Treatment of liver cancer with percutaneous embolization (coiling) or chemoembolization in MediClin Robert Janker Clinic
MediClin Robert Janker Clinic
Bonn, Germany
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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.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Chemoembolization <\/strong>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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\"><strong>After the first procedure<\/strong>, 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.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>clinical history taking<\/li>\n\t<li>review of medical records<\/li>\n\t<li>physical examination<\/li>\n\t<li>laboratory tests:\n\t<ul>\n\t\t<li>complete blood count<\/li>\n\t\t<li>general urine analysis<\/li>\n\t\t<li>biochemical analysis of blood<\/li>\n\t\t<li>TSH-basal, fT3, fT4<\/li>\n\t\t<li>tumor markers (AFP, CEA, \u0421\u0410-19-9)<\/li>\n\t\t<li>inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>indicators of blood coagulation<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>abdominal ultrasound\u200b scan<\/li>\n\t<li>CT\/MRI of abdomen<\/li>\n\t<li>preoperative care<\/li>\n\t<li>percutaneous embolization (coiling) or chemoembolization<\/li>\n\t<li>symptomatic treatment<\/li>\n\t<li>cost of essential medicines<\/li>\n\t<li>nursing services<\/li>\n\t<li>elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align: justify;\"><strong>During the first visit<\/strong>, 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.<\/p>\n\n<p style=\"text-align: justify;\"><strong>Chemoembolization <\/strong>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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\">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.<\/p>\n\n<p style=\"text-align: justify;\"><strong>After the first procedure<\/strong>, 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.<\/p>\n<\/div>","is_ambulant":"1","bh_fee":"0","only_for_children":"0","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"2","clinic_icon":"5ff81b474b0d4.jpg","city":"Bonn","clinic_site":"https:\/\/www.robert-janker-klinik.de\/","department_recommend":"3","country":"Germany","country_id":"1","clinic_name":"MediClin Robert Janker Clinic","cinic_name":"MediClin Robert Janker Clinic","department_id":"3870","duration":"6","direction":"Interventional radiology","min_duration":0,"clinic_id":"2596","paketPrice":3200,"paket":"<ul>\n <li> Interpreter up to 8 hours<\/li>\n <li>Translation of up to 5 pages<\/li>\n <li>Visa support<\/li>\n\n<\/ul>","title":"Treatment of liver cancer with percutaneous embolization (coiling) or chemoembolization","price":{"val":9809.560000000001,"type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"7","distance":"27","airport_title":"Cologne-Bonn"},{"id":"4","distance":"87","airport_title":"Duesseldorf"},{"id":"25","distance":"127","airport_title":"Dortmund Airport"}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}
Program id #
687506
PD Dr. med. Attila Kovács
Department of Diagnostic and Interventional Radiology
Specialized in: diagnostic and interventional radiology The program includes:
- Initial presentation in the clinic
- clinical history taking
- review of medical records
- physical examination
- laboratory tests:
- complete blood count
- general urine analysis
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- tumor markers (AFP, CEA, СА-19-9)
- inflammation indicators (CRP, ESR)
- indicators of blood coagulation
- abdominal ultrasound scan
- CT/MRI of abdomen
- preoperative care
- percutaneous embolization (coiling) or chemoembolization
- 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.
Required documents
- Medical records
- MRI/CT scan (not older than 3 months)
- Biopsy results (if available)
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About the department
The Department of Diagnostic and Interventional Radiology at the MediClin Robert Janker Clinic offers all modern diagnostic tests using ionizing radiation, imaging-guided tissue sampling procedures (biopsy) and minimally invasive therapeutic procedures. The patients can receive medical care both on an inpatient and outpatient basis. To achieve the optimal results, the department cooperates closely with specialists in the field of radiation therapy, oncology, neurology, neurosurgery and neuro-oncology, as well as urology, orthopedics, pain therapy and palliative care. Such collaboration helps to establish an accurate diagnosis and provide the most effective therapy. The Chief Physician of the department is PD Dr. med. Attila Kovács.
The doctors specializing in diagnostic radiology are responsible for the accurate and safe diagnostics using ionizing radiation systems. The key diagnostic options include magnetic resonance imaging, computed tomography, radiography and digital subtraction angiography for vascular imaging. In addition, the department's experts provide all types of biopsies, including vacuum and punch biopsy. All tissue sampling procedures are performed under CT guidance (with the exception of a prostate biopsy). The prostate tissue is taken under the guidance of MRI. The department also conducts systemic chemotherapy and immunotherapy sensitivity testing.
The department presents the widest range of imaging-guided interventional procedures. One of the most requested interventional treatment methods is transarterial chemoembolization (TACE). This is a local minimally invasive therapy used for the treatment of liver cancer and metastasis in the kidneys or thoracic wall. At the initial stages of liver cancer, a good result can also be achieved using ablation procedures. However, if the tumor has reached a fairly large size or spreaded metastasis, the patient will be prescribed transarterial chemoembolization. During the procedure, the arteries are embolized by small microspheres, which helps to stop the delivery of oxygen and nutrients to the tumor. The microspheres simultaneously direct high dose of a chemotherapeutic drug to the tumor and gradually release it. Such particles are the drug-coated granules. They allow the doctors to affect cancer cells more intensively. The department carries out two types of transarterial chemoembolization – selective for the tumor and selective for the segments of the organ. A tumor-selective type of therapy is carried out in the presence of a single metastasis in the liver, while segmental chemoembolization is performed in the case of multiple liver lesion. The advantage of this therapy is the targeted destruction of the tumor and metastasis, while maintaining healthy liver tissues.
The department's service range also includes radiofrequency ablation for the destruction of the tumor using heat. The variations of this technique are also thermal ablation and microwave ablation. However, radiofrequency ablation is the most common method of thermal tumor destruction. It is used for the treatment of malignant neoplasms and metastasis in the liver, lungs, kidneys and adrenal glands, retroperitoneal lymph nodes, bones and soft tissues. The procedure is carried out using sedation (anesthesia is not required). With CT guidance, a special probe is inserted into the body, which serves to increase the temperature of the tumor. The radiofrequency ablation allows the doctor to heat tumor cells to a temperature from 60 to 100 °C. Heat influences on the tumor until it is destroyed. The goal of radiofrequency ablation is to achieve the same result as in classical tumor removal. The best results using this technique can be achieved in tumors up to 4 cm in size or liver tumors up to 5 cm in size.
It is worth noting that the department's doctors also have excellent qualifications in kyphoplasty for the treatment of vertebral fractures (minimally invasive procedure). The kyphoplasty helps to relieve pain, and in many cases, it can completely eliminate the pain syndrome. During the procedure, the patient lies on his stomach. It lasts about 20 minutes and in most cases under general anesthesia. The essence of the therapeutic method is the introduction of a special cannula through the skin (at the level of the affected vertebra), which serves as a working channel for the introduction of the balloon. This balloon is filled with radiopaque liquid and is inflated under constant X-ray guidance. It has two functions, such as the alignment of the vertebra and the formation of a bed for the introduction of bone cement, which will help to restore the vertebra after the fracture. The kyphoplasty involves the use of a special biocement, which imitates real human bone tissue. The kyphoplasty has some risks (for example, damage to the nerve roots or the spinal cord itself), but the high professionalism of the department's doctors allows them to minimize these risks. To alleviate symptoms and strengthen the back muscles after therapeutic manipulation, additional drug therapy may be required.
The department specializes in the diagnostics and treatment of the following diseases:
- Benign pathologies
- Auditory nerve neuroma
- Arteriovenous malformations
- Systemic musculoskeletal pain syndromes
- Erectile dysfunction
- Focal cortical hyperplasia
- Benign brain lesions
- Benign prostatic hyperplasia
- Benign uterine tumors
- Varicocele
- Testicular pain
- Pituitary adenoma
- Certain types of infertility
- Focal liver formations
- Meningiomas
- Pathological vertebral fractures
- Uterine fibroids
- Malignant pathologies
- Bowel cancer
- Liver cancer, including metastatic lesions
- Kidney cancer, including metastatic lesions
- Skin cancer, including metastatic lesions
- Breast cancer
- Prostate cancer
- Soft tissue metastasis
- Other benign and malignant diseases
The department's range of medical services includes:
- Diagnostic radiology
- Biopsy (aspiration, punch biopsy)
- Systemic chemotherapy and immunotherapy sensitivity testing
- Computed tomography
- Magnetic resonance imaging
- Radiography
- Digital subtraction angiography
- Interventional radiology
- Transarterial chemoembolization (TACE)
- Thermal ablation
- Radiofrequency ablation
- Microwave ablation
- Cryoablation
- Electrochemotherapy
- Prostatic artery embolization
- Uterine artery embolization
- Kyphoplasty
- Other diagnostic and therapeutic options
Curriculum vitae
Education
- Study of Human Medicine in Kiel and Heidelberg.
Clinical and Scientific Career
- 1999 Doctoral thesis, Experimental Work on Biomechanical Support of the Heart, Department of Cardiac Surgery at the University Hospital Heidelberg. Subject: "Electron-microscopic examination of the musculus latissimus dorsi of the dog in chronic electrostimulation".
- 1997 - 2000 Work in the Department of Cardiac Surgery at the Ludwigshafen Clinic.
- 2000 - 2010 Work in the Department of Radiology at the University Hospital Bonn.
- 2005 Board certification in Diagnostic Radiology.
- 2009 Specialization in Neuroradiology.
- 2010 - 2012 Work in the Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Luebeck.
- 2011 CODMAN Prize of the German Society of Neuroradiology.
- 2012 Habilitation. Subject: "Modern non-invasive diagnostics for the planning and monitoring of interventional and surgical therapy".
Qualifications
- Medical Specialist in Diagnostic Radiology.
- Specialization in Neuroradiology.
- Certified Instructor of the German Society of Interventional Radiology and Minimally Invasive Treatment (DeGIR) in Interventional Radiology (A, B, C, D modules).
- Certified Q3 Instructor in Cardiac MRI and CT.
- Permission for advanced training courses in Radiology, Medical Association of North Rhine-Westphalia.
Memberships in Professional Societies
- German Society of Radiology (DRG).
- German Society of Interventional Radiology and Minimally Invasive Treatment (DeGIR).
- European Society of Radiology (ESR).
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
- European Society of Minimally Invasive Neurological Therapy (ESMINT).
- Radiological Society of North America (RSNA).
Photo of the doctor: (c) MEDICLIN Robert Janker Klinik
About hospital
The MediClin Robert Janker Clinic is a progressive medical facility, which has all the very latest diagnostic and treatment methods for the recovery of health of patients who suffer from cancers. The clinic was founded by renowned radiologist and surgeon Robert Janker. Today, its history has more than 80 years of successful clinical practice, which has brought worldwide fame and reputability to the medical center. The specialization of the clinic includes oncology, radiation oncology, diagnostic and interventional radiology, palliative care.
The work of the medical team of the clinic is based on the use of sparing and highly specialized therapeutic procedures. Each clinical case is individual and requires a special approach. The specialists of the medical facility guarantee their patients not only the most effective treatment, but also top-class medical care, respectful attitude and understanding of the needs and wishes of each patient.
The patients can receive medical care both on an inpatient and outpatient basis. The doctors of the clinic cooperate closely with many specialized Cancer Centers in Germany, as well as with many private practitioners. Along with conventional cancer treatments, the clinic also offers an individual counseling, psychological support, social care and other related activities.
The outstanding quality of the diagnostics and treatment is confirmed by certification in accordance with DIN EN ISO 9001: 2015 standards. In addition, the clinic is certified by the German Cancer Society. The clinic is also a certified cooperation partner of the Cancer Center Bonn-Rhein-Sieg.
Photo: (c) MEDICLIN Robert Janker Klinik, (c) depositphotos
Accommodation in hospital
Patients rooms
The patients of the MediClin Robert Janker Clinic live in modern and comfortable rooms. Each room is equipped with an ensuite bathroom with shower and toilet. The standard room includes a comfortable automatically adjustable bed, a bedside table, a table and chairs for receiving visitors, a wardrobe for storing clothes, a radio, a TV and a telephone (additional charges apply for using a telephone and a TV). The patient rooms also have WI-FI.
The patients with disabilities are accommodated in specially equipped rooms. The clinic also provides single enhanced-comfort rooms of a five-star hotel level.
Meals and Menus
The patients of the clinic are offered healthy and varied diet. The wishes and needs of the patient are always taken into account. The patients have a choice of several daily menus, particularly, a full menu, a basic menu, both diet and vegetarian menus. Breakfast and lunch are served in the cafeteria of the clinic, while dinner is served in the patient room.
The patients who live in enhanced-comfort rooms are offered an individual menu. In addition to breakfast, lunch and dinner, the patient is additionally provided with coffee and delicious cakes, fruit in the room.
Further details
Standard rooms include:
Toilet
Shower
Wi-Fi
TV
Religion
Religious services can be provided upon request.
Accompanying person
During an inpatient program, an accompanying person can stay with you in the patient room or in a hotel of your choice.
Hotel
During the outpatient program, you can stay at a hotel of your choice. Our managers will help you choose the most suitable option.
