Treatment of stage 4 stomach cancer in Germany

08.07.2021 | from Booking Health GmbH | Diagnosis & treatment

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Stomach cancer is a malignant pathology that ranks among the ten most common cancers in the world. More than 1 million new cases are diagnosed every year. The disease most often develops in males between the ages of 35 and 40. Thanks to the innovative technologies and new treatment methods in Europe, it is possible to prolong the life of patients and control the tumor even at stage 4. Nowadays, such methods are available in many German hospitals.

Content

Standard treatment and its disadvantages
Innovative treatment methods for stage 4 stomach cancer in Germany
Why is it better to undergo treatment in Germany?
How to undergo treatment in German hospitals?

Standard treatment and its disadvantages

Stage 4 stomach cancer is diagnosed when metastases are detected in areas of the body distant from the primary tumor. The treatment for most patients includes only chemotherapy, palliative surgery and symptomatic therapy. However, such an approach has considerable risks. These are as follows:

Surgery does not increase the survival rate of patients with stomach cancer.
Symptomatic therapy can alleviate the condition of patients only in the short term.
Standard chemotherapy has a negative effect on the healthy cells in the body, thereby causing various complications.
Only 15-20% of patients with metastases in the abdominal cavity achieve positive results after chemotherapy. The treatment indicators can be improved by increasing the dose of chemotherapy drugs, but it is impossible due to their toxicity.

Doctors in Germany provide treatment according to the improved protocols, which allow them to use high concentrations of chemotherapy drugs, perform successful surgery and eliminate complications. Moreover, all treatment methods are safe and have fewer complications.

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Innovative treatment methods for stage 4 stomach cancer in Germany

In stage 4 metastatic gastric cancer, German oncologists do everything possible to remove malignant tissue as much as possible, improve the quality of life of patients and prevent recurrence. For these purposes, they use the very latest methods, which include cytoreductive surgery and HIPEC, chemoembolization of metastases, modern options of drug therapy and radiation therapy, endoscopic procedures and others.

Cytoreductive surgery and HIPEC

In the case of spread of stage 4 stomach cancer to the peritoneum, doctors perform cytoreductive surgery – removal of visible tumor foci. However, surgical interventions for stomach tumors often cause additional dissemination of cancer cells in the abdominal cavity and their rapid multiplication. To avoid this complication and increase survival rate of patients, German doctors destroy the remaining abnormal cells using hyperthermic intraperitoneal chemotherapy (HIPEC).

The essence of the HIPEC method is that the abdominal cavity is washed with a solution of chemotherapy drugs heated to 40-44 °C. The procedure is more effective than classical chemotherapy and has the following advantages:

Hyperthermic intraperitoneal chemotherapy allows delivering high doses of drugs directly to the tumor foci.
Heating the solution allows the drugs to better penetrate cancer cells and enhances their antitumor properties.
Despite the high concentration of chemotherapy drugs, they do not penetrate the systemic circulation and do not cause any side effects.
The effect on cancer cells continues for a long time after the procedure.

Washing with chemotherapy drugs is performed using drainage systems. The procedure lasts about one and a half hours. The technique demonstrates excellent results after a single application, and therefore repeated procedures are not required.

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Embolization of metastases

Metastatic gastric cancer often causes secondary tumor foci in the liver. In this case, transarterial chemoembolization (blockage of blood vessels supplying the tumor) can be performed. It involves the introduction of emboli with chemotherapy drugs into the hepatic artery.

Chemoembolization works by means of two mechanisms:

Emboli block the vascular lumen as a result of which the tumor does not receive enough oxygen and its growth stops.
Chemotherapy drugs released from the emboli have a detrimental effect on cancer cells.

The manipulation is performed through a small incision in the groin. The doctor injects a contrast agent into the femoral artery through a small catheter, which helps detect the vessels of the tumor. The doctor then moves the catheter to the liver vessels under X-ray guidance and performs selective embolization – injects microspheres saturated with chemotherapy drugs.

Selective closure of the branches of the hepatic artery reduces the size of the tumor by several times without the risk of impairing liver function. Chemoembolization in cancer treatment is effective and safe for health.

Embolization of the arteries feeding the primary tumor is less common for gastric cancer. Most of these procedures are performed in people with advanced stomach cancer to stop bleeding.

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Targeted therapy

In the case of stomach tumors, German doctors widely use a new type of drug therapy – targeted therapy. It consists in prescribing drugs that affect individual molecular structures or mechanisms of the vital activity of cancer cells, which ensure their active growth and division. Unlike chemotherapy, this method has many advantages:

Targeted therapy drugs do not affect the entire body, but only certain targets on the surface of pathological cells.
Medicines are selected individually, depending on the presence of certain mutations in the genes. The last ones are determined using molecular genetic tests.
Targeted therapy can be used even in cases when other treatment methods are ineffective.

Targeted therapy at stage 4 gastric cancer can be used as a single treatment method, as well as in combination with systemic chemotherapy. The therapy involves the use of drugs from the group of inhibitors (blockers) of receptors, molecules and tumor growth factors.

With HER2 receptors, HER2 inhibitors are prescribed. If a signaling protein, which stimulates vascular growth (vascular endothelial growth factor) is detected, VEGF inhibitors are used. NTRK inhibitors are used in cases when a protein responsible for the growth and division of cancer cells is determined.

The course of targeted therapy consists of several doses of drugs, which are prescribed to the patient once in several weeks.

Immunotherapy

Checkpoints – a system of molecular mechanisms, which allow the tumors to evade the body's immune response, are located on the surface of most tumor cells. As a result, the immune system does not recognize malignant cells and cannot destroy them.

Checkpoint inhibitors – immunotherapy drugs that block the molecular mechanisms of tumor masking can be used for patients with stage 4 cancer. As a result, immune aggression against cancer cells is enhanced.

At the advanced stage of gastric cancer, checkpoint inhibitors affecting the PD-1 and PD-L1 proteins are included in the therapy regimen. These drugs do not have an anticancer effect, but they make the treatment easier to tolerate than chemotherapy.

Radiation therapy

Radiation therapy is often advisable for stage 4 stomach cancer. It helps to eliminate pain and prevent bleeding. The medical facilities in many countries most often conduct total body irradiation, which negatively affects the general condition of patients. However, Germany offers new methods of radiation therapy, which allow the specialist to provide treatment with minimal risk of complications.

Many German hospitals carry out this therapy using state-of-the-art linear accelerators. They accurately deliver radiation to the tumor from different angles, without involving the nearby organs (bowel, lungs, spinal cord) in the process. In this case, it is possible to regulate the radiation dose, which makes it possible to apply higher radiation doses to a particular area of the body.

Palliative care

Stage 4 cancers often develop complications, the most common of which are bleeding and gastrointestinal obstruction, caused by a large size of the tumor.

Doctors in Germany use endoscopic procedures to stop bleeding. These are the least traumatic methods of dealing with this complication. Endoscopic instruments are inserted into the upper gastrointestinal tract, after which the hemorrhagic vessels are ligated or coagulated under imaging guidance.

Gastrointestinal obstruction can be corrected by several methods, namely by stent implantation and gastrojejunostomy. In the first case, a hollow tube (stent) is placed in the narrowed or blocked area of the intestine that prevents tumor obstruction. Gastrojejunostomy involves the rapid formation of a connection (anastomosis) bypassing the area blocked by the tumor. This is necessary to maintain the digestion function.

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Why is it better to undergo treatment in Germany?

Germany offers high-quality treatment for gastric cancer and a wide range of medical procedures for patients. Germany is:

High level of professionalism of oncologists – German doctors can work in oncology hospitals only after long practical and academic training.
State-of-the-art medical equipment and advanced methods – modern technologies allow the specialists to accurately diagnose cancer and provide its effective treatment.
Comfortable rehabilitation – specialists give a huge role in the treatment of cancer to intensive rehabilitation aimed at the maximum possible recovery of patients.

European hospitals offer high standards of medical care.

How to undergo treatment in German hospitals?

Germany becomes more and more popular every year. It is chosen by people with cancer for the treatment of oncology. Booking Health is the only officially registered company in the field of medical tourism. The high quality of services provided by Booking Health is confirmed by the international ISO 9001:2015 certification.

The Booking Health specialists provide assistance on the following issues:

Selection of the best hospital with high success rates in the treatment of stage 4 gastric cancer.
Preparation of a diagnostic and treatment program without repeating previously performed procedures.
Minimum prices – the cost of treatment is lower due to the absence of additional coefficients for medical tourists.
Preliminary consultation with an experienced doctor.
Doctor's appointment on the most suitable dates.
Preparation of documents and provision of insurance against complications during treatment.
Control of invoices and return of unspent funds.
Monitoring of treatment at all its stages.
Emergency organization of additional medical procedures.
Booking airline tickets, hotel rooms, meeting at the airport and transfer.

You can find out the necessary information about medical programs, the cost and organization of treatment by sending your request on the bookinghealth.com website.