Where is it better to treat brain cancer?
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According to the WHO statistics, brain cancer counts only for 3% of all cancer cases. Nevertheless, this life-threatening condition requires maximal efforts, great competence, and the collective work of healthcare professionals. Fortunately, modern medicine offers a great variety of treatment options for patients with brain cancer. The development of the medical sphere is not the same in different countries all over the world. Thus, a number of effective procedures and drugs are available only in a limited number of countries.
The correct choice of the clinic, healthcare professional, and treatment scheme contributes much to the final result of therapy. It is better to take a close look at the world`s statistics and make your decision consciously.
Content
- What is important to consider during the decision-making?
- Receiving treatment in the native country
- Choosing surgical treatment
- Choosing radiation therapy
- Choosing chemotherapy and targeted therapy
- Choosing comprehensive approach
- How can I receive treatment abroad?
What is important to consider during the decision-making?
Being diagnosed with brain cancer means that you begin the long way of treatment in order to fight the disease and live a full life with your beloved people. Healthcare practitioners will give you a helping hand and accompany you along this way. Brain cancer is a complex pathology, which means you will be treated by a multidisciplinary team: an oncologist, neurosurgeon, neurologist, general practitioner, dietitian, psychologist, social worker, and others.
Selecting this team is extremely important, as the qualification of doctors significantly affects the final result of therapy. Thus, the first important point in choosing the right place for brain cancer treatment is assessing the experience and practical skills of a healthcare team.
The other significant aspect is the availability of all the necessary treatment options. Modern oncology offers a wide range of approaches and techniques for patients with brain cancer, including the following:
- Surgical treatment, including interventions for metastases removal.
- Radiation therapy, including radiosurgery – CyberKnife and Gamma Knife
- Chemotherapy and individual targeted therapy
- Comprehensive approach, including non-traditional methods
- Symptomatic treatment and alleviating side effects
Well-grounded elaboration of the treatment scheme is closely connected with the presence of related equipment and approval of certain drug techniques in the country.
Comprehensive oncological and neurological rehabilitation after the completion of treatment should be considered, as well. Rehabilitation facilitates the restoration of speech, walking, neurological functions, and the ability to fulfill activities of daily living. Clinics with special attention to this aspect demonstrate better results regarding quality of life and life expectancy. Rehabilitation also helps in acquiring valuable for the future life habits and getting used to living with the consequences of treatment (if there are any).
Possibility to take part in a clinical trial. Certain healthcare institutions combine active clinical practice with scientific research. Participating in a clinical trial is essential for people with advanced or resistant to other kinds of treating brain cancer. It gives the possibility to try innovative medication or intervention before it becomes approved for general use. In addition, taking part in a clinical trial is usually free of charge for a patient.
Receiving treatment in the native country
Patients with brain cancer often start treatment in their native country right after the diagnosis is established. This seems logical, as a diagnostic program should always be followed by corresponding treatment. Patients and their relatives are frustrated with the diagnosis, so they willingly follow the doctor`s recommendations regarding the immediate start of treatment.
Beyond all doubt, receiving medical help in the native country has obvious advantages, like:
- Diagnostic and treatment programs are performed in the same healthcare institution, often – under the general control of one treating physician
- Immediate start of the treatment program – there is no need to plan a long trip, solve organizational problems and get a visa for traveling abroad, seek specialized transport in case of a bad state of the patient, etc.
- Proximity of the hospital to the patient`s house and relatives – it is always possible to count on the help of close people.
- Low price of the treatment – treatment can be free of charge or be covered by the insurance, which is extremely important for people in restricted financial circumstances.
Nevertheless, coping with the first emotions from the diagnosis and assessing the situation more consciously are always useful. The medical potential of different countries worldwide is not the same. In addition, there are certain countries that are famous for brain cancer treatment.
If you are not a citizen of such a country, you should take a close look at the following possible disadvantages of treatment in the native country:
- Questionable quality of the diagnosis – sometimes, repeated preoperative examination in the specialized clinic leads to serious changes in the diagnosis and treatment plan
- Absence of surgeons with narrow specialization in the treatment of exactly this kind of tumor
- Unavailability of the equipment for certain treatment options, particularly good quality CyberKnife and Gamma Knife, proton therapy, 3D conformal radiation therapy
- Absence of the most effective medications – drugs of the latest generations cannot be approved for practical use in the country.
- Absence or insufficient quality of rehabilitation programs that can result in a bad general state even after the total removal of the tumor
Nowadays, it is totally possible to apply for the treatment in the most specialized hospitals worldwide, so there is no need to restrict treatment options to limited possibilities of the native country. Opportunity to receive better help and thus improve quality of life and life expectancy force many patients to seek qualified medical help abroad.
Choosing surgical treatment
Surgery is the most widespread treatment option in patients with brain cancer. Actually, this can be the only necessary intervention for a low-grade brain tumor.
When we talk about the world`s leading countries in the scope of brain surgery, we should pay particular attention to Germany and Switzerland.
Neurosurgery in these countries has several significant benefits for patient peculiarities:
- Using cortical mapping at the stage of planning the surgery. Before the intervention is started, surgeons identify specific areas of the brain cortex responsible for motor functions, speech, senses, memory, emotions, etc. This is extremely helpful in preserving the abovementioned functions. For example, when a tumor is located near the speech center, a patient stays awake during a part of the intervention, so a surgeon can control his ability to talk. Cortical mapping and precise performing of the surgery provide a better quality of life and a shorter rehabilitation period after the intervention.
- Using Image-Guided Surgery techniques. This computer-based approach implies using enhanced imaging devices (like high-resolution CT, MS-CT, FP-CT, MRI, etc.) to determine a tumor location very accurately. In combination with cortical mapping, it provides maximal preservation of the brain`s healthy tissue and minimal risk of neurological complications.
- Using drugs on the basis of the 5-aminolevulinic acid. This substance serves as a specific dye for tumor cells. With the help of a microscope and special light, a surgeon sees the difference between oncological cells and normal brain tissue during the surgery. Thus, he is able to remove the whole tumor safely. As a result, the patient receives a better outcome and minimal chance of the disease relapse.
Germany and Switzerland are also famous for treating brain metastases. Excellent diagnostic possibilities and precise surgical techniques give a chance to prevent the disease from spreading and come to a stable and long-term remission. Metastases can also be detected in the remote tissues and organs – in such cases, and neurosurgeons work in close cooperation with abdominal surgeons and other professionals.
One more important focus of attention is the treatment of inoperable brain tumors. Such neoplasms are located near vital structures of the brain (e.g., respiratory center) or can`t be reached without extensive damage to healthy brain tissues. In such cases, neurosurgeons in Germany and Switzerland perform partial removal of the tumor that alleviates neurological symptoms and provides sufficient material for the histological examination of the tumor. Other options include switching to additional treatment options in order to make a tumor shrink before further surgical intervention.
Choosing radiation therapy
Radiation therapy methods include a number of techniques that imply using high-energy radiation for the destruction of tumor cells. During the last decades, this approach has evolved from non-specific whole brain irradiation to the targeted delivery of high-energy particles directly to the tumor tissue.
Availability of the equipment is one of the main conditions for performing this kind of treatment. That is why Turkey and Germany are absolute leaders in providing such interventions. Comparing these two countries, Turkey is more affordable for international patients, while Germany offers a higher quality of equipment.
In different clinical situations, radiation oncologists choose between the following treatment options:
- Conventional radiation therapy uses high-energy X-rays and is mainly applied for whole brain radiation therapy in the presence of brain metastases. The amount of radiation correlates with the tumor`s grade but is always minimal in order to prevent healthy brain tissue from being damaged.
- 3-dimensional conformal radiation therapy implies using high-resolution CT and MRI scans to create a precise 3D model of the tumor in the context of surrounding unaffected tissues. Such an approach makes head irradiation more targeted, directing higher doses of radiation to the neoplasm.
- Intensity modulated radiation therapy is a particular type of 3D conformal radiation therapy with a regulated intensity of beams. Thus, beams with a higher energetic potential reach the tumor, while poor energy beams go through healthy tissues.
- Proton therapy uses proton beams for the destruction of superficially located tumors – tumors on the base of the skull or near the optic nerve. Proton beams are typically applied for external radiation therapy when less energy is required for the extermination of the neoplasm. This kind of treatment causes fewer side effects but needs exquisite adjustment of radiation dose.
- Stereotactic radiosurgery implies delivering a single but extremely high dose of radiation precisely to the tumor without any damage to healthy tissues. The most up-to-date equipment in this sphere includes CyberKnife and Gamma Knife, diverse models of which are available in clinics in Turkey and Germany. Gamma Knife is now considered to be the golden standard in the treatment of brain cancer.
- Fractionated stereotactic radiation therapy combines stereotactic precision with small daily doses of radiation. This is an extremely delicate technique that reduces the already low risk of damaging sensitive brain structures.
Radiation therapy is rarely a sole component of a brain cancer treatment scheme; usually, it starts after the surgery or accompanies chemotherapy. In certain cases, radiation oncologists in Turkey and Germany administer internal radiation therapy or brachytherapy, which uses implants for the delivery of radiation.
Choosing chemotherapy and targeted therapy
Generally speaking, chemotherapy itself is not an innovative approach. Administering certain drugs for destroying tumor cells or inhibiting their ability to grow and divide has come into clinical practice many years ago. The problem is that the blood-brain barrier physiologically protects the brain from all harmful substances. Unfortunately, medications for chemotherapy are also recognized by the barrier as undesirable compounds. That is why scientists make all the efforts to create new molecules that successfully reach brain tissue, destroy tumor cells and leave healthy tissues undamaged. During the last decades, the most prominent achievements in this sphere have been demonstrated by doctors from Israel and Germany. What is extremely important is that the theoretical results of clinical trials are transformed into practical experience and new treatment options without delay in these countries.
Medical oncologists and neuro-oncologists in Israel and Germany widely administer chemotherapy in patients with brain cancer, as it allows for slowing down tumor growth, destroying cancer cells remaining after the surgical intervention, or reducing oncologic symptoms.
Innovative drugs, available only in these countries, can be taken in few ways:
- By mouth. In this case, treatment can be outpatient; a patient visits the hospital only for control examinations.
- By intravenous injections. Such a treatment scheme requires regular visits to the healthcare institution. This is even better as a patient stays under close medical supervision and can easily contact his doctor if necessary. A catheter or port can be placed into the vein to facilitate drug intake.
- Through the shunt. This option is possible for the patients with shunts that are left after the surgery in order to remove excess fluid from the brain. Such a technique is a more invasive one, but it provides direct delivery of the drug to the brain tissue.
- In special wafers, that are put into the brain after the completion of the main surgery. Small dissolvable wafers with specific drugs release their content several weeks after the intervention and significantly lower the risk of the disease relapse. Only the most talented neurosurgeons and neuro-oncologists in Israel and Germany are authorized to perform such interventions.
Targeted therapy is the most up-to-date addition to standard chemotherapy. The term “targeted” means that the drug is highly individual and specific for a certain type of tumor. Targeted therapy`s action can be pointed at the tumor`s specific genes or proteins, its growth factors, and the tissue environment.
Anti-angiogenesis targeted therapy, which has shown the best effect in brain cancer treatment, is already available in Israel and Germany. This kind of therapy stops the formation of new blood vessels, so the tumor is gradually deprived of blood supply and essential nutrients. In such circumstances, the tumor shrinks, stop spreading and can be effectively treated by surgical or radiological techniques.
Choosing comprehensive approach
Integrative medicine is a relatively new approach to the treatment of brain cancer. Integrative complementary and alternative medicine (CAM) methods include healthy nutrition and dietary supplements, homeopathic remedies, herbal supplements, beta-glucans administration, massage, yoga, acupuncture and chiropractic care, hypnosis, and work with a psychologist, etc. Healthcare institutions that provide such treatment should be experts in all traditional treatment options, as CAM methods are only an addition to them, not a substitution. Due to these obvious benefits, more and more patients give preference to the comprehensive approach to brain cancer treatment.
Germany traditionally takes the leading position in the list of countries that provide CAM methods. German doctors highly appreciate integrative medicine, as it enhances the action of the conventional treatment methods, restores the patient`s immune system, alleviates unpleasant side effects of the main treatment, and improves the patient`s quality of life and sense of wellbeing in general. In addition, German specialists are qualified enough to apply integrative medicine principles individually in each clinical situation and have extensive knowledge in this sphere.
CAM methods are aimed not only at fighting against brain cancer but also at ensuring better life expectancy with improved quality of life. A good quality rehabilitation program after the treatment completion also fits into the overall framework of such an approach. That is why CAM methods are worth considering for sure.
How can I receive treatment abroad?
When we talk about brain cancer, it is crucial to start the correct treatment as soon as possible because this disease rarely gives a second try. Fortunately, the world`s medical borders are not strict these days, so patients and their relatives have the opportunity to choose a country, hospital, and attending physician without any limitations.
Covering the expenses related to medical services and traveling abroad is a special issue. For example, the average cost of surgical resection of cerebral germinoma is €28,970, the average cost of a germinoma removal with CyberKnife is €33,100, and the average cost of a Gamma Knife surgery is €16,450.
Sometimes it may be difficult to make the right step in this great variety of options and, afterward, arrange a journey abroad for the patient with such a diagnosis. Understanding this, the global medical provider, Booking Health company was founded to assist international patients in all tricky aspects of receiving treatment abroad.
Booking Health company helps patients in such important aspects as:
- Choosing the most appropriate clinic and doctor exactly for your case
- Getting an invitation for treatment from the clinic for faster medical visa receiving
- Getting an appointment on a convenient date and time
- Preliminary organization of comprehensive examination and further treatment
- Providing transfer from the airport to the clinic and back to the airport
- Assistance of interpreter and personal medical coordinator
- Providing medical insurance in case of complications (up to 200 000 euros)
- Preparation and translation of medical documents and recommendations from the clinic
- Help in further communication with your treating physician, if necessary
To start planning your medical trip, you should leave the request on the website of Booking Health company. After this, you will be contacted by our patient case manager to discuss all the details of your clinical situation and elaborate on future steps. Our aim is to help you in receiving the best possible treatment for the most affordable price.
Choose treatment abroad and you will for sure get the best results!
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!
Sources:
National Center for Biotechnology
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