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Appendix Cancer — CRS and HIPEC - Hyperthermic Intraperitoneal Chemoperfusion: treatment in the Best Hospitals in the World

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of General, Abdominal and Transplant Surgery

According to the Focus magazine, the Department of General, Abdominal and Transplant Surgery ranks among the best departments in Germany specializing in bowel cancer treatment! The department covers the full range of services in these medical fields and holds the leading position at the national and international level in terms of the number of surgical interventions performed and their success rate. Of particular interest are operations to treat cancer, organ transplants, as well as minimally invasive surgery.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of General, Abdominal and Vascular Surgery

According to the Focus magazine, the Department of General, Abdominal and Vascular Surgery ranks among the top German medical facilities specializing in the treatment of bowel and lung cancer! The department offers all the modern surgical options for the treatment of diseases of the abdominal cavity and blood vessels. The department's doctors have expert knowledge and vast experience in the treatment of colorectal cancer, stomach, esophageal, pancreatic cancers, liver metastases, inflammatory bowel diseases (diverticular disease, Crohn's disease, ulcerative colitis). Also, they specialize in the surgical treatment of vascular pathologies and thyroid diseases.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of General and Abdominal Surgery

The Department of General and Abdominal Surgery offers the full range of surgical treatment of diseases of the esophagus and abdominal organs, thyroid and parathyroid glands, as well as the interventions in bariatric surgery. The surgeons of the department have a deep knowledge in all open and minimally invasive surgical techniques, perform extensive operations of high complexity with maximum safety for the patient.

Tel Aviv Sourasky Medical Center

9.9/10
location_onIsrael, Tel Aviv

Department of General Surgery

The Department of General Surgery offers the full range of surgical treatment for patients. It performs both planned and emergency surgical interventions. The department is the leading medical facility in Israel, whose surgeons regularly demonstrate outstanding treatment results. The surgical interventions are performed by experienced doctors who were trained in the most famous American Medical Centers. The department's specialists prefer sparing minimally invasive interventions, which significantly shorten the hospitalization period and minimize the risks of complications.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Abdominal, Thoracic and Vascular Surgery

According to the Focus magazine, the Department of Abdominal, Thoracic and Vascular Surgery is included in the ranking of the top German departments specializing in colon cancer treatment! The department offers the full range of services in these medical fields. It provides the surgical treatment of diseases of the gastrointestinal tract, thyroid and parathyroid glands, thoracic organs and blood vessels. Special focus is on the treatment of gastrointestinal cancer. With appropriate clinical indications, preference is always given to minimally invasive surgical techniques.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of General and Abdominal Surgery

According to the Focus magazine, the Department of General and Abdominal Surgery ranks among the top German departments specializing in bowel cancer treatment! The department offers the full range of classical and minimally invasive methods for the treatment of common surgical diseases, cancer pathologies, diseases of the endocrine organs, proctological problems. The specialization also covers transplant surgery (liver, kidney and pancreas transplantation). The department is certified by the German Cancer Society for its outstanding results in the treatment of bowel, pancreatic, stomach and liver cancers.

University Hospital RWTH Aachen

9.2/10
location_onGermany, Aachen

Department of Adult and Pediatric General, Abdominal, Transplant Surgery

According to Focus magazine, the Department of Adult and Pediatric General, Abdominal, Transplant Surgery ranks among the top German medical facilities specializing in bowel cancer treatment! The department performs surgical treatment of general surgical diseases, abdominal pathologies, and also specializes in organ transplantation. Of particular interest are surgical oncology of the abdominal organs, as well as pancreatic and liver surgery. The department annually performs more than 3,000 surgical interventions, which contributes to its credibility at the national level.

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Abdominal, Thoracic and Vascular Surgery

The Department of Abdominal, Thoracic and Vascular Surgery offers all modern surgical interventions in these fields. Specialization covers the treatment of diseases of the abdominal organs, endocrine glands, pathologies of the lungs and chest wall, pathological vascular lesions of all parts of the body. In addition, kidney transplantation and pancreas transplantation are part of the surgeons' tasks. Whenever possible, operations are performed using minimally invasive techniques that have several advantages over classical interventions.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of General, Abdominal, Vascular and Endocrine Surgery

The Department of General, Abdominal, Vascular and Endocrine Surgery offers the full range of medical services in these fields. The department specializes in the surgical treatment of gastrointestinal cancers (surgical treatment of pancreatic, liver, stomach, esophageal and colon malignancies), hernia repair, treatment of gastrointestinal inflammatory diseases, endocrine surgery and surgical correction of vascular diseases and defects. The treatment of patients is carried out in close cooperation with the experts from related fields, particularly, with oncologists, gastroenterologists, radiologists, angiologists, etc.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of General, Abdominal and Vascular Surgery

According to the Focus magazine, the Department of General, Abdominal and Vascular Surgery ranks among the top German medical facilities specializing in the treatment of bowel cancer! The department offers the full range of surgical treatment of diseases of the abdominal organs and blood vessels, including the transplantation of abdominal organs. The sparing minimally invasive surgical techniques are widely used in the clinical practice, which allow to provide treatment in simple and complex clinical cases by making small incisions and using special tiny surgical instruments. The exceptional experience and profound knowledge of the department's doctors are also an integral part of the high treatment success rates.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of General, Abdominal and Transplant Surgery

According to the Focus magazine, the Department of General, Abdominal and Transplant Surgery ranks among the top German departments specializing in bowel cancer treatment! The department offers the full range of services in these medical fields and guarantees the first-class medical care at the university level. The department specializes in the treatment of diseases of the abdominal cavity, esophagus and thyroid gland, transplantation of liver, kidney and pancreas. The medical facility has won the reputation of one of the three largest and most successful Transplant Centers in Germany. Also, within the clinical practice, doctors hold highly-specialized consultations on rare diseases and provide 24-hour emergency care. 

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of General, Abdominal and Thoracic Surgery

According to the Focus magazine, the Department of General, Abdominal and Thoracic Surgery ranks among the top German departments specializing in bowel cancer treatment! The department offers the full range of surgical treatment of diseases of the thorax and abdomen, endocrine glands, blood vessels and morbid obesity. If possible, the preference is always given to sparing minimally invasive surgical techniques. The department performs more than 3,000 outpatient and about 2,600 inpatient interventions every year. The department has one of the largest interdisciplinary Obesity Centers, as well as one of three supraregional Centers for Pancreatic, Stomach and Esophageal Surgery.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of General, Abdominal, Transplant, Vascular and Pediatric Surgery

The Department of General, Abdominal, Transplant, Vascular and Pediatric Surgery covers the whole range of services in these fields. The department specializes in the treatment of diseases of the upper and lower gastrointestinal tract, liver, gallbladder, pancreas, thyroid and parathyroid glands, adrenal glands, as well as overweight. In addition, the department is a recognized Center for Vascular and Pediatric Surgery.

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of General, Abdominal, Adult and Pediatric Transplant Surgery

According to the Focus magazine, the Department of General, Abdominal, Adult and Pediatric Transplant Surgery ranks among the top German departments specializing in the treatment of bowel cancer! The department specializes in the treatment of tumors of the gastrointestinal tract, pancreas, liver, and retroperitoneal space (peritoneal carcinomatosis), liver, kidney, pancreas, bowel transplantations in children and adults, as well as the surgical treatment of obesity and general surgical interventions.

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Surgery

The Department of Surgery offers the full range of services in this field and specializes in general, abdominal, thoracic, transplant surgery. The medical team of the department, consisting of 10 specialized senior physicians, 30 medical specialists and assistant physicians, as well as highly motivated nursing staff, provides first-class treatment of tumors, inflammatory and degenerative diseases of the esophagus, stomach, intestines, pancreas, liver, gallbladder, spleen, lungs, thyroid and parathyroid glands. The department is headed by Prof. Dr. med. Helmut Friess.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of General, Abdominal and Transplant Surgery

According to the Focus magazine, the Department of General, Abdominal and Transplant Surgery is ranked among the top German medical facilities specializing in the bowel cancer treatment! The department offers the full range of services in these medical fields. The main clinical focuses include the surgical treatment of abdominal oncopathology, robotic surgery, minimally invasive surgery, endoscopy, organ transplantation and intensive care after surgical treatment. The department's doctors have special competence in the treatment of intestinal, pancreatic, stomach and liver cancers (certification of the German Cancer Society).

Appendix cancer is a rare type of oncological pathology. Less than 0.2 – 0.5% of malignant tumors of the digestive system account for appendix cancer. However, appendix tumors are characterized by a prolonged asymptomatic process of formation and a high degree of malignancy.

Overview

Appendix cancer denotes a slow-growing tumor that rarely reaches more than 2 cm in size. Appendix cancer is very difficult to detect in the early stages, so it is often detected already at 3-4 stages, when metastases to regional lymph nodes and liver, and occlusion of the appendix are observed. Much less common is appendix cancer, in which the tumor grows rapidly and gives metastases to the pelvic organs. Cancer of the appendix is most often found during the surgical removal of this appendix.

The causes that would explain the appearance of the disease have not yet been determined. However, certain factors can influence the appendix cancer appearance such as pathology of the functioning of enterochromaffin cells (happens due to increased production of serotonin); vasculitis (a process of inflammation in blood vessels); infections, which lead to disruption of the functioning of the gastrointestinal tract; excess of toxins in the body.

There are different types of appendix cancer. For example, the actual appendix cancer is a very rare form of the disease. The more common type of appendix cancer is the carcinoid tumor of the appendix (55% of the total number of carcinoid tumors of the gastrointestinal tract).

Regardless of the type of tumor, with its increase, the appendix also increases, and its lumen gradually closes, which leads to the emergence of acute appendicitis. In some cases, cancer of the appendix metastasizes to the lymph nodes and pelvic organs.

The obvious symptoms in carcinoid of the appendix when the appearance of a carcinoid stimulates increased production of serotonin, and this leads to diarrhea, redness, or cyanosis of the face, asthmatic attacks.

Symptoms

Appendix cancer in its early stages, like any other cancer, is often asymptomatic.

At the initial stages of cancer, it is important to pay attention to the following health conditions arising:

  • A feeling of discomfort in the lower right area of the abdominal cavity
  • An increase in the size of the abdomen, as well as the appearance of a hernia
  • Poor bowel permeability
  • The presence of acute and chronic pain in the abdomen

It should also be taken into consideration that in the later stages of the disease the following symptoms may occur:

  • Attacks of an asthmatic nature, which are represented by shortness of breath and difficulty in breathing
  • The presence of sharp pain in the neck and face
  • Possible compaction in the abdominal cavity
  • Various complications in the functioning of the heart

Diagnostics

The appendix cancer diagnosis is made based on the specifics of the disease in patients, determined by the laboratory and instrumental studies that include:

  • Clinical tests of urine and blood

Clinical tests of urine and blood are used as additional diagnostic methods.

  • X-ray examination

In recent years, it is rarely performed and mainly for inflammation of the appendix in children.

  • Ultrasound

Today, an ultrasound is the most common method for diagnosing appendicitis. On ultrasound, the inflamed appendix can be seen very well, whereas in a healthy condition it is difficult to see. Besides, the ultrasound will show fluid accumulation around the inflamed appendix.

  • CT scan
  • Diagnostic laparoscopy

Treatment

The common method of appendix cancer treatment, when the tumor has grown and metastasized, includes surgery usually supplemented with radiation or chemotherapy. At the best hospitals in the world, a chemotherapy method such as HIPEC is successfully used.

HIPEC – hyperthermic intraperitoneal chemotherapy is a method of treating oncological diseases of the internal organs of the abdominal cavity, even if it is a disease of advanced stage, with numerous metastases.

The HIPEC procedure is used after cytoreductive surgery. Cytoreductive surgery is a surgical method of treatment that involves partial or complete removal of the tumor. Cytoreductive surgery can be performed both after chemotherapy and before. Often, such surgery is the only method of treating inoperable tumors and a way to increase the sensitivity of the tumor to the subsequent course of hyperthermic intraperitoneal chemotherapy (HIPEC). Combining cytoreductive surgery with intraperitoneal chemotherapy HIPEC, doctors manage to achieve success in the treatment of appendix cancer patients, even in the most severe cases.

After all visible or possible neoplasms have been removed by surgery, a special sterile solution of chemotherapy drugs is injected into the abdominal cavity in compliance with the high-temperature regimen. This feature of the HIPEC allows treating patients with inoperable neoplasms, access to which is difficult. HIPEC also effectively destroys the remnants of previously removed tumors, even if the residual mass consists of microscopic cells. HIPEC is an effective procedure for patients with cancer that has metastasized to the abdominal cavity (carcinomatosis).

After performing cytoreductive surgery, during which all visible tumor formations are removed, doctors begin the HIPEC procedure. A solution of chemotherapy agents (usually cisplatin, oxaliplatin, etc.), warmed to a certain temperature (usually 40-42 degrees Celsius), which is higher than body temperature, is injected into the abdominal cavity. It is this temperature that is sufficient to effectively destroy abnormal cells. The solution is injected locally, directly into the tumor tissue, and for a short time. Therefore, HIPEC is much better tolerated than systemic chemotherapy. The solution stays in the abdominal cavity for 60-90 minutes, then it is removed, and the incision is sutured. This procedure kills all invisible cancer cells by delivering a high concentration of chemotherapy drugs directly to the area of tumor removal. Doctors can locally act on the tumor with high doses of drugs that are generally deadly if used in intravenous chemotherapy techniques. The drugs are not absorbed by the body, and therefore HIPEC does not cause side effects associated with conventional chemotherapy.

Advantages of hyperthermic intraperitoneal chemotherapy (HIPEC)

Advantages of the hyperthermic intraperitoneal chemotherapy (HIPEC) include:

  • Effectively killing abnormal cells without harming healthy tissues
  • Using highly concentrated substances exactly where they are needed – bypassing healthy vital organs
  • The ability to destroy invisible cancer cells in the tissues of the abdominal organs
  • The high temperature helps the chemotherapy penetrate deeper into the tissues and kill the invisible remnants of the tumor
  • The ability to use high doses of chemotherapy drugs, which is not possible with conventional chemotherapy
  • Unlike classical chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC) is performed once
  • High-temperature chemotherapy is metabolized differently – avoiding the usual chemotherapy side effects
  • The ability to quickly achieve the desired therapeutic effect

Where can I undergo CRS and HIPEC treatment abroad?

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

The following hospitals show the best success rates in appendix cancer treatment with cytoreductive surgery and HIPEC:

  1. University Hospital of Ludwig Maximilian University of Munich, Germany
  2. Charite University Hospital Berlin, Germany
  3. University Hospital Ulm, Germany
  4. Tel Aviv Sourasky Medical Center, Israel
  5. University Hospital Carl Gustav Carus Dresden, Germany

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

The cost of treatment abroad

The prices in hospitals listed on Booking Health are relatively low. With Booking Health, you can undergo appendix cancer treatment with CRS and HIPEC 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 of appendix cancer with HIPEC and CRS in Germany is 38,050 – 67,555 EUR.

The cost of treatment of appendix cancer with HIPEC and CRS in Israel is approximately 40,982 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 CRS and HIPEC treatment 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 cancer treatment with CRS and HIPEC in the best 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 appendix cancer treatment with cytoreductive surgery and HIPEC.

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.




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