Stomach cancer is a malignant pathology that ranks among the ten most common cancers in the world [3]. More than 1 million new cases are diagnosed every year [4]. The disease most often develops in males between 35 to 40 years old. Screening and awareness of potential causes are crucial for improving the prognosis, as gastric cancer diagnosed late often leads to a significantly reduced life expectancy compared to detection at early stages, underscoring the importance of public health initiatives to educate about risk factors and encourage timely medical check-ups. Thanks to innovative technologies and new cancer treatment methods in Europe, it is now possible to prolong patients' lives and control tumors even at stage 4. Nowadays, such methods are available in many German hospitals.
Standard gastric cancer treatment
Stage 4 stomach cancer is diagnosed when the tumor is no longer localized and metastases are detected in areas of the body distant from the primary tumor. Unlike early stages, where treatment options are more comprehensive, treatment for most patients includes only chemotherapy, palliative surgery, and control of symptoms [5]. However, this approach carries 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 harms 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 this is impossible due to their toxicity.
Doctors in Germany treat stomach cancer according to 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. Patients with stage 4 stomach cancer may explore novel treatment options alongside conventional therapies.
Targeted therapy for the treatment of stomach cancer stage 4 in Germany
In the case of stomach tumors, German doctors widely use a new type of drug therapy – targeted therapy. It consists of 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 the fourth stage of gastric cancer can be used as a single treatment method, as well as in combination with systemic chemotherapy. The targeted therapy involves using the 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 that 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 treatment consists of several doses of drugs, which are prescribed to the patient once in several weeks.
Checkpoint inhibitors for the treatment of stomach cancer stage 4 in Germany
Checkpoints – a system of molecular mechanisms that 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 metastatic gastric 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 anti-cancer effect, but they make the treatment easier to tolerate than chemotherapy.
Radiation therapy for the treatment of stomach cancer stage 4 in Germany
Radiation therapy is often advisable for stage 4 stomach cancer. It helps to eliminate pain and prevent bleeding. 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 specialists to treat stomach cancer 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 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 body area.
Innovative treatment methods for stage 4 stomach cancer in Germany
In stage four 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 a recurrence. For these purposes, they use the latest methods, which include cytoreductive surgery and HIPEC, chemoembolization of metastases, modern options of drug therapy and radiation therapy, endoscopic procedures, and others.
Hyperthermia: Heat-Based Cancer Fighting Technology
Hyperthermia represents a scientifically proven cancer treatment in Germany that oncologists integrate with traditional therapies to enhance outcomes for advanced cancer patients. This innovative method involves precisely controlled heating of tumor tissue to temperatures between 42-45°C, exploiting cancer cells' increased vulnerability to heat compared to healthy tissue.
German medical centers offer two primary hyperthermia approaches for gastric cancer patients. Local deep hyperthermia targets the abdominal region affected by the tumor, delivering focused heat for 60-120 minutes through advanced electromagnetic technology. Research demonstrates that regional hyperthermia combined with chemotherapy significantly improves disease control rates and extends median survival compared to chemotherapy alone. Whole-body hyperthermia heats the entire body to 38.5-40.5°C using infrared systems, creating systemic anti-cancer effects over 2-2.5 hour sessions.
The therapeutic mechanism works on multiple levels that benefit stomach cancer patients:
- Cancer cells lack an adequate oxygen supply, making them more susceptible to heat damage
- Elevated temperatures disrupt cellular metabolism and trigger programmed cancer cell death
- Heat enhances blood flow to tumors, improving chemotherapy drug penetration
- Temperature above 40°C activates heat shock proteins that stimulate immune recognition of cancer cells
- Damaged cancer cells lose their ability to repair themselves, amplifying cancer treatment effectiveness
Clinical advantages include virtually no side effects, outpatient treatment availability, and the ability to restore sensitivity in previously treatment-resistant tumors. Patients often experience reduced chemotherapy side effects like nausea and hair loss when hyperthermia is integrated into the protocol of cancer treatment in Germany.
Cytoreductive surgery and HIPEC in Germany
In the case of the spread of IV stage stomach cancer to the peritoneum, German doctors perform cytoreductive surgery – removal of visible tumor foci. However, surgical treatment for stomach tumors often causes additional dissemination of cancer cells in the abdominal cavity and their rapid multiplication. To avoid this complication and increase the survival rate of patients, German doctors destroy the remaining abnormal cells using hyperthermic intraperitoneal chemotherapy (HIPEC). [6]
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 penetrate cancer cells and enhances their antitumor properties.
- Despite the high concentrations 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.
Dr. Michael Lipp, a renowned specialist from the Department of General and Abdominal Surgery at Asklepios Hospital Barmbek Hamburg, has been at the forefront of HIPEC development since 2015. With years of hands-on experience treating patients with peritoneal carcinomatosis, Dr. Lipp shares his expertise on the technical aspects of the procedure, patient selection criteria, and the latest advances that make HIPEC one of the most promising treatment options for advanced stomach cancer with peritoneal spread.
Leading German Surgeon Dr. Lipp Reveals the Power of HIPEC in Cancer Treatment
PIPAC: Targeted Aerosol Therapy for Peritoneal Metastases
PIPAC represents a revolutionary advancement in treating stage 4 stomach cancer with peritoneal metastases, utilizing sophisticated laparoscopic technology to deliver chemotherapy directly into the abdominal cavity as a pressurized aerosol. This innovative technique overcomes the fundamental limitations of systemic chemotherapy by ensuring superior drug distribution and penetration into peritoneal tumor nodules that are typically resistant to intravenous treatments.
German medical centers employ PIPAC using specialized equipment that creates a therapeutic capnoperitoneum at precisely controlled pressure and temperature conditions. The procedure involves administering chemotherapy agents as an aerosol through laparoscopic ports, maintaining therapeutic pressure for 30 minutes to optimize drug absorption. This targeted delivery achieves significantly higher intraperitoneal drug concentrations while minimizing systemic exposure and associated toxicities.
The bidirectional approach combining PIPAC with systemic chemotherapy offers particular advantages for stomach cancer patients:
- Pressurized aerosol delivery ensures homogeneous drug distribution throughout the peritoneal cavity
- Enhanced drug penetration into tumor nodules up to 5mm depth compared to conventional methods
- Repeated procedures allow for ongoing tumor assessment and treatment modification
- Potential for converting unresectable disease to surgically manageable conditions
- Preservation of quality of life with outpatient treatment capability
PIPAC procedures can be performed every six weeks, allowing patients to maintain normal activities between treatments. The technique enables real-time monitoring of treatment response through peritoneal biopsies and cytological assessment, providing valuable feedback for optimizing therapeutic strategies.
TACE: Targeted Chemotherapy Delivery to Liver Metastases
Metastatic 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 using two mechanisms:
- Emboli block the vascular lumen; as a result, 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 the complex stomach cancer treatment in Germany appears to be 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 on people with advanced gastric cancer to stop bleeding.
"Targeting Cancer with Precision": Prof. Thomas Vogl on Revolutionary Chemoembolization Therapy
Dendritic Cell Vaccines: Precision Immune Training
Dendritic cell therapy represents one of the most sophisticated immunological breakthroughs in modern oncology treatment, earning Ralph Steinman the Nobel Prize in Physiology or Medicine in 2011 for discovering these remarkable immune system "generals." [7] German medical centers have pioneered the clinical application of this revolutionary treatment, offering stage 4 stomach cancer patients access to personalized vaccines that literally train the immune system to recognize and eliminate cancer cells with precision.
The therapeutic concept leverages dendritic cells' unique role as the most powerful antigen-presenting cells in the human immune system. These specialized cells act as immune educators, capturing tumor-specific antigens and presenting them to T-lymphocytes in a highly organized process that creates lasting anticancer immunity. What makes this approach particularly compelling for stomach cancer patients is its ability to generate comprehensive immune memory after a single treatment cycle.
German clinics employ a sophisticated two-step outpatient protocol that spans just one week. During the initial consultation, physicians collect 150-200ml of the patient's blood under strictly controlled laboratory conditions regulated by European medicines agencies and German regional councils. The patient's monocytes are then cultured with growth factors and tumor antigens in specialized clean-room facilities, transforming them into mature dendritic cells loaded with cancer-specific information.
The treatment process demonstrates remarkable efficiency and safety advantages for gastric cancer patients:
- Single vaccination creates lifelong anticancer immunity through the immune system's memory
- Outpatient procedure requires only two clinic visits separated by one week
- No significant side effects or complications reported in clinical studies
- Compatible with concurrent chemotherapy and radiation therapy
- Complete tumor regression achieved in documented clinical cases
The personalized nature of dendritic cell vaccines addresses the unique molecular fingerprint of each patient's cancer. Unlike conventional therapies that target all rapidly dividing cells, these vaccines teach the immune system to distinguish cancer cells from healthy tissue based on tumor-specific mutations and antigens.
Professor Frank Gansauge, a leading German immunotherapy expert with over 22 years of experience in dendritic cell therapy, has extensively documented the treatment's clinical potential. His clinic has achieved complete responses in advanced cancer cases, with some patients remaining cancer-free for over five years. In our exclusive interview, Professor Gansauge shares insights into this groundbreaking treatment approach and explains why dendritic cell vaccination represents the future of personalized cancer immunotherapy.
Leading Immunotherapy Expert Prof. Frank Gansauge: "Revolutionizing Stomach Cancer Treatment with Dendritic Cell Therapy"
Palliative Gastric Cancer Treatment: Comfort-Focused Care
When stage 4 stomach cancer advances, patients and their families may face difficult moments as complications arise that affect daily life and well-being. The most common challenges include bleeding and difficulty eating due to blockages, both of which can feel overwhelming but are manageable with compassionate, expert care.
German medical teams understand these fears and respond with gentle, minimally invasive cancer treatments designed to restore comfort quickly. When bleeding occurs, skilled physicians use advanced endoscopic procedures, carefully guiding tiny instruments to locate and seal problem areas without causing additional distress. These procedures succeed in stopping bleeding, often providing immediate relief and peace of mind.
When tumors block the digestive pathway, preventing normal eating and causing painful symptoms, German specialists offer hope through personalized solutions. For immediate relief, they can place a small expandable tube that reopens the passage, typically allowing patients to enjoy meals again within days. For those who may benefit longer-term, they create a gentle bypass route that preserves normal digestion for months ahead.
Every treatment decision honors the patient's wishes, comfort level, and goals, ensuring that each day can be lived with dignity and the precious ability to share meals with loved ones remains possible.
Why is it better to undergo gastric cancer treatment in Germany?
Germany stands as a global leader in advanced stage oncology treatment, offering patients access to pioneering treatments and world-class medical expertise that can significantly impact stage 4 stomach cancer outcomes.
German healthcare excellence is built on several key foundations:
- Exceptional medical expertise. German oncologists complete rigorous 6-8 year specialized training programs beyond medical school, including mandatory research components and international clinical experience, ensuring mastery of both traditional and cutting-edge approaches.
- Advanced treatment technologies. German medical facilities feature the world's most sophisticated equipment, including precision radiation therapy, robotic surgical treatment, and specialized laboratories for innovative therapies like PIPAC and dendritic cell vaccines.
- Comprehensive patient support. European healthcare standards guarantee comfortable rehabilitation facilities, personalized care coordination, and integrated support services addressing both medical and emotional needs.
- Strict quality standards. German cancer centers maintain rigorous certification requirements with continuous education mandates, ensuring physicians remain current with the latest scientific advances.
- Innovative treatment access. Patients gain access to experimental therapies and clinical trials often unavailable elsewhere, providing additional hope when standard treatments reach their limits.
This combination of expertise, technology, and compassionate care creates an optimal environment for achieving the best possible outcomes.
How to undergo treatment in the German clinics?
Many international patients seek advanced treatment of stage 4 cancer in Germany due to its exceptional medical standards and innovative therapeutic options. For those considering treatment abroad, professional medical tourism service Booking Health helps navigate the complex process of coordinating care in a foreign healthcare system.
Booking Health cancer specialists assist with the following issues:
- Personalized selection of the best hospital with high success rates in the treatment of stage 4 gastric cancer.
- Preparation of a diagnostic, interventional, or conservative treatment program without repeating previously performed procedures.
- Minimum prices – the average 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.
- Document preparation and provision of insurance against complications during treatment.
- Control of invoices and return of unspent funds.
- Treatment monitoring at all stages.
- Emergency organization of additional medical procedures.
- Booking airline tickets, hotel rooms, meeting at the airport, and a transfer.
For patients considering treatment in German clinics, the professional medical tourism organization can provide detailed information about available programs, associated costs, and coordination services. This support helps ensure that patients can focus on their treatment while experienced coordinators handle the logistical complexities of receiving care abroad.
International Cancer Care: Patient Stories with Booking Health
Frequently asked Questions of Our Patients About Stage 4 Stomach Cancer Treatment
Send request for treatmentTreatment options include chemotherapy, targeted therapy, immunotherapy, and palliative care. Advanced procedures such as hyperthermic intraperitoneal chemotherapy (HIPEC) may also be available to improve outcomes.
Benefits include access to state-of-the-art medical technology, experienced oncologists, and personalized treatment plans. German clinics often offer innovative therapies and participation in clinical trials, providing additional treatment options.
Effectiveness is monitored through regular imaging tests, blood tests, and clinical evaluations. These assessments help doctors determine the therapy's impact and make necessary adjustments.
Risks vary by treatment but can include side effects such as nausea, fatigue, and an increased risk of infections. Close monitoring and supportive care help manage these risks effectively.
While a cure for stage 4 stomach cancer is uncommon, advanced treatments in Germany can help control the disease, prolong life, and improve quality of life. The focus is on managing symptoms and extending survival.
Yes, immunotherapy in Germany offers checkpoint inhibitors and personalized dendritic cell vaccines. These treatments make therapy more tolerable than chemotherapy and can be effective even when other methods fail.
Stomach cancer treatment cost varies depending on the specific therapies needed. German clinics offer competitive pricing without additional tourist fees. A stomach cancer package in Germany typically includes comprehensive care coordination and treatment monitoring.
Yes, German hospitals welcome international patients seeking advanced stomach cancer treatment. Booking Health helps coordinate care, ensuring patients receive world-class treatment with proper documentation and insurance coverage.
University Hospital Duesseldorf, University Hospital of Ludwig Maximilian University of Munich, University Hospital Ulm. These facilities offer cutting-edge stomach cancer treatment in Germany, including personalized treatment approaches.
Booking Health provides comprehensive coordination, including hospital selection, treatment planning, cost optimization, and logistics. They ensure treatment success by connecting patients with experienced specialists and managing all administrative aspects of care abroad.
Stage 4 gastric cancer occurs when the tumor spreads beyond the stomach to distant organs or lymph nodes. This metastatic stomach cancer represents the most advanced form, requiring specialized treatment approaches to control disease progression and symptoms.
While cure is uncommon, incurable cancer treatment in Germany focuses on controlling the disease, extending survival, and offering quality of life improvement. Advanced therapies can significantly impact the stage 4 stomach cancer prognosis and patient outcomes.
Options include targeted therapy, immunotherapy, HIPEC, PIPAC, and dendritic cell therapy. German clinics combine traditional approaches with innovative treatments to achieve optimal life expectancy improvement for patients.
Dendritic cells are immune system educators that work against cancer. This cancer immunotherapy in Germany trains the immune system to recognize and eliminate cancer cells.
German treatment protocols significantly improve outcomes through advanced technologies and expertise. Stomach cancer survival in Germany benefits from precision medicine, innovative procedures, and comprehensive care.
The price of gastric cancer treatment in Germany depends on the specific therapies required. German healthcare offers transparent pricing with no hidden fees for international patients, ensuring access to world-class care at competitive rates.
Choose treatment abroad and you will for sure get the best results!
Authors:
This article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova, and Dr. Bohdan Mykhalniuk. 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:
[1] PubMed. Descriptive review of current practices and prognostic factors in patients with ovarian cancer treated by pressurized intraperitoneal aerosol chemotherapy (PIPAC): a multicentric, retrospective, cohort of 234 patients. https://pubmed.ncbi.nlm.nih.gov/37692848/
[2] PubMed. Dendritic Cell Vaccine Loaded with MG-7 Antigen Induces Cytotoxic T Lymphocyte Responses against Gastric Cancer. https://pubmed.ncbi.nlm.nih.gov/35480145/
[3] World Cancer Research Fund. Stomach cancer statistics. https://www.wcrf.org/preventing-cancer/cancer-statistics/stomach-cancer-statistics/
[4] Cancer Research Institute. What Makes Immunotherapy for Stomach Cancer a Promising Treatment? https://www.cancerresearch.org/immunotherapy-by-cancer-type/stomach-cancer
[5] NIH, National Cancer Institute. Stomach Cancer Treatment by Stage. https://www.cancer.gov/types/stomach/treatment/by-stage
[6] PubMed Central. Current role for cytoreduction and HIPEC for gastric cancer with peritoneal disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC9322542/
[7] PubMed. The 2011 Nobel Prize in physiology or medicine. https://pubmed.ncbi.nlm.nih.gov/22053831/
Read:
New Effective Treatments for Stage 4 Cancer (oncology)
Cancer immunotherapy in Germany
Dendritic cell therapy in cancer treatment in Germany - Vaccination against cancer
Article menu:
- Standard gastric cancer treatment
- Targeted therapy for the treatment of stomach cancer stage 4 in Germany
- Checkpoint inhibitors for the treatment of stomach cancer stage 4 in Germany
- Radiation therapy for the treatment of stomach cancer stage 4 in Germany
- Innovative treatment methods for stage 4 stomach cancer in Germany
- Why is it better to undergo gastric cancer treatment in Germany?
- How to undergo treatment in the German clinics?
- Frequently asked Questions of Our Patients About Stage 4 Stomach Cancer Treatment
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