Melanoma Treatment

Melanoma is a type of skin cancer, which originates from melanocytes. Melanocytes are mainly found within the epidermis, which is the top layer of the skin. These specialized cells produce a brown pigment – melanin, which can be of two types (eumelanin or pheomelanin). Skin color is dependent on the type of melanin a person has. Melanin protects the deepest layers of the skin from ultraviolet damage, which happens due to sun exposure.

What is Melanoma?

There are several types of skin cancer; melanoma (or malignant melanoma) is one of the rarest affecting 132,000 people globally. It is also one of the most aggressive skin cancers, able to metastasize (spread) and ensue further damage – if not treated early.

Most often, melanoma affects the skin, especially parts of the body excessively exposed to the sun. In some rare cases, the primary lesion is on mucous membranes (mouth and genital areas) and the eyes. Dermatologists classify melanoma based on histological features. Each type of melanoma differs from one another by the growth rate, its ability to penetrate into the deeper layers of the skin and subcutaneous structures, and metastases to lymph nodes and distant organs. The type of tumor, the stage at which the disease is diagnosed and whether there are any metastases, significantly affects the patient’s treatment and prognosis.

What Does Malignant Melanoma Look Like?

Skin cancer, in most cases, is diagnosed visually by detecting suspicious changes.

Malignant melanoma specialists use the “ABCDE” rule, to describe and recognize changes that can indicate a malignant process.

• Asymmetry: one half of the mole/birthmark does not match the other.
• Border: irregular, notched, blurred borders.
• Color: Unevenly color, the mole consists of many shades of brown, black, and sometimes pink and white pigment.
• Diameter: larger than 6 mm. (although melanomas can sometimes be smaller than that).
• Evolving: changes in size, color or shape over time.

Other signs to look for:

• A sore that does not heal.
• The spread of pigment to surrounding skin.
• Redness, swelling, or any other sign of inflammation.
• Sensation changes: itchiness, tenderness, pain.
• Surface changes: scaling, oozing, or bleeding.

If you have any of these features – you should get checked by a specialized dermatologist.

Melanoma Diagnosis in Israel

Herzliya Medical Center specialists apply the most modern, cutting-edge methods of diagnosis of melanoma in Israel.

Whether you arrive with an established diagnosis, or you are in need of a primary evaluation, we will make sure you get the best medical evaluation necessary for deciding on your treatment plan.

In order to do that, we will revise the data you bring with you, and refer you to any additional necessary procedures.

These are a few examples from the vast variety of diagnostic tools we use:

• Visual diagnostics – a dermatologist inspects suspicious lesion using a dermoscopy – a magnifying optical device that can help identify abnormalities.
• Confocal microscopy – this non-invasive method for diagnosis of melanoma is based on the ability of infrared radiation to penetrate through all layers of the skin, allowing professionals to determine the depth of the lesion and the stage of tumor development.
• Incisional biopsy – obtaining a sample directly from the area of the lesion for subsequent histological examination. Each sample is tested using the most innovative techniques, allowing our experts to understand the full genetic and molecular profile of the lesion.
• Imaging – MRI, PET-CT for determining whether the malignant cells have spread to any lymph nodes or internal organs.
• Blood tests – to follow and examine the function of key organs in your body.

Melanoma Treatment in Israel

The first step in deciding on a treatment plan is evaluating the stage of the disease. The stage represents the thickness of the melanoma in the skin, whether it has spread to nearby lymph nodes or any other organs, and certain other factors. Herzliya Medical Center provides the latest methods of melanoma treatments in Israel.

Here are some of the treatment options we offer:

Surgical Removal of Melanoma

This is often the first stage in treatment since radical surgery is necessary in order to fully remove the affected area of the skin. HMC’s dermatologists specialize in applying the Mohs technique for melanoma surgery.

During Mohs surgery, after each removal of tissue, a microscopic examination of surgical margins is performed. If the margins are clear from cancer cells – the procedure is considered complete. If, however, cancer cells are found, the surgeon will remove additional tissue and send it to microscopic examination and so on.

This way, we ensure the best possible outcome for you: the tumor is fully removed and there is minimal damage to the skin. If the imaging tests have shown that the cancer cells have spread to lymph nodes and/or internal organs – HMC’s oncological surgeons will remove the cancerous foci.

Melanoma removal cost depends on the extent of the surgery, and the spread of the disease.

By choosing Herzliya Medical Center, you will have the option to choose your treating physician and surgeon from a list of Israel’s leading specialists.

Immunotherapy

This melanoma treatment method involves the use of medicines to stimulate a patient’s own immune system to recognize and destroy cancer cells more effectively.

Here are a few examples:

• Interferon-alfa: a type of cytokine. Cytokines are proteins in the body that boost the immune system in a general way. Synthesized versions of cytokines, (i.e. interferon-alfa), are sometimes used in patients with melanoma. Interferon-alfa is sometimes prescribed as adjuvant therapy after surgery to try to prevent cancerous cells from spreading and growing. This may delay the recurrence of melanoma.
• Anti CTLA4 (YERVOY/Ipilimumab): this is a synthesized version of an immune system protein. This drug works throughout your body and helps activate cytotoxic T-cells, that fight cancer. By blocking the action of CTLA-4, Ipilimumab boosts the immune response against melanoma cells in the body. This drug has a somewhat low response rate, works slowly, but has a full recovery potential.
• Anti PD1 (KEYTRUDA/Pembrolizumab): a second-line treatment. Pembrolizumab targets PD-1, the action mechanism of the drug is the same as of Ipilimumab. This drug helps activate cytotoxic T cells in the skin itself. It is more specific and has a better response rate.

Costs of treating melanoma by immunotherapy depend on the duration of the treatment and stage of the disease.

Targeted Therapy

In the past few years, there was a major development in producing new and more specific drugs for melanoma.

Recent studies showed that some of the melanoma cells are different from normal cells by certain proteins and other factors. Following that discovery, scientists developed drugs that work as a guided missile – they destroy only cancer cells.

It’s important for you to know that not all patients have the kind of melanoma with that specific mutation, which causes the tumor to be sensitive to the drug.

During the pathological analysis of the tumor tissue, HMC’s specialists will perform genetic testing, which will determine if there are mutations in the tumor and whether you are a suitable candidate for targeted therapy.

Here at Herzliya Medical Center, you can receive the newest target therapy drugs, including:

BRAF inhibitors (ZELBORAF, TAFINLAR): half of all melanoma types have mutations in the BRAF gene. The mutations cause the melanoma cell to divide and grow quickly. These drugs help stop that.

MEK inhibitors (MEKINIST): MEK gene works the same way the BRAF gene does. The purpose of this drug is to stop its activity.

Costs of treating melanoma by targeted therapy depend on the duration of the treatment and stage of the disease.

Radiation

Radiation is helpful for reduction of pain and discomfort in patients with advanced melanoma, and as a complementary treatment after melanoma surgery.

Why choose HMC for Melanoma Treatments in Israel?

Herzliya Medical Center is a private medical facility, internationally known for its high professional level of doctors, modern medical equipment and superior quality, excellent care & hospitalization conditions.

Here at Herzliya Medical Center innovative methods and cutting-edge machinery are used for diagnosis and treatment of skin cancer.

By choosing Herzliya Medical Center, you can be sure you will get the best treatment – tailored especially for you. Herzliya Medical Center guarantees an individual approach and unsurpassed quality of care, helping patients from Israel and abroad to cope with malignant neoplasms of the skin.

No Bureaucracy:

At Herzliya Medical Center you don’t have to run from one doctor to another, or deal with making appointments and scheduling tests –

we will appoint a Case Manager for you, who will assists you in coordination, monitoring, and planning of your medical treatment in Israel with an emphasis on the quality of care.

The Best Physicians in Israel Work at HMC

Here at Herzliya Medical Center, all of Israel’s best experts are at your service. Unlike Israel’s general governmental hospitals, HMC allows you to choose your own treating physician, oncologist, and surgeon.