Treatment of Ovarian cancer with CRS and HIPEC - hyperthermic intraperitoneal chemotherapy
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Department of Adult and Pediatric Gynecology, Mammology, Obstetrics
According to the Focus magazine, the Department of Adult and Pediatric Gynecology, Mammology, Obstetrics is included in the ranking of the top German departments specializing in obstetrics and breast cancer treatment! The department offers the full range of diagnostics and treatment of diseases of the female reproductive system, breast pathologies. Also, the specialists of the department provide a comprehensive management of pregnancy, childbirth and postpartum care for both mother and child. Key attention is paid to the treatment of female genital cancers, as well as breast cancer treatment. For this purpose, the department has all the modern therapeutic techniques, as well as its our own innovative developments by the department doctors.
Department of Adult and Pediatric Gynecology, Mammology, Obstetrics
The Department of Adult and Pediatric Gynecology, Mammology, Obstetrics offers high-precision diagnostics and effective treatment of the full range of diseases of the female reproductive system and breast pathologies. The medical facility also employs a competent team of obstetricians, whose responsibilities include comprehensive management of pregnancy, childbirth, and postnatal care for mother and baby. More than 3,000 babies are born in the department's delivery rooms annually. The department cooperates closely with the UniFee Reproductive Medicine Center, which allows gynecologists to treat female infertility together with reproductive medicine specialists. The department's gynecologists focus on women with reproductive system cancers. The medical facility is certified by the German Cancer Society (DKG) as a specialized center. The specialists also successfully treat endometriosis, one of the most common benign gynecologic diseases. In the field of mammology, priority is given to the provision of medical care to women with breast cancer. Doctors perform comprehensive diagnostics, surgical and conservative treatment, and reconstructive plastic surgery after mastectomy. The department's specialists use state-of-the-art technical resources and their professional skills to provide each patient with high-quality medical service.
Department of Adult and Pediatric Gynecology, Mammology, Obstetrics and Reproductive Medicine
The Department of Adult and Pediatric Gynecology, Mammology, Obstetrics and Reproductive Medicine offers the full range of surgical and conservative treatment of pathologies of the female reproductive system, breast, as well as top-class obstetric services, including management of birth and postnatal care for both mother and baby. The department also has a Center for Reproductive Medicine, where one can undergo comprehensive diagnostics to detect the causes of infertility and use modern assisted reproductive technologies. The department's excellent technical equipment, highly qualified medical staff and the availability of advanced treatment methods allow providing optimal and individualized treatment at the highest level. The treatment of female reproductive cancers is of primary interest to the department's gynecologists. The department also admits girls and young women with congenital anomalies of the genital organs, menstrual disorders, delayed or premature puberty.
Department of Adult and Pediatric Gynecology, Obstetrics and Mammology
According to the Focus magazine, the Department of Adult and Pediatric Gynecology, Obstetrics and Mammology ranks among the top German departments specializing in the provision of obstetric services and breast cancer treatment! The department offers all diagnostic and therapeutic options for patients of all ages with diseases of the female reproductive system, mammary gland, as well as provides the comprehensive pregnancy management, childbirth and postpartum care in accordance with the highest standards of modern obstetrics. One of the priority focuses of the department’s work is the treatment of oncopathology in women. All specialists have excellent qualifications and tremendous experience, and therefore they achieve successful results even in extremely difficult clinical cases.
Department of Adult and Pediatric Gynecology, Mammology
According to the Focus magazine, the Department of Adult and Pediatric Gynecology, Mammology is one of the best medical facilities in Germany in its areas of specialization! The department offers a full range of preventive, diagnostic, and therapeutic services for women with diseases of the reproductive system and the mammary gland. The main focus is on the treatment of oncological diseases of the female genital organs and the mammary gland within specialized centers certified by the German Cancer Society (DKG). The department has accumulated significant clinical experience in the treatment of endometriosis, uterine fibroids, cervical dysplasia, urinary incontinence, and pelvic organ prolapse. The facility is developing the direction of pediatric gynecology with an emphasis on the surgical correction of congenital defects, treatment of infectious diseases (vulvitis, vulvovaginitis, and vaginitis), vaginal bleeding, labial adhesions, and ovarian cysts and tumors. A highly professional team of gynecologists and breast specialists with many years of experience takes care of women's health. The doctors pay special attention to comprehensive diagnostics, on the basis of which they create an individual treatment plan for each patient. The specialists are proud of the excellent results of their work, achieved thanks to their professionalism and state-of-the-art technical equipment.
Department of Obstetrics, Adult and Pediatric Gynecology
According to the Focus magazine, the Department of Obstetrics, Adult and Pediatric Gynecology ranks among the top departments in Germany specializing in obstetrics and breast cancer treatment! The department offers the full range of diagnostics and treatment of diseases of the female genital organs, as well as provides first-class obstetric services, prenatal diagnostics and comprehensive management of pregnancy, including high-risk pregnancy. As part of the National Cancer Center (NCT), the department ensures an individualized, interdisciplinary treatment of female oncopathology. All the therapeutic measures carried out by the doctors of the department meet the highest international standards.
Department of Gynecology and Mammology
According to the reputable Focus magazine, the Department of Gynecology and Mammology is one of the best medical facilities in Germany for breast cancer treatment! The department offers a full range of medical services for diseases of the reproductive system and breast pathologies, with a special emphasis on breast cancer. Of particular interest to the department's team is the treatment of uterine, ovarian, and vulvar cancers, breast cancer, uterine fibroids, endometriosis, urinary incontinence, and pelvic organ prolapse. The department enjoys the status of one of the largest and most advanced gynecological centers in Germany with excellent experience in gynecologic oncology. All diagnostic and therapeutic measures comply with modern international standards. The department offers excellent services in gynecologic surgery: almost all procedures are performed using minimally traumatic endoscopic, laparoscopic, and robotic (da Vinci) techniques. The department performs about 1,300 inpatient operations and over 600 outpatient surgical procedures annually. Strict hygiene and safety standards are observed in the operating rooms. Patients of the department are guaranteed personalized medical care using modern methods with proven effectiveness.
Department of Adult and Pediatric Gynecology, Mammology, Obstetrics
According to the Focus magazine, the Department of Adult and Pediatric Gynecology, Mammology, Obstetrics ranks among the top German departments specializing in obstetrics and breast cancer treatment! The department offers the full range of services in the areas of its specialization and is one of the largest medical facilities of this kind in Germany. Of particular interest is the treatment of cancers of the female reproductive system, including breast cancer, medical care for hormonal imbalance of gynecological genesis, treatment of urinary incontinence and pelvic organ prolapse in women, top-class obstetric care and integrated pregnancy management. In addition, the department's gynecologists admit women suffering from infertility. They can undergo comprehensive diagnostics of the reproductive system and the further required therapeutic manipulations, such as uterine fibroid removal, treatment of endometriosis and other pathologies, which prevent the conception of a child. The department also specializes in the treatment of congenital malformations and acquired gynecological diseases in children. The highly qualified team of doctors with colossal experience, who keep pace with advanced innovations in medicine, take care of the patients' health. The specialists do everything possible to restore the health of patients, taking into account their needs and wishes.
Department of Obstetrics, Adult and Pediatric Gynecology
The Department of Obstetrics, Adult and Pediatric Gynecology offers the full range of preventive, diagnostic, and therapeutic services for girls and women. The department treats general gynecologic diseases, precancerous conditions, and cancers of the female reproductive system. It also provides medical care to patients with hormonal disorders caused by gynecologic diseases and infertility. The medical facility also offers top-class obstetric services for pregnancy, childbirth, and postpartum care. In addition, the department's gynecologists admit girls and young women with gynecologic problems and puberty disorders. The medical team specializes in conservative and surgical treatment, while almost all surgical procedures are performed using minimally invasive techniques. The department is awarded quality certificates for the treatment of endometriosis, cervical dysplasia, ovarian cancer, and other pathologies. More and more women entrust their health to the department's gynecologists every year, which also indicates the highest level of medical service.
Department of Gynecology and Mammology
The Department of Gynecology and Mammology provides a wide range of medical services for the diagnosis and treatment of diseases of the female reproductive system and the mammary gland. The therapeutic options of the department include conservative and surgical methods. The main focus of the department's clinical practice is the medical care for women with oncological diseases such as uterine, cervical, ovarian, endometrial, vulvar, vaginal, and breast cancer. Since 2004, the department has had the status of the Breast Center (certified by the German Cancer Society (DKG) and the German Society for Senology (DGS)). The medical facility was also certified as a Center for Gynecologic Oncology by the German Cancer Society (DKG) in 2019. The department is also certified in accordance with DIN 9001:2015 standards, which indicates the excellent quality of medical care. If surgical treatment is indicated, minimally invasive surgical techniques are used whenever possible. Surgery for cancer is usually accompanied by chemotherapy, hormone therapy, immunotherapy, and radiation therapy. Women's health is in the safe hands of highly qualified experts with extensive clinical experience and thousands of lives saved.
Department of Adult and Pediatric Gynecology, Mammology and Obstetrics
The Department of Adult and Pediatric Gynecology, Mammology and Obstetrics offers the diagnostics and treatment of all gynecological diseases. The department specializes in the treatment of breast cancer and cancer of the female reproductive organs. All traditional and modern conservative and surgical methods are used for this purpose. The department also provides reliable and individual obstetric services at the Center for Mother and Child and offers all methods of prenatal diagnostics.
Department of Adult and Pediatric Gynecology, Obstetrics and Mammology
According to the Focus magazine rating, the Department of Adult and Pediatric Gynecology, Obstetrics and Mammology ranks among the top German departments specializing in breast cancer treatment! The department offers the full range of services in these medical fields. In the field of gynecology, it provides the diagnostics and treatment of all pathologies of the female reproductive system, including the gynecological problems in girls aged from 0 to 18 years. The department's obstetricians provide quality care for expectant mothers before, during and after pregnancy. The department's scope of activities also includes the management of high-risk pregnancies. The key focus of clinical activities is the treatment of oncological diseases of the female genital organs, including breast cancer.
Department of Gynecology, Mammology and Obstetrics
According to the Focus magazine, the Department of Gynecology, Mammology and Obstetrics ranks among the top German medical facilities specializing in breast cancer treatment and provision of obstetric services! The department provides all modern medical services in the fields of its specialization. The gynecologists treat both general and oncological diseases of the female reproductive sphere. Should surgical treatment be required, minimally invasive techniques will be used. The department's mammologists specialize in the treatment of breast cancer using all the classic and innovative therapeutic options. The department is also the Level I Perinatal Center, in which the patient receives the highest quality pregnancy management, comfortable childbirth and postpartum care.
Department of Gynecology, Mammology and Obstetrics
The Department of Gynecology, Mammology and Obstetrics offers the full range of services in these fields, providing patients with the optimal treatment based on the very latest scientific advances and innovative technologies. The department's tasks include diagnostics and treatment of all gynecologic diseases and breast pathologies, as well as pregnancy management, childbirth and postnatal care for both mother and baby, elimination of fertility problems in women. The department has modern equipment for invasive and non-invasive diagnostics, three operating rooms equipped with state-of-the-art technology, especially in the field of minimally invasive and robot-assisted surgery, as well as special devices for microsurgery and fetal surgery. A competent medical team consisting of 18 senior physicians, 25 assistant physicians and medical specialists, obstetricians and specially trained nursing staff annually admits approximately 5,000 women for inpatient treatment and provides outpatient medical care for 14,000 patients. In addition, the department has four maternity rooms, in which about 2,000 babies are born annually.
Department of Adult and Pediatric Gynecology, Obstetrics
According to the Focus magazine, the Department of Adult and Pediatric Gynecology, Obstetrics ranks among the top German departments specializing in obstetrics! The department offers the full range of diagnostics and treatment of all gynecologic diseases in women and girls. The specialization includes surgical gynecology and gynecologic oncology, obstetrics and perinatal medicine, gynecological endocrinology and reproductive medicine. A special focus is made on the treatment of malignant tumors of the female reproductive organs, which is carried out within the Comprehensive Cancer Center Muenster. All the very latest and most effective treatment methods are available here.
Department of Gynecology and Gynecologic Oncology
The Department of Gynecology and Gynecologic Oncology offers the full range of modern diagnostics and treatment of various diseases of the female reproductive system. Of particular interest is the surgical treatment of malignant diseases of the female reproductive organs. The department also specializes in the conservative and surgical treatment of inflammatory processes, benign tumors. The department's doctors have in their arsenal a variety of minimally invasive surgical techniques with the use of laparoscopy and hysteroscopy, which contributes to the most sparing and safe therapeutic process. An integral part of clinical practice is urogynecology, in particular the treatment of urinary incontinence and pelvic organ prolapse.
Ovarian cancer can occur at any period of life, but it is often diagnosed in patients of 40-50 years of age. In terms of incidence, ovarian cancer ranks second in gynecologic oncology with a significant prevalence of advanced forms (75-80%).
Content
- Overview
- Symptoms
- Diagnostics
- Treatment
- Where can I undergo CRS and HIPEC treatment abroad?
- The cost of treatment abroad
- How can I undergo CRS and HIPEC treatment abroad?
CRS, cytoreductive surgery, is the removal of the ovary with lymph nodes, often the removal of the uterus and resection of affected abdominal and pelvic organs.
HIPEC, hyperthermic intraperitoneal chemotherapy, is the flushing of the abdomen with a hot solution of chemo drugs after CRS. HIPEC destroys micrometastases and improves cancer treatment outcomes.
In most women, HIPEC is performed after an open surgery, so recovery takes up to 7-10 days.
The University Hospital Tuebingen, the University Hospital Ulm and the University Hospital Carl Gustav Carus Dresden specialize in CRS and HIPEC for ovarian cancer.
For more information and preliminary consultation with a doctor, leave your contacts in the "Treatment Request" form on the Booking Health website. A consultant will contact you the same day.
The cost of ovarian cancer treatment ranges from 51,000 euros to 92,000 euros. On the Booking Health website you will find a list of specialized clinics with current prices for treatment.
Overview
The problem of an ovarian cancer diagnosis is one of the most urgent in modern medicine. Its relevance is due to the undoubted increase in mortality from this pathology, that was noted in recent decades in many countries of the world.
The majority (75-87%) of ovarian cancer patients are admitted for treatment at advanced stages of the disease, at which the 5-year survival rate does not exceed 10%. Poor prognosis of ovarian cancer is due to both the absence of specific signs of the disease and the late treatment of patients.
Symptoms
In most cases, even with advanced forms of the pathology when the cancer process spreads through the body, medical signs may include loss of appetite, weakness, nausea, and an increase in the volume of the abdomen. Clinical manifestations of the advanced forms of the disease are more pronounced than ones of the early forms. In such cases, there is abdominal bloating, especially in the upper section of the abdomen, and satiety from small portions of food, which is due to the large volume of the tumor which creates difficulties in food passing. As the tumor grows, the volume of the abdomen increases, shortness of breath develops, and a feeling of fullness arises.
With advanced forms of ovarian cancer, the menstrual cycle is disrupted, dysfunctional uterine bleeding occurs, the amount of urine decreases, and constipation occurs.
Diagnostics
The asymptomatic development of ovarian cancer at the early stages of the disease forces clinicians to develop more advanced methods of cancer detection and to single out a group of patients with increased risks. Judgments about the significance of anamnestic data in patients with ovarian cancer are heterogeneous, but summarizing them, one can find medical signs preceding the development of a tumor in the form of endocrine hormonal disorders that can manifest as:
- Later onset of menstruation
- Infertility
- Diabetes mellitus
- Early or late menopause
- Obesity
- Myoma
- Endometriosis
It should be emphasized that the risk of ovarian cancer development increases if patients have a combination of 2 or 3 signs. Therefore, in presence of risk factors, every woman should have preventive examinations at least 2 times a year. This allows detecting ovarian cancer at an early stage of the disease.
The information about a history of chronic inflammation of the uterine appendages or surgery for a benign ovarian tumor is particularly important. It is known that with unilateral removal of a benign ovarian tumor, the appearance of ovarian cancer in another ovary is very likely. Information about tumor diseases in the family is also important. All of these details should be clarified in order to recognize ovarian cancer early.
To make the diagnosis, the patients are examined using ultrasound scanning of the pelvis. The advantage of the ultrasound method in the diagnosis of ovarian cancer is its high information content, simplicity, speed, harmlessness, painlessness, the possibility of repeated carrying out, and objective documentation.
The search for tumor markers is of great importance in the diagnosis of ovarian cancer. These are specific biological substances that are produced by the tumor and can be determined by biochemical or immunological methods. Concerning ovarian cancer, the most important is the associated antigen CA-125. The level of CA-125 above 35 U/ml is found in almost 80% of patients with ovarian cancer.
Treatment
For ovarian cancer, surgery is necessary. It allows establishing the stage of the disease and removal of the tumor. And not only the tumor that has grown in the ovary or fallopian tube in the lower abdomen, but also any cancer cells that have spread outside the pelvic region are subject to removal. Surgeons try to remove as much of the affected tissue as possible so that by the beginning of the chemotherapy course the patient has only a small number of pathological cells.
With ovarian cancer, the goal of any surgery is to remove affected tissues from the abdomen and any other areas where cancer has spread. Another purpose of the surgery is to find the organs and structures affected by cancer. It is on this basis that doctors determine the stage of the disease.
Patients often hear the term "staging surgery". It indicates the surgery required to obtain information. The doctor performs a surgery, which usually removes both ovaries along with the fallopian tubes, and also performs a hysterectomy (removal of the uterus and cervix).
Cytoreductive surgery (CRS) is surgery performed to remove the maximum volume of affected tissues. Additionally, the lymph nodes are excised, which is called lymphadenectomy. It is necessary to remove the lymph nodes of the abdominal cavity, which are located near the large blood vessels that carry blood to the heart and back. The lymph nodes along these blood vessels are most often at risk in metastatic ovarian cancer, so doctors remove them during surgery. If, as a result, tumor cells are found in the removed lymph nodes, doctors can establish the stage of development of the pathology.
When doctors perform such surgery as a part of the therapy in young women, they make every possible effort to preserve ovarian function and fertility. For example, only one fallopian tube and one ovary can be removed, while the other ovary along with the fallopian tube remains in place (if it is healthy at the time of the surgery).
CRS in combination with HIPEC therapy has shown the greatest effectiveness in the treatment of ovarian cancer. Other cancer treatments using CRS and HIPEC is also effective.
Hyperthermic intraperitoneal chemotherapy is one of the most innovative methods of treatment of advanced cancer, which is also known as HIPEC or hot chemotherapy. Today, chemotherapy HIPEC is the only type of therapy in medicine that can extend the life of patients with ovarian cancer by 20-50% when other methods are ineffective.
Many types of oncology that develop in the intra-abdominal organs can affect the peritoneal cavity. This indicates that cancer has progressed significantly. In this case, intravenous chemotherapy is usually not effective enough because the drugs simply do not reach the peritoneal cavity. The only efficient treatment in this case is intraperitoneal chemotherapy which allows drugs to target tumor lesions directly.
Hyperthermic intraperitoneal chemotherapy is a three-step treatment. First of all, a cytoreductive surgery is performed, during which doctors remove all affected tissues and organs (colon, ovaries, gallbladder, part of the stomach). After that, while the patients are still under the action of general anesthesia in the operating room, it is the turn of hyperthermic intraperitoneal chemotherapy.
Cytoreductive surgery takes 6-10 hours. It is performed by experienced surgeons, and, if necessary, also by gynecologists-oncologists. At the same time, HIPEC requires long and thorough preparation, extensive experience, and well-coordinated work of a whole team of medical specialists. Radiologists, medical oncologists, pathologists, nuclear medicine specialists, nutritional experts, anesthesiologists, and nurses are also involved in patient care.
About 3.5 liters of chemotherapy drugs are injected into the peritoneal area. Their temperature is 41-43 degrees. The solution circulates for 1.5 hours, penetrating all areas and affecting the tumor cells remaining after a patient is treated surgically. The fluid is then pumped out and the abdominal cavity is closed. Cytoreductive surgery and HIPEC may also be complemented by systemic chemotherapy.
However, in some cases, hyperthermic intraperitoneal chemotherapy (HIPEC) can be performed without surgery. Drugs can be injected into the abdominal cavity laparoscopically, through catheters.
Positive effects of HIPEC for ovarian cancer treatment include:
- The drug’s even distribution over the entire inner surface of the abdominal cavity, delivering high doses of the drug directly to malignant neoplasms
- The therapeutic effect of chemotherapy drugs increases due to heating
- Better penetration of the medical substances into the affected tissues and their ability to destroy the malignant cells left after surgery
- The drug does not affect healthy organs located outside the abdominal cavity, which reduces the risk of side effects development (those noticed after a patient is treated with conventional chemotherapy)
Besides, HIPEC can be used to treat ascites (fluid accumulation in the abdominal cavity), which often develops in patients with advanced cancer. This pathological process causes bloating and leads to the spread of cancer cells in the peritoneum up to the diaphragm.
Cytoreductive surgery with HIPEC, however, is not used in patients with metastases outside the abdominal cavity (cranial, pulmonary, and bone metastases). Also, HIPEC is not used in patients with multiple, inoperable liver metastases.
HIPEC is a very complex treatment that carries higher risks compared to side effects after a tumor is treated with standard surgical procedures. Most often, patients experience temporary deterioration of gastrointestinal function. During the surgery, there is also a risk of hemorrhage, kidney failure, clots in the lungs or brain, and bone marrow damage. In this case, the mortality risk is about 0-7%.
However, given the complexity of the disease and the high mortality risks of this pathology, the surgery is more preferable. Cytoreductive surgery in combination with HIPEC and systemic chemotherapy is currently the only treatment that can prolong the patient's life and improve its quality.
Where can I undergo CRS and HIPEC treatment abroad?
Health tourism is becoming more and more popular these days, as medicine abroad often ensures a much better quality of ovarian cancer treatment.
The following hospitals show the best success rates in ovarian cancer treatment with CRS and HIPEC:
- University Hospital Tuebingen, Germany
- Memorial Sisli Hospital Istanbul, Turkey
- Medicana International Istanbul Hospital, Turkey
- University Hospital Ulm, Germany
- Rambam Health Care Campus Haifa, Israel
You can find more information about the hospitals on the Booking Health website.
The cost of treatment abroad
The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo ovarian cancer treatment with CRS and HIPEC abroad at an affordable price.
The cost of HIPEC ranges from €51.818 to €92.416 and depends on the type of cancer, the extent to which it has spread and the level of the hospital.
You also need 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 requires 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 ovarian cancer treatment and other cancer treatments using CRS and HIPEC in the best hospitals in the world. 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 undergoing ovarian cancer treatment with CRS and HIPEC safely and successfully.
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.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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