Liver metastases. Diagnosis and treatment
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The liver is the laboratory of the body. Since all blood flows through the liver, it is one of the most common localizations of malignant tumor metastases. The cells of the neoplasm get into the blood flow and settle in the liver. Then they give rise to secondary tumors. Colorectal cancer and breast and skin cancers are the most common types of cancer that metastasize into the liver. 50% of cases of colorectal cancer result in liver metastases, while in melanoma, the number of such cases accounts for 30%. But even with metastatic cancer, doctors can take measures to prolong a patient’s life.
Content
- Diagnosis of metastases in the liver
- Methods of treatment in Germany
- Specialized hospitals
- Arrangement of the treatment of liver cancer metastases in Germany
Diagnosis of metastases in the liver
The detection of metastases in the liver requires a thorough diagnosis before starting treatment. The diagnosis aims to:
- Detect metastases in the liver
- Estimate the number of metastases
- Determine their size.
- Evaluate the localization of metastases, and their location relative to the blood vessels of the liver
- Determine the nature of their growth
- Detect the signs of breakdown, suppuration, or intergrowth into the adjacent tissues
The cancer metastases in the liver should be diagnosed only in a well-equipped clinic with the participation of experienced and highly-qualified specialists. Therefore, Germany is the best place to undergo a diagnosis.
The most advanced imaging techniques are used here, including:
- Magnetic resonance imaging
- Multispiral computed tomography
- Positron emission tomography
- Angiography (contrast-enhanced X-ray)
Fine-needle aspiration biopsy is used to determine the type of tumor cells and the degree of their maturity. With the use of a special needle, doctors obtain a fragment of the tumor from the liver and examine it.
The obtained data allow to:
- Assess the feasibility and potential effectiveness of various treatments
- Determine the prognosis of the patient survival
- Plan a surgical procedure or other methods of treatment
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Methods of treatment in Germany
The selection of treatments depends on a variety of factors. These primarily include the amount, size, and location of metastases. The type of cancer should also be taken into account. Depending on what kind of tissue the tumor consists of, it can have different sensitivity to radiation therapy, chemotherapy, and targeted therapy.
Here are some of the treatments used in German clinics:
- Chemoembolization. It is the most advanced technique, which does not use surgical treatment but allows an increase in life expectancy by two years in 30% of patients. Cytostatics and microemboli are administered into the hepatic artery, and their effect on the tumor lasts, on average, 30 days.
- Cryosurgery. It can be used only if the size of metastases is up to 5 cm. The tumor is cooled with liquid nitrogen, and it eventually dies. This technique shows the three-year survival rate in about 20% of patients.
- Laser therapy. The therapy uses MRI-guided needle placement into the tumor. The laser heats the tumor tissues, and it eventually dies. Laser therapy should be carried out if the liver has up to 5 metastases and their size does not exceed 5 cm. Instead of surgical treatment, it is used if the surgery is contraindicated or if metastases re-emerge after surgical treatment.
- Radiofrequency therapy. The therapy involves the ultrasound-guided introduction of electrodes into the metastases. Then doctors apply high power and high-frequency current to them, and eventually, tumor tissues heat up and die. The method is effective if the size of neoplasms does not exceed 4 cm.
- Alcoholization of metastases. This technique uses ultrasound-guided insertion of a fine needle that aims to inject ethyl alcohol into the tumor tissues. It destroys the tumor. The method shows a five-year survival rate in 30% of patients. The results are comparable to surgical treatment.
- Brachytherapy. Germany offers contact radiation therapy or brachytherapy involving the introduction of radioactive substances into the tumor. It is injected through several thin catheters that are placed in the liver. The benefits of the technique: are minimal damage to healthy tissues.
- Selective internal radiation therapy (SIRT). Selective internal radiation therapy is another effective way to destroy metastases, practically without affecting healthy tissues. The substance that accumulates in the tumor cells is injected into the hepatic artery. These are radioactive spherical spheres. The radiation leads to the destruction of metastases.
- Targeted therapy. The use of some drugs from the group of inhibitors of angiogenesis can slow the growth of metastases in the liver. They block the growth of new vessels feeding the tumor. Targeted therapy is usually combined with either surgical treatment or chemoembolization.
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Specialized hospitals
The treatment of liver metastases is the most successful in multidisciplinary University Hospitals. Medical institutions of this level have the necessary equipment to carry out technically complex interventional procedures and innovative types of radiation therapy. Doctors from different departments cooperate closely, so the attending physician can quickly get advice from colleagues on any changes in the patient's condition.
Among the leading hospitals, we should mention the following ones:
- University Hospital of Ludwig Maximilian University of Munich. The Department of Gastroenterology and Hepatology offers physical removal of metastases with a part of the liver (if necessary, a liver transplant from a healthy donor is performed afterward), as well as local destruction of metastatic foci. The head physician of the department, Professor Julia Mayerle, is a board member of the European Association of Gastroenterologists, Endoscopists, and Nutritionists (EAGEN).
- University Hospital Duesseldorf. The Department of Gastroenterology, Hepatology, and Infectology is the supra-regional center for the detection and treatment of chronic liver diseases and their complications. High-tech procedures allow patients to get rid of liver metastases and maintain the normal function of the organ. Patients can also take part in clinical investigations of new treatment options.
- University Hospital Ulm. The Department of Gastroenterology and Hepatology is a part of the Comprehensive Cancer Center Ulm (CCCU), which specializes in the treatment of gastrointestinal tract malignancies. For outstanding success in treatment, the department received a certificate from the German Cancer Society (treatment of liver cancer). Here, procedures are carried out for the suppression of liver metastases and the subsequent normalization of the gastrointestinal tract function.
- University Hospital Carl Gustav Carus Dresden. The Department of Gastroenterology and Hepatology specializes in minimally invasive treatment. Here, patients can undergo a preliminary examination, receive recommendations for treatment, and have non-surgical methods of therapy. If doctors recommend surgery as the best option, then the treatment will be carried out in cooperation with other hospital departments.
- Charite University Hospital Berlin. The Department of Hepatology and Gastroenterology is the medical institution of the highest level and a part of the specialized oncology center. Here, liver metastases of any origin and rare liver tumors are treated. The head physician of the department, Professor Frank Tacke, is a member of the European Association for the Study of the Liver (EASL), the European Academy of Tumor Immunology (EATI) and the German Liver Foundation.
You can find a full list of hospitals and detailed information about doctors on the Booking Health website.
Arrangement of the treatment of liver cancer metastases in Germany
Patients with metastases in the liver who receive quality treatment in the best German clinics have a longer life expectancy. Booking Health can arrange your trip for treatment. We are experts in the field of medical tourism.
The use of our services will ensure:
- Selection of the best clinic for the treatment of metastatic cancer and booking of the diagnostic and treatment program at the best price.
- Service package: assistance in obtaining a visa, booking a hotel located as close to the clinic as possible, booking airline tickets, translation of documents, interpreter services during your communication with the medical staff of the healthcare facility.
- Saving up to 70% of the total costs of treatment and its arrangement.
- Insurance towards covering unforeseen medical expenses for up to 200,000 euros.
- Doctor’s follow-up consultation within three months after treatment program completion at no extra charge.
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Authors:
The article was edited by medical experts, board certified doctors Dr. Vadim Zhiliuk, Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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