Skin Cancer Treatment in Germany

Skin cancer is one of the most common oncological diseases in the world. The two most common histological types are basalioma and squamous cell carcinoma. You can cure these oncological diseases in one of the medical clinics in Germany. This is a country with a high level of medicine. Doctors in Germany use such treatment methods as surgical interventions, laser therapy, photodynamic therapy, and new radiation therapy options. In the advanced stages of cancer, doctors use targeted therapy and immunotherapy.

Content

1. Surgical treatment
2. Local treatment methods for tumors in the early stages
3. Radiation therapy
4. Drug therapy
5. Why is it worth undergoing cancer treatment in Germany?

Surgical treatment

For most patients, surgery is the only treatment required to cure their cancer. However, the task is not only to save the patient from a dangerous disease, but it is also important to do this with minimal damage to the appearance of a person, and without disrupting the function of their organs and body parts located near the tumor.

Tumor excision is the most common treatment method. The doctor removes the skin tumor, moving back towards healthy tissue. After the operation, the material is sent for histological examination to make sure that the resection margin is clean. If the margin is clean, additional treatment is usually not necessary.

After excision, a defect remains on the skin. Whenever possible, it is closed with a suture. If the defect is large, then skin grafting is performed to achieve a good aesthetic result.

Mohs surgery is performed when the tumor is located in aesthetically, or functionally significant, areas: on the face, neck, reproductive organs, near the joints, etc. That is, wherever it is required to remove the tumor as carefully as possible, preserving as much surrounding tissue as possible.

The Mohs surgery is complex and lengthy. It is performed in several stages. The doctor removes the tumor with minimal involvement of the surrounding tissues. The material is then sent to the laboratory. The specialists check which resection margins are negative (without cancer cells) and which are positive. At the next stage of the operation, the doctor continues to cut off thin skin flaps, expanding the wound only in the direction where cancer cells are detected. The material is then examined again. As a result, the procedure is repeated 4-5 times until all the resection margins are clean.

Lymph node dissection is rarely used. Skin cancer is usually detected before it metastasizes to the lymph nodes. The technique is used for clinical signs of metastasis – in case of lymph node enlargement. 

Sentinel lymph node biopsy is an intraoperative diagnostic procedure that is performed when there is a high risk of tumor recurrence, on a tumor with a size of more than 2 cm, and in the absence of clinical signs of lymph node involvement. It is used in specialized centers. When performing surgery for skin cancer treatment in Germany, doctors perform a lymphoscintigraphy: they inject a radiopharmaceutical into the site of ​​the tumor, and then check with a gamma camera where it accumulates. The nodes that accumulate a radioactive substance are called sentinels – they are the first on the path of lymph outflow from the tumor. These nodes are removed and examined. If there are no metastases in them, then there are no metastatic foci in the lymph nodes located farther from the tumor. Therefore, the patient does not require lymph node dissection.

Treatment costs in specialized German cancer centers are as follows:

• The cost of Mohs micrographic surgery for skin cancer ranges between 4,700 EUR and 7,600 EUR.
• The cost of laser surgery for skin cancer ranges between 5,000 EUR and 8,300 EUR.
• The cost of cryosurgery for skin cancer ranges between 5,100 EUR and 8,300 EUR.

Local treatment methods for tumors in the early stages

Non-surgical local techniques are often used for treatment of skin cancer in the early stages, especially basalioma. They are more sparing, provide a good aesthetic result, and have a minimal risk of complications.

The options for minimally invasive local cancer treatment in Germany are as follows:

Cryotherapy is tumor freezing. As a result of the procedure, the skin area that was exposed to liquid nitrogen dies. The skin in this area becomes inflamed and blistered. After a few weeks, the wound heals. This is an old, reliable, and inexpensive treatment method, but it is less comfortable for the patient when compared to newer methods, and is more likely to cause skin scarring, since it is difficult for the doctor to control the depth of tissue freezing.

Photodynamic therapy is an innovative treatment method that provides excellent aesthetic results, even in large neoplasms. It is used for skin cancer treatment in Germany. A drug containing a photosensitizer is applied to the skin. It accumulates mainly in the cancer cells and, in much smaller quantities, in healthy tissues. The tumor is then exposed to a special light source. The sensitizer is activated and destroys the cancer cells from the inside.

Local chemotherapy is the application of a chemotherapy agent to the skin. It has been used for several weeks. The drug does not have a systemic effect on the body, but only destroys cancer cells in the area of ​​application.

Local immunotherapy involves the use of immunotherapy cream, which activates an immune response against the tumor and destroys it completely. It is necessary to treat cancer in the early stage with this drug within a few weeks. The therapy may cause systemic side effects: flu-like symptoms develop.

Laser vaporization is the destruction of a small tumor with a laser. The laser beam vaporizes the tissues. This method is used only for basal cell carcinoma, which is the most common type of skin cancer. After the procedure, a scab remains on the skin. It reliably protects the wound from the penetration of bacteria, so infectious complications after laser treatment are very rare. The scab disappears after wound epithelialization.

Radiation therapy

Skin cancer treatment at an early stage may involve the use of radiation as a radical (potentially curative) method. Its advantage is a good aesthetic result. However, side effects are possible and the risk of the recurrence of tumors many years after treatment increases. Therefore, it is not recommended to treat young people with skin cancer with radiation. Nor is it recommended to use radiation as a treatment for patients with an increased risk of recurrence of neoplasms (basal cell nevus syndrome, xeroderma pigmentosum), or patients with the presence of diffuse connective tissue diseases.

Options for the destruction of tumors up to 2 cm:

• close-focus roentgen therapy;
• gamma and electron therapy;
• brachytherapy (often used for eyelid tumors).

Radiation therapy can sometimes be used as an adjuvant (postoperative) treatment. In a case of squamous cell skin cancer, the patient is indicated for lymph node irradiation if the risk of recurrence is assessed as high and the tumor is larger than 2 cm. In addition, the technique can be used with a positive sentinel lymph node biopsy if the patient refuses surgery.

Postoperative irradiation of the tumor bed is carried out in a case of a positive resection margin. This is an alternative to revision surgery and reduces the risk of local recurrence.

Drug therapy

Systemic treatment methods for skin cancer are rarely used in Germany, as the disease is usually treated locally. However, when the tumor is detected in its advanced stages, doctors resort to medications.

Targeted therapy is the main method of systemic treatment for basalioma. Hedgehog signaling pathway inhibitors are prescribed to patients. They are used for advanced or recurrent cancer. The drugs are taken in capsules. In squamous cell carcinoma, EGFR inhibitors can sometimes be used. They reduce tumors in size.

Immunotherapy is the main method of systemic treatment for squamous cell skin cancer. Doctors use immune checkpoint inhibitors. These drugs target the PD-1 protein, and they are relatively safe for a patient’s health. They do not have a cytotoxic effect on cancer cells, but work only by enhancing antitumor immunity. This is the first-line therapy for squamous cell carcinoma. In basal cell carcinoma, immune checkpoint inhibitors are given as second-line therapy if the Hedgehog signaling pathway inhibitors fail.

Chemotherapy is rarely used. It is usually provided as a second- or third-line therapy, if targeted therapy and immunotherapy do not work.

Why is it worth undergoing cancer treatment in Germany?

Skin cancer treatment in Germany cures most cases of the disease, and does so with minimal damage to health and appearance. Germany is a country with advanced medicine, where one can find many hospitals famous for their medical services throughout the world. They employ reputable oncologists and oncodermatologists.

There are a few reasons for you to undergo treatment in Germany:

• Surgical removal of the tumor with a good aesthetic and functional outcome.
• Skin grafting for closing extensive defects, if necessary.
• When the tumor is localized in functionally and aesthetically significant areas, the Mohs surgery is performed, which makes it possible to reduce the volume of removed healthy tissues that surround the neoplasm.
• Most cases of skin cancer are successfully cured in Germany.
• In the early stages, non-surgical methods of tumor destruction are used: laser therapy, photodynamic therapy, and brachytherapy.
• Sentinel lymph node biopsies are performed to avoid lymph node dissection and its associated complications.
• German hospitals have modern methods of radiation therapy. They are very accurate, ensuring a low risk of post-radiation complications.
• The use of new medicines for drug therapy: instead of ineffective chemotherapy being used in advanced stages of skin cancer, immunotherapy and targeted therapy are used instead.

To undergo skin cancer treatment 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. The treatment will be easier and quicker 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 with you, and answer all of your 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 skin cancer treatment and achieve the best results.
• We will help you to overcome the language barrier and establish your communication with the doctor at the German hospital.
• We will reduce the waiting period for diagnostics and treatment, and you will receive medical care on the most suitable dates for you.
• We will reduce the price. The cost of treatment in Germany will be lower than usual due to the lack of overpricing and coefficients for foreign patients.
• Our specialists will solve any organizational issues: paperwork, transfers from the airport to the German hospital and back, hotel booking, and interpreting services.
• We will prepare your documents and translate them into English or German. You do not have to undergo any previously performed diagnostic procedures.
• We will stay in contact with the German hospital after the completion of your treatment.
• We will organize additional diagnostics and treatment, if necessary.
• We will buy medicines in the other country and forward them to your native country.

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

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!

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

Mayo Clinic

Canadian Cancer Society