Pancreatic Cancer Treatment in Germany

The term "pancreatic" specifies a tumor developing from the cells of the head, body, or tail of the organ. More than half of patients are diagnosed with cancer of the head of the pancreas, about a third of patients have the entire gland affected, and less often the tumor is localized in the body or tail of the organ.

The insidiousness and danger of this type of cancer is that, as a rule, it is diagnosed at an advanced, inoperable stage. This pathology has an extremely aggressive course and metastasizes early, which subsequently affects the life expectancy, survival rates, and therapy choice for pancreatic cancer.

Content

1. Why is pancreatic cancer dangerous?
2. What does diagnostics of pancreatic cancer include?
3. Surgery
4. Alternatives to surgical treatment
5. Treatment of pancreatic cancer stage 4
6. Symptomatic treatment
7. Why treat cancer in Germany?
8. Advantages of the surgical treatment of pancreatic cancer in German hospitals
9. The cost of treatment
10. How to organize pancreatic cancer treatment in Germany?

Why is pancreatic cancer dangerous?

Pancreatic cancer is one of the most severe diseases in oncological practice and one of the hardest to treat, and this is due to the certain factors:

1. Pancreatic cancer is characterized by late diagnosis making. The stage one-three can be almost asymptomatic, so patients visit a doctor when severe complications have already developed.
2. The anatomical location of the organ creates special requirements for the skill of the surgeon if surgery is a preferred treatment method. Surgery usually continues 6-8 hours and includes the comprehensive restructuring of the digestive tract.
3. The danger of developing complications after treatment is determined by the functions of the pancreas. If during surgery enzymes secreted by the pancreas accidentally get into the blood, severe intoxication develops, which can be lethal.
4. The average age of patients with pancreatic oncology is about 55 years, which negatively influences the availability of treatment options. The disease usually develops against the background of pancreatic or biliary tract pathologies.

What does diagnostics of pancreatic cancer include?

Often there are almost no symptoms at the initial stages of pancreatic cancer, which creates obstacles to the early disease detection. In addition to physical examination, it is necessary to undergo:

• Ultrasound scan
• Computed tomography (reveals the presence of atypical changes and estimates the size of the tumor)
• MRI (reveals the signs of metastases)
• Endoscopic retrograde cholangiopancreatography
• Biopsy

Surgery

The therapy regimen is adjusted to the cancer stage and size of the tumor, general condition, and personal preferences of patients.

The initial goal is the complete removal of the tumor and any other malignant loci in the body. If this is not possible, the focus will be made on preventing the tumor from growing and improving the general well-being of the patient.

Radical surgery remains the most effective method of pancreatic cancer treatment. With cancer affecting the head of the pancreas, as a rule, the Whipple surgery is carried out. During the Whipple surgery the affected area of the organ is excised together with the duodenum and part of the bile duct. To reduce the risk of recurrence development, the regional lymph nodes are also removed.

The main advantage of Whipple's surgery is its radicality, i.e. the possibility of the removal of the entire tumor.

Whipple's surgery is performed under general anesthesia. It is conducted traditionally (open surgery), through an incision in the abdomen, or laparoscopically, through small punctures in the abdominal wall. The localization of the tumor is considered when deciding on the type of surgery to conduct. However, in most cases, pancreatoduodenectomy is a method of choice.

Typically, after the surgery, chemotherapy and external radiotherapy are conducted.

If an inoperable tumor was detected during surgery and the process has spread to the stomach, duodenum, or bile duct, then the double bypass with gastric and biliary anastomosis is carried out in order to eliminate the obstruction.

When the process is beyond the stage 1-3 and radical cancer treatment is not possible, palliative surgery may be carried out. The purpose of such a surgery is to improve the quality of life of patients.

Alternatives to surgical treatment

In 80-90% of cases, the tumor is inoperable at the time of the diagnosis making due to the presence of metastases or tumor germination into large vessels.

As a rule, patients visit the German hospitals at such a stage of the process, when surgical treatment must be complemented by conservative therapy courses. In patients with advanced cancer, conservative therapy is the main method of cancer treatment that allows, in some cases, to achieve the stabilization of the process or even remission of pancreatic cancer. Performed before surgery, this therapy causes the tumor to shrink. When administered after the operation, it significantly reduces the risk of recurrence.

Depending on the sensitivity of tumor cells to pancreatic cancer treatments, certain types of conservative therapy may be assigned including chemotherapy, radiation therapy, or targeted therapy.

Treatment regimes are selected individually, while, as a rule, several chemotherapeutic preparations or a few treatment methods are used in combination. If necessary, tumor metastases are treated locally (e.g. with chemoembolization).

Since a large number of patients come to the German hospitals with inoperable tumors, a search for new drugs is underway. German hospitals specializing in oncology are already testing drugs that can prolong the lives of patients with advanced pancreatic cancer, such as dendritic cell and mRNA vaccines.

Treatment of pancreatic cancer stage 4

The diagnosis of pancreatic cancer stage 4 is made when the tumor has spread through the body. Pancreatic cancer stage 4 is found primarily at the age of 60 and older, i.e. in people with weak immunity.

Pancreatic cancer stage 4 is characterized by pathological functional changes, which include hypoxia (lack of oxygen supply) of all organs and intoxication against the background of impaired metabolism. The most dangerous sign is the extinction of the functions of the central nervous system and the brain.

The main and only method of treatment of pancreatic cancer stage 4 is chemotherapy since surgery will no longer help. This is explained by the fact that multiple malignant cells are present not only in the pancreas but also in other organs.

Chemotherapy for the treatment of pancreatic cancer stage 4 is aimed at suppressing further growth of atypical cells, which allows to slow down the pathological process and reduce the severity of clinical symptoms.

Symptomatic treatment

Most patients with pancreatic cancer experience pain. Symptomatic treatment plays an important role, especially at the advanced stage of the disease. It is necessary to arrange the appropriate medical care for the patient at the terminal stages.

Painkillers in the form of nonsteroidal anti-inflammatory drugs can be used to stop mild pains. With moderate and intense pain, opioids in an adequate dose are prescribed to be taken orally. If the facilitation of the medical condition isn’t happening, specific drugs are prescribed as well.

Medical care of such type also includes adequate anesthesia during diagnostic and therapeutic procedures.

Why treat cancer in Germany?

Cancer treatment in Germany has its advantages, among which the main ones are:

• Emergency organization of high-technology cancer treatment
• Conducting treatment exclusively in certified oncological centers, including university hospitals
• Selection of optimal individual therapy (the treatment tactics for each patient is chosen by the interdisciplinary oncological board with the participation of oncologists, surgeons, chemotherapists, and radiologists)
• An urgent start of treatment after the diagnosis making
• Following the international treatment protocols recommended by the European Oncology Society and German Oncology Society
• Constant monitoring of the tumor response to cancer treatment, timely adjustment of the treatment regimens, selecting more efficient therapeutic methods (this provides a high chance of cancer survival even at the advanced stages)
• When possible, use of minimally invasive surgical techniques
• Treatment with the last-generation medications
• Symptomatic therapy to minimize the side effects of chemotherapy and radiation therapy
• Early postoperative rehabilitation of patients
• The high-quality standards of medical services

Advantages of the surgical treatment of pancreatic cancer in German hospitals

Indicators of the effectiveness of surgical treatment of pancreatic cancer in Germany are one of the best in the world. It should be noted that German surgeons often agree to work with patients who are considered inoperable in their native countries. So, it is most likely that by choosing the treatment in oncological German hospitals, patients significantly increase their chances of getting rid of the deadly disease.

The effective surgical treatment of pancreatic cancer in Germany is associated with both the experience of German surgeons and the technical achievements of German medicine, which allows using sparing methods for surgery and robotic technologies that provide high accuracy of manipulations.

An important factor significantly affecting the life quality after surgery in Germany is medical rehabilitation. Complexes of medical rehabilitation in German hospitals make it possible to avoid many postoperative complications and return to a full life in the shortest time possible.

You’re welcome to learn more about the possibilities of treatment in German hospitals on the Booking Health website.

The cost of treatment

Before you start researching the cost of treatment in Germany, it is necessary to understand what the prices depend on. Let's start with the fact that prices in all German hospitals are based on one system – DRG. The price, in turn, depends on the specific diagnosis and treatment method:

• The cost of chemotherapy for pancreatic cancer is between 7,380 EUR and 12,100 EUR.
• The cost of chemotherapy and radiotherapy for pancreatic cancer is between 30,300 EUR and 45,800 EUR.
• The cost of the Whipple procedure for pancreatic cancer is between 26,400 EUR and 55,600 EUR.
• The cost of segmental pancreas resection for pancreatic cancer is between 26,500 EUR and 55,800 EUR.

The average price of oncological rehabilitation after pancreatic cancer treatment in Germany is 1,190 EUR per day, the minimum price is 1,041 EUR per day, and the maximum price is 1,553 EUR per day.

You can find the cost of treatment with other procedures on the Booking Health website.

How to organize pancreatic cancer treatment in Germany?

Constantly thinking over all the nuances of treatment organization is incredibly stressful for patients, especially for those who have never been to Germany. In such cases, the best decision is to use the help of a medical tourism agency.

Booking Health is one of the best medical tourism companies in the world, which many patients have trusted the arrangement of their treatments to.

Booking Health meets high standards of medical care, which is why patients return home with only positive impressions. A large number of new patients turn to Booking Health for arranging treatment in Germany after the recommendation of our regular clients.

Don’t hesitate to leave a request on the Booking Health website, so that a medical advisor could contact you.

Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova 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!

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Sources:

National Cancer Institute

Cancer Support Community

Healthline