Pancreatic (Pancreas) cancer
Pancreatic cancer is a dangerous illness with a severe clinical course and negative prognosis. The majority of patients die within a year after the diagnosis is confirmed. Incidence of the disease is approximately equal in different countries and counts for about 7 cases per 100 thousand of the population a year. Men are more prone to suffering from this disease than women. People around 60-70 years old are likely candidates for this illness. 75% of all patients, who have pancreatic cancer, are people over 50 years old.
The Booking Health portal presents 97 German clinics specializing in pancreatic (pancreas) cancer treatment
Show all clinicsDiagnostics of Pancreatic cancer
Pancreatic cancer diagnostics are tough because there are no specific symptoms of the illness that could warn a family doctor.
To establish and confirm a diagnosis, it’s necessary to perform the following tests:
- Methods of visualization. One can observe voluminous formations in the pancreas (from 2 cm), the expansion of the ducts, presence of metastases in the liver with the help of ultrasound examination or computed tomography. It is possible to carry out endoscopic ultrasound (endosonography), when the sensor is inserted into the stomach and duodenum. So the pancreas is visualized much better, and the probability of a diagnostic error is reduced.
- Targeted biopsy. A fragment of pancreas tissue is obtained for analysis. The procedure is conducted under ultrasound control. It helps to establish a diagnosis in 60-90% of cases if a person suffers from pancreatic cancer.
- ERCPG (endoscopic retrograde cholangiopancreatography) includes penetration of the instrument into the ducts of the pancreas. Meanwhile, a doctor can perform a biopsy to confirm the diagnosis, get the pancreatic juice, and expand the pancreatic ducts if there is such a need.
- Duodenum X-ray. As far as this organ is near to the pancreas head, cancer very quickly penetrates this part of the intestine. X-ray examination is performed with medicines that reduce the tone of smooth muscles. So the doctor has the opportunity to assess the degree of compression (squeezing) and invasion (germination) of the tumor into the duodenum.
- Laparoscopy implies penetration into the patient's abdominal cavity and is used to detect metastases. This is necessary to determine the possibility and feasibility of the surgical intervention, as well as to select an appropriate operation.
- Angiography is a type of X-ray examination, during which a contrast agent is introduced into the vessels. It assesses the condition of the hepatic artery, portal vein, and intrahepatic branches. The diagnostic method is used to assess the resectability of pancreatic cancer.
Best clinics for the pancreatic cancer diagnostics in Germany:
Treatment of Pancreatic cancer
Surgical removal of the tumor is performed in 10-15% of patients. Mostly these are young patients with good general health and stage 1-3 cancer. The operation will be effective in the absence of distant metastases or tumor germination in neighboring tissues. In these cases, the operation will be radical and give a chance for a full recovery.
If, after receiving the examination results doctor recommends radical surgical treatment, he discusses with the patient a particular type of intervention. In addition to the tumor, the surgeon can remove damaged areas of the duodenum, gall bladder, or lymph nodes. The Whipple procedure (pancreaticoduodenal resection) is used most often.
Also, palliative operations are carried out. The goal of such interventions is to eliminate some symptoms of pancreatic cancer and restore digestive function. They can be aimed at:
- Elimination of jaundice
- Elimination of the duodenum compression and restoration of the food lump passage
- Reduction of pain
- Restoration of pancreatic juice flow into the intestines
Radiation therapy is done before as well as after surgery if a tumor is not resectable. Chemotherapy is administered as a part of complex treatment at at stage one-three and at the advanced cancer stages.
The costs for the treatment in the specialized cancer centers in Germany are as follows:
- 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.
Innovative treatment of Pancreatic cancer
Irreversible Electroporation (NanoKnife) is a way to treat malformations located in hard-to-reach regions of the body, one of which is the pancreas. The essence of the technique is in the local impact on the cell structures of the malignant tumor by a non-thermal method. The impact is due to short-time impulses with the creation of a high voltage electric field.
Microscopic pores are formed in the cell membrane – this disrupts the normal metabolism of the cancer cell. As a result of such damage, they die by apoptosis, and not necrosis, as during treatment with low or high temperatures. In the case of the pancreas, this is critical because of the structural integrity of the vessels, nerves, and other tissues surrounding the organ preservation.
Proton therapy is a technique based on focused irradiation of the affected pancreas tissues with a proton beam. It is a subspecies of corpuscular therapy (Particle therapy) when other particles are used for treatment. Due to the ability to control the proton beam, which is irradiated at the cancer cells, the method remains safe for surrounding tissues and affects the pathological focus. The DNA of cancer cells is damaged under the influence of protons, which leads to their death without necrosis. The remains of atypical structures are destroyed by the immune cells of the human body.
Treatment of stage 4 pancreatic cancer
Standard treatment of stage 4 pancreatic cancer with metastases includes chemotherapy, targeted therapy, immunotherapy, and palliative procedures.
In addition to standard cytostatic chemotherapy, doctors in developed countries use targeted therapy with EGFR, PARP, and TRK inhibitors to treat stage 4 cancer. It is selected individually, depending on the identified mutations.
Some patients are also considered candidates for treatment with immune checkpoint inhibitors. PD-1 inhibitors are effective for high microsatellite instability (MSI-H) and mutations in the MSI or MMR genes. The drug pembrolizumab (Keytruda) prevents tumors from evading attacks from the immune system.
Many patients with stage 4 cancer require stenting to normalize bile flow. To control the pain syndrome, a celiac plexus block or splanchectomy is performed that involves the removal of the nerves innervating the gland. In developed countries, it is performed through short incisions in the chest, which makes the intervention less traumatic.
Dendritic cells for pancreatic cancer treatment
Hospitals in Germany use not only standard but also innovative treatments for pancreatic cancer. Some clinics offer dendritic cell treatment for pancreatic cancer. They provide T cells with targets for immune attack.
Dozens of dendritic cell-based vaccines for pancreatic cancer have already been developed and are being tested in clinical and preclinical studies. Although the treatment is still not standard, dendritic cell cancer treatments are performing well in research. They improve survival for both inoperable patients and those who have undergone surgery to remove the tumor.
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 pancreatic cancer treatment in Germany:
Rehabilitation after treatment of Pancreatic cancer
After treatment of complex oncological diseases, most patients require rehabilitation. 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 necessary 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 the 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 society and perform everyday tasks in new conditions.
In German clinics, rehabilitation is carried out comprehensively. Patients are provided with qualitative care here. Doctors' monitoring and conservative treatment allows for avoiding 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, and physiotherapists. Social and occupational therapy is carried out, as well. If necessary, people are taught how to eat properly, take care of a colostomy or urostomy, etc.
In Germany, rehabilitation is carried out with the maximum 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:
Author:
The article was edited by a 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:
European Society for Medical Oncology
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
