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Treatment of stage 4 adrenal cancer in Germany in 2024 | Booking Health

Treatment of stage 4 adrenal cancer in Germany

The article was reviewed by an expert in the field of medicine Prof. Dr. med. Thomas Vogl
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If you need detailed information on methods and costs of treating earlier-stages adrenal cancer, you'll find it here.

Adrenal cancer is a rare but very aggressive tumor. According to clinical statistics, it usually develops in people over 40 years old. More than half of the patients amongst these people are women. Since the adrenal glands are endocrine organs, the tumor is hormonally active in every 2 out of 3 patients. German hospitals use innovative treatment methods to treat this malignant pathology, which allows them to achieve excellent results both with localized tumors and advanced cancer.

Content

  1. Standard treatment methods and their disadvantages
  2. The very latest and most effective treatment for stage 4 adrenal cancer in Germany
  3. Why is adrenal cancer treatment more effective in Germany?
  4. Specialized hospitals for stage 4 adrenal cancer treatment
  5. How to undergo treatment in Germany?

Standard treatment methods and their disadvantages

 

Stage 4 adrenal cancer is characterized by the development of distant metastases in the lymph nodes, other organs, and systems (metastatic cancer). They most often develop in the lungs and liver. If the tumor is hormonally active, adrenal hormones are then also released in excessive amounts, which contributes to various metabolic disorders.

Currently, the most common treatment methods are chemotherapy, radiation therapy, and surgery. However, they are often performed according to outdated protocols, which have many disadvantages:

  • Classical chemotherapy affects not only the tumor, but also the healthy cells. As a result, the body is greatly weakened and its immunity decreases.
  • Radiation therapy also affects the body systemically, causing various severe complications.
  • Open surgical procedures involve a large area of intervention, due to which, the patient’s recovery lasts for a long time.
  • All these methods are ineffective, unable to completely cure the disease, or increase the patient’s life expectancy.

European hospitals practice improved standard treatment options, which are less toxic and minimize the risk of negative symptoms.

The very latest and most effective treatment for stage 4 adrenal cancer in Germany

 

German hospitals use new treatment techniques for stage four adrenal cancer. These can prolong and improve patients' lives, as well as eliminate complications. The most effective among them are embolization, chemotherapy, various radiation techniques, immunotherapy, and minimally traumatizing surgical interventions.

Embolization of metastases

 

Embolization is a method which involves blocking the vessels from which a tumor receives blood. This process involves the injection of emboli (containing various substances) into the arterial lumen. The emboli are delivered to the blood vessels using a catheter inserted through a small incision in the groin. As a result, the tumor stops developing after a while, due to a lack of nutrients that are necessary for its functioning.

There is also a special variant of the procedure – transarterial chemoembolization. This involves the use of microspheres as emboli, which include chemotherapy drugs – cytostatics. Chemoembolization in the treatment of adrenal cancer allows the doctors to additionally affect the tumor with high doses of chemotherapy drugs. For several weeks, the drugs are evenly released from the microspheres, without causing any systemic side effects in most patients. After this procedure, the pathological tissues die off quickly.

Embolization can be used as a standalone procedure or as preparation for surgery. In stage 4 adrenal cancer, it is required to prolong a patient's life and is often combined with other treatment methods. As a preoperative procedure, it is usually performed when the tumor is large and has an ample blood supply.

The results of embolization are as follows:

  • reduced tumor size;
  • reduced blood loss during an operation;
  • reduced risk of complications during and after surgery;
  • stable blood circulation and a reduced risk of cardiovascular complications;
  • Ceased progression of the pathological process.

Stage 4 adrenal cancer often spreads liver metastases. To destroy them, doctors use hepatic artery chemoembolization. This procedure allows them to reduce the size of the metastatic foci several times, whilst preserving the liver’s function.

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Chemotherapy

 

Chemotherapy is a medical treatment that uses drugs which act on cancer cells. The doctors in Germany usually use an Italian protocol (EPD-M) for chemotherapy, which demonstrates the best survival rates of patients. This involves the constant use of combinations of chemotherapy agents. The use of this scheme can significantly increase the life expectancy of patients. Many of them can live for several years after their diagnosis.

Chemotherapy for stage 4 adrenal cancer usually involves the administration of a drug that suppresses the adrenal glands and prevents tumor cells from actively multiplying. In the early stages of adrenal cancer, it is used in monotherapy. In the advanced stage of pathology, it is combined with 1-3 innovative chemotherapy agents.

New radiation techniques

 

Adrenal cancer refers to tumors which are insensitive to radiation. Therefore, conventional types of radiation therapy do not always ensure a sufficient solution. The results can be improved with an increased radiation dose, but in these cases, the risk of post-radiation complications will be high, since not only the pathological, but also the healthy tissues are highly irradiated.

German hospitals use modern radiation therapy methods, which makes it possible to increase the dose of radiation for the tumor, without increasing the toxicity to the healthy tissues. These include:

  • Intensity-modulated radiation therapy (IMRT) is a radiation therapy method which can be used to irradiate cancer from different angles, whilst simultaneously adjusting the intensity of the exposure.
  • Stereotactic radiation therapy is a high-precision technology of radiosurgery, which uses sophisticated equipment. It allows the doctors to set the coordinates of the irradiation with millimeter accuracy and carry out the procedure sparingly.
  • Brachytherapy is a type of radiation therapy in which a radiation source is placed inside the patient's body using radioactive seeds. The last seeds are injected directly into the area of the tumor, where they are evenly distributed into the tissues. At the same time, the beams do not pass through the healthy tissues, which reduces the risk of complications.

Radiation methods are usually combined with the partial removal of a tumor. Instead of surgery, they are used to suppress the primary tumor in cases where surgery is contraindicated. Radiation therapy is often used for the treatment of bone metastases. It reduces the risk of pathological fractures and also reduces pain.

Radiation therapy for adrenal cancer

Surgical treatment

 

Some primary tumors are not very large and can be totally removed, but many patients require the surgical removal of the adrenal gland. Since a tumor produces hormones, causing systemic symptoms, an intervention is required to eliminate them. As a rule, open surgery becomes the first option of choice, but in Germany, it can be performed using laparoscopic equipment. This technique is less traumatic, has less complications, and provides a quick postoperative recovery period.

Laparoscopic operations are also performed in cases when adrenal cancer is a consequence of oncology in other organs. German hospitals use modern laparoscopic techniques to remove the tumor without spreading malignant cells to the abdominal cavity. Studies show that the laparoscopic removal of metastases allows for the achievement of good survival rates and reduces the risk of recurrence, compared to standard open procedures.

The success of a laparoscopic treatment is also related to the characteristics of the tumor. In most cases, adrenal metastases are small and less aggressive than primary adrenal malignancies.

Immunotherapy

 

Immunotherapy is a drug treatment which blocks specific protein molecules on the surface of cancer cells (checkpoint inhibitors). Thanks to these, the malignant tumor evades the patient’s immune response and rapidly increases in size. As soon as the drugs suppress the activity of these proteins, the immune system independently begins to effectively counteract the cancer.

Checkpoint inhibitors targeting PD-L1 proteins have shown excellent results in the treatment of stage 4 adrenal cancer. They are used in cases where the pathological cells contain these molecules. It is possible to control the disease in 25% of patients with their help, and in 10% of patients, the tumor and metastases are reduced in size by more than 30%.

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Why is adrenal cancer treatment more effective in Germany?

 

Even stage 4 cancer treatment can be successful. Although these tumors are very aggressive, the introduction of new treatment approaches has significantly improved patients' survival rates. In Germany, more than a third of patients with metastases live for more than 5 years after their diagnosis.

This is possible due to the following advantages:

  • All surgical procedures are performed using safe methods, which ensure the rapid recovery of a patient.
  • German hospitals employ top-class specialists who undergo long-term training and receive relevant qualifications.
  • Clinical investigations are carried out in almost every medical facility in Germany, which makes it possible for patients to be first in receiving new treatment technologies.
  • Availability of the best innovative drugs and state-of-the-art equipment.
  • Due attention is paid to the recovery of patients after their medical procedures.

The medical staff carefully monitor the well-being of patients and do everything possible to ensure a comfortable stay for patients in the hospital.

Specialized hospitals for stage 4 adrenal cancer treatment

 

Surgeons, oncologists, and endocrinologists are involved in the treatment of adrenal cancer. The combined work of doctors allows a patient to get rid of a tumor and its metastases, as well as normalize the level of adrenal hormones. The following hospitals are leading in their treatment of adrenal cancer:

  1. University Hospital of Ludwig Maximilian University of Munich, Department of Adult and Pediatric Urology
  2. Urology Clinic Munich-Planegg Munich, Department of Adult and Pediatric Urology, Andrology
  3. University Hospital Ulm, Department of Adult and Pediatric Urology
  4. University Hospital Heidelberg, Department of Adult and Pediatric Urology
  5. Charite University Hospital Berlin, Department of Adult and Pediatric Urology

How to undergo treatment in Germany?

 

To undergo treatment of stage 4 adrenal cancer in the best oncology hospitals in Germany, you can use the services of Booking Health. The qualified specialists of our company will take care of all the organizational aspects, which includes the following:

  • personalized selection of the most suitable medical center for diagnostics and treatment in Europe;
  • preparation of a treatment program, based on all of your previously performed procedures;
  • a doctor's appointment on your desired date and a preliminary consultation;
  • control of your medical program at all its stages;
  • assistance in buying and forwarding medicines;
  • monitoring of invoices and the return of any unspent funds;
  • prices will be reduced for you – the average cost of treatment will be minimal due to the lack of coefficients for foreign patients (saving up to 50%);
  • Booking Health employees will fully organize your trip abroad, book your tickets, book a hotel room, meet you at the airport, and take you to the hospital by car.

Our portal provides detailed information about the best hospitals in the world, treatment in Europe, the doctors, and the cost of treatment. To find out more detailed information, you can send a request on our website or contact us on the specified phone numbers.

 

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See the interview for more information:

CHEMOEMBOLIZATION AND OTHER METHODS OF THE ADVANCED-STAGE CANCER TREATMENT – interview with Prof. Dr. med. Thomas Vogl

Authors: 

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!

Our editorial policy, which details our commitment to accuracy and transparency, is available here. Click this link to review our policies.

 

Sources:

American Cancer Society

National Cancer Institute

Cancer.Net

 

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