Treatment of bladder cancer with embolization or chemoembolization (program ID: 688792)
University Hospital of Ludwig Maximilian University of Munich
Christian G. StiefSpecialized in: adult and pediatric urology
Department of Adult and Pediatric Urology
- Initial presentation in the hospital
- Clinical history taking
- Review of available medical records
- Physical examination
- Laboratory tests:
- Complete blood count
- General urine analysis
- Biochemical analysis of blood
- Tumor markers
- Inflammation indicators (CRP, ESR)
- Ultrasound scan
- CT scan / MRI
- Preoperative care
- Embolization or chemoembolization, 2 procedures
- Symptomatic treatment
- Cost of essential medicines
- Nursing services
- Elaboration of further recommendations
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.
Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.
When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.
Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.
After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.
After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
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About the department
According to the Focus magazine, the Department of Adult and Pediatric Urology at the University Hospital of Ludwig Maximilian University of Munich ranks among the top German departments specializing in prostate cancer treatment
The department offers the full range of diagnostics and treatment of urological diseases in men and boys. The department employs comprehensively trained, experienced doctors, who use in their practice all the advanced medical achievements. Each patient is provided with an individual approach to therapy with due consideration of specific needs and wishes. The patients also benefit from close cooperation with the specialists from other departments and specialized medical institutions. The Chief Physician of the department is Prof. Dr. med. Christian G. Stief.
Many urological diseases require surgical treatment, therefore the department performs open, endoscopic and minimally invasive interventions (depending on the clinical indications). Also, the department has an innovative da Vinci Si HD robotic system. Special attention is paid to tumor surgery (nerve-sparing prostatectomy, kidney tumor removal, cystectomy with bladder prosthetics, etc.). The department is certified as the Prostate Cancer Center according to the standards of the German Cancer Society. This fact confirms the credibility of the department in this field and the high success rates in prostate cancer treatment.
In addition, the treatment of benign prostatic hyperplasia is of particular interest to the doctors of the department. The department is one of the few South German centers, which offers the possibility for conducting Holmium laser enucleation of the prostate (HoLEP) as a standard treatment method for benign prostatic hyperplasia. With this method, even a very large gland can be removed through the urethra (namely, transurethrally). Thanks to the introduction of this technology, the doctors of the department completely abandoned usual surgical interventions through the anterior abdominal wall or bladder (open prostate adenoma enucleation). At the same time, the limitations associated with the prostate size are practically absent.
The operation is as sparing as possible for the patient. The urinary catheter is removed in 2-3 days after the intervention, after which the patient is discharged from the hospital. On average, the department performs 2-3 holmium laser enucleations per day. To date, patients have never needed a blood transfusion. The effectiveness of this method is confirmed by numerous international trials, so it is recommended by the German and international urological associations.
The department’s range of medical services includes:
- Diagnostics and treatment of prostate cancer
- Prostate-specific antigen blood test
- Palpation (digital rectal examination)
- Transrectal ultrasound examination
- Transrectal prostate biopsy
- Magnetic resonance imaging (MRI)
- Surgical treatment, including laparoscopic and robotic surgery
- Radiation therapy
- Hormone therapy
- Follow-up monitoring of treatment results
- Multimodal therapy
- Diagnostics and treatment of bladder cancer
- Photodynamic diagnostics
- Transurethral resection of the bladder (TUR-B)
- Hybrid surgeries
- Diagnostics and treatment of kidney cancer
- Ultrasound examinations
- Сomputed tomography
- Magnetic resonance imaging
- Surgical treatment
- Systemic drug therapy
- Diagnostics and treatment of testicular tumors
- Clinical examination
- Ultrasound examination
- Serum tumor markers
- Diagnostics and treatment of penile cancer and precancerous conditions
- Fluorescent diagnostics
- PET-CT of the lymph nodes
- Biopsy of the sentinel lymph nodes
- Laser therapy
- Radical surgery (at progressive stages)
- Radiation therapy
- Diagnostics and treatment of benign prostatic hyperplasia
- Transrectal ultrasound examinations
- Urodynamic examinations
- Ultrasound measurement of bladder wall thickness
- Transurethral resection
- Holmium laser enucleation of prostate (HoLEP)
- Photoselective vaporization of the prostate adenoma (GreenLight laser)
- Thermal methods
- Diagnostics and treatment of urethral stricture (minimally invasive and open interventions)
- Diagnostics and treatment of urinary incontinence and pelvic prolapse in women (urogynecology)
- Diagnostics and treatment of urinary incontinence in men
- Conservative therapy
- Drug therapy
- Surgical treatment
- Diagnostics and treatment of urolithiasis
- Conservative therapy (drugs)
- Extracorporeal shock wave lithotripsy
- Percutaneous nephrolitholapaxy
- Diagnostics and treatment of erectile dysfunction (impotence)
- Psychological help
- Drug therapy
- Hardware treatment methods
- Surgical treatment
- Diagnostics and treatment of infertility (andrology)
- Semen cryopreservation (freezing)
- Laparoscopic ligature in varicocele
- Vasectomy (male sterilization)
- Vasovasostomy (surgery to restore fertility)
- Testicular sperm extraction (TESE)
- Microsurgical epididymal sperm aspiration (MESA)
- Transurethral resection of the ejaculatory ducts (TURED)
- Diagnostics and treatment of urologic diseases in children
- Other diseases and treatment methods
- 1978 Beginning of the study of Medicine, Faculty of Medicine, Saarland University.
- 1980 Entry into the Student Foundation of the German People (Studienstiftung des deutschen Volkes).
- 1982 Three-month practice in Bophuthatswana (South Africa).
- 1982/83 Study in Freiburg (Breisgau).
- 1983/84 One-year practice in Montpellier (France) as a Scholar of the French government and the German Academic Exchange Service (DAAD).
- 1984 Admission to medical practice, military service in the Department of Urology at the Bundeswehr Hospital in Ulm, (Prof. Altwein).
- 1985 Doctoral thesis defense with honors, University Hospital Homburg.
- 1987 Assistant Physician in the Department of Urology, University Hospital Freiburg (Prof. Sommerkamp).
- 1987/88 Research Fellow in the Department of Urology at the University of California, San Francisco (Prof. Tanago) as a Scholar of the German Research Foundation (DFG) (during one year).
- 1988 Assistant Physician at the University Hospital Freiburg (one-year practice in Surgery, Prof. Farthmann).
- 1989 Assistant Physician in the Department of Adult and Pediatric Urology at the Hannover Medical School (Prof. Jonas).
- 1990 Examination for the title of the Medical Specialist (Senior Physician).
- 1991 Habilitation and Venia Legendi in Urology.
- 1995 Managing Senior Physician.
- 1996 Visiting Professor.
- 1999 Certification for additional training in Urology (Special Surgical Urology).
- 2001 Venia Legendi in the advanced training courses in Special Surgical Urology.
- 2004 Head of the Department of Adult and Pediatric Urology at the University Hospital of Ludwig Maximilian University of Munich.
- 2005 - 2007 Chairman of the Publishing Bureau at the European Association of Urology.
- 2006 - 2012 Junior Editor of the European Urology.
- 2007 Editor of the weekly medical website, Stiefs Consultation 'im Münchner Merkur and affiliated daily newspapers.
- 2010 Co-Editor of the Der Urologe Journal.
- 2014 and 2015 Chairman, International Consultation on Malignant Urologic Diseases.
- 2018 Member of the Scientific Council (Medical Committee).
Over 200 publications in peer reviewed journals
Editor of numerous German and English language monographs
Photo of the doctor: (c) LMU Klinikum
Accommodation in hospital
- Program [Description]
Treatment of bladder cancer with embolization or chemoembolization
- Hospital: University Hospital of Ludwig Maximilian University of Munich
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