Treatment of Glioblastoma in Germany
Best hospitals and doctors for glioblastoma treatment in Germany
Leading hospitals
Cost for treatment
Glioblastoma remains the most dangerous brain tumor. It is a grade 4 tumor, which is the highest grade. Once diagnosed, the average life expectancy of a patient with this disease is 3 months, if it’s left to its natural course. If treated, the average life expectancy reaches 1-2 years.
Glioblastoma treatment in Germany involves the use of modern methods: intraoperative fluorescence‐guided surgery, radiosurgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy. Brain cancer treatment can only prolong your life expectancy, but does not cure the pathology completely. The five-year survival rate for patients is 10%. This means that glioblastoma treatment helps one patient out of ten to live more than 5 years from the time the disease is diagnosed.
More and more people prefer to undergo their treatment in Germany. The specialists in this country use modern methods of brain cancer treatment. These can alleviate symptoms, reduce the size of the neoplasm, and slow down its growth. Ultimately, doctors in German hospitals help a person with glioblastoma live longer and have a better quality of life.
Content
- Diagnostics of the disease
- Therapy in Germany
- Surgery in Germany
- Radiation therapy
- Radiosurgery
- Chemotherapy
- How to undergo medical treatment in Germany?
Glioblastoma is a fast-growing brain cancer. Glioblastoma is always considered a stage 4 cancer.
Brain cancer treatment includes minimally invasive stereotactic surgery, radiation therapy, chemotherapy, targeted therapy, and tumor treating fields (TTF) therapy.
The price for MRI-guided laser ablation starts at €57,985. The cost of chemotherapy and radiotherapy starts at €24,500. You can find other prices on our website.
Best hospitals in Germany are:
- University Hospital of Ludwig Maximilian University of Munich
- University Hospital Rechts der Isar Munich
- Helios Hospital Berlin-Buch
- University Hospital Frankfurt am Main
- Clinic of Advanced Biological Medicine Frankfurt am Main
Diagnostics of the disease
Despite the fact that doctors in Germany use modern and high-tech methods to diagnose glioblastoma, this disease is usually detected at its advanced stages. This is one of the reasons why glioblastoma treatment remains a very challenging task. The pathology does not manifest any symptoms for a long time. If there are any symptoms, this means that an effective treatment for the brain cancer can be complicated, since the neoplasm will have reached a large size and invaded or compressed nearby, functionally important areas of the central nervous system.
People usually go to the doctor with complaints such as headaches or dizziness. They will have some signs of increased intracranial pressure and focal neurological symptoms. Patients may also develop meningeal syndrome.
Doctors in Germany diagnose glioblastoma with an MRI scan. This diagnostic method is the most accurate one for detecting brain tumors, which allows doctors to:
- confirm the presence of a tumor;
- assess its boundaries and the degree of invasion of the surrounding tissues;
- determine the localization of the tumor;
- identify the blood vessels that feed the tumor;
- suggest a histological type.
In addition to a conventional MRI, healthcare professionals in Germany use advanced magnetic resonance imaging techniques to diagnose glioblastoma. They use functional and perfusion MRI, MR arteriography, venography, and spectrography.
Doctors in Germany also use a PET scan to detect all of the glioblastoma foci more accurately. Although the neoplasm will not spread outside the brain, as it is hampered by the blood-brain barrier, it can metastasize within the CNS. PET scans involve the injection of radioactive glucose into the body. The substance accumulates in the tumor cells, after which, it will make all the tumor fragments visible.
This technique is used in Germany to diagnose glioblastoma before and after surgery (to determine the results of the operation). Once brain cancer therapy is completed, PET scans allow doctors to assess the radicalness of the intervention and identify any residual tumor cells.
Despite the availability of highly informative methods for imaging brain structures, the final diagnosis is only made after a biopsy. A biopsy is a procedure to take a sample of tissue in vivo for its examination. The material obtained during a biopsy is sent to the laboratory for histological examination.
Prior to starting therapy, it is important to accurately determine the histological type of the neoplasm. To do this, hospitals in Germany perform a stereotactic biopsy. This is a standard procedure in many countries, but in German hospitals, a feature of a stereotactic biopsy is the absence of the need to use a frame that is tightly fixed to the patient's head with screws. As a result, the patient tolerates the biopsy more easily. In addition, doctors achieve a better aesthetic effect by preventing any skin scars.
The biopsy is performed under MRI or CT guidance. A needle is inserted through a hole drilled in the head and a piece of the tumor is taken, which is sent for histological examination. After the biopsy, it becomes clear what kind of tumor it is, and which methods for brain cancer treatment will be appropriate for this tumor.
Therapy in Germany
Hospitals in Germany use the following methods for glioblastoma treatment:
- surgery;
- external beam radiation therapy;
- radiosurgery (delivers high doses of radiation that allow for glioblastoma treatment within a single session);
- chemotherapy;
- immunotherapy;
- targeted therapy.
A standard treatment protocol for glioblastoma involves the safest possible surgical resection of the neoplasm, followed by radiation therapy and chemotherapy. Doctors develop the treatment regimen by taking into account the patient's age, the degree of brain damage by the tumor process, the location of glioblastoma, and other factors.
German doctors pay due attention to symptomatic treatment, which improves a person's well-being and reduces their risk of developing life-threatening cerebral edema. The treatment of glioblastoma in Germany also includes innovative approaches, such as immunotherapy and the prescription of targeted drugs.
Surgery in Germany
The tumor is often detected at a stage when the surgical treatment of glioblastoma is impossible. The reasons for this may be the large size of the neoplasm, its deep location, or its invasion into the functionally important areas of the brain. In some patients, the cancer can still be treated with surgery. However, it is usually not possible to radically remove the neoplasm. When performing surgery for glioblastoma treatment, doctors remove only the main part of the tumor.
German neurosurgeons always use the intraoperative 5-ALA fluorescence technique. 72 hours before surgery, the patient drinks a solution containing 5-ALA. During this time, the tumor cells have time to actively accumulate it. When the surgeon examines the surgical field using a special microscope, he can accurately see the boundary between the affected and healthy brain tissues. The use of fluorescence navigation significantly increases the percentage of complete tumor resection and improves the medical outcomes in the postoperative period.
Surgery can also be palliative. A person undergoes surgery to implant intraventricular shunts. These provide patients with a normal CSF outflow and eliminate intracranial hypertension. This method for glioblastoma treatment in Germany does not prolong life, but it alleviates the symptoms of the disease.
Radiation therapy
An additional method for glioblastoma treatment in Germany is radiation therapy. External beam radiation therapy can be prescribed for various purposes. This is most often performed either after surgery in order to destroy the remaining tumor cells, or instead of surgery, if the fight against cancer with surgery seems ineffective, and therefore impractical. Radiation therapy can reduce the size of the neoplasm.
If patients are undergoing their treatment in Germany, they can count on receiving better quality radiation therapy. Although the cost of the treatment will be higher, the tumor will receive a larger dose of radiation. At the same time, the healthy tissues will receive a minimum dose of radiation, which reduces the risk of complications and the number of side effects.
Cancer treatment in German hospitals is carried out using the following methods:
- 3D conformal radiation therapy;
- intensity-modulated radiation therapy;
- proton therapy.
In addition to the standard radiation dosing regimen, hypofractionated radiation therapy can also be used. In these cases, the patient receives a higher daily dose of radiation (more than 200 kGy per day), which reduces the total number of fractions, the duration, and the cost of treatment.
In contrast, the daily dose of radiation in hyperfractionated radiotherapy is reduced and is less than 180 kGy per day. The aim of this approach is to reduce the toxicity that may develop more than 3 months after the completion of the course of treatment.
Radiosurgery
Another method of cancer treatment is radiosurgery. This therapeutic method directs large doses of radiation to the tumor, accurately repeating its contours. As a result, necrosis (death) of malignant tissues occurs. In terms of the survival of patients, the technique is comparable to surgical treatment in Germany. But, at the same time, it has a number of advantages:
- there is no need to perform a craniotomy (an opening of the skull);
- there is practically no period of postoperative recovery;
- lower cost of treatment;
- less severe pain syndrome;
- lower risk of complications.
Among the modern methods of radiosurgery, the Gamma Knife technique is considered the "gold standard" for glioblastoma treatment. Before starting treatment, radiologists determine the exact location of the glioblastoma using a stereotaxic frame, a 3D coordinate system. The source of ionizing radiation is controlled by a robot that directs the beams with an accuracy of tenths of a millimeter. Thanks to this, the technique provides "surgical precision" of irradiation: the glioblastoma receives the maximum radiation load, but the healthy tissues remain intact.
Treatment in Germany is carried out using modern radiosurgical techniques, in which there is no need for rigid fixation of the patient's head in a stereotaxic frame.
Chemotherapy
Cancer treatment often involves the use of drugs that block cell growth. However, chemotherapy only plays an auxiliary role in glioblastoma treatment, and its possibilities are limited. The choice of drugs is also limited, since most of them simply do not penetrate the blood-brain barrier. Accordingly, they do not reach the tumor and do not block its growth.
The basis of chemotherapy for glioblastoma is an antitumor drug with an alkylating type of action. The drug is prescribed after surgery, to those with a high risk of recurrence or an incomplete tumor removal. Patients can receive the drug in pills or by injection.
Another effective type of chemotherapy is the implantation of plates with drugs directly into the brain, in the area of the malignant focus. The drug is released slowly over several weeks. At the same time, a high local concentration is created, which effectively affects the tumor.
How to undergo medical treatment in Germany?
As a rule, a person receives better, more modern, and safer treatment in Germany. Therefore, many people are not deterred by the higher cost of treatment in Germany compared to their native country. Those who can afford it go to one of the German hospitals to receive top-class medical services.
Booking Health is ready to take care of the arrangement of your treatment in Germany. We will select the best hospital for you, one that has succeeded in the fight against cancers of the central nervous system. Due to the lack of overpricing for foreign patients, the price for your treatment will be up to 50% lower. The cost of your treatment will be the same as it is for German citizens.
Booking Health will provide you with the following benefits:
- preparation of your diagnostic and therapy program, taking into account your previous examinations, which means that you will not have to repeat your diagnostic procedures, and therefore the overall cost of treatment in Germany will be lower;
- direct communication with your attending physician;
- an appointment at the hospital on the most suitable date for you;
- reduced waiting time for your treatment;
- control of the program at all its stages;
- assistance in buying and forwarding medicines to your native country;
- ensuring communication with the hospital and your attending physician upon the completion of your treatment program;
- control of prices for medical services provided and the return of unspent funds.
In addition to organizational services and reduced prices for your treatment, you will also benefit from top-class services. We will book airline tickets and a hotel for you, and we will help you to prepare your documents for traveling abroad. The Booking Health employees will meet you at the airport, take you to the hospital, and support you throughout your stay in Germany.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. 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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