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Bladder Cancer — Embolization or Chemoembolization: treatment in the Best Hospitals in the World

MediClin Robert Janker Clinic

9.5/10
location_onGermany, Bonn

Department of Diagnostic and Interventional Radiology

The Department of Diagnostic and Interventional Radiology offers all modern diagnostic tests using ionizing radiation, imaging-guided tissue sampling procedures (biopsy) and minimally invasive therapeutic procedures. The patients can receive medical care both on an inpatient and outpatient basis. To achieve the optimal results, the department cooperates closely with specialists in the field of radiation therapy, oncology, neurology, neurosurgery and neuro-oncology, as well as urology, orthopedics, pain therapy and palliative care. Such collaboration helps to establish an accurate diagnosis and provide the most effective therapy.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department offers the full range of diagnostics and treatment of urological diseases in men and boys. The department employs comprehensively trained, experienced doctors, who use in their practice all the advanced medical achievements. Each patient is provided with an individual approach to therapy with due consideration of specific needs and wishes.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top medical institutions in Germany for prostate cancer treatment! The department offers the full range of high-precision diagnostics and effective treatment of diseases of the urogenital system, genitals in men and boys. It treats about 3,000 inpatients and 9,000 outpatients with the clinical cases of varying severity every year.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Urology

According to the Focus magazine, the Department of Urology ranks among the top German medical institutions specializing in prostate cancer treatment! The department offers the full range of high-precision diagnostic studies and effective therapeutic options for men with diseases of the genitourinary system. The doctors of the department specialize in the treatment of prostate cancer, benign prostatic hyperplasia, kidney, testicular cancers, urolithiasis, erectile dysfunction and urinary incontinence. There are also excellent qualifications in the field of reconstructive urology.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers all types of modern diagnostic and therapeutic services for patients with urologic diseases. Of particular interest is the treatment of urogenital tumors in men and urogynecological diseases. The department also specializes in kidney transplantation, which is carried out within the specialized center. This center is the largest in Germany and Europe and annually demonstrates high treatment success rates. In addition, the department's competence covers the treatment of urological problems in boys of all age groups.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department offers the full range of diagnostics and treatment of the urinary system in men and boys. The department has a long history, rich traditions, and is also a recognized center of excellence in the treatment of all urological diseases. The department specializes in the treatment of malignant urological diseases, reconstructive surgery, pediatric urology, treatment of urinary tract dysfunction and kidney stone disease.

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers the full range of advanced methods of diagnostics and treatment of all genitourinary system diseases, including in children. Of particular interest is the treatment of patients with urinary tract and kidney tumors, kidney stone disease, prostate diseases, treatment of urinary incontinence, andrologic disorders and urological problems in young patients. Since 2010, the department has been certified as the Prostate Cancer Center (certified by the German Cancer Society, recertified in 2016).

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Adult and Pediatric Urology, Andrology

According to the Focus magazine, the Department of Adult and Pediatric Urology, Andrology ranks among the best departments in Germany specializing in prostate cancer treatment! The department offers the full range of diagnostic and therapeutic services in the fields of its expertise. The department's medical team specializes in the treatment of diseases of the urinary tract in women and men, as well as in the treatment of pathologies of the reproductive system in adult men and children, andrological diseases in men. The primary focus of the clinical practice of the department's doctors is medical care for patients with kidney, bladder, ureteral, urethral, prostate, testicular and penile cancers. The department's specialists keep pace with medical innovations, so most surgical interventions are performed using sparing laparoscopic techniques that do not require large incisions in the skin and soft tissues. To treat prostate cancer, doctors successfully use robot-assisted prostatectomy with the da Vinci surgical system. This intervention has many advantages over classical surgery and is available only in the best hospitals in the world. In addition, the department's doctors demonstrate excellent results in the treatment of kidney stone disease, urinary incontinence and pelvic organ prolapse. A specially trained team of doctors has been formed for the treatment of urological pathologies in children. Of particular interest is the correction of congenital genitourinary anomalies in young patients.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Urology

According to the Focus magazine, the Department of Urology ranks among the top medical institutions in Germany specializing in prostate cancer treatment! The department offers the full range of diagnostics and treatment of urinary tract diseases in men. Of particular interest are kidney transplantation, treatment of benign and malignant urologic diseases. The department has become one of the pioneers in the field of minimally invasive robot-assisted surgery (da Vinci), thanks to which it has exceptional experience in this area. In addition, the department became the second medical facility in Germany, which performed kidney transplantation using a da Vinci robotic system.

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department has all the diagnostic and therapeutic options to provide first-class medical care for patients with diseases of the genitourinary system. The priority focus is reconstructive urology, in particular, the whole range of urethral surgery, procedures for the treatment of urinary incontinence (including artificial sphincter implantation, sling procedures), as well as penile surgery for congenital or acquired malformations, prosthetics in case of erectile dysfunction.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Urology

The Department of Adult and Pediatric Urology offers the diagnostics and treatment of all diseases of the urinary system organs (kidneys, ureters, bladder, urethra, etc.), as well as of the male reproductive organs in adults and children. The department specializes in the surgical and drug treatment of oncological diseases, correction of complex malformations, and plastic reconstructive urology. The department is the certified Prostate Cancer Centre.

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Adult and Pediatric Urology

The Department of Adult and Pediatric Urology provides high-precision diagnostics and effective treatment of the full range of diseases of the kidneys, urinary tract, bladder, prostate, testicles and their appendages, vas deferens and penis. The treatment of urologic cancers is of particular interest. The focus of pediatric urologists is on young patients with congenital and acquired malformations of the genitourinary system. The department has its in-house advanced operating rooms, an X-ray unit, and two stations with 57 beds. The high quality of medical care is confirmed by many prestigious certificates, including the DEKRA certificate and the certificate of the European Board of Urology. As one of the best urologic facilities in Germany and a leading urology clinic in Munich, the department has been offering patients the daVinci robot-assisted surgery since 2009, which has many advantages for patients: minimal pain, speedy recovery, the highest level of precision compared to conventional surgical interventions.

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department offers the widest range of modern diagnostic and therapeutic methods for accurate detection and treatment of diseases of the genitourinary system in men and boys. The priority focus of the department is the treatment of prostate cancer (certification of the German Cancer Society).

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German medical facilities specializing in prostate cancer treatment! The department offers services for the diagnostics and treatment of diseases of the kidneys, urinary tract and pathologies of the reproductive organs in men. The therapeutic options are complemented by the treatment of urological problems in children. The department's doctors focus on the patients with oncopathologies (prostate cancer, renal cell cancer, bladder cancer, testicular cancer). Of particular interest is minimally invasive therapy of stones in the kidneys, ureters and bladder. The doctors have in their arsenal conventional and the very latest conservative, drug and surgical therapies, which allow them to achieve the best result in clinical cases of varying severity.

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Adult and Pediatric Urology

According to the Focus magazine, the Department of Adult and Pediatric Urology ranks among the top German departments specializing in prostate cancer treatment! The department deals with the diagnostics, conservative and surgical treatment of diseases of the genitourinary system in men and boys. If necessary, surgical treatment may be provided with the use of sparing minimally invasive techniques, which allows to ensure early recovery for the patient. In the treatment of benign prostatic hyperplasia, kidney stone disease, ultramodern laser technologies are widely used. The department treats more than 1,800 inpatients and about 5,000 outpatients every year.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology is one of the best institutions of its kind in Germany and offers patients the full range of radiological studies and imaging-guided minimally invasive therapy. The department’s scope of tasks also includes imaging diagnostics in children of all age groups, detection and invasive treatment of cerebral vascular pathology (neuroradiology). Patient care is provided both on an inpatient and outpatient basis.

Bladder cancer is a severe oncological disease that often recurs after treatment. It is usually detected at an early stage, when organ-preserving treatment is possible. Nonetheless, 50% of patients sooner or later have a relapse. In 15% of patients, pathology is detected only after the development of metastases.

In the advanced stages of the disease, doctors perform more radical operations: they remove the entire bladder, lymph nodes, and surrounding tissue. However, it is not always possible to perform a surgical intervention. Sometimes patients are weakened by the disease, and in some cases the tumor grows large and becomes inoperable. In such situations, doctors resort to other treatment options, including embolization and chemoembolization of the pelvic arteries.

Content

  1. What are embolization and chemoembolization
  2. Who can be candidates for embolization
  3. How is the procedure performed
  4. Embolization results
  5. Why it is worth undergoing chemoembolization abroad
  6. Treatment in Europe with Booking Health at an affordable price

What are embolization and chemoembolization 

 

Embolization is a treatment option in oncology that involves block of the arteries feeding the tumor. They are closed with emboli. As a result, cancer cells do not receive oxygen and die quickly.

A more advanced version of this procedure is called transcatheter chemoembolization (TACE). In this case, the treatment of patients with bladder cancer involves an additional effect on the tumor with the help of chemotherapy.

The dual mechanism of action on cancer cells ensures quick results. After the procedure, bleeding stops immediately. The neoplasm is rapidly decreasing in size. In some cases, cancer treatment with TACE can bring the tumor into a resectable state.

Who can be candidates for embolization 

 

The mainstay of treatment for bladder cancer is surgery. Doctors perform organ-preserving surgery: transurethral resection. They remove tumors endoscopically and then conduct intravesical chemotherapy or immunotherapy.

With muscle invasive cancer, the bladder must be removed. This operation is called a cystectomy. In the advanced stages, other methods of treatment are used. These may be chemotherapy, immunotherapy, etc. Radiation can rarely be used. For TACE, lipiodol fat emulsion with chemotherapy drugs or drug-eluting microspheres is used. They not only clog the blood vessels, depriving the tumor of the blood supply, but also damage the cancer cells with cytostatics for several weeks.

Embolization is not the most common method for the treatment of bladder cancer. This is an advanced procedure that is technically complex. It is used by a small number of hospitals.

The technique is primarily suitable for patients with inoperable bladder cancer. The procedure is carried out for advanced disease, tumor recurrence, weakened condition of the patient, severe hematuria (excretion of blood in the urine). It shrinks swelling and stops bleeding.

How is the procedure performed 

 

An X-ray-guided intervention is minimally invasive. It is performed through transfemoral access. The doctor makes a small incision in the leg to insert a catheter into the femoral artery. The catheter is then advanced into other smaller vessels that feed the bladder.

A differentiated selection of the sizes of microcatheters and microspheres that can withstand short-term compression allows them to be introduced specifically into the vessels carrying blood to the tumor. However, transcatheter arterial embolization for pelvic tumors is a complex and often lengthy procedure. It can last up to 3 hours. With malignant pelvic tumors, the arterial blood flow is very branched, the arteries are always convoluted, often of small diameter, which leads to great technical difficulties in catheter insertion.

Despite all the difficulties, the procedure is being carried out successfully in Europe. The doctors usually manage to close the vessels feeding the tumor, avoiding serious complications.

After arterial catheterization, angiography is performed. Doctors inject a contrast agent to assess the blood supply to the bladder and the tumor. Then an embolysate is injected, which closes the lumen of the vessels. As a rule, the internal iliac artery is subject to embolization, less often the upper cystic artery and other vessels.

The doctors in Europe prefer superselective arterial embolization for bladder cancer. This means that they do not close the entire artery completely, but its small branches, located as close as possible to the tumor. This approach makes the procedure safer for the patient. Cancer cells die due to a lack of blood supply, while healthy tissue is almost not damaged.

TACE is preferred over pure embolization, as in this case an additional therapeutic effect is provided by cytostatics. In Europe, microspheres eluting chemotherapy drugs are commonly used. For pelvic neoplasms, they provide three times higher response rate to treatment than the use of oily chemoembolization.

Embolization results 

 

When treating advanced bladder cancer using chemoembolization, the following goals can be achieved:

  1. Tumor becomes resectable. If earlier its removal was considered impossible, then after reducing the size of the neoplasm, the doctor can perform a radical operation, trying to cure cancer. 
  2. Control over bleeding. In the advanced stages of bladder cancer, patients suffer from bleeding, including massive, life-threatening ones. After embolization, bleeding stops. This procedure is more effective and more selective than arterial ligation. It allows avoiding surgery, after which the patient needs to recover for a long time. In 80% of patients, the absence of bleeding persists for more than 4 months. If it recurs, embolization can be repeated.
  3. Tumor size reduction. Its reduction entails an improvement in the patient's condition, an increase in life expectancy, and the creation of conditions for the use of other treatment methods. The pressure of the neoplasm on neighboring organs decreases, so the risk of cancer complications decreases.

Why it is worth undergoing chemoembolization abroad 

 

The TACE method has been used in oncology for decades, but it is usually used to treat primary or metastatic liver neoplasms. TACE is a relatively new method for the treatment of bladder cancer. This is a technically complex procedure, and only a few hospitals can perform it.

We will select for you a medical center in Europe, whose doctors have extensive experience in using TACE for bladder cancer. Therefore, the procedure will be safe for health, with the best therapeutic result.

There are several reasons for you to undergo the TACE procedure abroad: 

  • High-precision diagnostics. It allows doctors to perfectly assess the blood supply to the bladder tumor in order to perform TACE with the best outcome. 
  • Adequate pain relief. You will not have any discomfort during the procedure. Adequate anesthetic management is very important as the operation can take 2-3 hours. 
  • Mostly drug-eluting microspheres are used instead of oily TACE. Arterial chemoembolization with microspheres is 3 times more effective. 
  • Superselective TACE performance. It is safer for health, since the embolysate is injected into small-caliber arteries located as close to the tumor as possible. 
  • Doctors use coils or a balloon catheter to protect non-target vessels from emboli penetration to reduce the risk of complications.
  • Arterial embolization for the treatment of bladder cancer can be successfully combined with other methods: surgery, chemotherapy, immunotherapy.

Treatment in Europe with Booking Health at an affordable price 

 

To undergo treatment in one of the European hospitals, please use the services of the Booking Health company. On our website, you can see the cost of treatment in different hospitals, compare prices and book a medical care program at a favorable price. Transarterial chemoembolization (TACE) in European hospitals will be easier and faster for you, and the cost of treatment will be lower.

Please leave your request on our website. Our employee will contact you and advise you about treatment in Europe. The Booking Health company will take care of the organization of your trip. We will provide the following benefits for you:

  • We will choose a hospital for treatment in Europe, whose doctors specialize in the treatment of bladder cancer and show the best results.
  • We will help you overcome the language barrier, establish communication with your attending physician.
  • We will reduce the waiting time for the start of the medical care program and book a doctor's appointment on the most suitable dates.
  • We will reduce the price. The cost of treatment in European hospitals will be lower due to the lack of additional coefficients for foreign patients.
  • We will take care of all organizational issues: documents for entering the country, transfer from the airport, hotel, interpreting services, etc.
  • We will prepare a program and translate medical documents. You do not have to repeat the previously performed diagnostic procedures.
  • We will provide communication with the hospital after treatment in Europe.
  • We will organize additional diagnostic examinations and treatment in European hospitals, if necessary.
  • We will buy medicines abroad and forward them to your native country. 
  • We will help you keep in touch with the hospital and the doctor after treatment in Europe. 

You will receive treatment from the best doctors in the world. The Booking Health employees will help reduce the cost of treatment and solve all organizational issues, and you will only have to focus on restoring your health.

Authors: Dr. Nadezhda IvanisovaDr. Sergey Pashchenko




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