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Treatment of Cancer of Unknown Primary (CUP) in Germany

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Cancer of unknown primary (CUP) diagnosis
3315
Cancer rehabilitation
951

Vivantes Neukölln Hospital Berlin

10/10
location_onGermany, Berlin

Department of Hematology, Oncology and Palliative Medicine

The Vivantes Neukölln Hospital is the maximum care hospital and one of the largest healthcare facilities in Berlin.  There are more than 20 specialized departments and centers, including pediatric departments. In total, the hospital has 1,200 beds. The hospital uses innovative technologies and the latest treatments, as
Cancer of unknown primary (CUP) diagnosis
9878

Medias Cancer Clinic Burghausen

10/10
location_onGermany, Burghausen

Department of Oncology and Surgical Oncology

The Medias Cancer Clinic Burghausen positions itself as a private highly specialised medical facility with international leadership in cancer treatment. The key areas of specialization of the clinic include regional chemotherapy, surgical oncology, hyperthermia, immunotherapy and pain therapy. The ultimate value of each emp
Cancer of unknown primary (CUP) diagnosis
11624

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Cancer of unknown primary (CUP) diagnosis
11085

Helios Hospital Berlin-Buch

9.7/10
location_onGermany, Berlin

Department of Oncology and Palliative Care

According to the reputable Focus magazine, the Helios Hospital Berlin-Buch ranks among the top medical facilities in Germany! The clinic is proud of its rich history, which dates back over 100 years, as well as the status of a maximum care medical center with exceptionally high success treatment rates. The medical institution is
Cancer of unknown primary (CUP) diagnosis
10305

St. Vincentius Hospital Karlsruhe-Academic Hospital of the University of Freiburg

9.8/10
location_onGermany, Karlsruhe

Department of Hematology, Oncology, Immunology and Palliative Care

The St. Vincentius Clinic is the largest multidisciplinary medical institution and academiс hospital of the Albert Ludwig University of Freiburg. Treatment and diagnosis of patients is conducted by doctors with a scientific degree. They are introducing the latest progressive techniques. The clinic has at its disposal the latest
Cancer of unknown primary (CUP) diagnosis
11402 help10122

MediClin Robert Janker Clinic

9.5/10
location_onGermany, Bonn

Department of Oncology and Palliative Care

The MediClin Robert Janker Clinic is a progressive medical facility, which has all the very latest diagnostic and treatment methods for the recovery of health of patients who suffer from cancers. The clinic was founded by renowned radiologist and surgeon Robert Janker. Today, its history has more than 80 years of successful clin
Cancer of unknown primary (CUP) diagnosis
11215

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Hematology and Oncology

The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniver
Cancer of unknown primary (CUP) diagnosis
11656

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Cancer Center

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Cancer of unknown primary (CUP) diagnosis
10549

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Hematology, Oncology, Adult and Pediatric Rheumatology

According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all fields of
Cancer of unknown primary (CUP) diagnosis
0

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Cancer of unknown primary (CUP) diagnosis
10125

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Oncology and Hematology

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Cancer of unknown primary (CUP) diagnosis
11455

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Oncology

According to the reputable Focus magazine, the University Hospital Carl Gustav Carus Dresden ranks among the top five German hospitals! The hospital is the benchmark for modern high-quality medicine. Positioning itself as a maximum care medical facility, the hospital represents all medical fields. There are 26 specialized depart
Cancer of unknown primary (CUP) diagnosis
13415

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Hematology and Oncology

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Cancer of unknown primary (CUP) diagnosis
10922

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Hematology and Oncology

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Cancer of unknown primary (CUP) diagnosis
10021

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Hematology, Oncology and Pulmonology

According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
Cancer of unknown primary (CUP) diagnosis
9783

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Charité Comprehensive Cancer Center

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Cancer of unknown primary (CUP) diagnosis
9951
| from Booking Health GmbH

Content

  1. Cancer highlights
  2. Types of cancer of unknown primary
  3. Diagnostics in Germany
  4. Cancer treatment in Germany: principles
  5. Chemotherapy overview
  6. Immunotherapy
  7. Radiation therapy
  8. Is surgery an option?
  9. Treatment in German hospitals
  10. The cost of treatment in Germany
  11. Going to Germany for treatment of cancer of unknown primary (CUP)

 

Cancer of unknown primary (CUP) includes malignant neoplasms localization of which can not be established during medical examination. According to the European Society for Medical Oncology, this category of malignant neoplasms is detected in 3-5% of all oncology cases.

Cancer highlights

 

In cancer of unknown primary (CUP) metastases cause symptoms earlier than the tumor does. A primary neoplasm sometimes is so small that it does not manifest itself clinically, and sometimes the tumor origin remains unknown even after medical examination methods.

In cancer of unknown primary (CUP), tumor metastases can manifest with the lymph nodes damage, damage of bones, and various organs and tissues.

Highlights of cancer of unknown primary (CUP) are:

  • No signs of primary tumor (patients seek medical help related to symptoms caused by metastases)
  • Early metastases formation
  • Uncharacteristic spreading of metastatic process (e.g. metastases of pancreatic cancer in the bone tissue, etc.)

Types of cancer of unknown primary

 

These tumors are divided into adenocarcinomas, squamous cell carcinomas, poorly differentiated carcinomas, and undifferentiated neoplasms.

Neuroendocrine carcinomas are often mentioned separately because these tumors belong to a treatable subgroup as they are similar to small cell lung carcinoma and are treated accordingly. Histochemical staining, immunological tests, tests for specific genes and cellular receptors are helpful in determining the nature of tumors.

Diagnostics in Germany

 

Very often cancer is detected only at the stage of metastases spreading, causing prolonged symptoms that worsen with time.

After a thorough medical examination, detected neoplasms are determined to be secondary tumors, or metastases, while the primary tumor is localized elsewhere in the body. Unfortunately, determining the initial location of the tumor isn’t possible in some cases. For such cases, metastases that are present in various parts of the body are the primary indicator of a malignant process.

Luckily, German doctors can deal with this phenomenon. During medical examination of patients with cancer of unknown primary (CUP), they make efforts not only for establishing a specific diagnosis at any cost. They try to figure out which patients are in critical health condition, and which patients will benefit from existing and widely used methods of treatment, such as chemotherapy and hormone therapy.

Diagnostics includes several steps:

  • First, the anamnesis is collected, which includes evaluating the medical history of oncology, as well as other pathologies of organs and tissues
  • Then patients undergo physical examination, where the lymph nodes, skin, the mammary glands, prostate, rectum, female and male genitals are checked
  • Thirdly, laboratory tests are conducted, commonly including biochemical blood tests, blood tests for oncomarkers and others
  • The final step is instrumental diagnostics that combines ultrasound scan, X-ray imaging, MRI, and CT scan (endoscopic medical examination is possible when neoplasm is thought to be located in certain organs)

Cancer treatment in Germany: principles

 

At present, in German hospitals, following principles are developed for treatment of cancer of unknown primary (CUP):

  • Therapy is elaborated individually, taking into account the data of preliminary examination
  • Subtypes of oncology are distinguished, which are sensitive to certain treatments
  • All patients receive symptomatic therapy
  • After treatment completion, results of therapy are evaluated

Even when the prognosis is unfavorable, treatment regimens that prolong a patient's life or improve its quality are used. However, along with potential benefits, German doctors consider potential side effects of palliative treatment.

Medical protocol highlights that there’s no internationally approved treatment regimen for cancer of unknown primary.

When developing the treatment tactics for cancer of unknown primary (CUP), it is very important to identify the primary tumor type if possible, as based on the type of cancer, the patient receives appropriate therapy.

Cancer cells may mutate, so it is not always possible to establish where the tumor has originated from or where it’s located now. However, the treatment of cancer of unknown primary (CUP) in German hospitals is possible even under such circumstances. Treatment tactics is based on the patient's complaints, as well as on the biological characteristics of the growth of cancer cells.

Chemotherapy overview

 

The most widely used method of treatment of cancer of unknown primary (CUP) is chemotherapy. Chemotherapy acts systemically on the whole body, which seems like a reasonable treatment choice, since the localization of the tumor isn’t identified.

Before starting any treatment, patients undergo comprehensive diagnostics, even more so in case of cancer of unknown primary (CUP).

In regard to treatment tactics for CUP, the decisive factor is the resistance of cancer cells to chemotherapy drugs. Statistics shows that many patients have chemotherapy-resistant cancer of unknown primary.

The systemic effect of chemotherapy, that is usually related to high toxicity and side effects, provides patients with CUP with the benefits of eliminating undetected cancer cells and damaging a primary tumor.

Different types of chemotherapeutic drugs with specific targets are used in the treatment. For example, in poorly differentiated carcinoma with affection of the lymph nodes, platinum-containing chemotherapy is used. In undifferentiated neuroendocrine carcinoma, drugs containing cisplatin and etoposide are used. In adenocarcinoma with bone and liver damage, low toxic chemotherapy with a focus on symptomatic effect is used.

After several chemotherapy sessions, German doctors check how malignant cells respond to chemotherapy. Then they evaluate the potential medical benefits of therapy and its possible side effects.

Immunotherapy

 

Immunotherapy usually does not belong to commonly used methods of treating CUP. However, it’s effectiveness is studied currently.

Immunotherapy activates the immune system in a way that enables it to fight cancer. Immunotherapy has shown positive results in the treatment of certain types of cancer, which allows considering immunotherapy an alternative to chemotherapy in eligible patients.

Radiation therapy

 

In the treatment of cancer of unknown primary (CUP), radiotherapy is a more symptomatical option.

Radiation therapy is used for squamous cell carcinoma with the involvement of the lymph nodes. It is combined with induction platinum-containing chemotherapy for a more pronounced effect.

Hormone therapy

 

Hormone therapy involves the use of synthetic hormones that influence levels of naturally produced hormones, which a malignant neoplasm depends upon.

As for cancer of unknown primary (CUP), hormone therapy is an option if cancer is hormone-dependent.

Hormone therapy is used for adenocarcinoma with elevated PSA levels in men. The course of hormone therapy in this case is similar to the one used in the treatment of prostate cancer.

Is surgery an option?

 

It’s true that surgery is a first-line therapy method for most cancers. However, surgery in cancer of unknown primary can eliminate only some cancer cells. Surgical treatment can be a local treatment of CUP, if malignant cells are detected in the lymph nodes that are eligible for removal. Women with affection of the axillary nodes are treated with surgery. The lymph nodes are excised with optional mastectomy. In other cases, surgical treatment is always followed by radiotherapy or chemotherapy.

Therapy for metastatic processes, in general, less often includes surgical removal of the pathological focus, since partial resection or complete removal of an organ is rarely reasonable when the primary focus is undetected. More often, the local treatment for metastases includes the use of external gamma irradiation, and chemotherapy, supplemented by hormone therapy (if the tumor is assumed to be hormone-dependent).

Treatment in German hospitals

 

German hospitals have learned how to treat cancer of unknown primary (CUP), including even the most complex cases of it.

In German hospitals, the atmosphere of sincere service to the patient is created. Openness, sociability, great responsibility, and efficiency, readiness to deal with difficult cases that require thoughtfulness and hard work is impressive. And many international patients have witnessed that.

You can find out more about cancer treatment in Germany on the Booking Health website.

The cost of treatment in Germany

 

The highlights of the diagnosis, the number of the required medical procedures, and the pricing policy of the hospital influence the cost of treatment in Germany. However, the prices in Germany aren’t that different from prices in other European countries, but are significantly lower than in the US or the UK.

The cost of diagnosis of cancer of unknown primary (CUP) in Germany starts at 9,227 EUR.

You may undergo additional procedures that aren’t included in the initial treatment program, but are necessary for your therapy. It is important to keep in mind that the initial price might not cover the full cost of treatment. You don’t need to worry about it though. You will be informed about the full cost of treatment in due time.

To specify the overall cost of cancer treatment in Germany, leave the request on the Booking Health website.

Going to Germany for treatment of cancer of unknown primary (CUP)

 

Thousands of patients choose Germany to undergo their treatments. Today, cancer treatment in Germany has gained the reputation of one of the most efficient in the world. In addition to the highly qualified doctors, German medical facilities are famous for their excellent service and impeccable technological equipment, which is regularly modernized and updated. This is why there is every opportunity to treat diseases that might not be a subject for treatment within your region.

As one of the world’s best medical tourism agencies, Booking Health can make cancer treatment in Germany accessible for you. With services Booking Health provides you don’t need to worry about anything. Such services include choosing the right medical facility, negotiating with the hospital, preparing medical documents needed for travel (including a medical visa), scheduling tickets and booking accommodation.

Booking Health works with highlights of the situation and listens to your wishes. If you want to get quality treatment in Germany, contact Booking Health by filling the request form on the company’s website.

Authors: Dr. Vadim ZhiliukDr. Sergey Pashchenko

Prof. Dr. med. Maike de Wit, Prof. Dr. med. Karl Reinhard Aigner, Prof. Dr. med. Hartmut Döhner, PD Dr. med Peter Reichardt, Prof. Dr. med. Christian Meyer zum Büschenfelde



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