Treatment of Rectal Cancer in Germany

Rectal cancer is a widespread pathological process. In most cases, the diagnosis is already made at the third or fourth stage of cancer, when the disease gives a complication in the form of metastasis.

Rectal cancer treatment in Germany has significant benefits such as innovative therapy methods, high-quality diagnostics, and specialists with many years of experience, which eventually lead to excellent results. With timely contacting German clinics, the chance of a full recovery increases significantly.

Content

1. Overview
2. Symptoms
3. Diagnostics
4. Stages
5. Rectal cancer treatment
6. Radiation therapy
7. Chemotherapy
8. Immunotherapy
9. Where can I undergo rectal cancer treatment in Germany?
10. The price for treatment in Germany
11. How can I undergo rectal cancer treatment in Germany?

Overview

Rectal cancer is a malignant tumor that grows from the mucous membrane of the intestinal wall. Colorectal cancer develops slowly, by transforming from polyps into malignant tumors. Rectal cancer is the second most common cancer in people over the age of 55.

According to statistics, the incidence of rectal cancer increases with age, but young people can also develop rectal cancer. Up to 7% of rectal cancer cases occur in people under 50. The development of colon cancer begins with a polyp growing from the tissue of the intestine, with its gradual transformation into a cancerous tumor. Already formed colon tumor continues to grow into the colon or rectum, while tumor cells spread further throughout the body through the blood, forming a number of the metastasis.

Diagnosed at an early stage, colon cancer can be cured in 90% of cases. In Germany, approximately 100,000 cases of rectal cancer have been prevented and approximately 50,000 cases of rectal cancer were detected at an early stage, and fully treated.

Symptoms

The difficulty in colorectal cancer diagnosis is in the detection of the tumor at an early stage due to the mildness of the symptoms. As a rule, the first symptoms appear only at the second or third stages of the disease.

Thus, doctors recommend undergoing check-up at least once a year. Colorectal cancer can be suspected when:

• Patient experiences constant weakness, the feeling of tiredness and sleepiness, changes in productivity
• For no apparent reason, the body temperature rises periodically
• Patient experiences constant sweating at night
• Patient loses weight due to the appetite loss
• Patient experiences nausea or vomiting
• Patient feels aching pain in the stomach area, that worsens with the progression of the disease
• Patient experiences stool problems, characterized by prolonged constipation or diarrhea
• Patient notices blood in the stool (at the advanced stages)

If colon cancer is at the metastasis stage, additional signs may appear, depending on the location of the colon tumor and its metastases.

Diagnostics

At its initial stages, rectal cancer is almost asymptomatic. This is why rectal cancer treatment in Germany includes regular preventive examinations in patients after 40.

One of the most informative methods of diagnostics is an endoscopic examination of the intestine (colonoscopy). With a colonoscope, the doctor can examine the intestines from the inside, as well as establish the histological type of tumor by making the biopsy. Moreover, if necessary, a doctor can remove the polyp immediately.

Other most common diagnostic procedures are:

• CT scan
• X-ray examinations
• Irrigoscopy (X-ray of the large intestine with contrast medium)

During the irrigoscopy a small amount of barium is injected into the patient's colon, due to which the tumor can be detected on an X-ray.

The detection of neoplasms in the colon is not difficult for highly qualified specialists. First of all, the doctor asks about the symptoms the patient is concerned about and how long ago the first ones have appeared. Next, the doctor examines the patient, palpates the abdomen and lymph nodes to determine pain. Laboratory and instrumental examinations are also carried out, such as:

• Complete blood count and urine analysis
• Biochemical analysis of blood
• Coprogram
• Coagulogram
• Irrigoscopy
• Sigmoidoscopy
• Magnetic resonance imaging

Any tumor in the colon is excised for histological examination to identify the type of tumor. Colon tumor samples are taken during colonoscopy, under anesthesia.

To exclude the presence of metastasis, other organs are also examined:

• Ultrasound examination of the abdominal organs
• Chest X-ray
• Fibrogastroscopy (FGS)

Stages

The stages of development of the pathological process depend on the tumor size and presence of metastasis. In general, there are four stages of rectal cancer, each of which has its characteristics:

• First stage. A malignant neoplasm is small, and, as a rule, does not exceed two centimeters. There are no metastases or clinical symptoms.
• Second stage. The size of the tumor reaches up to 5 centimeters. The disease is actively progressing. The first symptoms are noted.
• Third stage. The tumor grows up to 7 centimeters; the metastasis process in other organs is detected. The surrounding tissues, as a rule, are not affected yet.
• Fourth stage. A tumor is more than 8 centimeters in size; numerous metastases in adjacent tissues and distant organs are found.

Rectal cancer treatment

After carrying out the necessary examinations and the final confirmation of the diagnosis, therapy is prescribed. The specific protocol is selected taking into account individual features of the patient’s condition. The choice of treatment depends on the stage of the pathological process, the exact location of the tumor, the affection of the surrounding tissues and organs, etc.

In hospitals in Germany, the following treatment methods are used:

• Surgery
• Chemotherapy
• Radiation therapy
• Immunotherapy

In some cases, doctors combine the methods and apply several techniques at once.

Radiation therapy

In the modern clinical practice of rectal cancer treatment in Germany, various methods and options of radiation therapy are widely used, both preoperative and postoperative ones.

Preoperative radiation therapy makes it possible to halve the frequency of cancer recurrence from 10.9 to 5.6% and to increase the number of sphincter-sparing operations. Postoperative radiation therapy for rectal cancer is focused on fighting distant metastases.

Preoperative radiation therapy for the second or third stages of rectal cancer often includes local treatment because the risk of recurrence is relatively high. This risk is associated with the proximity of the rectum to the pelvic structures and organs, and the spread of the malignant process to nearby organs is expected. In some cases, there are also some technical difficulties associated with the limited possibilities in terms of tumor access during the resection procedures.

Preoperative radiation therapy in combination with chemotherapy has become the standard rectal cancer treatment in Germany, as such treatment protocol has demonstrated high rates of efficacy and less pronounced toxicity in comparison with postoperative radiation therapy.

According to the international recommendations, the standard treatment for stage 3 rectal cancer is a combination of chemotherapy and radiation therapy performed before surgery.

This made it possible for hospitals in Germany to successfully implement a selective approach to chemotherapy and radiation therapy at the preoperative stage, prescribing the treatment only to patients with a high risk of local recurrence of rectal cancer. This approach eliminates the negative consequences of both chemotherapy and radiation therapy.

The benefits of radiation therapy include:

• Destruction of tumor cells or reduction of their malignant potential
• Reducing the tumor volume
• Reducing the risk of rectal cancer recurrence
• Improving the quality of preparation for surgery

In most cases, the result of chemotherapy and radiation therapy combination leads to the complete destruction of the cancerous tumor.

Chemotherapy

In hospitals in Germany, chemotherapy is used when cancer enters the stage of metastasis. Most often, metastasis affects the nearby lymph nodes. In men, it also affects the prostate gland, in women – the uterus and ovaries. At the advanced stages, the liver, lungs, and brain are affected.

Chemotherapy can be prescribed before or after surgery. Preoperative chemotherapy helps to reduce the tumor to an operable size. Postoperative chemotherapy is prescribed immediately after surgery and is aimed to destroy undetected metastasis or residual cancer cells.

The oncologists of German hospitals use preoperative chemotherapy to slow down the growth of the tumor, eliminate metastasis, and shrink the tumor. Then the tumor is removed surgically.

Postoperative chemotherapy is performed after surgical removal of the tumor to prevent recurrence and eliminate metastasis in distant tissues and organs.

Doctors use chemotherapy for metastasis of colorectal cancer at the advanced stages of the disease, when it is impossible to remove the tumor surgically. In this case, double or triple combinations of chemotherapy drugs are used. This type of treatment is often combined with immunotherapy.

After the chemotherapy treatment, the patient stays under constant supervision of the doctor. Colonoscopy and a digital rectal examination after chemotherapy are recommended every 3 months. An abdominal ultrasound is recommended every 6 months. A program of preventive measures and examinations is elaborated for each patient individually, due to which recurrence of rectal cancer can be prevented.

Immunotherapy

Immunotherapy uses drugs that attack specific molecules on cancer cells. Immunotherapy can be combined with chemotherapy or prescribed as an independent treatment. Immunotherapy is usually used in patients with colorectal cancer at the stage of metastasis.

Rectal cancer treatment with immunotherapy aims to activate the body's immune system. Drugs help the cells of the immune system to find the tumor and destroy it.

Immunotherapy drugs are used to treat advanced forms of rectal cancer and its recurrence.

There are two approaches to treatment with immunotherapy. Drugs can either block the growth of new vessels in the tumor (due to a lack of nutrients, the neoplasm dies), or simply just stop the growth of the cancer cells.

Immunotherapy drugs may help some patients and not help other patients. Recently, progress has been made in determining who is most likely to benefit from specific targeted drugs. To determine this, molecular genetic and immunohistochemical analyses of tumor tissue are performed.

Where can I undergo rectal cancer treatment in Germany?

1. University Hospital Duesseldorf
2. University Hospital of Ludwig Maximilian University Munich
3. University Hospital Ulm
4. University Hospital Frankfurt am Main
5. University Hospital Heidelberg

You can check out the full list of hospitals on the Booking Health website.

The price for treatment in Germany

The price for treatment of rectal cancer in hospitals listed on the Booking Health website is relatively low.

With Booking Health, you can undergo rectal cancer treatment in Germany at a lower cost. The cost varies, as the price for treatment depends on the hospital, the diagnosis, and the complexity of treatment.

The price for treatment with chemotherapy in Germany is approximately 8,000 EUR. The price for treatment with chemotherapy and radiation therapy combined is approximately 15,000-20,000 EUR.

How can I undergo rectal cancer treatment in Germany?

It is not easy to choose the right hospital. To receive quality service, it is necessary to have experience and accurate information on the therapy results of the specific hospital.

We can help you during this difficult period. Booking Health will select a hospital, taking into account your wishes and the peculiarities of the disease.

We have up-to-date information on the success rates of hospitals in Germany. You can be free of unnecessary troubles, while Booking Health takes care of all organizational issues. Our goal is to find the best rectal cancer treatment in Germany for you.

Rectal cancer can be treated! The earlier you start the treatment, the higher the chances of returning to your usual life.

We will provide you with information on the hospitals and the cost of treatment. Leave a request on the Booking Health website and our manager will contact you shortly.

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!

Our editorial policy, which details our commitment to accuracy and transparency, is available here. Click this link to review our policies.

Sources:

National Cancer Institute

American Society of Colon and Rectal Surgeons

Annals of Oncology