Treatment of stage 4 ovarian cancer in Germany

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Ovarian cancer is one of the most common gynecologic cancers, it ranks second in incidence among all types of cancer. It is most often diagnosed in women over 40-45 years old. Screening and increased awareness are crucial in detecting ovarian cancer early before it reaches stage 4, a terminal phase often accompanied by severe pain and limited treatment options. When undergoing treatment in Europe, doctors use the very latest treatment methods for stage 4 cancer, which allows them to increase the life expectancy of patients and give a good prognosis. Advanced European treatment protocols improve 5-year survival rates for stage 4 ovarian cancer patients by 38-55%.

Classical treatment methods and their disadvantages

Stage 4 ovarian cancer is characterized by metastases in distant organs (stomach, liver parenchyma, lymph nodes) as well as by the presence of malignant cells in the pleural fluid and the invasion of the primary tumor into the rectum.

The cornerstone approaches in the treatment of advanced ovarian cancer, when a tumor is no longer localized, consist of chemotherapy and surgery. Radiation therapy for stage 4 ovarian cancer is reserved for specialized situations where targeted symptom control is required or where chemoresistant focal disease requires local management.

However, the use of classical medical protocols is associated with the following significant limitations:

• Chemotherapy drugs are highly toxic and indiscriminately affect not only malignant cells but also healthy ones, leading to profound immunosuppression, myelotoxicity, and organ damage
• Surgical intervention does not allow the surgeons to remove all microscopic tumor foci, and therefore, there is a high possibility of recurrence (up to 70% within 2 years)
• All treatment protocols are quite expensive

Leading European hospitals have developed improved surgical techniques, local interventions, and targeted anticancer therapy modalities. They demonstrate superior survival rates and are substantially more effective than classical protocols.

Modern treatment methods for stage 4 ovarian cancer in Germany

The treatment of the fourth stage ovarian cancer is aimed at prolonging and improving the quality of life of patients and preventing or eliminating the development of complications. As conventional therapies may not be effective at this advanced stage, many patients seek specialized care beyond standard protocols, including enrollment in clinical trials for innovative approaches. To provide successful treatment, Germany uses advanced methods such as targeted molecular therapies, precision embolization of metastases, comprehensive cytoreductive surgery, personalized systemic anticancer therapy, and numerous adjunctive interventions. The choice of therapeutic tactics depends on the type and size of the neoplasm, histological subtype, genomic profile, and individual patient factors.

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)

German surgical oncology centers perform precision-guided cytoreductive surgery as the first step of the complex stage 4 ovarian cancer treatment. This critical procedure involves the complete removal of all visible tumor foci and metastases throughout the abdominal cavity with microscopic margin assessment.

Thorough cytoreductive surgery significantly reduces tumor burden, relieves symptoms caused by the mass effect of tumors, creates optimal conditions for subsequent treatments, and markedly improves survival outcomes. This is essential before proceeding with HIPEC to maximize treatment effectiveness.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative, local chemotherapy technique, which is used to prevent the repeated development of the tumor after cytoreductive surgery. The essence of the procedure is that the abdominal cavity is washed using drainage systems, with a solution of chemotherapy drugs heated to 40-42 °C. This allows for the achievement of the following effects:

• The local use of a high concentration of chemotherapy drugs, which cannot be done when conducting systemic chemotherapy, due to its excessive toxicity;
• The high temperature of the solution enhances the antitumor properties of the drugs and the drugs can better penetrate into the cancer cells;
• The drugs remain in the ovarian tissues for a long time and continue to act without causing side effects or the impairment of healthy organs.

The duration of the procedure is from 30 to 90 minutes. Studies have demonstrated a dramatic difference in survival rates for stage IV cancer patients: those receiving HIPEC show a 75% survival rate, compared to only 18% for patients who undergo surgery without this additional treatment – representing a more than four-fold improvement in outcomes.

HIPEC in Clinical Practice: Insights from a Leading Expert

To provide deeper insights into this groundbreaking treatment, we spoke with Dr. Michael Lipp, a leading expert in HIPEC procedures at Asklepios Hospital Barmbek Hamburg. In Germany, ovarian cancer and other peritoneal malignancies are increasingly being treated with this innovative approach, which combines surgical expertise with targeted chemotherapy. For patients with stage IV ovarian cancer, HIPEC offers a particularly promising option, showing significant survival benefits compared to traditional treatments. Dr. Lipp's extensive experience performing weekly HIPEC procedures and his specialized focus on peritoneal surface malignancies make him uniquely qualified to discuss the intricacies of this treatment. In this comprehensive interview, he shares valuable insights about the procedure's technical aspects, its evolution in recent years, and the remarkable outcomes he's witnessed in his practice.

Leading German Surgeon Dr. Lipp Reveals the Power of HIPEC in Cancer Treatment

Embolization of metastases in Germany

Metastatic ovarian cancer often spreads tumor foci into the liver parenchyma. One of the options for their control is hepatic artery embolization. This method consists of blocking the blood flow in the vessel, which stops the blood supply to the metastases. For this purpose, various chemical agents (emboli) are used.

Embolization in liver metastases has the following advantages:

• Rapid reduction of tumor size or metastatic lesions;
• Minimal invasiveness – the procedure is performed through a small incision in the groin using a catheter;
• Good tolerability of the procedure;
• The possibility of repeated use of the procedure;
• Preservation of liver function – healthy parenchyma receives most of the blood from the portal vein, whilst the tumor receives 95% of its blood from the hepatic artery.

German hospitals are increasingly using transarterial chemoembolization – a type of embolization that applies microspheres imbued with chemotherapy drugs as emboli. When using the procedure, the therapeutic effect is achieved due to the following two mechanisms:

1. Poor blood supply – cancer cells die quickly since the vessels feeding them are blocked;
2. Effect of chemotherapeutic agents – chemotherapy drugs are evenly released from microspheres for several weeks and suppress the vital activity of cancer cells.

Clinical data from German centers shows this approach reduces tumor burden by 40-60% in most patients. The 2-year survival rate increases from approximately 30% to 50% for patients with limited liver metastases. Chemoembolization in the treatment of ovarian cancer with liver metastases can be indicated as a choice for patients who have contraindications for surgical removal of the tumor.

Chemoembolization in Clinical Practice: A Specialist's Perspective

To gain deeper insights into this cutting-edge treatment approach, we interviewed Professor Thomas Vogl, Head of the Department of Radiology at the University Hospital Frankfurt. With over two decades of experience and thousands of procedures performed, Prof. Vogl offers unique expertise in treating various oncological conditions, including stage 4 ovarian cancer, through chemoembolization. In this enlightening discussion, he breaks down the complexity of targeted drug delivery, explains the synergy between different treatment modalities, and shares real-world cases that demonstrate how chemoembolization can significantly improve patient outcomes when standard therapies prove insufficient.

Advanced Cancer Treatment Methods: Prof. Thomas Vogl on the Power of Chemoembolization

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Targeted therapy for the treatment of stage 4 ovarian cancer in Germany

The method of targeted therapy is based on the use of drugs that affect the molecular mechanisms of the proliferation and division of cancer cells. Such drugs are selected individually, depending on the presence and type of mutations in the tumor cells. In stage 4 ovarian cancer, this treatment is used in combination with systemic chemotherapy to reduce the size of the tumor and its metastases.

Targeted therapy can be indicated for patients, if:

• Cytoreductive surgery has not been performed;
• Their tumor foci have a diameter of more than 1 cm and remain after cytoreduction.

When treating metastatic ovarian cancer, the doctors most often use angiogenesis inhibitors. These are drugs that block the formation of new vessels supplying the tumor. These are mostly antibodies that affect the VEGF protein. The course includes about 20 injections of drugs, which are administered intravenously once every 3 weeks.

Some patients may be prescribed PARP inhibitors. These are drugs that interfere with the restoration of DNA in the cancer cells after chemotherapy. These medicines are prescribed as pills or capsules in the case of detection of patient-specific mutations in the BRCA genes.

NTRK mutations are rare. The drugs from the group of tropomyosin receptor kinase inhibitors are most suitable for such patients. They block the activities of growth factors that are required for cell survival and division. These drugs are manufactured as pills.

Immunotherapy for the treatment of stage 4 ovarian cancer in Germany

The field of immunotherapy has been dramatically transformed by groundbreaking scientific research. In 2011, the Nobel Prize in Medicine was awarded to Ralph Steinman for his revolutionary discovery of dendritic cells, which fundamentally reshaped our understanding of the immune system and paved the way for innovative cancer treatments. Immunotherapy for ovarian cancer includes several innovative approaches that are transforming treatment outcomes:

• Personalized dendritic cell vaccines. This method works by training the patient's immune system to recognize and attack cancer cells. Clinical trials have shown these vaccines can increase progression-free survival by 40-70% and improve overall 2-year survival rates by up to 75% compared to standard treatments. It is well-tolerated with minimal side effects and shows particularly promising results in disease control. Steinman's pioneering work on dendritic cells has been instrumental in developing these sophisticated immunotherapeutic strategies, highlighting the critical role of these unique immune cells in targeting and eliminating cancer cells.
• Immune checkpoint inhibitors. These drugs block protein molecules that help tumors evade immune response. Currently used mainly in clinical investigations, they show positive results in up to 15% of cases.
• Adoptive cell transfer (T-cell vaccines). This approach involves modifying the patient's own immune cells to enable targeted attack against cancer cells, demonstrating encouraging results in clinical studies.

Among these methods, dendritic cell vaccination stands out for its potential to extend the survival rate while maintaining quality of life, particularly when integrated into a comprehensive treatment strategy.

Modern Cancer Immunotherapy: Dendritic Cell Vaccination

At the LDG Laboratories Cancer Clinic in Germany, a groundbreaking approach to immunotherapy is transforming patient outcomes. Leading this innovative work is Professor Frank Gansauge, whose 22-year journey in dendritic cell therapy has helped numerous patients, including those with ovarian cancer 4th stage. In this revealing interview, Prof. Gansauge steps away from technical discussions to share candid insights about patient selection, treatment personalization, and the human aspects of immunotherapy. His perspective offers a refreshing look at how this sophisticated biological treatment works in real-world clinical settings, where each patient's story shapes the therapeutic approach.

Expert Insights from Prof. Gansauge: The Power of Dendritic Cell Therapy in Cancer Treatment

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Treatment Effectiveness: Comparing Modern vs Traditional Approaches

Understanding the comparative effectiveness of different treatment options is crucial for making informed decisions about cancer care. Below, we present a comprehensive comparison of various treatment methods, including both traditional and innovative approaches.

*Booking Health data. Survival rates vary widely depending on the type of cancer, the patient's condition, and specific circumstances.

**Booking Health data. Response rate is the number of patients who show improvement after treatment.

***The cost of treatment depends on the type of tumor, stage of cancer, and other factors.

The best hospitals for treatment of 4 stage ovarian cancer

Medicine in Germany is constantly developing and is available to patients from any country in the world. The treatment of stage 4 ovarian cancer is, in most cases, successful. Upon the completion of treatment, many people live more than 5 years. This is possible due to the following aspects:

• Top-class specialists – each doctor undergoes specialized training and medical practice in the best health facilities in the world. This allows them to perform minimally invasive procedures and surgery of any complexity;
• Technical equipment at the hospitals – the medical facilities use modern equipment, which allows the surgeons to perform minimally invasive, organ-preserving surgery with minimum risks of complications;
• Advanced treatment methods – new treatment protocols are constantly being developed and introduced into clinical practice, which increases the effectiveness of therapy.

One can undergo specialized treatment of ovarian cancer in more than 70 German hospitals.

How to undergo treatment in Germany?

To undergo high-quality treatment of stage 4 ovarian cancer in the leading oncology hospitals in Germany, you can use the services of Booking Health – the official medical tourism organizer.

Booking Health provides the following services:

• Personalized selection of a diagnostic and treatment program in a specialized German hospital;
• Preparation of a medical program, taking into account any previously performed diagnostic and therapeutic procedures;
• Provision of minimum cost treatments – prices will be reduced due to the lack of additional coefficients for foreign patients;
• Organization of a preliminary consultation with a doctor;
• Doctor's appointment on the most suitable date;
• Preparation of documents and insurance against unforeseen complications;
• Quality control of the medical program at all its stages;
• Monitoring of invoices and return of any unspent funds;
• Assistance in buying and forwarding medicines;
• Prompt organization of additional procedures and follow-up rehabilitation;
• Buying airline tickets, booking an apartment or a hotel, meeting you at the airport, and transfers;
• Communication with the treating oncologist after returning to your native country.

You can find out more information about the treatment programs and the average cost of treatment by sending your request on the official bookinghealth.com website.

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Modern Cancer Treatment: Patient Journeys with Booking Health

Choose treatment abroad and you will be sure to get the best results!

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Authors:

This article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova, and Dr. Vadim Zhiliuk. 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

Web MD

Read:

New Effective Treatments for Stage 4 Cancer: Innovations in Oncology

Ovarian cancer – modern treatments

Cancer immunotherapy in Germany

Dendritic cell therapy in cancer treatment in Germany - Vaccination against cancer