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Colon 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).

Colon cancer occupies one of the leading places among all malignant tumors. Currently, there is a steady increase in both morbidity and mortality rates from intestinal cancer. 

Overview

Colon cancer is the second most common cancer that affects mainly the elderly.

Colon cancer is represented by benign and malignant neoplasms, different in shape, localization, and histological structure. Typically, the disease begins with small, benign polyps that form on the inside of the colon. Over time, polyps can develop into a malignant tumor.

Benign colon tumors can be asymptomatic and are often detected by doctors during a general diagnostic examination.

Also, signs of benign colon tumors are diarrhea, abdominal pain, and blood in the stool. Villous tumors can lead to anemia. Large benign formations also cause intestinal obstruction.

Blood in the stool without mucous impurity content manifests itself as a tumor of the sigmoid colon. The pathology of the descending colon is evidenced by dark mucous content. In malignant formations of the proximal intestine, bleeding, often latent, is expressed only in anemia. Also, symptoms of colon cancer can be a false urge to egest, which are caused by spasms of the anus sphincters. In the later stages of tumor formation, constipation and intestinal obstruction appear. There may also be a feeling of incomplete defecation. Besides, in patients with colon cancer, symptoms such as decreased appetite, weakness, and sudden weight loss are noted. As the disease progresses, the liver enlarges, and an accumulation of fluid in the abdominal cavity appears.

If benign tumors in patients are detected early, they can be removed during the colonoscopy and the risk of cancer can be reduced. Therefore, even for healthy people under the age of 50, doctors recommend regular screening tests. If colon cancer has developed, there are currently many treatments for it.

Symptoms

Patients with colon cancer often experience the following symptoms:

  • Increased fatigue and weakness, irritability, decreased appetite, bad breath, sleep disturbances
  • Nausea, vomiting, increased bloating, abdominal pain, a feeling of heaviness in the epigastric region
  • Increased gas production, diarrhea or constipation, periodic severe abdominal pain
  • Blood presence in the stool
  • Constant sharp pains in the rectal area, lack of physiological relief after defecation
  • General weakness, increased fatigue, low-grade fever, anemia, weight loss

Diagnostics

If colon cancer is suspected, patients are often referred to undergoing the following examinations:

  • Blood tests ( general blood test, liver enzyme and tumor markers CEA and CA19-9)
  • Fecal test

It helps to detect minor blood contents in the stool (used as a screening test for the early diagnosis of colon cancer)

  • Colonoscopy

During the procedure, which is usually performed under sedation, an endoscope (a thin optic probe with a camera) is inserted through the rectum into the colon and the doctor is allowed to visually examine the intestinal cavity. If polyps are found, they are usually removed. Also, a biopsy is sometimes done during a colonoscopy. For patients over 50, colonoscopy is recommended every 5-10 years.

  • Virtual colonoscopy

This innovative examination uses a CT device to simulate images of the colon and abdomen.

  • CT or MRI

With these diagnostic methods, doctors obtain detailed images of the body's soft tissues; these studies are carried out to detect metastasis.

  • PET scan

Radioactive sugar is injected into the blood during the procedure. Fast-growing cancer cells absorb more sugar than healthy cells. Thus, a larger amount of radioactive substance accumulates in the tumor tissue, and a special camera provides detailed images of these areas. Based on this, doctors identify the localization of tumor cells in patients.

Treatment

The main treatment for patients with colon cancer is surgery. Improvement in the surgery technique and anesthetic management made it possible to reduce the number of complications and postoperative mortality. Previously, complex chemotherapy was used to treat patients with metastatic colon cancer, the effect of which, unfortunately, did not significantly prolong the life of patients. The problem is that metastases in the peritoneum don’t have powerful blood supply as, for example, the liver. Because of this, the effectiveness of chemotherapy drugs decreases.

The achievement of recent years in the field of oncological practice is the techniques of surgery conducting with the opening of the abdominal cavity (laparotomy), removal of neoplasms visible (cytoreductive surgery), and subsequent rinsing of the abdominal cavity with a hot solution of modern chemotherapeutic drugs. The innovative technique, called hyperthermic intraperitoneal chemotherapy (HIPEC), has already become widespread all over the world.

The goal of cytoreductive surgery is the removal of all tumor foci detected in the patients, including the primary tumor and distant metastases. When planning cytoreductive surgery in patients with multiple locations of the metastases, the development of surgery tactics should be carried out for patients individually at a consultation with surgeons, radiologists, and chemotherapists, taking into account various prognostic factors.

The advantage of hyperthermic intraperitoneal chemotherapy (HIPEC) is the injection of the anticancer drugs directly into the abdominal cavity at significantly higher dosages, which ensures their higher concentration in the affected tissues with minimal risk of complications. The use of high temperature, to which malignant tumor cells are more sensitive than unaffected tissues, enhances the therapeutic effect. HIPEC can deliver drug doses 20 times higher than conventional chemotherapy. And high temperatures enhance their action and at the same time damage tumor cells at the DNA level, disrupting the process of their recovery.

At the first stage of intraperitoneal chemotherapy HIPEC, cytoreductive surgery is performed, which includes partial removal of most of the tumor. Cytoreductive surgery is relevant in cases where the removal of the entire lesion is impossible. Then the patients are injected with a solution of chemotherapy drugs warmed up to 42 degrees Celsius. The abdominal cavity is thoroughly washed after the cytoreductive surgery, after that the chemotherapy drug is drained, and the peritoneum is sutured.

Most often, the method of HIPEC is used in the treatment of tumors of the gastrointestinal tract – stomach cancer, pancreatic cancer, colon cancer, peritoneal mesothelioma, metastases in the abdominal cavity from other types of cancer.

In general, the result of hyperthermic intraperitoneal chemotherapy (HIPEC) largely depends on the form of the malignant oncological process and the degree of tumor cells’ spread, and the more limited it is, the more possible performing the HIPEC becomes.

In terms of contraindications the most common are: the presence of numerous distant, localized far from the abdominal cavity metastases (in the lungs, bones, brain), extensive damage to the peritoneum, involvement in the process of vital organs, and a pronounced deterioration in the general physical condition of patients.

Unfortunately, not every patient can be prescribed HIPEC. In each clinical case, the question of the expediency of this procedure is decided for patients on an individual basis.

However, with HIPEC, doctors are saving the lives of patients in situations that were previously considered hopeless. It is particularly effective in the treatment of peritoneal carcinosis (on the spread of cancer cells to the peritoneum). At the same time, HIPEC is especially effective in ovarian cancer and tumors originating from the appendix (pseudomyxoma peritonei). It also gives good results in peritoneal carcinomatosis regarding colon cancer, some types of stomach cancer, and cancer of the small intestine, with peritoneal mesothelioma and primary adenocarcinoma of the peritoneum.

Besides, the HIPEC method can be used as a kind of palliative measure, pursuing its goal not to completely heal the patient (for example, with advanced stages of cancer), but to eliminate complications of the disease.

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 colon cancer treatment.

The following hospitals show the best success rates in colon cancer treatment with CRS 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 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 colon cancer treatment with CRS and HIPEC at an affordable price.

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

The cost of treatment of colon cancer with HIPEC and CRS in Germany is 38,154-67,436 EUR.

The cost of treatment of colon cancer with HIPEC and CRS in Israel is approximately 41,292 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 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 shift some responsibility onto a medical tourism agency.

As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about colon cancer treatment with CRS and HIPEC in the best hospitals. Therefore, 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 with cytoreductive surgery and HIPEC.

Medical tourism can be easy!

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




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