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Treatment of Duodenal Cancer 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

Duodenal cancer diagnosis
1513
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
2192
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
38161

Helios Hospital Berlin-Buch

9.7/10
location_onGermany, Berlin

Department of Gastroenterology, Hepatology and Infectology

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
Duodenal cancer diagnosis
3109
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7576
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
41476

University Hospital Duesseldorf

8.5/10
location_onGermany, Duesseldorf

Department of Gastroenterology, Hepatology and Infectology

According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
Duodenal cancer diagnosis
4947
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7140
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
50365

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Gastroenterology and Hepatology

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Duodenal cancer diagnosis
3528
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
8396
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
50049

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Gastroenterology and Hepatology

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
Duodenal cancer diagnosis
3277
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7873
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
47325

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Gastroenterology, Hepatology, Pulmonology, Allergology, Endocrinology and Diabetology

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
Duodenal cancer diagnosis
4451
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7489
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
44065

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Gastroenterology, Hepatology and Infectology

According to the 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 field
Duodenal cancer diagnosis
0
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
0
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
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
Duodenal cancer diagnosis
4333
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7300
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
44482

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Gastroenterology, Hepatology, Nephrology, Infectology, Endocrinology and Diabetology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Duodenal cancer diagnosis
5126
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
8348
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
49967

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Gastroenterology and Hepatology

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
Duodenal cancer diagnosis
5810
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
9369
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
59134

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Gastroenterology, Hepatology and Infectology

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
Duodenal cancer diagnosis
5798
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7239
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
58735

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Hepatology and Gastroenterology

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
Duodenal cancer diagnosis
6698
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7166
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
67417

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Gastroenterology, Metabolic Disorders and Internal Intensive Care

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
Duodenal cancer diagnosis
5093
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
8159
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
50039

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Gastroenterology, Endocrinology, Metabolism and Clinical Infectology

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Duodenal cancer diagnosis
4341
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7179
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
41011

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Gastroenterology, Hepatology and Infectology

According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
Duodenal cancer diagnosis
4964
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7132
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
38161

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Gastroenterology, Hepatology and Pulmonology

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
Duodenal cancer diagnosis
4429
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
7211
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
44124

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Gastroenterology, Hepatology, Endocrinology and Infectology

The University Hospital Rechts der Isar Munich was founded in 1834. It combines long traditions with the very latest advances in modern medicine. The medical facility includes 33 specialized departments and 20 interdisciplinary centers, where patients can receive top-class medical care in all medical fields. The hospital annuall
Duodenal cancer diagnosis
4949
Diagnosis and conservative treatment of duodenal cancer with 1 course of chemotherapy
8511
Multimodality treatment of duodenal cancer with cytoreductive surgery and HIPEC
50001
| from Booking Health GmbH

Duodenal cancer is a rare tumor of the gastrointestinal tract. Its treatment requires major surgery. Doctors in medical hospitals in Germany remove tumors not only through a large abdominal incision, but also with a minimally invasive laparoscopic technique. Doctors successfully cope even with the advanced stages of the disease. To reduce the risk of recurrence after surgery, the specialists use radiation therapy, chemotherapy, and in the advanced stages of cancer, doctors in modern medical hospitals use intraperitoneal chemotherapy and immunotherapy.

Content

  1. What is duodenal cancer
  2. Principles of treatment
  3. Surgical treatment
  4. Radiation therapy
  5. Chemotherapy
  6. Why is it worth undergoing treatment in Germany

What is duodenal cancer

 

The duodenum is the first part of the small intestine. It is located just behind the stomach. This is the most important "node" of the digestive system. A food bolus from the stomach, pancreatic juice with enzymes from the pancreas and bile from the liver enter the duodenum.

Not all duodenal tumors are primary. The duodenum may be affected with gastric cancer, pancreatic or extrahepatic bile duct cancer.

Primary duodenal malignant tumors are rare and account for 0.5% of intestinal neoplasms. Most often they are formed in the descending part of the intestine. Adenocarcinoma is more common among all histological types – 80% of cases.

Clinical forms of the disease: 

  • stenosing form – causes gastrointestinal obstruction, disrupts the advancement of the food bolus;
  • infiltrative ulcerative form – the tumor grows mainly towards the intestinal wall, and it is often complicated by bleeding and perforation;
  • polyposis form – grows mainly in the duodenal cavity. 

At the time of detection, 60% of duodenal neoplasms had already spread to regional lymph nodes or the liver. Patients do not have severe symptoms.  It takes an average of 6-12 months from the manifestation of the first signs of the disease to the performance of the radical surgery.

The main symptoms are as follows: 

  • pain in the upper abdomen; 
  • jaundice;
  • nausea;
  • vomiting.

To diagnose the disease, esophagogastroduodenoscopy is performed. This is an endoscopic examination involving the insertion of a tube with a video camera into the duodenum through the mouth, esophagus and stomach. If the doctor sees a suspicious formation, he can immediately perform a biopsy.

Principles of treatment

 

Duodenal cancer is a rare disease, so the standards for the treatment of this disease have not been finalized. Different hospitals use different approaches to treatment.

In any case, surgery is considered a priority way to fight cancer. The cancer that can be removed is considered resectable. If the radical surgical intervention cannot be performed, it is called unresectable.

Resectable tumors must be removed completely – this is the only way to cure cancer. The standard operation is pancreaticoduodenal resection. It involves the removal of the duodenum, a large part of the pancreas and adjacent organs and tissues. But very rarely, only at an early stage of the disease, the doctor may limit himself to removing a small portion of the duodenum.

After surgery, patients may require radiation therapy, chemotherapy, or a combination of them in the following cases: 

  • metastases detected in the distant lymph nodes; 
  • cancer invasion through the wall of the organ. 

So far, standard recommendations for postoperative treatment have not been developed. There is evidence that adjuvant radiation therapy and chemotherapy reduce the risk of tumor recurrence, but it is not yet clear whether they increase patient survival. Therefore, different hospitals have different opinions about the need and scope of postoperative treatment.

Some hospitals in Germany offer neoadjuvant therapy. This is the irradiation of tumors and chemotherapy, which are carried out before surgery. It is precisely known that they allow doctors to reduce the tumor size, eliminate some metastases, lower the stage of the disease, and also make the tumor removal surgery less traumatic for the patient. However, there is no conclusive evidence that preoperative treatment improves patient survival.

Some patients are diagnosed with an unresectable tumor. It cannot be removed, at least not immediately. Therefore, patients receive radiation therapy and chemotherapy. Many undergo palliative surgery to relieve symptoms and prevent complications. In some cases, the tumor shrinks enough that the doctor may try to remove it during radical surgery.

Should the tumor be detected at the metastatic stage, the disease is considered incurable. Radical operations cannot be performed in such situations. Doctors are limited to palliative interventions. Distant metastatic foci in the bones, lungs, and brain are controlled with radiation therapy. All patients with advanced cancer receive chemotherapy. Some hospitals in Germany also use immunotherapy with checkpoint inhibitors.

Surgical treatment

 

Surgery is performed for most patients with duodenal cancer. Whenever possible, doctors seek to perform the radical operation. It aims to completely remove the tumor and has the potential to cure cancer. If the cancer is detected late, or the health condition does not allow radical surgery, doctors perform palliative surgical interventions: they relieve symptoms and create conditions for the use of other treatment methods, such as chemotherapy.

Here some of the operations to be performed for the treatment of duodenal cancer: 

Segmental duodenal resection is the most sparing surgery that is performed in the early stages of the disease. The doctor removes part of the intestine and sutures the ends together to restore the integrity of the digestive tract.

Pancreaticoduodenectomy (Whipple procedure, pancreaticoduodenal resection) is the main operation for cancer treatment for patients in whom the tumor could not be detected at an early stage. This is the most frequently performed intervention. The doctor removes the duodenum completely, along with the head of the pancreas and regional lymph nodes. It is often necessary to remove part of the stomach, gallbladder, part of the common bile duct.

This is a complex operation, which is unsafe for health. It lasts for several hours. The doctor needs not only to remove the organs involved in the tumor process, but also to restore the functions of the digestive system. To this end, a reconstructive stage of the surgical intervention is performed. The doctor connects the stomach to the small intestine, connects the bile and pancreatic ducts to it.

Pancreatoduodenectomy often causes complications. Mortality in the world during and after this surgery averages 5%. Nonetheless, in specialized hospitals in Germany, mortality does not exceed 1%.

Whipple procedure is usually performed through a large abdominal incision. Surgeons in some medical hospitals in Germany also perform the operation using the laparoscopic technique. The surgery through short incisions is less traumatic. Patients lose less blood, recover faster and spend less time in the hospital.

Palliative surgery is performed in cases where radical tumor removal is not possible. Palliative surgical interventions aim to restore the patency of the digestive tract and eliminate obstructive jaundice. The doctor can remove part of the intestine, implant a stent in the site of ​​tumor stenosis, perform a bypass, namely attach the part of the small intestine located below the duodenum to the stomach so that the food bolus can bypass the stenosed site. Some patients also require bile relieving surgery.

Radiation therapy

 

Radiation therapy for the treatment of duodenal cancer can be used in the following cases: 

  • after surgery – to reduce the risk of recurrence; 
  • instead of surgery – if surgery cannot be performed due to the advanced stage of the disease, or the patient has medical contraindications for surgical treatment; 
  • as the main method of local control of the tumor and metastatic foci in the advanced stage of the disease. 

Doctors use external beam radiation therapy. The hospitals in Germany use the very latest methods that are safer for health. They are very accurate and deliver beams to the target from different sides, so healthy tissues receive a minimum of radiation. This results in the reduced risk of post-radiation complications.

Chemotherapy

 

For the treatment of patients with duodenal cancer, drugs are usually used systemically, less often local application of drugs is applied – hyperthermic intraperitoneal chemotherapy (HIPEC).

In Germany, systemic chemotherapy is used in the following cases: 

  • advanced stage of cancer – as the main treatment option; 
  • after tumor removal surgery, to reduce the risk of recurrence; 
  • with recurrence of the neoplasm after primary treatment. 

The main combinations for chemotherapy: CAPOX, FOLFOX, FOLFIRI. As a rule, two or three drugs are used at the same time. The choice of the scheme is determined not only by the stage of the disease, but also by the state of the patient's health. More effective therapy usually turns out to be more toxic.

The HIPEC technique is used after surgery to reduce the risk of tumor recurrence after its removal. Doctors wash the patient's abdomen with a heated solution of chemotherapy drugs to kill any remaining cancer cells in the abdomen. The perfusion lasts 1-1.5 hours. The solution temperature of 40-42 degrees allows cytostatics to better penetrate into tissues, destroying tumor foci to a depth of 2-3 mm. In Germany, the HIPEC technique is used for many oncological diseases: for the treatment of stomach cancer, colon cancer, ovarian cancer and other abdominal neoplasms. With duodenal cancer, the method is used infrequently. As a rule, the HIPEC procedure is used if the tumor has spread to the peritoneum.

For the treatment of the advanced stages of duodenal cancer, doctors in Germany use immunotherapy. The specialists use immune checkpoint inhibitors. These drugs have low toxicity and have a minimum number of medical contraindications, so they can be used even in patients weakened by the disease. The drugs do not have a direct cytotoxic effect, but provide a reduction in tumor foci by enhancing antitumor immunity.

Why is it worth undergoing treatment in Germany

 

Many medical tourists prefer to undergo duodenal cancer treatment in German hospitals, as this country offers advanced medicine. There are a few reasons for you to receive medical care in one of the German hospitals:

  • the early stages of cancer can be treated with minimally traumatic laparoscopic duodenal resection;
  • extensive experience in performing a complex surgical intervention – pancreaticoduodenal resection, which is used in most patients for the treatment of duodenal cancer;
  • the mortality of surgical operations for cancer removal is less than 1%, while the global average is 5%, and in countries with poorly developed medicine, the mortality rate reaches 9%;
  • some patients can undergo laparoscopic surgery;
  • the operation is followed by the very latest options for cancer irradiation – very accurate, with a minimum dose of radiation for the tissues adjacent to the tumor;
  • when cancer spreads to the peritoneum, doctors in some medical hospitals in Germany use hyperthermic intraoperative chemotherapy to reduce the risk of recurrence of the disease;
  • the use of modern schemes of drug therapy for cancer, including immunotherapy.

To undergo treatment of duodenal cancer in Germany, please use the Booking Health service. On our website you have the opportunity to get up-to-date and accurate information about the cost of treatment in Germany, compare prices in different German hospitals and book a medical care program at a favorable price. Cancer treatment will be easier and faster for you, and the cost of treatment in Germany will be lower.

You are welcome to leave your request on the Booking Health website. Our employee will contact you, consult, answer all questions. We will take care of the organization of your trip abroad. We will provide the following benefits for you:

  • We will select the best German hospital, whose doctors specialize in the treatment of stomach cancer and duodenal cancer, as well as achieve the best results.
  • We will help you overcome the language barrier and establish communication with a doctor at the German hospital.
  • The waiting period for your cancer screening and treatment will be reduced, and you will receive medical care on the most suitable dates.
  • We will reduce the price. The cost of treatment in Germany will be lower than usual due to the elimination of overpricing and coefficients for medical tourists. 
  • Our specialists will solve any organizational issues: paperwork, transfer from the airport to the German hospital and back, hotel booking, interpreting services.
  • We will prepare your medical documents and translate them into English or German. You do not have to repeat the previously performed diagnostic procedures.
  • We will keep contact with the German hospital after the completion of treatment.
  • We will arrange additional medical examinations and treatment, if necessary.
  • We will buy medicines in another country and forward them to your native country.

While the best specialists in the world are taking care of your health, the Booking Health staff will help reduce the cost of treatment in Germany and take care of all the travel arrangements.

 

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

European Society for Medical Oncology

Cancer. Net




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