Treatment of Gliomatosis in Israel

Numerous reviews indicate that foreign patients appreciate the competent organization of the treatment process, comfortable conditions, and the provision of a companion who helps resolve organizational issues in a foreign country. The affordable cost of therapy is also of great importance. Despite the negative prognosis of the disease, Israeli clinics manage to significantly alleviate symptoms, slow the progression of the malignant process, and maintain the patient's quality of life.

About the Disease

Brain gliomatosis is a rare form of glial tumour in which malignant cells affect several areas of the brain, spreading diffusely without clear boundaries. In the last decade, gliomatosis is no longer considered a separate disease but rather an aggressive type of diffuse glioma.

Depending on the type of cells in the tumour zone, the following types of gliomatosis are distinguished:

• astrocytic (the most common);
• oligodendroglioma;
• glioblastoma (the most aggressive).

The exact causes of the disease development have not been established, but factors contributing to the occurrence of mutations characteristic of tumour gliocytes have been identified.

Factors stimulating malignant cell transformation include:

• chemical and physical mutagenic factors (radioactive radiation, toxic chemicals, food colorants and emulsifiers, air contaminated with industrial waste);
• oncogenic viruses (herpes virus, cytomegalovirus);
• suppression of the immune system (some medications have immunosuppressive effects, as do long-term chronic diseases);
• some hereditary diseases;
• genetic predisposition.

It is important to note that neither frequent stress nor traumatic brain injuries are considered proven causes of gliomatosis.

Since gliomatosis spreads diffusely, clinical signs can vary significantly and gradually increase. The main symptoms of the disease include:

• headache;
• signs of increased intracranial pressure (nausea, vomiting, feeling of pressure on the eyes);
• dizziness;
• neurological disorders (coordination problems, unsteady gait, speech and vision problems);
• cognitive changes (memory decline, inability to concentrate, slowed thinking, difficulties in performing routine tasks);
• behavioral changes (increased irritability, aggressiveness, decreased activity, apathy);
• epileptiform seizures (often one of the first signs).

Treatment Methods for the Disease

Since the tumour has a diffuse nature and affects several areas of the brain, treatment of gliomatosis must be comprehensive. At the Ichilov Clinic, therapy is based on a multidisciplinary approach: neuro-oncologists, radiologists, chemotherapists, and molecular diagnostics specialists collaboratively develop an individual treatment plan.

Chemotherapy

Typically combined with sessions of radiation therapy. At the Ichilov Clinic, chemotherapy courses are conducted using the latest chemotherapeutic agents that combine effectiveness and minimal toxicity. These agents do not cause severe side effects, which are particularly difficult for weakened patients to tolerate. The most effective combination of several agents is polychemotherapy. Their selection depends on the molecular profile of the tumour.

Radiation Therapy

The Ichilov Clinic widely uses modern methods of targeted radiation, which is especially important for diffuse tumours. IMRT (Intensity-Modulated Radiation Therapy) is usually applied – high-precision radiation using modern computerized accelerators. This technique allows for maximum doses of radiation to be directed specifically at the massive areas of gliomatosis while minimizing negative impacts on important brain structures. The therapeutic effect is enhanced when radiation is combined with chemotherapy.

Targeted and Molecularly-Directed Therapy

Targeted therapy is a treatment that affects specific molecular mechanisms that ensure the growth and survival of tumour cells. In the case of brain gliomatosis, this method is particularly valuable, as classical surgical methods are ineffective for diffuse oncological diseases. In Israeli clinics, an extensive genetic analysis of the tumour tissue sample is conducted before prescribing targeted therapy. The advantages of this method include its high selective effectiveness and the absence of severe side effects for the patient.

Immunotherapy

For certain molecular characteristics of the tumour, drugs that enhance the patient's own anti-tumour immunity may be used. The Ichilov Clinic uses drugs based on specific monoclonal antibodies.

Symptomatic and Supportive Therapy

Since gliomatosis causes a wide range of neurological disorders, the Ichilov Clinic pays great attention to supporting brain functions. To this end, the treatment program includes:

• medication therapy (anti-edema, anticonvulsants, drugs to control intracranial pressure);
• measures to prevent complications;
• physiotherapeutic methods;
• exercises to restore motor functions;
• sessions with a neuropsychologist.

Neurorehabilitation

At the Ichilov Clinic, neurorehabilitation is included in the treatment plan from the very beginning. The rehabilitation program includes:

• correction of motor disorders;
• improvement of cognitive skills;
• sessions with a speech therapist and neuropsychologist;
• activities for adaptation in daily life.

Innovative Programs and Clinical Trials

Since gliomatosis is an extremely rare and complex tumour, Israel actively participates in international research. Patients may gain access to:

• new molecular drugs;
• personalized drug regimens based on tumour genetic markers;
• experimental combinations of chemotherapy and radiation sessions.