Melanoma and Skin Cancer Treatment in Sheba
The Ella Lemelbaum Institute for Immuno-Oncology is dedicated to world-class melanoma treatment and continuous research into this widespread disease. Our top-tier staff, including clinicians, researchers, nursing staff, and support staff, are all dedicated to providing our patients and their families with integrative, total care.
To that end, the Ella Institute works in conjunction with some of the leading melanoma treatment centers around the globe, including the National Institutes of Health (NIH) in the United States.
We are proud to provide the absolute latest in melanoma treatment, including advanced immunotherapy techniques and the opportunity to participate in many ongoing clinical studies.
The Ella Institute exists due to the generosity of the Lemelbaum family, in memory of their daughter, Ella.
Staff
There our staff members
- Professor Jacob Shachter serves as the President of the Ella Institute. Prof. Shachter possesses expertise in melanoma and skin cancer treatment.
- Dr. Ronnie Shapira is one of Israel’s leading medical oncologists and is an Acting Director of the Ella Institute. Dr. Shapira received her MD from the Sackler School of Medicine at Tel Aviv University and completed her residency at Meir Medical Center.
- Nethanel (Nati) Asher, MD, is a senior physician, oncology specialist in the Ella Lemelbaum Institute of Immuno-Oncology at Sheba Medical Center.
- Dr. Michal Besser serves as the head of the Ella Institute’s Clinical Laboratory. Dr. Besser earned her PhD in immunology from the University of Munich in Germany and conducted her postdoctoral studies at the Weizmann Institute of Science in Israel.
Clinical Research
Continuous research is conducted at the Ella Institute, with over 10 studies currently ongoing. Eligible patients receive treatment under the strictest ethical and safety standards.
Sheba Medical Center is a leader in tumor-infiltrating lymphocytes (TIL) immunotherapy. TIL is a promising treatment for patients with malignant metastatic melanoma, or melanoma that has spread beyond the outermost layers of the skin. These patients often have weakened immune systems and receive transfers of immune cells, with very encouraging results having been seen in clinical research. Sheba Medical Center has improved the TIL protocol and hopes to make use of it in other types of cancer in the future.
Skin Cancer
There are several various types of skin cancer, but squamous and basal cell skin cancers are the most frequently seen. Over 5 million people develop these types of cancer each year, more than 3 million of whom are Americans. These cancers typically form on areas of the skin that receive a lot of sun exposure, like the face, ears, forearms, and backs of the hands. They are usually highly treatable if discovered early enough.
Although melanoma makes up a small portion of all skin cancers, it is one of the most aggressive types of skin cancer. It develops in the melanocytes, the cells responsible for pigment production in the skin. Unfortunately, melanoma can form on any skin area, regardless of sun exposure. Again, melanoma can often be treated successfully if discovered soon enough.
Risk Factors
The risk factors for skin cancer include:
- Sun and other ultraviolet light exposure
- Older age
- A family history of skin cancer
- Pale skin tone
- Having many moles on the skin
- A history of severe sunburns
Types
Melanomas and other skin cancers are categorized according to several factors, such as stage 4 melanoma. These include how far the cancer has infiltrated into the skin, the size of the original tumor, and whether the cancer has spread to adjacent lymph nodes or distant areas of the body.
While early stage cancer always have the best prognoses, effective treatment is available for even metastatic, or widespread, skin cancers.
Symptoms
Some signs and symptoms of skin cancer include:
- Skin appearance changes, such as moles that change shape or color, new moles and other blemishes
- Scaly or bleeding skin areas
- Non-healing sores on the skin
- Soreness of skin areas
Skin cancers are typically surgically removed and then analyzed by a pathologist. A detailed pathologic examination is necessary to properly diagnose and stage 4 melanoma and other skin cancers.
Treatment
At Sheba Medical Center we provide world-class medicine with a personal touch by providing our patients with the support of an integrative team of dermatologists, medical oncologists, pathologists, surgeons, and researchers. This comprehensive approach helps to give our patients the best possible treatment outcomes.
In early-stage melanomas where skin infiltration is less than 1 mm, the cancer is usually surgically excised. Pathologists examine the surgical margins, or edges, of the excised specimen to make sure all cancer cells were removed. Nearby lymph nodes are also usually checked to ensure there has been no spread of cancer.
If the skin penetration is greater than 1 mm, the treatment plan may also include body scans to be certain cancer has not infiltrated other areas of the body. Several surgeries and lymph node samplings may be necessary to be sure the cancer is limited locally. Patients are often referred to the Plastic Surgery Department for reconstructive procedures following skin cancer removal.
In the event that the cancer is already metastatic, or spread throughout the body, chemotherapy may be employed after consultation among the treatment team. The exact type of chemotherapy used is dependent on the patient’s condition, cancer type, and extent of metastasis. Sheba Medical Center has both conventional chemotherapy as well as biological treatments available. These include the TIL immunotherapy referenced above and treatments using interleukin 2.
Fecal microbiota transplant
A gut microbiome is the totality of microorganisms, bacteria, viruses, protozoa, fungi, and their collective genetic material present in each person’s gastrointestinal tract. Recently, scientists discovered that the microbiome works closely with the immune system so that a change in the flora of the bacteria has an effect on the body’s immune response to many health conditions, including treatments for oncological diseases. By eradicating the microbiota of a melanoma patient who is unresponsive to immunotherapies and replacing it with bacteria taken from melanoma patients who have responded to the treatment, through the use of a fecal transplantation, this procedure can significantly improve a patient’s body’s responsiveness to immunotherapy.
Immunophoresis
The innovative Immunophoresis approach uses a special filter to remove specific immune-suppressive cytokines produced by cancer tumors. Selective removal of these targeted cytokines is intended to neutralize the cancer’s ability to block natural immune defense mechanisms, which are significantly compromised during late-stage, metastatic cancer. In this manner, the treatment re-energizes the immune system to aggressively fight the malignancy. An added benefit lies in the relative lack of side effects or detrimental impact on quality of life typical of other cancer treatments.
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