgery
Surgical removal is the primary and most commonly used method for treating acral lentiginous melanoma, especially in the early stages. The main goal of surgical intervention is to completely remove the tumour with clear margins, that is, with a section of healthy tissue around it, to minimize the risk of recurrence. Depending on the size, location, and stage of the cancer, several types of surgical techniques are used:
- wide local excision. This method involves removing the melanoma with a certain margin of normal tissue around the tumour, known as the excision margin. The size of the margin is determined based on the thickness of the melanoma and can range from 1 to 2 cm. This helps reduce the likelihood of melanoma recurrence;
- amputation of the phalanx. In cases where the melanoma is located on a finger due to its size or depth, partial or complete amputation may be required to avoid recurrence and provide the patient with the best chances of survival;
- sentinel lymph node biopsy. Sentinel biopsy is used when there is suspicion of cancer cell spread through the lymphatic pathways. The procedure involves marking and removing the first – sentinel lymph node, where cancer may metastasize from the primary tumour. The node is examined under a microscope for cancer cells.
- reconstructive surgery. After the removal of large tumours or in cases where significant skin excision has been performed, reconstructive plastic surgery may be necessary. To restore function and appearance of the affected area, skin flaps or grafts from healthy areas of the patient's body are used during the procedure.
The choice of surgical technique depends on a number of factors, including the stage and location of the melanoma, and the ability to meet the functional and aesthetic needs of the patient.
Immunotherapy
Immunotherapy is an approach that stimulates or restores the body's own immune system's ability to fight cancer cells. Special drugs, such as checkpoint inhibitors, block the proteins that allow cancer cells to “hide” from the immune system.
The effectiveness of immunotherapy varies depending on the specific clinical situation and individual characteristics of the body. Immunotherapy targets specific proteins on the surface of immune or cancer cells, removing the brakes on the immune system and stimulating it to attack and destroy malignant cells.
Targeted Therapy
Targeted therapy is a method aimed at specific molecular targets that play a key role in the growth and survival of cancer cells. Targeted therapy is most often used to treat metastatic or unresectable forms of cancer in patients whose tumours have certain genetic mutations. For example, patients with a mutation in the BRAF gene, which is present in approximately 40-50% of all patients with metastatic melanoma, may use BRAF inhibitors and MEK inhibitors that block the molecular signaling pathway that stimulates the growth and division of cancer cells.
Chemotherapy
Chemotherapy is used in cases of advanced melanoma. This treatment method is less effective compared to immunotherapy and targeted therapy for this type of malignant pathology. Therapeutic procedures are based on the use of specific cytotoxic drugs to destroy cancer cells.
Radiation Therapy
Radiation therapy is recommended for controlling the disease in a specific area, especially if surgical treatment is not possible, or to reduce symptoms in advanced melanoma. Ichilov uses the latest radiation therapy equipment, such as the TrueBeam linear accelerator produced by Varian Medical Systems, and Lunac.
These are examples of the most advanced equipment on the market for radiation therapy and radiosurgery systems. They provide high precision and speed of irradiation in the treatment of cancer and other diseases. Both traditional radiation therapy techniques and advanced modulated methods, including VMAT (volumetric modulated arc therapy) and SRS/SBRT (stereotactic radiosurgery/stereotactic body radiation therapy), are used in treatment.
- Radiation therapy
- Chemotherapy
Diagnostic Methods for the Disease
Ichilov conducts comprehensive and accurate diagnostics of acral lentiginous melanoma. This allows for adequate and timely treatment and significantly improves the prognosis for the patient.
First Day
Patient diagnostics begin with a physical examination and medical history collection. The doctor analyzes the symptoms and compiles a list of the most informative specialized studies.
Second Day
The patient undergoes laboratory tests and imaging tests.
- Laboratory studies. May include blood tests aimed at assessing the overall condition of the body and the functioning of organs that may have metastasized.
- Dermatoscopy. A non-invasive procedure that allows for the assessment of the structure and distribution of the tumour's pigment.
- Sentinel lymph node scintigraphy.
- Sequential photography. The method of serial photography allows tracking the dynamics of changes in pigmented spots or areas of skin.
- Genetic testing. In some cases, testing for genetic mutations that may affect the prognosis and treatment of the patient (e.g., BRAF, c-KIT) may be recommended.
Third Day
Interpreting the research results provides the necessary data for accurate diagnosis and selection of the optimal treatment strategy. The decision to initiate treatment for acral lentiginous melanoma is made by doctors from several specialties. Typically, the team includes: a dermatologist, surgical oncologist, oncodermatologist, specialists prescribing systemic treatment, including chemotherapy, immunotherapy, and targeted therapy, a pathologist, and a geneticist.
The team approach allows for consideration of all aspects of the disease and the patient's characteristics. The multidisciplinary team is capable of assessing the risks and benefits of available treatment options, combining different perspectives and expertise.
How Much Does Treatment Cost
The cost of treating acral lentiginous melanoma at the Ichilov clinic in Israel depends on many different factors: the stage of the disease, the volume and complexity of the surgical operation, the need for additional therapy, including chemotherapy, radiation, targeted therapy, or immunotherapy. The cost is influenced by the number of consultations and the complexity of diagnostic procedures, the duration of stay in the medical center, expenses for the accompanying person's accommodation, transportation, and translation services.
Contact a medical consultant by phone, through online chat, or a special feedback form on the website to find out the clinic's ratings, reviews, and treatment costs. A more detailed and accurate individual estimate is calculated after reviewing the medical documentation and determining the optimal treatment protocol for the specific patient.
Advantages of Treating Acral Lentiginous Melanoma at Ichilov Clinic
- Highly qualified specialists, quality, and safety of treatment.
- Multimodal approach and personalized therapy programs.
- Innovative technologies, research, and development.
- Language support for foreign patients.
- Patient-centeredness, support during treatment, and post-treatment follow-up.
Even before arriving at the clinic, you can schedule a remote video consultation via Zoom or Skype with doctors who have a high level of specialization and expert reputation in the treatment of acral lentiginous melanoma. Consult with professionals who know everything about the possibilities and modern methods of therapy.