Treatment of stage 4 thyroid cancer in Germany
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Thyroid cancer is not the most common disease. More than 120,000 cases of thyroid cancer are diagnosed around the world every year, which is 1% of all malignant tumors. Germany is constantly developing and introducing into practice the latest treatment methods to improve the health of patients and defeat the disease at the localized and advanced stages.
Content
- Standard treatment of stage 4 thyroid cancer and its disadvantages
- Advanced treatment methods for stage 4 thyroid cancer in Germany
- Why is it advisable to undergo treatment in Germany?
- How to undergo treatment in German hospitals?
Standard treatment of stage 4 thyroid cancer and its disadvantages
There are several types of thyroid cancer, namely follicular, papillary, medullary, and anaplastic (undifferentiated) cancer. Stage 4 in the first three cases is detected due to the spread of cancer cells to the nearest tissues and the presence of distant metastases. The anaplastic type is considered to be stage 4 cancer from the moment of diagnosis since this tumor is very aggressive.
The worldwide standard treatment protocols for stage four thyroid cancer include surgery and radioiodine therapy. However, they have the following disadvantages:
- Not all tumors can be treated surgically.
- Not all tumors are sensitive to radioiodine therapy.
- Classical surgery is associated with the risk of damaging recurrent laryngeal nerves and developing voice disorders.
- Radical thyroid surgery leaves a scar 10-15 cm long on the patient's neck, which often causes discomfort.
- Patients often require additional treatment methods, which may not be available in hospitals in developing countries.
The new cancer treatment protocols already used in Germany demonstrate excellent statistics of survival rates in patients. The hospitals in this country also offer various additional treatment options, which can significantly improve the condition of patients and prevent the development of recurrence.
Advanced treatment methods for stage 4 thyroid cancer in Germany
Treatment for advanced thyroid cancer is required to reduce the size of the tumor, remove metastases, prolong patients' lives and relieve symptoms. Germany uses such methods as modern surgical treatment, radioiodine therapy, systemic therapy using innovative drugs, radiation therapy, and embolization of metastases. The choice of the treatment method largely depends on the type of cancer and the patient's clinical characteristics.
Surgical treatment
Patients with stage 4 thyroid cancer are indicated for the surgical removal of the tumor and metastases. The surgeons resect the gland, several groups of lymph nodes, and, if required, the tissues adjacent to the tumor, to which it has already spread.
To make the intervention minimally traumatic and minimize the risks of postoperative complications, doctors in Germany use the following surgical techniques:
- Endoscopic interventions – gland removal through small punctures in the neck using endoscopic instruments. The accuracy of the procedure is ensured by image guidance using a miniature camera.
- Robot-assisted surgery – removal of an organ using robotic technology. The intervention is performed by a robot, while a doctor controls the manipulations.
The amount of tissue removed depends on the type of thyroid tumor. For example, in the case of papillary and follicular cancer, surgeons try to remove only a part of the lymph nodes to avoid complications. The resection is followed by radioiodine therapy, which destroys the remaining metastases.
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Radioiodine therapy
In 95% of cases, patients with stage 4 thyroid cancer have cancer cells sensitive to iodine-containing substances, and these cells can absorb them in large quantities. It determines the effectiveness of radioiodine therapy – a treatment method with radioactive iodine for malignant tumors.
After the administration of drugs into the body, the active substances accumulate mainly in the tumor and its metastases. The healthy tissues remain almost intact since only thyroid cells can actively absorb iodine. It should be noted that such treatment also affects distant metastases of the tumor.
Hormone therapy
After surgery to remove the tumor and radioiodine therapy, the patient needs lifelong hormone therapy. For these purposes, doctors prescribe tableted thyroid hormones, which are no longer produced in the body. The treatment allows doctors to maintain metabolic functions of the body, reduce the risk of recurrence, and slow down the growth of a tumor only if it was partially removed.
Specialists in Germany widely use synthetic thyroid hormones that suppress the production of thyroid-stimulating hormone (TSH). The last one is the pituitary hormone, and its decreased levels lead to a slowdown in tumor growth. Synthetic thyroid hormones are prescribed in the form of pills. The dose is calculated individually, depending on the TSH levels in the blood.
Chemotherapy
Chemotherapy for stage 4 thyroid cancer is indicated for the medullary and anaplastic tumor treatment. It is used in cases where other treatment methods are ineffective.
German hospitals use only modern anticancer drugs of the latest generation, which, unlike standard ones, are less toxic and cause a minimum number of negative side effects.
Targeted therapy
Targeted therapy is more effective in thyroid cancer. It is a drug therapy method that acts on the molecular mechanisms of the vital activity of tumor cells. Targeted therapy is most effective for tumors, which cannot be treated with radioactive iodine. It can also be used for malignant tumors, which cannot be removed with surgery.
The doctors in Germany use several groups of drugs that are selected individually. These include:
- Multikinase inhibitors are drugs that simultaneously block several types of protein molecules in cancer cells. They act using two mechanisms: they suppress the activity of proteins involved in the growth of abnormal cells and inhibit the formation of new vessels required for the blood supply to a malignant tumor. Multikinase inhibitors are available in the form of pills.
- RET inhibitors are used in the presence of changes in the RET gene to block specific molecules involved in the multiplication of cancer cells. Therapy with such drugs can be used for stage 4 cancer of papillary or follicular types if radioiodine therapy is ineffective. RET inhibitors are taken in capsules, 2 times a day.
- NTRK inhibitors are used in the presence of mutations in the corresponding gene. These drugs have been recently introduced into clinical practice – they were approved in Europe in 2019. They are usually prescribed when other treatment options do not give any results. The drugs are taken in the form of pills.
- BRAF and MEK inhibitors are used for anaplastic thyroid cancer that has limited treatment options. The drugs block molecules responsible for the division of cancer cells.
All targeted therapy drugs act purposefully on the structures of cancer cells, without affecting healthy ones. That is why such treatment is well tolerated by patients and has a minimum of side effects, which disappear within a few days after the therapy start. As a rule, therapy does not cause any complications.
Radiation therapy
Radiation therapy is used in the medullary and anaplastic thyroid cancer treatment since these types of tumors are unable to absorb radioactive iodine. This type of treatment is usually appointed after surgery to remove the tumor partially. However, if surgical intervention is contraindicated in a patient, radiation can also be used as the main treatment option.
Germany uses methods of external beam radiation therapy on linear accelerators. Such equipment allows doctors to deliver high doses of radiation directly to the pathological focus with minimal damage to the healthy parts of the body. The increased radiation intensity contributes to the reduction in the total treatment time. One session of radiation therapy lasts a few minutes, while the number of sessions is reduced several times as compared to standard methods.
Embolization of metastases
Metastases can be surgically removed in only a small number of patients. Therefore, to destroy metastatic foci, German hospitals often give preference to a minimally invasive procedure called embolization. The essence of the technique is that the doctor blocks the vessels providing blood supply to the tumor with emboli – chemicals. The last ones are injected into the arteries. As a result, the tumor tissues do not receive enough oxygen and quickly die.
The procedure does not require open surgery. The doctor makes a small incision in the skin and then inserts a catheter into the arterial bed. A contrast agent is used to detect the vessels supplying the tumor. Then the arteries are blocked by emboli, which stop the blood supply to the tumor. The procedure is performed under X-ray guidance.
Recently, Germany has been increasingly using transarterial chemoembolization. This type uses microspheres with anticancer drugs such as emboli. They are released in doses over several weeks after the procedure, affecting only the pathological focus. Chemoembolization in cancer treatment provides additional damage to cancer cells and prevents the growth of metastases.
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CHEMOEMBOLIZATION IN GERMANY - Prof. Thomas Vogl
Why is it advisable to undergo treatment in Germany?
The treatment of stage 4 thyroid cancer in German oncology hospitals is almost always successful due to the following reasons:
- Effective treatment methods – the use of modern medical protocols and the best drugs.
- High-quality diagnostics – the use of molecular genetic tests to accurately determine the type of tumor, and select an effective treatment method.
- Advanced equipment – each medical center has innovative equipment for all types of modern medical procedures.
- Highly qualified specialists – all practicing oncologists undergo training at prestigious universities and long internships.
- Government funding – huge funds are allocated annually for the various medical fields' development.
European hospitals also pay due attention to the rehabilitation after the completion of the main course of treatment for the full recovery of patients. The leading German hospitals that demonstrate the highest success rates in the treatment of advanced thyroid cancer are:
- Martha-Maria Hospital Munich, Department of General and Abdominal Surgery, Hernia Surgery, Endocrine Surgery, Thoracic Surgery
- University Hospital Ulm, Department of General and Abdominal Surgery
- University Hospital Frankfurt-am-Main, Department of General and Abdominal Surgery
- University Hospital Marburg UKGM, Department of Abdominal, Thoracic and Vascular Surgery
- University Hospital Carl Gustav Carus Dresden, Department of Abdominal and Colorectal Surgery, Hepatobiliary Surgery, Hernia Surgery, Bariatric Surgery, Endocrine Surgery, Thoracic and Vascular Surgery
You can find the detailed and updated information about these and other hospitals on the Booking Health website. For stage 4 thyroid cancer treatment in Germany, a thyroidectomy costs about €9,700 on average. The specialized radioiodine therapy and the hormone replacement therapy that follows cost an average of €17,300.
How to undergo treatment in German hospitals?
To undergo specialized treatment in Europe for stage 4 cancer, you can contact Booking Health – an international medical tourism organizer.
The employees of the Booking Health company provide the following services:
- Personalized selection of a qualified cancer center and a treatment program.
- Preliminary preparation of a medical program, taking into account previously performed procedures.
- Consultation with an experienced physician.
- Provision of reduced prices – the average cost of treatment is formed without additional coefficients for foreign patients.
- Booking a doctor's appointment on the most suitable dates.
- Independent medical program monitoring at all its stages.
- Assistance in buying and forwarding the required medicines.
- Control of invoices and return of unspent funds.
- Prompt organization of additional diagnostic and therapeutic procedures.
- Preparation of documents and insurance against possible complications during treatment.
- Top-class services: organization of flight, and accommodation, interpreting services, transfer.
- Communication with the medical center after returning home.
If you want to get professional assistance in planning cancer treatment in Germany, to find out the cost of medical services and more detailed information about medical programs, please, send us your request on the official bookinghealth.com website.
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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!
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