Treatment of Bile Duct Tumors or Klatskin Tumors in Germany
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Klatskin tumor is a malignant neoplasm affecting the bile ducts. It’s necessary to start therapy immediately after the diagnosis making, since the neoplasm is prone to rapid growth and metastasizing. The disease usually progresses very quickly, so it is important to contact a specialist as soon as possible when the first signs of illness appear. Therefore, the longer left untreated, the lower chances of a favorable prognosis are.
Content
- General principles of treatment of bile duct tumors in Germany
- Phases of treatment of bile duct tumors or Klatskin tumors
- Surgery
- Alternative cancer treatment methods
- Palliative treatment of Klatskin tumor
- Rehabilitation after treatment of bile duct tumor
- The cost of treatment in German hospitals
- How to go to Germany for treatment?
General principles of treatment of bile duct tumors in Germany
The overwhelming majority of patients with Klatskin tumor face the diagnosis after a more or less long examination for jaundice, which most often becomes the first manifestation of the disease. Therefore, the faster the correct diagnosis is made, the earlier it is possible to take measures against jaundice and the less harm there would be for patients with bile duct dysfunction, which is especially important before complex surgery. Therefore, the correct diagnosis is step 1.
Since jaundice occurring in Klatskin tumor has the so-called mechanical character, meaning it’s caused by a violation of bile outflow from bile ducts (the presence of a mechanical obstacle in the form of a tumor), then it is necessary to quickly and efficiently restore the outflow of bile in order to cure jaundice. Drainages can be made below the tumor, which allows the patient to restore physiological flow of bile because in such a situation the bile enters the intestine. Alternatively, the possibility of performing a radical surgery can only be evaluated by a surgeon hepatologist.
The treatment of bile duct tumors or Klatskin tumors in German hospitals is a complex task, as bile duct cancer is a dangerous disease. It accounts for about 3% of all the tumors of the gastrointestinal tract. The Klatskin tumor itself affects not only the bile ducts, but also the liver, pancreas, gallbladder, blood vessels, and finally lymph nodes. At the advanced stages, the intestines, stomach, and lungs are affected.
For the treatment of bile duct cancer in German hospitals, the newest techniques and advanced technologies are used, which significantly increases the chances of recovery. Even though this is a rather rare disease, German hospitals pay sufficient attention to bile duct cancer treatment, which allows achieving very good results.
Phases of treatment of bile duct tumors or Klatskin tumors
Treatment of bile duct tumors consists of three or four main stages, each of which equally determines the success of cancer treatment.
The main stage of cancer treatment of patients with a Klatskin tumor is the removal of the affected tissue along with the biliary ducts draining. If a smaller-sized liver lobe is removed, chemoembolization and further surgical treatment are not performed. To increase the radicality of surgery, it is also necessary to remove the 1st segment of the liver. The general principle of modern surgery for the treatment of Klatskin tumor is a combination of bile ducts resection with extensive liver resection. The stages of the operation allow considering the surgical treatment of Klatskin tumor one of the most complex operations on the abdominal organs.
When liver vessels are affected by the Klatskin tumor growth, the volume of surgery can be increased and include resection of the vessels with the subsequent restoration of their integrity. Surgery is complemented by the reconstruction of the bile outflow tract.
Taking into account the initially severe condition of patients, who often suffer from mechanical jaundice, cholangitis and severe complications of cholangitis (i.e. cholangogenic abscess), the risks of operation rise. In this regard, there are strict requirements to performing the surgery, since postoperative complications in the initially weakened patient may be a serious threat. The technical complexity of the operation is connected with the fact that the surgeon has to manipulate in the limited liver gate space.
Therefore, all key points of treatment of bile duct tumor that determine its risks, success rates and radicality must be analyzed and planned before the surgery. To do this, a team of diagnosticians, surgeons, and oncologists should have a relevant experience. The oncological board estimates all the peculiarities of the course of the disease in each particular patient and makes the most likely forecast for various treatment options. A suitable combination of efficiency and safety is the basic principle of choosing a treatment regimen for each patient with a Klatskin tumor.
Surgery
The main method of treatment of bile duct tumors is the surgical one. However, it is connected with certain difficulties, primarily due to poor operability and high risk of postoperative complications.
Klatskin tumor in most cases isn’t big, therefore, in the treatment of Klatskin tumor resection is often used. This operation is connected with a low number of postoperative complications and mortality rate, but it’s not always possible to achieve the maximum positive result after such treatment of the Klatskin tumor. When the tumor is advanced, resection of several liver segments is possible, up to extended right hemihepatectomy. With a severe overall state, e.g. in the elderly patients and patients with the 4th stage of bile duct cancer with extensive tumor invasion, a high-tech outer or inner drainage is recommended.
There are other methods of treatment of Klatskin tumor that are not connected with risks of developing liver failure. As a radical surgical bile duct cancer treatment in patients with the proximal localization of the tumor, the Klatskin tumor resection can be used within the borders of healthy tissues.
Minimally invasive methods of treatment of bile duct tumors that eliminate bile hypertension effectively and relatively safely are very common in countries with the advanced healthcare systems. Such interventions are mostly palliative but they reduce the severity of clinical symptoms significantly.
Alternative cancer treatment methods
One of the alternatives medicine can offer today is photodynamic therapy. The therapy is a novel cancer treatment that is already used in some German hospitals for the treatment of malignant neoplasms of the gastrointestinal tract. This cancer treatment is effective in restoring biliary drainage and improving the quality of life of patients with inoperable and advanced Klatskin tumors.
Radiation therapy can also be helpful. Adjuvant and preoperative radiation therapy is used to reduce the tumor volume and make it resectable. This therapy is usually carried out in German hospitals along with chemotherapy. For patients with Klatskin tumors, special radiation methods are used, such as brachytherapy and intraoperative radiation therapy (i.e. irradiation during surgery).
In the past, healthcare practitioners were convinced that chemotherapy for bile duct cancer treatment of any localization doesn’t really affect the survival of patients. Nevertheless, in recent years, publications have been made indicating significance of systemic chemotherapy in the treatment of Klatskin tumor.
Chemotherapy for this diagnosis is prescribed in low dosages, primarily to enhance radiotherapy effect during a bile duct cancer treatment course. Therefore, it is currently becoming optimal to carry out adjuvant (postoperative) systemic chemotherapy in patients with Klatskin tumor, regardless of the radicality of the cancer treatment performed. This makes it possible to count on a good life expectancy in most patients.
Palliative treatment of Klatskin tumor
Palliative treatment of Klatskin tumor includes measures that will improve the general condition of patients with bile duct cancer if it is impossible to conduct a surgery.
A method of supportive therapy is chosen in accordance with the following factors:
- Main complications
- Possible side effects of therapy
- The possibility or inability to carry out surgery
- Spreading and size of the primary tumor
- The general condition of patients with cancer and their medical story
Rehabilitation after treatment of bile duct tumor
Since medicine can specify no precise causes of bile duct cancer, it’s possible to talk only about the prevention in general.
It is worth implementing proper nutrition for both matters of prevention and rehabilitation. Food should be riched with supplements and plant-based fiber. It is advisable to consume many vegetables, fruits, and liquid foods. It is also not recommended to expose the body to various pathogens, this also concerns sunlight.
The most general recommendation medicine can give is to monitor your health state constantly. If your relatives have had any oncological diseases, then you should regularly undergo diagnostic examinations. This will help to reveal the existing diseases and risk factors.
The cost of treatment in German hospitals
The cost of treatment is mostly based on procedures included in the medical program. Some patients undergo minimally invasive interventions, while others need extensive open surgery in combination with chemotherapeutic treatment.
The cost of treatment in Germany is somewhat higher than in other well-known foreign hospitals, for example, in Israel and Spain. However, it is fully compensated by the high quality of medical services provided here. The average costs for the most common treatments are:
- Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage – 13,200 EUR
- Diagnosis and treatment of cancer of the bile duct with partial hepatectomy – 39,300 EUR
- Diagnosis and treatment of cancer of the bile duct with chemotherapy – 8,700 EUR
- Treatment of cholangiocarcinoma (Klatskin tumor) with embolization or chemoembolization – 29,700 EUR
The average price of rehabilitation after bile duct cancer treatment in Germany is 850 EUR per day, the minimum price is 630 EUR per day, and the maximum price is 1,083 EUR per day. For more information about the prices for cancer treatment in German hospitals visit the Booking Health website.
How to go to Germany for treatment?
Booking Health provides the widest range of services related to medicine in German hospitals in general and the treatment of Klatskin tumor specifically.
If you want not only to get high-quality bile duct cancer treatment in Germany but also to conduct preventive measures related to the possible diseases you may have, know that Booking Health will help you arrange any medical program you need.
In Germany, treatment of bile duct tumors in children is performed as well. Of course, before the start of bile duct cancer treatment, it is necessary to undergo comprehensive examination in German hospitals.
If you have any questions regarding cancer treatment in Germany, leave the request on the Booking Health website for a medical consultant to contact you shortly.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. 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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