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About US

The Surgical Oncology Division, Rabin Medical Center was established with a mission statement of providing the best and updated surgical care and combined modality therapy for cancer patients. We strongly believe that in order to deliver good care to our patients, we have to continuously monitor our long-term and short-term results, learn from our mistakes and complications, and provide the best possible cancer care while marinating the best possible quality of life for our patients.

Academic environment is essential for progress, educating young surgeons and students helps not only future patients, but also with their drive for knowledge, asking questions that make as re-think the decisions we take, and therfore helping us to look deeper into our daily practice and make it better.

The Surgical Oncology Division, Rabin Medical Center operates in close collaboration with the medical and radiation oncology branches of the Davidof Cancer Center. The team includes surgeons, clinical nurses, research coordinators, and the Surgical Oncology Laboratory personnel. We offer surgical and combined modality therapy for a variety of malignant disorders. We have gained experience and expertise in the treatment of the following disorders:

 

Peritoneal surface malignancies

Each patient is evaluated by a multidisciplinary team of experts. After initial evaluation at the Surgical Oncology Clinic, patients that are eligible for cytoreductive surgery and delivery of HIPEC and/or EPIC are being discussed at a multidisciplinary conference. Further imaging tests, if required, are performed at Rabin Medical Center. Surgical planning and HIPEC protocol are being discussed.
All patients are evaluated by GI oncologist for detailed treatment planning.

Each patient is examined by a specialized anesthesiologist for evaluation and preparation of anesthesia for these complex procedures.

After discharge from the hospital, patients are routinely followed both at the Surgical Oncology Clinic and at the GI Oncology Clinic, Davidof Center. We also conduct basic and clinical research in this field.

 

Colon cancer

 

Patients diagnosed with cancer of the colon or pre-malignant polyps that can not be removed by colonoscopy are referred to the Surgical Oncology Clinic for initial evaluation and treatment planning. Cross sectional imaging is then performed (CT scan or PET scan). In the absence of metastatic disease, surgery is performed followed by adjuvant chemotherapy when required. Patients with liver or lung metastasis are discussed in a multidisciplinary conference in order to select the best treatment option.

Patients with peritoneal dissemination are considered for cytoredcution + HIPEC.

We conduct clinical and basic research in colorectal cancer. We have identified novel biomarkers for colon cancer (CCAT-1 and CRC-specific microRNA). We developed new technologies for early detection of colon cancer in blood and stool samples.

 

In collaboration with the United States Military Cancer Institute (USMCI) we conducted several clinical trials and developed a new staging technique called Targeted Nodal Assessment.

 

Rectal Cancer

 

Patients diagnosed with carcinoma of the rectum are currently treated by a multi-modality approach combining surgery, radiation therapy, and chemotherapy.

Following diagnosis by colonoscopy and biopsy, a staging process begins in order to select the best treatment option for any given patient. This process involves a CT scan of the chest, abdomen and pelvis or whole body PET-CT examination intended to document or rule out the presence of distant metastasis. A combined evaluation of rigid rectoscopy and endorectal ultrasound (ERUS) (instruments allowing the surgeon to inspect, measure the tumor penetration, lymph node involvement, and the tumor's distance from the anus) is then performed. This is done as an outpatient procedure at the Surgical Oncology Clinic. In very early tumors or polyps, local excision may be considered in selected patients. In tumors limited to the rectal wall, rectal resection (low anterior resection) with resection of the surrounding lymph nodes (total mesorectal excision, TME) is the treatment of choice without additional radiation or chemotherapy. If the tumor invades through the rectal wall or lymph nodes are involved, a course of combined radiation therapy and chemotherapy is recommended.

 

 Gastric Cancer (cancer of the stomach)

There are several tumors affecting the stomach. The most common tumor type affecting the stomach and the junction between the esophagus and the stomach (JEG) is the adenocarcinoma. Patients diagnosed with adenocarcinoma of the stomach or the GEJ are referred in most cases to surgical therapy. After initial visit to the Surgical Oncology Clinic the extent of disease can be evaluated by several ways. The initial assessment includes, blood tests for tumor markers and a CT scan of the chest, abdomen and pelvis or PET-CT. Selected patients are also evaluated by endoscopic ultrasound (EUS) and/or video laparoscopy.

Patients with local disease will be of offered surgical therapy in the form of partial or total resection of the stomach (subtotal gastrectomy or total gastrectomy). Resection of the stomach is performed with clearance of all lymph nodes that may harbor metastasis. Clusters of lymph nodes are located around the stomach and adjacent organs and removed in a certain technique developed in Japan and widely adopted in some Western countries called D2.

The Surgical Oncology Divison at Rabin Medical Center is an integral part of the European Union Network for Excellence in Gastric Cancer (EUNE). This organization combines gastric cancer experts from all over Europe with the main goal of improving outcomes of gastric cancer treatment.

 

Malignant Melanoma

 Melanoma is a tumor arising from the pigmented (dark) cells of the skin or skin nevi. It can also arise from other internal body areas or organs like the mouth, anus, and eye. In most cases, melanoma is discovered in early phases when surgical excision, performed correctly by an expert can cure the disease. Since Melanoma may spread to lymph nodes and other body organs, it is imperative to evaluate the extent of disease before, during and after any form of therapy.  The Melanoma Disease Management Team combined of doctors and nurses from several disciplines in Rabin Medical Center. Every patient diagnosed with melanoma is evaluated by this group of melanoma experts.

Location of the tumor, presence of suspicious lymph node, and presence of additional lesions is being looked for by the surgeon and the dermato-oncologist.

Presence or absence of distance metastasis is studied using whole body CT scan or a combination of PET scan and MRI of the brain in patients with higher risk to harbor metastasis. Mapping of the lymph nodes is done the day prior to surgery and serves the surgeon for locating and removing the first lymph node that is most likely to harbor metastasis, the Sentinel Lymph Node (SLN). During surgery the tumor is removed with a surrounding healthy tissue and the Sentinel lymph node is identified and removed as well. In cases of melanoma located on the head, face, or neck and in melanomas requiring complex wound closure after excision, a dedicated plastic surgeon will be involved in all the process of surgical planning, surgery, and follow up.