Overview

Germ cell tumors in children are growths that typically develop from reproductive cells in the ovaries in girls and in the testes in boys. In addition to gonadal germ cell tumors, the growths can occur in several other parts of the body, including the lower back, abdomen, chest, and inside the brain.


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Germ cell cancers are not common, which is why it is critical to choose a medical center with top tier technologies and specialists who are experienced in diagnosing and treating the disease. At Sheba, every treatment program for children with germ cell tumors is custom designed at our Pediatric Hemato-Oncology Division, using the latest techniques and based on an integrative approach to healing. Depending on where the tumor is located, our hemato-oncologists collaborate with pediatric specialists from the Urology Department, Gynecology Department and the Surgery Division.

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About Retinoblastoma

Although retinoblastoma is the most common type of pediatric eye cancer, it is still rare. It is typically diagnosed in infants and young children around two years old, and it occurs equally in girls and boys. Diagnosis in children over six years old is uncommon.

Approximately three out of four children with retinoblastoma suffer from unilateral retinoblastoma, in which there is a tumor in only one eye. Bilateral retinoblastoma refers to cases in which both eyes are affected. More than nine out of ten children with retinoblastoma in the US are cured, but the prognosis is less optimistic if this eye cancer has spread to other tissues or organs.


The eyes begin to develop in utero, when cells called retinoblasts rapidly multiply to create new cells for the retina. After this early stage of the eye’s development, retinoblasts cease to reproduce and instead grow into mature retinal cells. When this process goes wrong and the retinoblasts grow out of control, the result is retinoblastoma.

Usually, the course of events that leads to retinoblastoma starts with a mutation in the RB1 gene, which is the gene that prevents cells from growing uncontrollably.

When left untreated, retinoblastoma tumors can grow to fill most of the eyeball. If cells break away from the main tumor on the retina, they can form additional tumors on other parts of the eye. Over time, retinoblastoma can also spread beyond the eyeball to lymph nodes and other organs. However, the vast majority of cases are detected and treated when retinoblastoma is present only in the eyeball.

Very few known risk factors exist for retinoblastoma, but some possible factors include:

  • Age: Most diagnoses occur before the child is three years old, and rarely after age six
  • Heredity: Having a parent who had congenital retinoblastoma; however, retinoblastoma may also occur in a child without any family history of the cancer
  • Parental lifestyle: Exposure to chemicals in diesel or gasoline exhaust during pregnancy; the mother not eating enough fruits and vegetables during pregnancy; exposure of fathers to radiation; older age of the father

In general, the symptoms of retinoblastoma in children present before age two, and they are noticed most frequently by a parent or doctor. The most common signs include:

Leukocoria: Also called “white pupillary reflex,” this is the most typical symptom of retinoblastoma; it refers to when the eye’s pupil looks white when light shines into it
(instead of red because of blood vessels at the back of the eye)

Strabismus: A problem with eye teaming, also called “lazy eye”

Nystagmus: Involuntary eye movements

Redness of the white part of the eye or around the eye

Different color in each iris

Weak vision or a change in vision

Eye pain

Retinoblastoma is classified into three main groups, based on the stage:

  1. Intraocular retinoblastoma: The cancer is limited to the eye
  2. Extraocular retinoblastoma: The cancer has spread beyond the eye. Orbital retinoblastomas refer to when cancer has only moved into the eye socket, versus metastatic retinoblastomas, which have spread to other distant organs
  3. Recurrent retinoblastoma: The cancer has returned – either to the eye or in other body parts

The stage of retinoblastoma is strongly associated with the prognosis for children who have this cancer. Staging is also significant for designing the most effective treatment program.


What is Retinoblastoma?

The eyes begin to develop in utero, when cells called retinoblasts rapidly multiply to create new cells for the retina. After this early stage of the eye’s development, retinoblasts cease to reproduce and instead grow into mature retinal cells. When this process goes wrong and the retinoblasts grow out of control, the result is retinoblastoma.

Usually, the course of events that leads to retinoblastoma starts with a mutation in the RB1 gene, which is the gene that prevents cells from growing uncontrollably.

When left untreated, retinoblastoma tumors can grow to fill most of the eyeball. If cells break away from the main tumor on the retina, they can form additional tumors on other parts of the eye. Over time, retinoblastoma can also spread beyond the eyeball to lymph nodes and other organs. However, the vast majority of cases are detected and treated when retinoblastoma is present only in the eyeball.

 

What are the risk factors for retinoblastoma?

Very few known risk factors exist for retinoblastoma, but some possible factors include:

  • Age: Most diagnoses occur before the child is three years old, and rarely after age six
  • Heredity: Having a parent who had congenital retinoblastoma; however, retinoblastoma may also occur in a child without any family history of the cancer
  • Parental lifestyle: Exposure to chemicals in diesel or gasoline exhaust during pregnancy; the mother not eating enough fruits and vegetables during pregnancy; exposure of fathers to radiation; older age of the father

 

What are the symptoms of retinoblastoma?

In general, the symptoms of retinoblastoma in children present before age two, and they are noticed most frequently by a parent or doctor. The most common signs include:

  • Leukocoria: Also called “white pupillary reflex,” this is the most typical symptom of retinoblastoma; it refers to when the eye’s pupil looks white when light shines into it
    (instead of red because of blood vessels at the back of the eye)
  • Strabismus: A problem with eye teaming, also called “lazy eye”
  • Nystagmus: Involuntary eye movements
  • Redness of the white part of the eye or around the eye
  • Different color in each iris
  • Weak vision or a change in vision
  • Eye pain

 

What are the stages of retinoblastoma?

Retinoblastoma is classified into three main groups, based on the stage:

    1. Intraocular retinoblastoma: The cancer is limited to the eye
    2. Extraocular retinoblastoma: The cancer has spread beyond the eye. Orbital retinoblastomas refer to when cancer has only moved into the eye socket, versus metastatic retinoblastomas, which have spread to other distant organs
    3. Recurrent retinoblastoma: The cancer has returned – either to the eye or in other body parts

The stage of retinoblastoma is strongly associated with the prognosis for children who have this cancer. Staging is also significant for designing the most effective treatment program.

 

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Retinoblastoma in Children

Retinoblastoma is a cancer that begins in the retina, the light-sensitive nerve tissue at the back of the eye. It is the most common type of eye cancer in children and comprises about 2% of all pediatric cancers. Fortunately, due to advanced diagnostics and modern treatments, more than 95% of children with retinoblastoma can now be cured. Choosing a hospital with state-of-the-art technologies and expert specialists is therefore critical for retinoblastoma treatment. Sheba Medical Center in Israel features top physicians who trained at world-renowned cancer centers. Our team is knowledgeable and experienced in the latest therapies to fight retinoblastoma in children.


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At Sheba, every treatment program for cancer is based on a holistic approach to healing. We custom-design each child’s therapy, taking comfort and overall quality of life into consideration. Our team is dedicated to maintaining supportive, open lines of communication between the doctors, family, and child.

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Osteosarcoma Overview

Osteosarcoma is a relatively uncommon bone cancer, and treatment can be complex. It is therefore imperative to choose a medical facility that is experienced with treating osteosarcoma in children. At Sheba Medical Center in Israel, our multidisciplinary doctors offer progressive therapies and techniques against this cancer. We have a premier team of pediatric oncologists, orthopedic surgeons, radiation oncologists, and other specialists who have undergone training at internationally renowned cancer centers. Our physicians use frontline expertise to custom-tailor every child’s treatment program.


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Holistic healthcare is a foundation of cancer treatment at Sheba, especially when caring for our young patients. We make personalized medical decisions that consider the individual child’s comfort and overall well-being. Our compassionate team believes in open communication between the doctors, child, and family, so that you know what to expect throughout every step of your child’s treatment.


Recently, diagnosis and treatment has progressed to combine testing in the field of molecular biology along with conventional methods. At Sheba, we use these advanced tests to aid in both diagnosing the disease and directing the drug therapies so they are custom tailored for each individual patient – and for each stage of the disease.

Molecular biology testing includes methods such as:

  • FISH
  • PCR
  • Next generation sequencing, such as gene panel sequencing (DNA and RNA), mutation profile characterization, methylation profile and response markers for immunotherapies.

Altogether, our approach is one of precision medicine (also called personalized medicine), based on a deep understanding of the biological responses underlying the disease. We interpret all test results cautiously and stringently in order to enable a highly informed selection of innovative treatments.

Our Hemato-Oncology Division is characterized by a specialized interest in applying precision medicine for bone and soft tissue sarcomas. As a rule, we strive to customize the most effective treatment program for each individual patient.

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Wilms Tumor Overview

Wilms tumor is the most common type of kidney cancer in children, and a multidisciplinary approach to treatment is often required. When treated promptly and aggressively, the treatment for Wilms tumor is usually successful. At Sheba Medical Center in Israel, our pediatric specialists are skilled and experienced in treating this disease. We will use precise diagnostics to categorize and stage Wilms tumor quickly, and we will custom-design your child’s cancer treatment with the latest research-based therapies. Our doctors are involved in many cutting-edge research to explore new therapies for Wilms tumors, and we bring this expertise to caring for each individual child.


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When treating our young patients, we apply a compassionate bedside manner and holistic approach to medicine. Your child’s overall well-being is essential to planning an efficient, pain-free, and integrative treatment program. Cancer can have devastating effects on you and your child’s quality of life. In addition to offering progressive medical therapies from a range of Sheba’s hospital divisions and specialties, we also offer a variety of supportive services to provide for both your emotional and physical needs.

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Glioma Overview

In order to plan and administer the best treatment program for your child as soon as possible, a fast and precise diagnosis of childhood glioma is necessary. At Sheba Medical Center in Israel, our pediatric brain tumor specialists are highly qualified and experienced in diagnosing and treating low-grade and high-grade gliomas with a personalized approach. Our facilities feature advanced technologies and the latest therapies, and our multidisciplinary team comprises leading surgeons, oncologists, and pathologists who have trained at the best cancer centers worldwide.


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Sheba’s campus is all-inclusive, which allows us to provide integrative treatments efficiently and comfortably.

We treat pediatric glioma with a compassionate, holistic approach that considers the child’s quality of life. From the first evaluation through our comprehensive follow-up services, you and your child will benefit from the expertise of our medical professionals. Cancer can have devastating effects on the physical and emotional well-being of your child and his/her entire family, and we offer a variety of support services to address your needs.

Brain tumors in children are the second most common tumors caused by pediatric cancers.
In the Pediatric Hemato-Oncology Division at Sheba, we diagnose a brain tumor in about 40 children each year.

At our Pediatric Neuro-Oncology Department, we provide the most innovative treatments possible for children. Our specialists relate to each young patient with compassionate, personalized medicine. Our laboratory is a world leader in neuropathology, offering the initial pathological diagnosis, as well as highly precise, advanced molecular diagnostic testing.

We provide each child who suffers from a brain tumor with 24/7, multi-disciplinary care under the full supervision and cooperation of the Pediatric Hemato-Oncology Division. Our department also leads the Israeli affiliation to the PINOC group, a team involved with experimental therapies for brain tumors.

A child with a brain tumor undergoes a complex set of treatments, interacting with a wide range of medical disciplines. Our goal is to provide each child and his or her family with the most professional, personalized and helpful source of integrative care and support.

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Astrocytomas Overview

We treat children and adolescents with astrocytomas at Sheba Medical Center in Israel. Almost half of all pediatric brain tumors are astrocytomas, and our team of doctors is highly experienced in treating this cancer. Using advanced, precise technologies, we diagnose childhood cancers precisely to design the most effective, customized treatments. Our pediatric specialists are world-renowned leaders in cancer research and treatment. We bring our unique expertise to caring for each and every child with cutting-edge, progressive therapies that are not available elsewhere.


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Our physicians use a compassionate manner and a holistic approach when treating children. Your child’s quality of life is essential to planning an efficient, integrative, and comfortable treatment program. We understand that cancer can have serious effects on the overall well-being of your child and your entire family. We offer a variety of professional support services to address your physical and psychological needs.

Brain tumors in children are the second most common tumors caused by pediatric cancers.
In the Pediatric Hemato-Oncology Division at Sheba, we diagnose a brain tumor in about 40 children each year.

Our specialists relate to each young patient with compassionate, personalized medicine. Our laboratory is a world leader in neuropathology, offering the initial pathological diagnosis, as well as highly precise, advanced molecular diagnostic testing.

We provide each child who suffers from a brain tumor with 24/7, multi-disciplinary care under the full supervision and cooperation of the Pediatric Hemato-Oncology Division. Our department also leads the Israeli affiliation to the PINOC group, a team involved in developing groundbreaking therapies for brain tumors.

A child with a brain tumor undergoes a complex set of treatments, interacting with a wide range of medical disciplines. Our goal is to provide each child and his or her family with the most professional, personalized, and helpful source of integrative care and support.

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Request a consultation

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Medulloblastoma Overview

Medulloblastoma is a rare but invasive brain tumor, and it is critical to choose a premier team of pediatric specialists for treatment. At Sheba Medical Center in Israel, our Hemato-Oncology Division doctors are experienced in accurately diagnosing and treating this disease with personalized therapies. Our facilities feature advanced technologies and cutting-edge treatments by world-recognized leaders in cancer treatment. Pediatric brain tumor specialists collaborate to assess your child’s case and customize the most effective treatment for medulloblastoma.


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Sheba features a comprehensive, all-inclusive campus that enables us to provide integrative treatments efficiently and comfortably. If your child requires a bone marrow/stem cell transplant, we have access to state-of-the-art molecular laboratories to identify a perfect donor match. If no genetically suitable donor can be located, Sheba can use stem cells from the extensive data bank of the National Marrow Donor Program.

We treat medulloblastoma with a holistic approach that considers quality of life and how the whole body is functioning. From the first evaluation of your child’s case through our comprehensive follow-up services, you and your child will benefit from the expertise of compassionate medical professionals. Cancer can have devastating effects on the physical and emotional well-being of your child and his/her entire family, and we offer a variety of support services to address your needs.

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Rhabdomyosarcoma Overview

Rhabdomyosarcoma (RMS) is a soft tissue tumor that is relatively uncommon, and treating this disease can be complex. It is essential to choose a medical facility and team that is knowledgeable and experienced with RMS in children. At the Hemato-Oncology Division of Sheba Medical Center in Israel, our multidisciplinary doctors offer cutting-edge therapies and techniques to treat rhabdomyosarcoma. Our pediatric oncologists, hematologists, and other specialists have undergone training at premier cancer centers worldwide, and we use our frontline expertise to custom-design every child’s treatment program.


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We are committed to holistic healthcare, especially when treating our young patients. We consider the individual child’s comfort and overall well-being – both physical and psychological –to make personalized medical decisions. Our compassionate team believes in open communication between the doctors, child, and family, so that you fully understand the condition and always know what to expect.

Recently, diagnosis and treatment has progressed to combine testing in the field of molecular biology along with conventional methods. At Sheba, we use these advanced tests to aid in both diagnosing the disease and directing the drug therapies so they are custom tailored for each individual patient – and for each stage of the disease.

Molecular biology testing includes methods such as:

  • FISH
  • PCR
  • Next generation sequencing, such as gene panel sequencing (DNA and RNA), mutation profile characterization, methylation profile and response markers for immunotherapies.

Altogether, our approach is one of precision medicine (also called personalized medicine), based on a deep understanding of the biological responses underlying the disease. We interpret all test results cautiously and stringently in order to enable a highly informed selection of innovative treatments.

Our Hemato-Oncology Division is characterized by a specialized interest in applying precision medicine for bone and soft tissue sarcomas. As a rule, we strive to customize the most effective treatment program for each individual patient.

top 10 hospitals in the world 2020

Request a consultation

Ready to contact us for a consultation about your condition and our medical services?
The staff of our International Medical Tourism Division is ready to help.

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Ewing Sarcoma Overview

Sheba Medical Center in Israel provides complete and comprehensive care to patients with Ewing Sarcoma. As the largest hospital in the region, Sheba grants access to a multidisciplinary team of top-tiered medical professionals and groundbreaking treatments. Our 360-degree approach ensures first-rate care to patients from all over the world.


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Ewing sarcoma patients are treated by a team of specialists who have trained at internationally renowned cancer centers around the world. Since no two cases are alike, our expert doctors come together to diagnose, stage, and build individualized treatment plans for each patient.

Sheba’s holistic approach to healthcare puts the needs of the patient and the family first. We understand that cancer treatment has far-reaching effects on your quality of life, and we’re here to help. You and your family will have the support of our compassionate therapists, psychologists, social workers, and nutritionists. We will keep you informed every step of the way throughout your child’s treatment at Sheba.


Recently, diagnosis and treatment has progressed to combine testing in the field of molecular biology along with conventional methods. At Sheba, we use these advanced tests to aid in both diagnosing the disease and directing the drug therapies so they are custom tailored for each individual patient – and for each stage of the disease.

Molecular biology testing includes methods such as:

  • FISH
  • PCR
  • Next generation sequencing, such as gene panel sequencing (DNA and RNA), mutation profile characterization, methylation profile and response markers for immunotherapies.

Altogether, our approach is one of precision medicine (also called personalized medicine), based on a deep understanding of the biological responses underlying the disease. We interpret all test results cautiously and stringently in order to enable a highly informed selection of innovative treatments.

Our Hemato-Oncology Division is characterized by a specialized interest in applying precision medicine for bone and soft tissue sarcomas. As a rule, we strive to customize the most effective treatment program for each individual patient.

top 10 hospitals in the world 2020

Request a consultation

Ready to contact us for a consultation about your condition and our medical services?
The staff of our International Medical Tourism Division is ready to help.

Please select the appropriate button to get started.

Request a consultation