Kidney cancer is one of the most common types of malignant tumors. More than 250,000 cases are diagnosed in the world every year. According to statistics, it usually develops in people aged between 60 and 65 years of age. The disease is most often detected at its early stages, but stage 4 cancer is diagnosed in every sixth patient. Using the classical treatments rarely gives a good prognosis. Nowadays, German hospitals practice innovative methods, which allow the doctors to achieve successful results in 70% of cases, even at an advanced stage of kidney cancer.
- Standard treatments for stage 4 kidney cancer and their disadvantages
- Modern treatments for stage 4 kidney cancer in Germany
- Other effective treatments
- Benefits of cancer treatment in Germany
- Specialized hospitals for the treatment of stage 4 kidney cancer
- How to organize stage 4 kidney cancer treatment?
Standard treatments for stage 4 kidney cancer and their disadvantages
Stage 4 kidney cancer is diagnosed in the following cases: the tumor has spread outside the membranes of the organ to the adjacent tissues and lymph nodes, and also when the cancer cells have spread to the distant organs with blood flow.
In most cases, the treatment for this stage of the cancer involves the use of chemotherapy and radiation therapy, but these methods have significant drawbacks. They are as follows:
- They allow for the restraint of the growth of the tumor for some time, but they are not able to completely stop the development of the pathological process.
- Classical radiation therapy and chemotherapy affect not only the tumor, but the whole body. This significantly weakens the patient's body and worsens their quality of life.
- They require a long treatment course and considerable investments.
- They often do not have any effect at all.
In extremely severe cases, open surgery may be indicated.
Modern treatments for stage 4 kidney cancer in Germany
German hospitals are constantly carrying out scientific research and developing new technologies, allowing their doctors to be introduced to new algorithms for stage 4 kidney cancer treatment first. Among the most effective methods of treatment are embolization, targeted therapy, and immunotherapy. In some forms of oncology, treatment in Europe involves the surgical removal of the kidney and any single metastases in other organs.
Embolization of metastases
Embolization is a procedure which involves closing the lumen of the arteries feeding the malignant tumor. Both the tumor cells and the tissues eventually die due to insufficient blood supply. Embolization allows doctors to reduce the tumor’s size, eliminating the main symptoms of the pathology, increasing the patient's life expectancy, and preparing him for other surgical procedures.
The doctors use special emboli to reduce the blood supply of the tumor. These may be spirals, hemostatic sponges, cyanoacrylate glues, or alcohols. German hospitals also apply a method called transarterial chemoembolization – the closure of blood vessels using microspheres saturated with chemotherapy agents. This provides an additional effect on the tumor, using drugs, which are gradually released from the microspheres and penetrate the cancer cells, thereby destroying them.
Embolization in stage 4 kidney cancer treatment also has the following effects:
- It helps stop bleeding, which can be very dangerous and lead to life-threatening conditions.
- It stimulates the immune response by releasing specific antigens from dead cancer cells. Once in the blood, they activate the body's immune system, which makes it possible to eliminate not only the tumor, but also distant metastases in other tissues and organs.
- Chemoembolization in cancer treatment allows the microspheres to release chemotherapy agents for several weeks, directly into the pathological focus, which, in contrast to standard chemotherapy, reduces the number of negative side effects.
As an additional medical procedure prior to surgery, embolization can be used in order to reduce the tumor size and reduce blood loss during the surgical interventions. It is most often used in combination with nephrectomy (kidney removal), which helps to increase the patient's life expectancy. The best effect will be achieved when the tumor is up to 7 cm large.
Patients with tumor thrombosis of the large veins receive the greatest benefit from embolization. The procedure results in blood clot reduction, so the operation to remove them becomes safer. In addition, renal artery embolization in stage 4 metastatic kidney cancer can be combined with various drug therapy options (for example, immunotherapy).
The recovery after embolization is rapid – all unpleasant symptoms disappear 2-3 days after the procedure. During this period, the doctors in Germany prescribe detoxification, analgesic, and supportive therapies, which improve the general tolerance of the treatment.
All cancer cells have specific molecular targets on their surface, which differ in their structure depending on the type of tumor. Targeted therapy is a modern type of drug therapy, which involves the use of chemotherapy agents that act directly on the molecular targets. Germany uses kinase and angiogenesis inhibitors for targeted therapy.
Targeted therapy has the following benefits:
- Drugs for targeted therapy are selected individually, depending on the sensitivity of tumor cells to them.
- Unlike classic chemotherapy, it only targets cancer cells and has minimal side effects.
- In kidney cancer, targeted therapy can not only increase the overall, and recurrence-free, survival rate of patients, but also provide them with a good quality of life, due to its low toxicity.
- Most drugs for targeted therapy are supplied in oral forms: patients take them as pills or capsules.
- Malignancies always contain a large number of vessels, since they grow rapidly and must receive more blood. The medications used not only inhibit the growth of the tumor, but also block the formation of new blood vessels. If new vessels do not form, the disease does not progress and the tumor decreases in size.
When conducting targeted therapy, drugs can be prescribed in a continuous course, or for several weeks, with interruptions to restore the body. Medicines from the mTOR inhibitor group are administered intravenously, once a week.
Immunotherapy is a drug therapy for kidney cancer which uses drugs to block checkpoints on the surface of cancer cells – checkpoint inhibitors. Checkpoints are signaling molecules, which allow the abnormal cells to become "invisible" to the immune system by inhibiting the activity of T-cells. There are many types of them, amongst which, the most studied are the receptor and ligands of programmed cell death 1 (PD-1) and programmed death ligand 1, 2 (PD-L1, PDL2). They are the targets of most drugs.
Nowadays, German doctors use more than ten different immunotherapy drugs for kidney cancer, as well as their combinations. Once the drugs have blocked the checkpoints, the immune system begins to destroy the tumor and metastases. Due to this, immunotherapy can have the following effects in stage 4 kidney cancer:
- reduction of tumor foci size;
- absence of development of new metastases during the therapy;
- long-term stabilization of the tumor size, and then its gradual reduction;
- increase in the life expectancy of the patient by several years.
The first drugs from the group of checkpoint inhibitors were approved by the FDA and EMEA (in the US and Europe) in 2015. They are considered second-line drugs, which means that they are used in cases where the disease cannot be controlled using standard methods. Since 2019, immunotherapy has been used as first-line therapy for metastatic cancer, as it shows better results compared to the classical treatments for kidney cancer.
Other effective treatments
In stage 4 kidney cancer with metastases, surgery is often required. The operation (nephrectomy) involves a partial or total removal of the affected organ. With extensive lesions, the adjacent tissues and/or other organs have to be removed as well.
In order to make the surgical procedures less traumatic and the recovery period shorter, European hospitals perform such operations using the following new technologies:
- Laparoscopic removal is a surgical procedure that uses modern laparoscopic techniques. It allows the doctors to perform image-guided surgery through a small skin incision, in an extremely short period of time.
- Kidney removal with the da Vinci Surgical Systems is an operation using robotic equipment, which guarantees high accuracy, minimal tissue damage, and no risk of medical error.
If the number of metastases is small, they can be removed or destroyed by radiation. German hospitals use new types of irradiation, which ensure the accurate delivery of radiation to the tissues, with minimal risk of post-radiation complications. The very latest methods of radiation therapy not only inhibit the growth of metastatic tumors, but also prevent bone fractures and relieve pain.
Benefits of cancer treatment in Germany
German oncology hospitals offer innovative sparing treatments, which are effective even at the advanced stages of kidney cancer. These methods can increase the life expectancy of patients by several years, eliminate symptoms, and prevent serious complications.
It is worth noting the following benefits:
- Accurate diagnosis – German hospitals use high-precision equipment for diagnostics and screening, as well as modern laboratory tests. This enables them to choose the appropriate treatment method individually for each patient.
- Highly qualified doctors – each specialist undergoes long-term training in the best medical universities, as well as a specialized internship, and receives all the necessary licenses for their admission to medical practice.
- Best drugs – Germany uses only the latest modern drugs, which have less toxicity and side effects.
- Equipment in hospitals – each medical facility has everything necessary to provide treatment to the patient using any method.
- Rehabilitation period – special attention is paid to the maximum possible recovery of the patient after the treatment’s completion.
Kidney cancer can be treated in more than 65 German hospitals. Cancer treatment in Germany is usually successful.
Specialized hospitals for the treatment of stage 4 kidney cancer
In Germany, stage 4 cancer is treated in large university hospitals and specialized urological centers. In the first case, doctors have more opportunities to involve specialists from various fields of medicine in the therapeutic process. In the second case, they can pay more attention to specific methods of advanced kidney cancer treatment. The leading hospitals in Germany that specialize in the treatment of kidney malignant tumors are:
- University Hospital of Ludwig-Maximilian University of Munich, Department of Adult and Pediatric Urology
- University Hospital Ulm, Department of Adult and Pediatric Urology
- Urology Hospital Munich-Planegg Munich, Department of Adult and Pediatric Urology
- University Hospital Heidelberg, Department of Adult and Pediatric Urology
- Charite University Hospital Berlin, Department of Adult and Pediatric Urology
How to organize stage 4 kidney cancer treatment?
You can take advantage of professional and qualified treatment in Germany by sending a request on the official website of the Booking Health company. Booking Health is a leader in organizing treatment for patients from all over the world.
After receiving your request, our managers will contact you as soon as possible and provide all the necessary support in organizing your treatment. We will take care of the following things:
- selection of the best German medical center for the diagnosis and treatment of your kidney cancer, based on the annual reports;
- preliminary consultation with a doctor;
- doctor's appointment on your desired date;
- provision of a favorable cost of treatment, without any extra charges or coefficients for foreign patients;
- preparation of the required documents, requesting a visa and an invitation for treatment;
- provision of medical insurance;
- booking airline tickets and a hotel room;
- arrangement of interpreting services;
- control of the medical program at all its stages;
- monitoring of invoices and return of any unspent funds;
- assistance in buying and forwarding medicines;
- communication with the hospital after your treatment is complete.
When cooperating with us, you can save your precious time and undergo high quality treatment in Germany.
To find out the exact prices and more detailed information about kidney cancer treatment programs, please send us your request on the bookinghealth website.
Choose treatment abroad and you will get the best results surely!
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Alexandra Solovey. 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!