Treatment of thyroid cancer (carcinoma) in Germany
Thyroid cancer is the most common tumor of the endocrine system. It often occurs because of the others thyroid gland diseases. It can affect not only adults, but also children. Anaplastic thyroid cancer is the most dangerous one. It is characterized by fast tumor growth, early metastasis and resistance to treatment.
Thyroid cancer – Diagnostics
Instrumental and laboratory examination methods are the basis of the diagnostics. Clinical examination is nondiagnostic, because malignant and benign thyroid gland formations virtually don’t have differences in size and shape.
Ultrasound of the thyroid gland reveals the type of formation. It can be solid (a nodule) or cystic (a cavity with fluid) formation. With the help of ultrasound, a number of nodules can be counted. Ultrasound is also used to control the fine needle aspiration biopsy procedure.
Fine needle biopsy of the node is performed with the help of a needle. Several tissue samples are taken for cytological examination. The doctor conducts a biopsy of all nodules, which are more than 1 cm in diameter. Also, all suspicious (according to ultrasound) nodules are examined. If necessary, a lymph node biopsy is performed to identify possible metastases.
Excisional biopsy is performed under anaesthesia. The main indication is inconclusive results of cytological examination. A fragment of the thyroid gland is taken with the help of surgery. Then, its histological examination is performed. If the cancer is detected in the sample, the extent of the operation increases. The diagnostic procedure in this case turns into a fully-fledged surgical operation aimed at the removing of the thyroid gland, lymph nodes, and, if necessary, other affected tissues.
Positron-emission tomography is a high-tech research method, available in German hospitals. The method is based on the ability of radioactive iodine to accumulate in the tissues of the tumor. PET allows to assess the stage of the pathological process, to detect metastases, to detect the recurrence of cancer after treatment.
Additional research methods are:
- Computed tomography
- Chest X-ray examination
- Blood tests for thyroid hormones, TSH, calcitonin
- Analysis for the carcinoembryonic antigen
Best clinics for the thyroid cancer diagnostics in Germany:
University Hospital Ulm
Hannover Medical School (MHH)
Tel Aviv Sourasky Medical Center
Thyroid cancer – Treatment
Surgery is the main treatment for thyroid cancer. Patients can achieve a complete recovery if the cancer is detected at the early stages. The essence of the treatment is the complete removal of the organ. A surgeon can also remove the lymph nodes in the neck area.
Other treatment techniques are:
- Radioiodine therapy. Malignant cells absorb iodine more intensively than the normal ones. Therefore, when radioactive iodine is injected into the patient's body, the tumour is destroyed. The technique is effective for the destruction of thyroid cancer metastases, as well as those areas of the tumour that cannot be removed surgically.
- Remote radiation therapy is used for certain types of cancer (medullary, anaplastic), which don’t respond to radioiodine therapy. In this case, the tumour or metastases are irradiated remotely. This allows to destroy the tumour or slow down the growth of thyroid cancer. Radiation therapy is also used to reduce pain in later stages of the disease.
- Hormonal therapy is prescribed after surgery on the thyroid gland. This kind of treatment is used to replace hormones that are no longer produced in the body and to maintain normal metabolism. Hormonal therapy is prescribed as a life-long treatment. Also hormone therapy slows the growth of the tumour, if it was not completely removed. This occurs because of the suppression of thyroid-stimulating hormone (TSH) production in the pituitary gland.
- Chemotherapy is performed rarely, as it is not effective for thyroid cancer treatment. Chemotherapy is performed during the latter disease stages and in the case of anaplastic cancer, when other treatments are ineffective.
Thyroid cancer – Innovative treatment
The implementation of the new treatment techniques helps to increase patients’ life-expectancy, to reduce the risk of recurrence and to make the whole therapy process safer.
The latest medical developments of recent years are:
- Endoscopic surgeries. After an open removal of the thyroid gland, a scar remains on the neck, which creates a cosmetic defect. Endoscopic removal of the thyroid gland is used as an alternative method of surgical treatment. Thin instruments are inserted through the small incisions in the neck.
- Robot-associated surgeries. In the best German hospitals, endoscopic surgeries are performed to remove the thyroid gland with the help of robotic equipment. This allows to improve the aesthetic effect, reduce the risk of complications, and shorten the rehabilitation period.
- Overcoming resistance to radioiodine therapy. Some types of thyroid cancer do not respond to radioiodine therapy. Currently, new drugs targeted at the cells with changes in the BRAF genes are being explored. As a result of drugs administration, thyroid cancer cells begin to accumulate radioactive iodine, and the disease becomes susceptible to this type of treatment.
- Targeted therapy. Standard chemotherapy has low efficacy for the thyroid cancer. But there are new drugs that are aimed at atypical thyroid cells.
The following medicines have been already used:
- Inhibitors of kinases
- Inhibitors of angiogenesis
German university hospitals develop new chemotherapy programs that could slow down the growth of the tumour and prolong life for patients with anaplastic thyroid cancer.
Best clinics for the thyroid cancer treatment in Germany:
University Hospital Ulm
Hospital Sachsenhausen - Academic Hospital of the University of Frankfurt am Main
Hannover Medical School (MHH)
Thyroid 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
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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