Nasal Cancer Treatment in Israel

Dr. Orit Gotfeld

Head of the Head and Neck Division of the Oncology Institute

Thanks to a combination of scientific research, clinical experience, and technological infrastructure, Israel has become one of the key places for head and neck cancer therapy. Nasal cancer treatment in Israel is conducted according to a comprehensive individual program that includes advanced surgical and conservative methods. Israeli oncologists perform precise tumor verification, analyze its molecular markers, determine the anatomical features of the nasal cavity and sinuses, and predict the behavior of the neoplasm. Thus, with early-stage tumor diagnosis and comprehensive antitumor therapy, a positive prognosis is often indicated.

>80%

of patients choose an online consultation with an Israeli expert before arriving at the clinic

>30%

of patients received innovative treatments unavailable in local clinics

2384

patients have used comprehensive medical services

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Table of Contents

Treatment Methods

Diagnosis

Prices

In Israeli clinics, the organization of the treatment process is also strictly structured. The patient undergoes a comprehensive examination within a few days, with diagnosis and therapy program development handled by a multidisciplinary medical commission, allowing for the determination of the optimal strategy. Reviews indicate that comfortable treatment conditions, assistance provided by the clinic in resolving organizational issues, and reasonable costs are very important for international patients.

About the Disease

Nasal cancer consists of malignant neoplasms that arise in the nasal cavity or paranasal sinuses. The disease is relatively rare, and its timely diagnosis is complicated by the fact that the first symptoms resemble those of common ENT inflammation. The tumor can form from different types of cells – glandular, squamous, neuroendocrine – and the characteristics of each type vary.

The peculiarity of nasal cancer is that the tumor develops in an anatomically complex area where vital structures that ensure breathing, vision, and smell are located. Therefore, even minor changes require precise assessment.

There is no single exact cause for the occurrence of malignant neoplasms in the nose, as is the case with most cancerous tumors. It has been proven that various types of mutations occurring in the cells of the nasal mucosa and sinuses act as triggering mechanisms. Known factors significantly increase the risk of developing the disease:

• occupational hazards (wood dust, leather, textile dust, flour production waste, chemical solvents);
• chronic inflammatory processes (rhinosinusitis, septal deviation, polyposis);
• infection with human papillomavirus;
• smoking.

In the early stages, the disease successfully masquerades as common ENT pathologies. For this reason, the diagnosis is often made late, when symptoms become pronounced, and the malignant process spreads throughout the body.

The most characteristic clinical signs include:

• persistent nasal congestion, difficulty breathing;
• discharge from one nostril (often with blood);
• headaches;
• reduced or lost sense of smell;
• sensation of pressure in the area of the paranasal sinuses;
• recurrent nosebleeds;
• pain in the area of the eye socket and upper jaw;
• constant tearing;
• swelling of the eyelid or cheek;
• sensation of a foreign body in the nose.

In the late stages of the disease, the following symptoms may manifest:

• vision impairment (double vision, decreased sharpness);
• change in the shape of the nose;
• enlargement of cervical lymph nodes;
• difficulties in opening the mouth.

Treatment Methods for the Disease

The Ichilov Clinic employs a multi-level, personalized approach to the treatment of nasal and paranasal sinus tumors. Thanks to an effective combination of methods, excellent results can be achieved even in advanced stages of therapy, in clinically complex cases.

Surgical Treatment

The primary therapeutic method remains surgical removal of the tumor. The type of surgery and the volume of resected tissues depend on the location and stage of development of the neoplasm. In cases where the tumor is detected on one side of the nasal cavity, partial rhinsectomy is permissible. If the tumor focus is located in the nasal septum, and in cases of significant tumor size, a decision may be made for complete rhinsectomy, i.e., removal of all tissues in the nasal cavity. Often, surgical intervention is not possible when the tumor grows and malignant cells spread.

Key features of surgery at the Ichilov Clinic include:

• endoscopic endonasal surgery – a standard method allowing for tumor removal through natural pathways, without external incisions, using HD endoscopes and 3D visualization systems, characterized by effectiveness and minimal trauma;
• extended endoscopic access – often performed even in cases where traditional open surgeries are conducted (involvement of the eye socket and base of the skull in the pathological process);
• combined access – a combination of endoscopy and microsurgery allows for tumor removal even in hard-to-reach places while maximizing the preservation of healthy tissues;
• reconstructive surgery – to eliminate cosmetic defects that arise, a reconstructive plastic surgery using the patient's own tissues or 3D-printed implants is performed within the same intervention.

Radiation Therapy

Radiotherapy sessions usually form part of a comprehensive antitumor program but may replace surgical intervention in the early stages of the disease. Typically, radiation therapy is conducted after surgery (neoadjuvant radiotherapy) to destroy any remaining viable cancer cells post-intervention. If, for any reason, surgical treatment is not possible, therapy begins with simultaneous chemotherapy and radiation.

At the Ichilov Clinic, IMRT – intensity-modulated radiation therapy is most commonly used, allowing for the adjustment of the dose and direction of the radioactive beam. The main impact is on the pathological focus, with minimal involvement of surrounding healthy tissues. Sessions are conducted on modern linear accelerators capable of operating in various modes.

Chemotherapy

At the Ichilov Clinic, chemotherapy drugs are selected after histological analysis of tumor tissues and molecular-genetic analysis.

Chemotherapy comes in two types:

• neoadjuvant – prescribed before surgery to reduce tumor size and facilitate future resection and alleviate painful symptoms;
• adjuvant – conducted after surgical removal of the neoplasm to destroy any remaining malignant cells.

Israeli clinics use low-toxicity chemotherapy drugs of the latest generation, exerting minimal impact on the weakened patient’s body and not causing severe side effects. To enhance the therapeutic effect, combinations of several chemotherapy drugs (polychemotherapy) are used. Schemes with dose modification based on the patient's genetic characteristics are also employed, for which pharmacogenetic testing is conducted.

Targeted and Immune Therapies

The advanced molecular-genetic diagnostics of tumors conducted in Israel allow for the identification of targets for:

• targeted drugs that block growth receptors or vascular factors – proteins without which the growth and division of malignant cells are impossible;
• immune drugs that help the patient’s own antitumor immunity find and destroy cancer cells.

These methods are applied in the late stages of the disease, when other treatment methods are ineffective, as part of comprehensive programs for localized tumors with a high risk of recurrence.

Diagnostic Methods for the Disease

The high qualifications of specialists and the modern equipment of the Ichilov Clinic allow for diagnostic examinations to be conducted within three days, determining the correct diagnosis.

First Day

On the first day of their stay at the clinic, the patient must attend a primary consultation with the treating oncologist. During the appointment, the doctor reviews medical documentation, familiarizes themselves with complaints, conducts a superficial examination, and prescribes additional examinations.

Second Day

Conducting examinations:

• endoscopic examination of the nasal cavity;
• CT of the paranasal sinuses and base of the skull;
• MRI of the brain, sinuses, and neck;
• biopsy (obtaining a sample of tumor tissues for cytological and immunohistochemical studies);
• determination of the molecular-genetic profile of the tumor (NGS diagnostics);
• laboratory blood tests (general and biochemical analyses, detection of tumor markers, immunological tests, analysis for certain viral infections).

Third Day

The medical council reviews the obtained results, based on which the diagnosis is determined and effective antitumor methods are selected.

How Much Does Treatment Cost

Advantages of Treatment in Israel

• High level of physician training.
• Clinics equipped with modern technology.
• Use of the latest medications and advanced therapeutic and diagnostic methods.
• Comfortable conditions.
• Affordable prices.

International patients can have an online consultation with an Israeli doctor without leaving home. To do this, it is necessary to contact the clinic's consultant, provide the required medical documentation, and connect at the agreed time. The specialist will assess the reviewed conclusions and test results and recommend further treatment.