Glioblastoma
Glioblastoma is a brain tumor with a high level of malignancy. The incidence of the disease is 2-3 cases per 100.000 people per year. This pathology is not very widespread as compared to the cancer of other localizations. But if we talk only about the central nervous system cancer pathologies, the incidence of glioblastomas accounts for more than 50% of all malignant brain tumors.
The Booking Health portal presents 60 German clinics specializing in glioblastoma treatment
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Diagnostics of Glioblastoma (Brain Tumor)
Non-invasive instrumental methods help to detect a tumor in the brain. The following imaging methods are applied for this purpose:
- X-ray
- Computed tomography
- Magnetic resonance imaging
Biopsy is required for the establishment of the diagnosis. Stereotactic biopsy is usually performed as it helps to obtain tissue samples from different areas of the tumor for further histological examination. This significantly reduces the likelihood of diagnostic error.
Best clinics for the glioblastoma diagnostics in Germany:
Treatment of Glioblastoma (Brain Tumor)
It is difficult to treat glioblastoma, and the survival rate of patients remains low even at stage 1-3. The tumor grows very fast and affects the vital functional areas of the brain.
Currently, traditional methods of treatment are:
- Surgical resection is an open surgery that implies the craniotomy performance. The glioblastoma is removed. The complexity of such operations is connected with the impossibility of removing tissues with a margin, as it affects the functions of the brain. For the accuracy of the operation, doctors use a variety of high-tech equipment, such as: neuronavigation, operating microscopes, ultrasonic aspirators-destructors. Better the equipment in the clinic is, higher the chances of success after the operation are.
- Radiation therapy is carried out both intraoperatively (contact radiotherapy) and remotely. Irradiation of a tumor can slow its growth.
- Radiosurgery and proton surgery. The tumor is influenced by the focused beam of ionizing particles. Radiosurgical methods are cheaper, but they are less accurate. Proton therapy is more accurate, it allows to avoid damage of the adjacent healthy brain tissues, but this therapy requires expensive equipment, therefore it is available only in certain clinics.
- Chemotherapy. The effectiveness of the medications administration remains low, as they are not able to cross the blood-brain barrier. Nevertheless, doctors continue struggle against this issue. Possibility of the chemotherapy injection into the brain through a small hole left after the operation with a tube inside is being investigated.
Innovative treatment of Glioblastoma
New techniques of glioblastoma treatment are constantly investigated. In the recent years the usage of new medications that can slow down the tumor growth, has been started. The following drugs are:
- Inhibitors of angiogenesis (bevacizumab is used for glioblastoma)
- Growth factor inhibitors
- Hypoxic cell sensitizers (they help to increase the effectiveness of the radiation therapy due to the oxygenation of the tumor cells)
The latest surgical methods of glioblastoma treatment are:
Fluorescent diagnostics is used within the framework of the surgical treatment. The patient drinks the solution, which is selectively accumulated in the tumor tissue. As a result, the surgeon sees glioblastoma cells in a special light which is emitted by the surgical microscope during the operation. Fluorescence diagnostics helps the doctor to distinguish healthy tissues from the pathologically changed ones.
Endoscopic surgeries. If the tumor is small and located near the ventricles or pituitary gland, an operation without skull opening can be performed. If the glioblastoma is located near the pituitary gland then surgical instrument access is performed through the nasal cavity. Similarly, some tumors located in the ventricles of the brain can be removed with access through the small holes in the skull, which are made on the border of the hair growth.
Latest techniques of radiation therapy provide the accurate beams influence on the tumor without involving healthy tissues. Advanced clinics use the following methods of treatment:
- Stereotactic conformal radiotherapy (3D-CRT). Accurate beam targeting on the tumor cells is performed.
- Intensity modulated radiation therapy (IMRT) allows to create a high-intensity stream of beams, forming the radiation field of the particular form (corresponding to the tumor shape).
- Image-guided radiation therapy (IGRT). Computed tomography is used during the therapy in order to visualize the tumor and direct the radiation more accurately.
Tumor treating fields (TTFs) is the latest glioblastoma treatment method. The electric field triggers the apoptosis (death) of the brain tumor cells and healthy cells are not damaged at the same time. The device for generating an alternating electric field is used constantly, 18 hours a day. The third research phase of this glioblastoma treatment method was completed only in 2016. Trials have shown that the life expectancy of patients with this aggressive form of cancer increases approximately twice: from 1-2 years to 2-4 years.
Immunotherapy for glioblastoma
So far, no glioblastoma immunotherapy has been approved or used as a standard treatment for this disease. Many methods are, however, used as part of clinical trials, including:
- Cytokines
- Stimulated immune cells
- Oncolytic viruses
Great hopes are placed on CAR T-cell therapy, which has already shown good results for many types of cancer, allowing for a successful cure or long-term survival for patients with aggressive tumors even beyond stage one-three. In this type of immunotherapy for glioblastoma, T cells are taken from a patient, and their genome is modified so that they can attack specific targets on the surface of cancer cells. The modified T cells are then injected again into the body, and they actively attack the tumor.
Dendritic cells for glioblastoma
Another promising option for the treatment of glioblastoma with immunotherapy is dendritic cell-based vaccines. The treatment of glioblastoma with dendritic cells (DCs) is carried out after surgery to lower the risk of recurrence. Dendritic cell therapy for glioblastoma has also shown good results for the treatment of inoperable and recurrent tumors.
Dendritic cell-based vaccines for glioblastoma are made individually from the patient's immune cells. They are collected from peripheral blood. Vaccination for glioblastoma is carried out in three doses. The course is repeated after 2, 4, and 8 months, and then the drug is administered every 6 months.
We also recommend that you watch the video on our YouTube channel "Booking Health", where the leading specialists of the specialized clinic talk about the advantages and peculiarities of dendritic cell therapy.
Best clinics for the glioblastoma treatment in Germany:
Rehabilitation after Brain tumor treatment
The most modern rehabilitation programs are used in Germany. They are adapted individually for each patient, and are based on the disease stage, age, physical possibilities, and the results of treatment. Different specialists such as: therapists, neurologists, psychologists, rehabilitators, kinesiotherapists, physiotherapists are involved in the rehabilitation process.
The following methods of rehabilitation are used:
- Dosed physical activity
- Training on the simulators and in the pool
- Individual orthoses
- Physiotherapy
- Acupuncture
- Manual therapy
- Transcranial magnetic stimulation
- Natural factors of the nature (mud, thermal waters, etc.)
- Individual or group therapy with a psychologist
Rehabilitation may include medicamentous support. It is necessary to hold a consultation with the patient about the proper nutrition and the way of life which is important for him in the current situation.
Rehabilitation programs in Germany are designed for 2 weeks. If necessary, they can last much longer. In this country, the patient is provided with qualitative care, accommodation in comfortable rooms and individually selected meals.
Rehabilitation programs in Germany show one of the best results in the world. Most patients successfully restore their working capacity and excellent health there. They remain physically active, return to the full social and family life.
Best clinics for neurological rehabilitation in Germany:
Author:
The article was edited by medical expert, board certified Dr. Nadezhda Ivanisova. 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
The cost of services includes
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
