google_counter
background_img

Neuroendocrine Tumors (NETs) — Chemotherapy: treatment in the Best Hospitals in the World

MediClin Robert Janker Clinic

9.5/10
location_onGermany, Bonn

Department of Oncology and Palliative Care

The Department of Oncology and Palliative Care provides palliative treatment for patients with incurable diseases. The goal of the department's doctors is to alleviate the symptoms of the disease and improve the quality of human life. The department's specialists use an individual approach to each patient and always take into account his wishes. A competent multidisciplinary team, which consists of palliative care experts, nurses, psycho-oncologists, physiotherapists and social workers, works here for the benefit of patients.

Medias Cancer Clinic Burghausen

10/10
location_onGermany, Burghausen

Department of Oncology and Surgical Oncology

The Department of Oncology and Surgical Oncology specializes in the conservative and surgical treatment of the full range of cancers. The department is one of the leading in the field of its competence in the international medical arena and treats patients with especially complex clinical cases. The priority focuses of the department's medical team include regional chemotherapy, hyperthermia, immunotherapy, surgical oncology and pain therapy. The goal of the department's doctors is to achieve an optimal therapeutic result with minimal damage to the healthy tissues.

Memorial Sisli Hospital Istanbul

9.2/10
location_onTurkey, Istanbul

Department of Oncology

The Department of Oncology offers the full range of high-quality medical services for prevention, diagnostics and treatment of malignant tumors of various localization. With the advanced conservative and surgical methods of cancer treatment, the department has the status of one of the leading in Turkey, and is also known for its achievements in cancer treatment in Europe and the USA. The diagnostics is carried out in collaboration with the Departments of Radiology and Nuclear Medicine, which have state-of-the-art imaging systems. The specialists of the medical facility competently combine effective regimens of chemotherapy and radiation therapy with surgical interventions for tumor resection. With appropriate clinical indications, the doctors also successfully use hormonal therapy, immunotherapy, antibody therapy and targeted therapy. Depending on the particular clinical case, the aim of the department's physicians is to achieve a complete recovery or long-term remission.

Memorial Bahcelievler Hospital Istanbul

9.2/10
location_onTurkey, Istanbul

Department of Oncology and Radiation Oncology

The Department of Oncology and Radiation Oncology offers the full range of medical services for prevention, diagnostics, treatment and follow-up monitoring of cancer patients. The doctors of the clinical practice mostly use such treatment methods as surgical resection (if possible, laparoscopic and robot-assisted), various chemotherapy and radiation therapy regimens. The specialists also successfully apply hormonal therapy, immunotherapy, antibody therapy, targeted therapy and other innovative techniques. The advanced medical and technical base of the department allows the doctors to detect malignant processes in the human body at any stage, as well as effectively treat cancer, achieving a complete cure or long-term remission.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology

The Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology offers the full range of services in these fields. It provides the accurate diagnostics and effective treatment of oncological diseases, benign and malignant blood pathologies, rheumatic and infectious diseases. A separate focus of the department is palliative care aimed at relieving pain and improving the quality of life of the terminally ill patients. The doctors of the department have unique clinical skills and rich experience, which contributes to high treatment success rates.

Rambam Health Care Campus Haifa

9.8/10
location_onIsrael, Haifa

Department of Oncology

The Department of Oncology provides the comprehensive diagnostics and treatment of malignant diseases of various organs and anatomical structures at the highest level of modern medicine. The department's experienced oncologists offer innovative treatment regimens using chemotherapy and radiation therapy. Of particular interest is also the effective palliative care aimed at improving the quality of life of patients with the advanced stages of cancer. The department is certified by the European Society for Medical Oncology (ESMO) and is one of the leading specialized Israeli departments.

Medicana International Istanbul Hospital

9/10
location_onTurkey, Istanbul

Department of Oncology

The Department of Oncology offers diagnostics and treatment of the full range of malignant diseases. The department specializes in the treatment of lung, breast, prostate, stomach and other abdominal cancers, etc. The department offers the full spectrum of treatments, ranging from conservative therapy with the chemotherapeutic drugs to the very latest methods of surgical treatment and radiotherapy. Both diagnostics and treatment are conducted in cooperation with other hospital’s departments, including radiation oncology, nuclear medicine, etc.

Samsung Medical Center Seoul

9.8/10
location_onSouth Korea, Seoul

Department of Oncology and Hematology

The Department of Oncology and Hematology offers the full range of services in these medical fields. The main clinical focuses include diagnostics and treatment of various forms of oncological diseases and blood diseases. The medical team of the department strives not only to prolong the life of patients, but also to improve its quality.

 

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Hematology and Oncology

The Department of Hematology and Oncology offers the full range of diagnostics and treatment of blood diseases, coagulation disorders, oncological diseases and related pathological conditions. The treatment is provided both on an outpatient and inpatient basis. The patient is offered a comprehensive treatment, including intensive care to eliminate side effects associated with the tumor and therapy, development of individual recommendations on nutrition, physiotherapeutic measures and psycho-oncological care.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Cancer Center

The Cancer Center offers the comprehensive diagnostics, effective treatment and follow-up care for patients with cancer of varying severity. Thanks to the productive research work of the center's specialists, it offers the most modern and unique treatment methods, which have no analogues in most other countries of the world. Clinical activities are mainly focused on the treatment of breast cancer, cancer of the female reproductive organs, prostate, intestinal cancer, skin cancer, head and neck tumors, malignant diseases in children, lung, liver, stomach, pancreas cancers and neuro-oncological tumors. To ensure comprehensive medical care, there is maintained close cooperation with specialists from all related fields.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Hematology, Oncology, Adult and Pediatric Rheumatology

The Department of Hematology, Oncology, Adult and Pediatric Rheumatology offers the full range of modern diagnostics and treatment of malignant diseases, rheumatic pathologies, including particularly complex clinical cases in these fields. In addition, the department's doctors specialize in stem cell transplantation and occupy leading positions in this field at the international level. The medical team of the department makes every effort to guarantee each patient an individual, first-class treatment, based on the very latest achievements of modern medicine and human respect, understanding of the needs of each patient.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology

The Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology offers the full range of diagnostics and treatment in these fields. The department specializes in the treatment of benign and malignant diseases of the digestive system, liver and bile ducts, the hematopoietic system, etc. Much attention is paid to the interdisciplinary cooperation (Cancer Center Mainfranken, etc.).

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Oncology and Hematology

The Department of Oncology and Hematology offers accurate diagnostics and effective treatment of benign and malignant blood diseases, as well as solid tumors. The department's specialists are proud of the excellent results in the field of bone marrow transplantation, which is among the department’s priority focuses. The department has 61 beds. Medical care is carried out both on an outpatient and inpatient basis.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Oncology

The Department of Oncology offers the full range of diagnostics and drug therapy of cancer diseases. The doctors have a broad arsenal of all the very latest methods of chemotherapy, immunotherapy and targeted therapy using innovative drugs. All the necessary specialists from the related fields are involved in the treatment planning, for example, surgeons, radiation therapists, and experts in the field of radiology. Thus, the patient is provided with tailored, comprehensive medical care at the highest level of university medicine.

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Hematology and Oncology

The Department of Hematology and Oncology offers the full range of diagnostics and treatment of diseases of the hematopoietic system, such as acute or chronic leukemia, malignant lymphomas, as well as solid malignant tumors, which require chemotherapy or other systemic therapies. The department offers all systemic treatments, including bone marrow transplantation, antibody therapy. The main goal of each medical team employee is to provide patients with a competent medical care.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Hematology and Oncology

According to the Focus magazine, the Department of Hematology and Oncology ranks among the top German medical facilities specializing in bowel cancer treatment! The department offers the full range of specialized diagnostics, treatment and follow-up care for patients with oncological diseases and blood diseases. The department's doctors have in their arsenal many innovative effective methods to fight against cancer. In addition, a number of clinical trials are carried out here in order to develop the very latest targeted drugs, immunotherapy drugs, etc. All the department's specialists regularly undergo advanced training courses, which help them to keep abreast of innovations in medicine and to guarantee the best therapy result for patients.

Neuroendocrine tumors (NETs) can occur in any organs where endocrine cells are normally present: in the gastrointestinal tract, lungs, thymus, kidneys, ovaries, prostate, mammary and thyroid glands, skin. Neuroendocrine cancer is rare with usually slowly growing tumors in which a significant deterioration in the quality of life of patients, even in the presence of metastases, occurs at a late stage of the disease.

Overview

The neuroendocrine system is represented by cells located in various organs: the digestive tract, thyroid gland, adrenal glands, respiratory tract, etc. These types of cells perform regulatory functions and are also able to synthesize biologically active substances, including hormones. Neuroendocrine tumors are classified as malignant (Merkel's cancer, neuroendocrine thyroid cancer) and mixed neoplasms, for example, pheochromocytomas or carcinoids, which have the potential for malignant transformation.

Neuroendocrine tumors are functional, in other words, they are characterized by the production of hormones. For example, pheochromocytoma produces large amounts of adrenaline and norepinephrine, leading to persistent arterial hypertension that can threaten the patient's life. Treatment of neuroendocrine cancer is mainly surgical but can also include chemotherapy. Cancer treatment is complemented by measures to normalize hormonal balance, as well as – if we are talking specifically about malignant neoplasms – chemotherapy and radiotherapy.

Neuroendocrine tumors (NETs) of the abdominal and retroperitoneal organs account for about 20% of all neoplasms of the gastrointestinal tract, pancreas, and other organs, and about 2% of all malignant neoplasms. Neuroendocrine cancer’s most frequent localization is the gastrointestinal tract (about 73.7% of cases) and the bronchopulmonary system (about 25.1% of cases). Within the gastrointestinal tract, neuroendocrine cancer is localized in the small intestine (about 28.7% of cases), the appendix (about 18.9% of cases), and the rectum (about 12.6% of cases). The overall 5-year survival rate of neuroendocrine cancer patients regardless of location is about 67.2 – 82%.

Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms originating from neuroendocrine cells of the embryonic intestine with biologically active properties. Neuroendocrine cancer can occur in any organs where endocrine cells are normally present. Thus, given such a wide range of NETs, your doctor of potentially any specialty can encounter NETs in the practice (however, it should be noted that in most cases, your doctor can be unfamiliar with neuroendocrine cancer).

Of course, the question arises about the incidence of NETs. More recently, it was believed, and the majority of doctors continue to have a stable idea that neuroendocrine cancer is a rare pathology. However, data from large population studies suggest the opposite.

The approximate incidence of neuroendocrine cancer is 5 per 100 thousand people per year. Considering that the majority of neuroendocrine tumors are characterized by relatively slow growth, the true incidence is much higher and amounts to approximately 35 per 100 thousand people per year. Besides, the incidence of neuroendocrine cancer is growing significantly faster than other types of cancer. Of great interest is the fact that neuroendocrine tumors of the gastrointestinal tract are more common than cancers of the stomach and pancreas (pancreas) combined. Such a significant increase in the frequency of occurrence can probably be explained, firstly, by the improvement of diagnostic methods, in particular, endoscopic, and, secondly, by the availability of high-precision imaging methods, such as computed and magnetic resonance imaging. Considering that in the future there will be improvements in diagnostic methods, as well as their widespread introduction, it can be expected that neuroendocrine cancer will be detected even more often.

For neuroendocrine cancer, a completely different clinical course is typical, in particular, the rate of progression and response to therapy. However, there is no doubt that the earlier the diagnosis is made, the more effective the treatment will be.

This important fact is proved by data on the survival rate of patients with neuroendocrine cancer, depending on the prevalence of the disease.

Symptoms

So, the obligatory participation of the therapist in the diagnosis of neuroendocrine cancer is primarily since the clinical picture of NET corresponds to diseases from completely different disciplines. In addition to specific clinical syndromes, for example, Cushing's syndrome or acromegaly, caused by hypersecretion of cortisol and growth hormone, respectively, in most cases there are non-specific symptoms.

So, the following clinical manifestations are most common for neuroendocrine cancer:

  • Hot flashes
  • Diarrhea
  • Damage to heart valves
  • Bronchoconstriction syndrome

Rarely discussed syndromes in this cancer are:

  • Diabetes, metabolic syndrome, non-alcoholic fatty liver disease
  • Arterial hypertension
  • Neuromyopathy
  • Pigmentation, arthropathy
  • Hypoglycemia
  • Ulcerative lesion, rash
  • Mental disorders

Thus, the manifestation of NET symptoms often mimics a large number of different diseases common in the general population, the diagnosis, and treatment of which are performed by a primary care physician – your doctor. The natural development of NET is accompanied by the so-called carcinoid syndrome.

For about 10–12 years, patients with this type of NETs are diagnosed with irritable bowel syndrome, and at the time of establishing an accurate diagnosis of NET, there is already a distant spread of the disease, while we remember that the patient's survival depends on the prevalence of the process. Thus, taking into account, first, the high prevalence of NETs, which is most likely to continue to increase; secondly, a polymorphic clinical picture of NETs, which is characterized by nonspecific and widespread symptoms and syndromes in the general population; thirdly, a more optimistic prognosis with early diagnosis of NETs and prescription of therapy, your doctor plays an initiating role in the treatment of NET, the importance of which cannot be overestimated.

Diagnostics

Treatment of neuroendocrine cancer begins with diagnostics, during which the tumor is visualized, its size and localization are assessed, the histological type of tumor and the stage of cancer are established. Methods used in the diagnosis of neuroendocrine tumors include:

  • Primary examination and consultation with your doctor
  • Examination and consultation with an oncologist
  • Detailed biochemical blood and urine tests to determine the concentration of hormones or other substances
  • Blood test for chromogranin A
  • X-ray
  • PET-CT with somatostatin
  • Computed tomography, magnetic resonance imaging
  • Biopsy 

Biopsy and histopathological examination are necessary to establish whether the lesion is benign or malignant. Biopsy of neuroendocrine tumors is not always technically possible, and in such cases, the diagnosis is made based on indirect signs.

  • Immunohistochemical analysis

Neuroendocrine tumors can have several specific characteristics: genetic characteristics, the presence of certain proteins in the cell membrane, etc.

Treatment options

Chemotherapy is commonly used to treat and manage neuroendocrine tumors (NETs). Your doctor may prescribe chemotherapy for certain reasons including:

  • Control of symptoms caused by too much of certain hormones being released by a tumor (functional tumor)
  • Slowing down of the growth and symptoms of cancer
  • Destruction of neuroendocrine cancer cells
  • Relieving the symptoms of neuroendocrine cancer (palliative therapy)

Your doctor will consider your personal needs to plan the chemotherapy, doses, and schedules of treatment. Your doctor may decide on a combination of different drugs or other treatments with chemotherapy.

Chemotherapy uses anticancer drugs to destroy cancer cells. It is usually only used to treat poorly differentiated neuroendocrine tumors when other treatments don’t work or can’t be used.

Chemotherapy may be a systemic therapy, which means that the drugs travel through the blood to reach and destroy cancer cells all over the body. Chemotherapy may also be local. Local chemotherapy is given to a specific area of the body. Chemoembolization can be used to deliver chemotherapy directly to metastatic tumors.

Your doctor will choose the chemotherapy drugs or their combination depending mainly on where cancer originated. Chemotherapy drugs used alone or in combination to treat NETs include:

  • Capecitabine (Xeloda)
  • Temozolomide (Temodal)
  • Streptozotocin (Zanosar)
  • 5-fluorouracil (Adrucil, 5-FU)
  • Cisplatin
  • Carboplatin (Paraplatin, Paraplatin AQ)
  • Etoposide (Vepesid, VP-16)
  • Doxorubicin (Adriamycin)

The overall goal of the treatment of neuroendocrine cancer is to remove the primary tumor and metastases.

In the case of widespread tumor processes, the presence of metastases and recurrence of NETs, cytoreductive methods are used to reduce the tumor mass before chemotherapy.

A promising area is the study of combination therapy with chemotherapy and targeted therapy.

For patients with inoperable and metastatic NETs, peptide receptor radionuclide therapy with somatostatin analogs is preferred. The effectiveness of chemotherapy drugs differs depending on the expression of different subtypes of somatostatin receptors by NET cells and the possibility of penetration of chemotherapy drugs into the tumor tissue. The response to treatment is determined using biochemical markers (chromogranin A) and imaging techniques (CT and MRI).

Thus, the use of chemotherapy for the treatment of neuroendocrine cancer allows your doctor to effectively control the hormonal syndrome of overproduction of regulatory peptides, significantly improving the quality of life of cancer patients.

Where can I undergo treatment with chemotherapy abroad?

Health tourism becomes more and more popular these days, as medicine abroad, often ensures a much better quality of treatment with chemotherapy.

The following European hospitals show the best success rates in the treatment of neuroendocrine tumors with chemotherapy:

  1. MediClin Robert Janker Clinic, Germany
  2. Medias Cancer, Clinic Burghausen, Germany
  3. Memorial Sisli Hospital Istanbul, Turkey
  4. Memorial Bahcelievler Hospital Istanbul, Turkey
  5. University Hospital Ulm, Germany

You can find more information about the European hospitals on the Booking Health website.

The cost of treatment with chemotherapy

The prices in European hospitals listed on Booking Health are relatively low. With Booking Health, you can undergo treatment of neuroendocrine tumors with chemotherapy at an affordable price.

The cost of treatment varies, as the price depends on the hospital, the specifics of the disease, and the complexity of its treatment.

The cost of treatment with chemotherapy in Germany is 6,949 – 9,893 EUR.

The cost of treatment with chemotherapy in Turkey is 3,766 – 3,896 EUR.

You might want to consider the cost of possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment may differ from the initial price.

To make sure that the overall cost of treatment is suitable for you, contact us by leaving the request on the Booking Health website.

How can I undergo treatment with chemotherapy abroad?

It is not easy to self-organize any treatment abroad. It takes certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.

As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about the treatment of neuroendocrine tumors with chemotherapy in the best European hospitals. We will help you select the right clinic taking into account your wishes for treatment.

We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment. Our services aimed at you safely and successfully undergoing treatment of neuroendocrine tumors with chemotherapy.

Medical tourism can be easy!

All you need to do is to leave a request on the Booking Health website and our manager will contact you shortly.




Feedback of our customers from other resources

Need Help?

Thank you!

We received your treatment application in the best Europe clinics. Our manager will contact you within the next 24 hours.