Treatment of Cervical Paraganglioma in Germany
Best hospitals and doctors for cervical paraganglioma treatment in Germany
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A cervical paraganglioma is a neuroectodermal tumor. This neoplasm most often develops in the neck, near the carotid artery. The two most common types of tumors are carotid body and vagal paragangliomas. They grow in the carotid sinus, located at the carotid artery bifurcation, or from the jugular ganglion of the vagus nerve. Most tumors can be removed completely, and cancer does not recur after treatment, but surgery on the neck, near large vessels and nerves, is not safe. You will need the services of experienced and highly qualified surgeons to avoid complications. You can undergo your treatment in one of the German Cancer Centers specializing in the treatment of head and neck tumors to get rid of cancer without consequences for your health. You can find the cost of treatment in Germany and make your appointment at a hospital on the Booking Health website.
Content
- Principles of treatment of a cervical paraganglioma
- Surgical treatment options
- Preoperative embolization
- Radiation therapy
- Why is it better to undergo your paraganglioma treatment in Germany?
- How to travel to Germany for cancer treatment?
Principles of treatment of a cervical paraganglioma
A cervical paraganglioma is usually a non-aggressive tumor. It grows very slowly. Still, when this neoplasm is detected, a watchful waiting is not used, and a patient is immediately referred for cancer treatment. This is due to the fact that the paraganglioma is constantly progressing. The tumor size grows, and the larger it becomes, the more difficult it is to remove.
The mainstay of paraganglioma treatment is surgery. Most patients do not require any other treatments.
In the advanced stages of the disease, and in the case of aggressive paragangliomas, radiation therapy is conducted to reduce the risk of recurrence.
Sometimes the tumor is too large to be safely removed, or a patient has metastases at the time of diagnosis. In such situations, radiation therapy becomes the main cancer treatment method, which helps to restrain the progression of the paraganglioma for a long time.
Surgical treatment options
The surgical treatment will depend on the type of tumor growth and the stage of cancer. Most tumors can be removed completely. The only question is whether additional interventions on the carotid artery will be required. The tumor often invades the carotid artery wall, including the muscle layer. Such cases require opening the artery wall and closing the defect, and sometimes there is a need to replace a part of the blood vessel with a graft.
Below are surgical interventions that can be performed to treat paragangliomas:
Subadventitial tumor excision. During this operation, a doctor removes only a paraganglioma and does not practically damage the carotid artery. The surgical intervention is carried out in the early stages, with a tumor size of up to 2 cm, if this has not spread beyond the carotid artery bifurcation.
Since the blood vessel is not opened, there is no massive blood loss. Still, the outcomes of the intervention largely depend on a surgeon's experience. Careless movements lead to the carotid artery wall crushing or separation of an atherosclerotic plaque. This may cause the formation of a blood clot and the development of severe postoperative complications. In addition, doctors can damage the hypoglossal and glossopharyngeal nerves, which causes neurological complications. It is better to undergo your treatment abroad, in a good hospital, to avoid consequences for your health.
Paraganglioma removal with external carotid artery resection. This technically complex operation is performed if the tumor partially covers the external carotid artery. When the neoplasm invades the blood vessel wall, spreading not only to the adventitia (outermost layer), but also to the muscle layer, it becomes impossible to separate the tumor tissue from the blood vessel wall without opening it. As a result, a part of the artery wall must be removed.
When a doctor starts the operation, he often does not know how deep the tumor has invaded. Imaging diagnostic methods do not accurately determine the degree of the neoplasm invasion. Therefore, the operation is often planned as a simple tumor removal. Nonetheless, already in the process of its performance, it may turn out that it is also necessary to remove the affected area of the carotid artery.
During the operation, doctors isolate and ligate the external carotid artery. If they have not managed to isolate it for at least 0.5 cm, a vascular clamp is applied to the common and external carotid arteries. The blood vessel is resected from the place of bifurcation, and a vascular suture is applied to the defect. The tumor is removed using the en bloc technique, together with a section of the carotid artery and its branches, which are ligated.
Paraganglioma removal with external carotid artery prosthetic repair. This is the most complex operation, the need for which occurs infrequently. The intervention is performed when the carotid artery is covered by more than two-thirds. This operation requires highly qualified vascular surgeons with extensive experience in surgical interventions on head and neck blood vessels. If you are undergoing treatment in Germany, you can count on good results and a minimal risk of complications.
During the operation, the blood vessel is cut outside the tumor. It is partially removed. Since the tumor affects the entire artery circumference, the defect cannot simply be closed with sutures or patches. It is necessary to implant a vascular prosthesis made of artificial materials or a graft, a part of the blood vessel from another part of the patient's body. As a rule, the great saphenous vein in the thigh is used for grafting.
Preoperative embolization
Preoperative embolization can reduce the risk of complications if a complex surgical intervention is planned. After this procedure, the tumor is poorly supplied with blood, decreases in size, so it is easier for a doctor to remove it, and a patient does not lose much blood during the operation. Embolization is usually performed when the size of the neoplasm is more than 3 cm.
Embolization is a minimally invasive procedure performed from inside the blood vessels, through an incision in the leg or arm. This involves a block of the blood vessels that carry blood to the tumor. For this procedure to be effective, all arteries must be closed. Physicians may use a variety of solid or liquid materials:
- polyvinyl alcohol particles;
- isobutyl-2 cyanoacrylate with lipiodol;
- hemostatic sponge particles;
- bucrylate, silicone and other liquid materials.
Sometimes the tumor is supplied with blood from a single blood vessel, and, in other cases, there may be several such arteries. Doctors inject a contrast agent to see where the blood supply comes from to the paraganglioma. These blood vessels are then blocked by emboli. The operation is carried out a few days after eliminating tissue swelling.
Radiation therapy
Radiation therapy is one of the main treatments for most types of cancer. Still, this can rarely be used for a paraganglioma. This is due to several reasons:
- paragangliomas can usually be cured by surgery, and after a complete removal, the tumor rarely recurs even without radiation therapy;
- the tumor is located in an inconvenient place for irradiation, since there are too many vital organs and tissues nearby that cannot be damaged by radiation;
- paragangliomas are radioresistant tumors, so higher doses of radiation are required to destroy them than to treat most other types of cancer.
Nevertheless, radiation therapy may sometimes be required. This type of treatment of paraganglioma is sometimes used after surgery if the risk of recurrence is increased. Radiation therapy can also be used in the case of an inoperable tumor in order to restrain its growth for as long as possible and relieve a patient of symptoms associated with the compression of the blood vessels and organs of the neck.
If you need radiation therapy, it is better to have this treatment in Germany. This country uses the latest technologies, including stereotactic radiotherapy and radiosurgery, proton therapy and other techniques. These make it possible to destroy the tumor with radiation so precisely that the surrounding healthy tissues are almost not affected.
Why is it better to undergo your paraganglioma treatment in Germany?
Thousands of patients from all over the world travel to Germany for cancer treatment. This country offers advanced medicine, the latest methods of fighting cancer, safe and effective operations, and, at the same time, the prices are relatively low. They are higher than in countries with poorly developed medicine, but prices in Germany are lower compared to Japan and developed countries of North America.
There are a few reasons for you to go to Germany for the treatment of paraganglioma:
- hospitals in this country employ doctors who are among the best in the world;
- high-precision diagnostics allows doctors to establish a diagnosis even without a biopsy and optimally plan cancer treatment;
- there are highly specialized centers for the treatment of head and neck cancer, which have extensive experience in treating even such rare tumors as paragangliomas;
- doctors perform neck surgery with a minimal risk of complications;
- specialists from hospitals in Germany can completely cure most cancer cases, and the risk of recurrence of the disease does not exceed 10%;
- surgeons perform operations of any complexity, including resection of the external carotid artery with its prosthetic repair;
- doctors use the latest radiation therapy options, which very accurately irradiate the tumor with little or no damage to the healthy tissues surrounding it;
- hospitals in Germany offer comfortable conditions, a full-fledged care, accompanying and symptomatic therapy.
In Germany, you can get rid of cancer once and for all, safely, reliably, with minimal discomfort and a low risk of recurrence.
How to travel to Germany for cancer treatment?
You are welcome to use the services of the Booking Health company, a medical tourism provider. With our service, you can find the prices in different German hospitals, compare them and make your treatment appointment at the best price.
All these opportunities facilitate easier, faster and cheaper cancer treatment for you. Prices are lower due to the lack of additional fees for foreign patients.
When contacting a hospital directly, a person often has to wait too long for an answer, overcome the language barrier, and solve many organizational issues. The initial price of the program often increases after the start of cancer treatment, sometimes several times. But when making your treatment appointment through Booking Health, you do not have to worry about these issues. We will fully organize your trip to the German hospital. You will receive insurance that will cover all extra expenses, so the cost of treatment in Germany will not increase for you. This may even be lower. In this case, the Booking Health specialists will help to return unspent funds after completing your medical care program.
Please leave your request on our website to make your appointment for cancer treatment in Germany. Our employees will study your documents, contact you within a few hours, advise on all issues, help you to choose the most suitable hospital and organize your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk 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!
Sources:
National Center for Biotechnology
