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Colon Cancer Treatment in Israel

Colon Cancer Treatment in Israel

Colon cancer is the second most common cancer in the Western world, occurring most commonly in older adults. Generally, it begins as small, benign polyps that develop on the inside of the colon. Over time, these polyps can turn into colon cancers. When polyps are detected in their early stages, they can be removed during a colonoscopy, thereby preventing the development of cancer. Regular screening tests (colonoscopies and fecal occult blood test) for the general population from age 50 are therefore an essential and standard medical recommendation. If colon cancer does develop, a range of treatments are available to help control it.

At Sheba Medical Center’s Gastroenterology Institute, a team of specialists in gastroenterology and genetics works closely with surgeons, oncologists, radiologists, and pathologists to provide colon cancer treatment in Israel. Regular multidisciplinary discussions are held to discuss and custom-tailor the most effective therapy for each patient, as well as advise both the patient and family members about future prevention.

Colon Cancer

Risk Factors

While there is no scientific certainty about what causes colon cancer, various factors are known to raise your risk of this colorectal disease – including lifestyle behaviors and medical history:

  • Age: most people are older than 50, although colon cancer can be diagnosed at any age
  • African-American race
  • Previous polyps or colon cancer
  • Inflammatory intestinal conditions, such as Crohn’s disease and ulcerative colitis
  • Family history; one or more blood relatives who have had colon cancer
  • Genetic syndromes, such as familial adenomatous polyposis (FAP) and Lynch syndrome (also known as hereditary nonpolyposis colorectal cancer – HNPCC)
  • Low-fiber, high-fat diet
  • Obesity
  • Sedentary lifestyle
  • Smoking
  • Excessive consumption of alcohol
  • Diabetes or insulin resistance
  • Radiation therapy to treat previous cancers

Colon Cancer Stages

If you have received a diagnosis of colon cancer, staging the cancer is generally the next step. Staging helps to determine the extent of your cancer, which is essential for designing the most suitable treatment plan. Most colon cancers begin with an adenoma, a non-malignant tumor that can gradually develop into adenocarcinoma cancer. Removing this benign tumor will greatly reduce the risk of developing malignant cancer. The stages of colon cancer are as follows:

| Stage 0

Cancer cells are found in the innermost layer of the intestinal wall

| Stage 1

The tumor has spread into the muscle layer of the colon; growth at this stage is still regarded as local

| Stage 2

The tumor has penetrated the outermost layer of the colon, but growth is still considered local

| Stage 3

The tumor has penetrated the colon wall and spread into nearby lymph nodes; growth at this stage is still regarded as local

| Stage 4

Metastasis has occurred; the cancer cells have migrated through the bloodstream or lymph nodes, spreading to other organs, such as the liver, lungs, or abdominal organs

Symptoms

In the early stages of colon cancer, most patients do not experience any symptoms. Once signs and symptoms appear, they vary according to the cancer’s size and specific location in the large intestine.

Possible symptoms include:

  • A persistent change in bowel habits, such as constipation or diarrhea, or a change in stool consistency
  • Rectal bleeding or blood in your stool; black stool
  • Continual abdominal discomfort, such as cramps, gas or pain
  • Unexplained weight loss
  • Iron deficiency/anemia
  • Sensation that the bowel doesn’t empty completely
  • Weakness or fatigue

All of the above are suspicious but non-specific signs that can also appear in many benign conditions. Only a full medical assessment can determine if they indicate the presence of colon cancer.

Diagnosis

If your doctor suspects that you may have colon cancer, the following tests may be performed:

Manual examination

Using a gloved, lubricated finger, the doctor performs a rectal examination to check for polyps, nodules, bleeding, or other problematic signs

Blood tests

Certain blood tests can be helpful, such as a CBC (complete blood count), liver enzymes, and tumor markers (CEA and CA19-9)

Fecal occult blood test

Can detect tiny traces of blood in the feces; used as a screening test for early detection of colorectal cancer

Colonoscopy

Recommended by gastroenterologists and oncologists for early detection and prevention of colon cancer. While the patient is under sedation, an endoscope (a thin optical fiber connected to a camera) is inserted through the rectum into the colon, providing a view of the intestinal cavity. If polyps are discovered, they can be removed and a biopsy can also be performed. It is advisable to have a colonoscopy every 5 to 10 years from age 50.

Virtual colonoscopy

A new and innovative test that uses a CT device to simulate the colon and abdominal cavity

CT or MRI

These techniques record detailed images of soft tissues in the body; used to check if the tumor has spread to distant organs

PET scan

A radioactive sugar is injected into the blood; cancer cells, which are fast growing, absorb more sugar than normal cells, and a special camera is then used to create a picture of the areas of the body that show more radioactivity. The picture helps to identify the location of cancer cells in the body.

Endorectal ultrasound

An endoscope with a special ultrasound device is inserted into the rectum to see how far the cancer has spread through the rectal wall and whether it has spread to any nearby tissues or organs

Needle biopsy

Using a thin needle, a small piece of tissue is removed from the tumor. Most of the time, this procedure is done during the colonoscopy.

colon cancer treatment

Colon Cancer Treatment in Israel

At Sheba, our physicians will consider the details of your condition, including the stage and location of the cancer and any other health issues, to recommend the most effective treatment plan.

Surgery

1. Surgery for early stage colon cancer – If the tumor is very small, a minimally invasive procedure may be performed, such as:

  • Removing polyps during the colonoscopy
  • Laparoscopic surgery: May be used when polyps can’t be removed during the colonoscopy. This procedure is done through small incisions in the abdominal wall.
  • Endoscopic mucosal resection: Removes larger polyps and a small piece of the colon’s inner lining

2. Surgery for more advanced colon cancer

  • Partial colectomy: The part of the colon that contains the cancer is removed, along with some of the normal adjacent tissue. The healthy parts of the colon or rectum are then reconnected.
  • Ostomy: When it’s not possible to reattach the healthy parts of the colon or rectum, this surgery creates a stoma (an opening) in the abdominal wall that allows stool to be eliminated into a bag. An ostomy can be temporary or permanent.
  • Lymph node removal: Lymph nodes may also be removed during colon cancer surgery.

3. Surgery for metastatic cancer

When the cancer is extremely advanced, an operation may be done to relieve colon blockage and improve symptoms. This procedure doesn’t cure the cancer, but works to relieve bleeding, blockage, or pain.

HIPEC – Hyperthermic Intraperitoneal Chemotherapy

This breakthrough, alternative therapy delivers high and heated doses of chemotherapy directly into the abdomen. HIPEC, which is performed at Sheba, may be used to treat colon cancer that has spread to the lining of the abdominal cavity.

Chemotherapy

After surgery, colon cancer treatment in Israel may include chemotherapy to destroy any cancer cells that remain in the body, reducing the risk of recurrence. The drugs will typically be given for six months and can include one type of chemotherapy or a combination of two types. Chemotherapy may also be administered before an operation to shrink a large cancer.

Radiation therapy

Radiation therapy can be used to kill cancer cells; it may also be used to shrink a tumor before surgery. Radiation is sometimes combined with chemotherapy.

Targeted drug therapy

Targeted drugs work by blocking specific abnormalities in cancer cells, causing the cells to die. This treatment is generally used in conjunction with chemotherapy, and it is recommended mainly for people with advanced colon cancer.

Immunotherapy

Immunotherapy modifies the cells of your immune system so they fight cancer directly. Usually, immunotherapy is recommended only for advanced colon cancer.

Treatments in clinical research

At Sheba Cancer Center, several clinical studies to examine the safety and efficacy of new treatments are ongoing. Our doctors can discuss any suitable options with you.

Meet Our Team

Aviram Nissan

Prof. Aviram (Avi) Nissan, MD

Head of Department of Surgery C
Prof. Nissan is a world-recognized physician in Oncological Surgery, with particular expertise in complex tumors of the digestive system. He is a leading specialist in HIPEC treatment of abdominal metastasis, and he is one of the first doctors to learn PIPAC and bring it to Israel. In addition, Prof. Nissan has extensive experience in the surgical treatment of colorectal cancer, stomach cancer, and sarcomas (soft tissue tumors). As the director of the Laboratory of Surgical Oncology at Sheba, he is actively researching tumors of the digestive tract and peritoneal cavities. Prof. Nissan has received numerous prestigious awards, and he publishes and lectures widely around the world.
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Einat Shacham-Shmueli

Einat Shacham-Shmueli, MD

Senior Oncologist, Gastrointestinal Clinic
Dr. Shacham-Shmueli received her medical degree from the Sackler School of Medicine, Tel Aviv University. She specializes in gastrointestinal malignancies – cancers of the stomach, esophagus, liver, pancreas, gallbladder, colon, anus, and rectum. Dr. Schacham-Shmueli has authored more than 25 original scientific articles in international journals. She is a member of the Israel Society of Oncology and Radiotherapy, as well as an investigator for the NCI (National Cancer Institute), RTOG (Radiation Therapy Oncology Group), and CTEP (Cancer Therapy Evaluation Program).
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Ben Boursi

Ben Boursi, MD

Physician, Gastrointestinal Cancer Clinic
Dr. Boursi specializes in Clinical Oncology and Radiotherapy. His research focus is in the prevention and early detection of cancer using innovative technologies, along with epidemiological and genetic data. Dr. Boursi has developed models for the early detection of colorectal cancer and pancreatic cancer. He is widely published in leading scientific journals, and his research has been featured at major international oncology conferences and cited in popular media.
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