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Stomach 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).

Stomach cancer is a malignant tumor that occurs in the stomach tissues. Most tumors are formed from the inner layer (stomach lining), which normally produces mucus and gastric juice. These tumors are called adenocarcinomas, and they account for about 90% of all gastric malignancies.

Stomach cancer overview

Stomach cancer can occur in various parts – in part of the junction of the esophagus and stomach, in the fundus of the stomach, in its main part (body), and in its outlet. Depending on the location of the tumor, different symptoms occur.

A tumor in the stomach can interfere with digestion; prevent food from passing into the lower parts of the digestive tract. A cancerous tumor growing into the wall of the stomach can spread to other organs – to grow into the colon and pancreas. When a tumor is located near the esophagus, it can disrupt the passage of food into the stomach. As a result of all this, weight loss occurs followed by physical exhaustion. The tumor can spread through the lymphatic and blood vessels to other organs (liver, lungs, brain, bones, etc.).

Causes

The leading oncologists around the world are looking for the answer to what causes stomach cancer, but the reliable causes of the appearance of malignant neoplasms of the stomach have not yet been found. However, to date, the conditions that affect the appearance of cancer cells in the gastric mucosa are well studied.

As with other malignant neoplasms, there is no one specific cause or predisposing medical factor that causes the development of stomach cancer.

Nutrition is of great importance. Excess starchy foods, a low intake of fresh vegetables and fruits, a lack of animal protein in the diet, and an excess of animal fats contribute to the development of the disease. A negative role is played by alcohol abuse, smoking, irregular eating, poor chewing of food.

Undoubtedly, the presence of chronic stomach diseases plays an important role. With the prolonged existence of a chronic inflammatory process in the gastric mucosa (chronic gastritis), in the presence of gastroduodenal reflux, when the contents of the duodenum and bile are thrown into the stomach, the background for the growth of malignant tumors is created. Often polyps, which can transform into a malignant form, lead to stomach cancer. Therefore, timely treatment of these diseases is of high importance in the prevention of stomach cancer.

Symptoms

Stomach cancer has no significant symptoms in its early stages. Signs of stomach cancer are mistaken for other diseases, such as gastritis. But an exacerbation of gastritis leads few people to a doctor’s office. Unpleasant sensations are removed with available medicines and patients hope that the health condition will recede. But if the patient notices that they are getting tired quickly, have lost a lot of weight, and are constantly experiencing discomfort in the stomach, the patient should consult an oncologist.

The manifestations of progressive stomach cancer are highly dependent on the location of the tumor. If it is located in the upper section, when the esophagus passes into the stomach, dysphagia appears – difficulty swallowing. If the tumor is located in the lower part of the stomach, during the transition to the duodenum, vomiting the food that has just been eaten can occur. Also, severe heartburn and abdominal pain that does not go away become constant.

Even if it seems that "it hurts slightly", or "you have to be patient, and it will go away", do not take risks, and if you experience the following symptoms, immediately consult a doctor:

  • Increased fatigue
  • Severe unintentional weight loss
  • Constant discomfort in the stomach and abdomen
  • Difficulty swallowing food
  • Constant abdominal pain
  • Frequent vomiting
  • Constant severe heartburn

Diagnostics

A patient with suspected stomach cancer can be prescribed a set of diagnostic tests, both laboratory and instrumental.

The EGD is an endoscopic procedure that is usually primarily prescribed for the diagnosis of gastric oncology. To examine the insides of the organ, the doctor uses a flexible tube with a high-resolution video camera; the video is displayed on the screen in real-time. If during the examination, the doctor sees pathological changes in the walls of the stomach, then he takes samples of suspicious tissues for further laboratory analysis.

In addition to the endoscopic examination, radiography with a contrast agent, laparoscopic diagnostics, and various types of tomography is used to confirm the diagnosis. Computed tomography and MRI for stomach cancer allow specialists to get a complete picture of the development of the disease and the pathways of its metastasis; during positron emission computed tomography (PET CT), the doctor receives information about cancer cells at the molecular level.

Based on the research results obtained, the team of the leading oncologists of the hospital determines the further tactics of treating the patient.

Treatment

The main and practically the only method of radical treatment of stomach cancer is surgery. However, despite the improvement of surgical techniques, the prognosis of surgery only in the treatment of common forms of the disease remains unsatisfactory. As shown by the multivariate analysis in surgical oncology among patients operated on for stomach cancer, independent risk factors for cancer recurrence are an undifferentiated tumor type and germination of the serous membrane of the stomach that is inefficiently treated with surgery.

In the last 15 years, interest has increased in the study of the effectiveness of intraperitoneal administration of chemotherapy drugs for stomach cancer treatment. As a result, the use of hyperthermic intraperitoneal chemotherapy HIPEC has become widespread.

Hyperthermic intraperitoneal chemotherapy (HIPEC) aims to affect macro- and microscopic metastases, free tumor cells in the peritoneal fluid. Hyperthermic intraperitoneal chemotherapy (HIPEC) is indicated not only for palliative surgery procedures that leave metastases on the peritoneum but also for cytological detection of tumor cells. A number of specialists in surgical oncology expand the indications, considering it necessary to use it in the treatment of stomach cancer and in all cases of tumor germination of the serous membrane of the stomach.

Conventionally, the HIPEC procedure can be divided into intraoperative and postoperative. Hyperthermic intraperitoneal chemotherapy (HIPEC) was initially used in the form of a single injection of a chemotherapy drug into the abdominal cavity at the final stage of the surgery, and then intraperitoneal administration of chemotherapy drugs began to be used in the postoperative period in the form of multi-day courses. Now, many specialists in surgical oncology consider the administration of drugs during surgery in combination with hyperthermia the most effective method of stomach cancer treatment.  For a longer and more uniform flow of chemotherapy drugs into the abdominal cavity, special dosage forms of anticancer drugs have been created for HIPEC that provide their prolonged action.

Currently, HIPEC is rarely performed with a single drug. The advantage of polychemotherapy is confirmed by different studies in surgical oncology. Patients operated for stomach cancer with further infiltration of the heated chemotherapy drugs, eventually, show the best survival rates.

In surgical oncology, some doctors practice the combination of HIPEC and systemic chemotherapy for stomach cancer treatment. Among patients who had metastatic lesions of the peritoneum, a significant improvement in survival was noted in the case of a combination of HIPEC and systemic additional chemotherapy.

A surgical oncology practice indicates low toxicity of HIPEC, the possibility of obtaining with its help a positive effect of treatment of stomach cancer patients. Some studies show the relatively long survival of stomach cancer patients who were treated with HIPEC.

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 stomach cancer treatment.

The following hospitals show the best success rates in stomach 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 they provide 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 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 stomach cancer with HIPEC and CRS in Germany is 38,211 – 67,817 EUR.

The cost of treatment of stomach cancer with HIPEC and CRS in Israel is approximately 40,422 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 in the world. 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 stomach 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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