Treatment of endometrial cancer (uterine cancer) in Germany
Endometrial cancer is a malignant tumor that forms from the epithelial cells of the uterus inner layer. This oncological disease is more common in developed countries than in developing ones. 60% of women suffers from endometrial cancer during postmenopausal period, 40% of patients is in the reproductive or premenopausal age. The overall rate of endometrial cancer is constantly growing and currently it is 15-20 cases per 100.000 of population per year.
Endometrial cancer – Diagnostics
The main methods of endometrial cancer diagnostics are cytological and histological examination.
- Aspiration biopsy helps to receive the biological material for cytology. The procedure is performed with Brown’s syringe, without dilatation of the cervical canal. If a doctor performs a cytological examination only once, then the atypical cells can be identified with a probability of up to 35%. If the diagnostic procedure is performed several times, the sensitivity of the technique increases up to 50-55%.
- Cervicogisteroscopy is an endoscopic method of diagnostics that detects the tumor, assesses the extension of the pathological process and helps to perform the targeted biopsy. Feasibility of fractional curettage is assessed with the help of the cervicogisteroscopy.
- Fractional curettage helps to receive the biological material from the different areas of the uterus. Further, the histological examination is carried out. The procedure helps to detect a tumor at the early stage with a 80-100% probability, depending on the endometrial cancer localization.
Best clinics for the endometrial cancer diagnostics in Germany:
University Hospital Tuebingen
University Hospital Rechts der Isar Munich
University Hospital Duesseldorf
Endometrial cancer – Treatment
The purposes of treatment in case of endometrial cancer are the removal of the tumor and prevention of its metastasizing.
Traditionally, there are three ways of treatment, such as:
- Radiation therapy
- Drug therapy
Surgical intervention may have different volume.
This question is discussed individually depending on the exact clinical situation and a number of factors, such as:
- Tumor size
- The extent of its invasion into the myometrium
- Presence of metastases in the regional lymph nodes
- Histological structure of the endometrial cancer
- Tumor differentiation
- Presence of cancerous emboli in blood vessels
- Presence and severity of the concomitant pathology
A hysterectomy is performed in case of a favorable prognosis. If the prognosis is unfavorable, the extended extirpation of the uterus with appendages, lymph nodes, and omentum is performed.
Radiation therapy is an addition to the surgery. Pelvic area, vagina (most often the tumor spreads metastases into this area), and other areas of regional metastasis are irradiated.
Chemotherapy and hormonal therapy presuppose the medications prescription. They are administered before the surgery, as well as after it. There are many programs of drug therapy, which are selected individually for each patient.
In addition to traditional treatment methods of endometrial cancer that have already been used for many years, there are also latest therapeutic techniques. In developed countries, the latest achievements in the field of pharmacology and surgery are used.
Targeted therapy differs from the common chemotherapy as it affects only the tumor, and do not harm healthy cells of the body that divide quickly. In the treatment of endometrial cancer, such drugs as Temsirolimus, Gefitinib, and Bevacizumab are used.
Sentinel lymph node biopsy is used in case of endometrial cancer with metastases. Sentinel is the name of lymph nodes which are the closest to the malignant tumor, as they block its further metastatic extension. Thanks to injection of dyes or isotope indicators into the body, pelvic lymph nodes with metastases can be detected. Then they are removed.
Endometrial cancer – Innovative treatment
Photodynamic therapy (PDT) is the treatment method, which is based on the possibility of the light waves of a certain length to influence the atypical cells. The procedure implies injecting into the patient's body special substances – photosensitizers. Pathologically altered cancer cells can accumulate them. After absorption of the corresponding drugs, a laser is inserted into the body. It can generate light waves of a certain length. Due to the selective influence, the laser affects only cancer cells with a photosensitizer inside.
Under the influence of light, triplet oxygen in the structures is transformed into the singlet one with the simultaneous formation of a large number of free radicals. Such reaction leads to the necrosis and apoptosis of the tumor at the molecular level. The main advantage of PDT during the treatment of endometrial cancer is its organ-preserving ability. Healthy cells which have no photosensitizers inside are not exposed to laser radiation.
Immunotherapy. The purpose of the method is to "teach" the body to fight against cancer cells. In the laboratory conditions, doctors have recreated biological response modifiers (BRMS), which are able to stimulate and inhibit certain functions of the immune system.
This technique allows to perform the following:
- Suppress growth and development of atypical cells
- Help the immune structures to “recognize” altered tissues better
- Increase regeneration potential of healthy cells
- Block rebirth of normal cells into the cancer ones
After the injection of the specific biological response modifiers, the body’s own immune system begins to fight against the tumor.
Best clinics for the endometrial cancer treatment in Germany:
University Hospital Tuebingen
University Hospital Rechts der Isar Munich
Charite University Hospital Berlin
Endometrial cancer – Rehabilitation
Most patients require rehabilitation after the treatment of complex oncological diseases. It includes the following aspects:
- Prevention of complications that may occur as a result of treatment. It can be pneumonia, lymphostasis, thromboembolic or infectious complications.
- Restoration of general health. The elimination of the consequences after surgeries and chemotherapy is carried out. The functions of internal organs are restored with the help of various medical and rehabilitation measures.
- Restoration of occupation. A person must not just stay alive. He must have physical and intellectual capabilities, which are sufficient for employment.
- Psychological support. First of all, it is required for patients, whose occupational performance was harmed because of the disease. Patients with deterioration of appearance also will benefit from psychological help.
- Restoration of appearance. If necessary, you can use surgical and other methods in Germany to restore appearance defects caused by cancer. For example, to carry out the reconstruction of the breast.
- Social and domestic rehabilitation. A person with reduced workability is trained to act in the society and perform everyday tasks in new conditions.
In German clinics, rehabilitation is carried out in a comprehensive manner. The patients are provided with qualitative care here. Doctors' monitoring and conservative treatment allow to avoid complications, which usually happen after treatment of oncological diseases. Psychotherapy, physiotherapy and physical therapy are actively used in Germany.
Specialists in different medical spheres take part in the rehabilitation process. These are massage therapists, speech therapists, specialists in physiotherapy exercises, physiotherapists. Social and occupational therapy is carried out, as well. If necessary, people are taught how to eat properly, take care of the postoperative scar etc.
In Germany, rehabilitation is carried out with the maximum level of comfort for the patient. A person feels the results quite quickly and it improves his motivation and promotes further recovery.
Best clinics for oncological rehabilitation in Germany:
Max Grundig Clinic Buehl
1412.43Per daySee More
Author: Dr. Nadezhda Ivanisova
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc