Kidney Cancer (renal Cell Cancer) — Embolization or Chemoembolization: treatment in the Best Hospitals of Germany
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Department of Interventional Radiology
The Department of Interventional Radiology offers the full range of imaging examinations, as well as innovative image-guided minimally invasive techniques for the treatment of tumors, vascular diseases and internal pathologies (for example, CT, MRI, PET-CT, SPECT). The department's doctors have deep knowledge and colossal experience in the field of interventional radiological methods of treatment, which represent an excellent alternative to open surgical interventions. Despite the high level of technical equipment and the presence of advanced computerized systems, the focus is always on the person with his individual needs. Compliance with current clinical protocols and high professionalism of the department's specialists contribute to the successful clinical practice, as well as the reputability of the department among the best medical facilities of this kind in Germany.
Department of Interventional Radiology and Neuroradiology
The Department of Interventional Radiology and Neuroradiology offers a full range of advanced imaging diagnostics and minimally invasive treatments on both an inpatient and outpatient basis. The department has state-of-the-art medical equipment for imaging tests such as X-ray, computed tomography, magnetic resonance imaging, digital subtraction angiography, and mammography. The medical facility also performs many highly effective interventional therapeutic procedures under image guidance, which in many cases allow patients to avoid traumatic open surgery. For example, the department successfully performs local fibrinolysis, thrombectomy, percutaneous transluminal angioplasty, hemostasis, transarterial chemoembolization, uterine artery embolization, and other procedures. The department's neuroradiologists specialize in brain and spinal cord imaging and the treatment of central nervous system disorders. Interventional neuroradiology focuses on the treatment of carotid artery stenosis, brain aneurysms, arteriovenous malformations, dural fistulas, subdural hematomas, brain tumors, skull base and spinal tumors, and chronic back pain. The department's medical team has extensive clinical experience in their areas of expertise. The specialists are guided by the recommendations of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) and the German Society for Neuroradiology (DGNR), which helps to achieve the best results.
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.
Department of Interventional Radiology
The Department of Interventional Radiology specializes in the full range of minimally invasive image-guided interventions for diagnostic and therapeutic purposes. Diagnostic interventional procedures allow obtaining tissue samples for further laboratory tests. Most minimally invasive interventional procedures are performed for the treatment of vascular obstruction or stenosis, as well as for tumor destruction. The surgeon inserts special catheters and/or probes through small skin punctures. All surgical procedures are performed under image guidance – X-ray, digital subtraction angiography, ultrasound, CT, MRI. The specialist can clearly see all the anatomical structures and a pathological focus, thanks to which he accurately controls the delivery of the catheter to the required site and all subsequent manipulations. It is worth noting that the department was awarded the quality certificate of the German Society for Interventional Radiology (DeGIR) in 2018, which guarantees effective treatment in accordance with modern medical standards. The department's doctors have the necessary skills and qualifications, which allow them to select the best treatment option for each patient and ensure its successful conduction.
Department of Interventional Neuroradiology
The Department of Interventional Neuroradiology offers the full range of services in the areas of its specialization. The medical facility provides imaging diagnostics and low-traumatic image-guided interventional treatment of nervous system diseases. The department's specialists have rich experience and exceptional professional skills in the field of interventional procedures for acute and chronic vascular diseases, such as ischemic strokes, brain hemorrhages, cerebral artery stenosis, brain aneurysms, and vascular malformations. The department's neuroradiologists cooperate closely with neurologists and neurosurgeons so that each patient receives an optimal treatment regimen based on the expert opinions of the specialists. The department's medical team has state-of-the-art computed tomography (CT), magnetic resonance imaging (MRI), and MR angiography systems that are actively used for diagnosing patients and therapeutic procedures. Medical care is provided in compliance with current clinical protocols. The department also offers many outpatient medical services, which is an advantage for many patients.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of medical services in these fields. In order to ensure the most accurate and reliable diagnostics, the department has state-of-the-art systems for CT, MRI, PET, ultrasound and X-ray examinations, as well as PET-CT and SPECT-CT hybrid examinations. The department specializes in interventional radiology, namely, imaging-guided therapy. It performs all vascular (for example, vascular recanalization) and non-vascular imaging-guided interventions (for example, tumor ablation). The department is one of the largest and leading medical facilities of this kind in Europe.
Department of Interventional Radiology
The Department of Interventional Radiology offers a full range of modern imaging tests and image-guided therapeutic procedures. The department performs imaging examinations for patients from all departments of the University Hospital Oldenburg: X-ray, computed tomography, magnetic resonance imaging, sonography, mammography, and angiography; diagnostic examinations are performed on an outpatient basis. To ensure accurate diagnosis and effective treatment, the department has state-of-the-art medical equipment, including a 64-slice spiral CT scanner, two high-performance 1.5 Tesla MRI scanners, advanced equipment for digital subtraction angiography, pulsed fluoroscopy, and many other devices. The department's team of physicians also specializes in image-guided therapeutic interventional procedures – the treatment of vascular stenoses and occlusions, malignant tumors, and chronic back pain. Therapeutic manipulations are often performed on an outpatient basis. The department adheres strictly to radiation safety standards, so patients can expect highly effective and safe treatment.
Department of Adult and Pediatric Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Interventional Radiology, Neuroradiology specializes in modern imaging examinations and minimally traumatic image-guided interventional procedures. Of particular interest to the department's experienced medical team is individualized minimally invasive therapy for cancer and the treatment of pain syndromes and vascular pathologies. The medical facility has state-of-the-art equipment for X-ray scanning, angiography, ultrasound scanning, CT, MRI, and PET/MRI. The diagnostic devices are adapted for children, including newborns. During examinations and treatment, the department's specialists strictly meet radiation protection standards. As for treatment, special attention in clinical practice is paid to interventional procedures for vascular diseases and malignant tumors. These procedures are performed using catheter-based techniques under CT, MRI, or angiography guidance. Despite the low trauma rate of interventional manipulations, their effectiveness is comparable to full-fledged surgery. The medical facility cooperates closely with other departments at the hospital, thus providing comprehensive medical care at the highest level of university medicine. The department's successful clinical practice has been recognized by prestigious quality certificates, including the ClarZert certificate and certificates from the German Cancer Society (DKG) and the German Radiological Society (DRG).
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology provides the full range of services in these fields and specializes in conducting radiologic examinations, high-intensity focused ultrasound (HIFU) therapy, vascular, oncological, orthopedic and urologic interventions. The department includes specialized Sections for Gynecologic, Pediatric and Orthopedic Radiology.
Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology and Neuroradiology
The Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology and Neuroradiology offers the full range of modern radiological examinations and minimally invasive imaging-guided treatment of various diseases. Most often, radiologists have to deal with the diagnostics and therapy of tumors, inflammatory processes, injuries, pathologies of the heart and vascular diseases. The combination of advanced medical technologies and high professionalism of the doctors working in the department are the key to the successful treatment results.
Department of Adult and Pediatric Interventional Radiology
The Department of Adult and Pediatric Interventional Radiology provides the full range of medical services in the area of its specialization. The department offers modern diagnostic rooms with advanced equipment for imaging examinations for patients with suspected cancer, diseases of the cardiovascular system, thorax, abdominal organs, musculoskeletal system, and breast diseases. The department's diagnostic systems are adapted for examining children of different age groups. The medical facility also offers many therapeutic services, the most popular of which include MRI-guided treatment of uterine fibroids with high-intensity focused ultrasound (HIFU) and uterine artery embolization, prostate adenoma treatment with prostate artery embolization, tumor treatment with brachytherapy, percutaneous radiofrequency ablation, percutaneous microwave ablation, and transarterial chemoembolization. The doctors working at the medical facility also have rich experience in the interventional treatment of vascular pathologies and arteriovenous malformations. The department has an excellent reputation and regularly diagnoses and treats patients not only from Germany but also from other countries in the world.
Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of services in these medical fields. Here patients can undergo all modern imaging diagnostic studies and therapeutic procedures, the quality of which corresponds to high international standards. The department also specializes in conducting radiological studies in children and adolescents. The cutting-edge technical equipment and the rich clinical experience of doctors contribute to the successful work of the department.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of modern diagnostic and therapeutic procedures in this field. For this purpose, it has advanced medical equipment: magnetic resonance imaging (MRI), multispiral computed tomography (CT), duplex sonography and digital X-ray, fluoroscopy, etc. In the field of interventional radiology, the focus is on the treatment of vascular diseases, for example, the doctors of the department conduct special measures for dilating the vessels in peripheral arterial occlusive disease and closing the vessels in complicated bleedings. Also, the range of services in this field is complemented by the installation of drainage and port systems, punctures, and special percutaneous methods for tumor treatment.
Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology
The Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology offers the full range of services in these fields. It conducts all types of modern imaging studies: sonography, digital X-ray, angiography, multilayer computed tomography and conventional MRI, positron emission tomography (PET/CT), etc. The department also specializes in minimally invasive treatment of various tumors, vascular pathology (obstruction and vascular stenosis). The Section of Experimental Radiology is engaged in active research to optimize existing methods and develop new ones.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of services in these medical fields. It conducts all modern radiological examinations and imaging-guided minimally invasive interventions for the treatment of various benign and malignant diseases. A feature of the department is imaging diagnostics in children and adolescents. There are specially adapted devices with minimal irradiation for this purpose.
Department of Interventional Radiology
The Department of Interventional Radiology provides the full range of medical services in the area of its specialization. The team of the department's doctors specializes in diagnostic and therapeutic image-guided interventional procedures. The doctors have at their disposal the most advanced imaging devices, including X-ray systems, ultrasound devices, equipment for computed tomography and magnetic resonance imaging. In most cases, the department's specialists perform interventions on the vessels, and therefore doctors from the Department of Vascular Surgery are often involved in the therapeutic process. The use of state-of-the-art equipment allows the patients to get rid of pathological changes in the vessels of any part of the body, excluding open invasive surgery with its high risks. The department's medical staff has excellent qualifications and vast clinical experience, so patients confidently trust their health to real professionals.
Most malignant kidney tumors are detected at a stage when the disease can be treated with surgery. Therefore, laparoscopic partial nephrectomy or radical nephrectomy (total kidney removal) with ureterectomy (removal of the ureter) are considered the main treatments for cancer of this organ. However, in some patients, cancer is detected at an unresectable stage. This form of the disease cannot be cured, but it can be controlled for a long time by combining systemic therapy with localized procedures. One of the best treatment options in this case is chemoembolization. This is a minimally invasive endovascular procedure that is used in German clinics. It shrinks the size of kidney tumors or stops their growth. The cost of embolization or chemoembolization for kidney cancer (renal cell cancer) is between 24,500 EUR and 41,200 EUR.
Content
- The principle of the treatment method
- When can chemoembolization be used?
- How is chemoembolization performed?
- How effective is the chemoembolization procedure?
- Where can I undergo treatment?
The principle of the treatment method
Chemoembolization is a combination of two treatment methods that work through two different mechanisms:
- Embolization is the closure of the arteries supplying the tumor in order to deprive it of blood supply
- Regional chemotherapy is the delivery of chemotherapy drugs to the arteries supplying the tumor
Any malignant tumor has a very intense blood supply. The neoplasm needs a lot of oxygen and nutrients for continuous growth. Tumors therefore release growth factors that activate angiogenesis (the formation of new blood vessels). The development of new microvessels can be seen even in places where only 100-300 cancer cells accumulate.
Since malignant tumors are abundantly supplied with blood, consuming a lot of oxygen and energy, they are sensitive to deterioration of the blood supply. Arterial embolization procedures can therefore quickly shrink the size of the neoplasm and sometimes even ensure the complete disappearance of the tumor.
Embolization for kidney cancer in Germany is rarely performed as a stand-alone treatment. It is sometimes performed before kidney removal surgery in order to reduce blood loss and the severity of postoperative symptoms such as pain and hematuria (blood in the urine). However, the procedure is more often used as part of chemoembolization and less often as part of radioembolization, that is, in combination with regional chemotherapy or radiation therapy.
Chemoembolization has become a common method of cancer treatment since the 1980s, when it was successfully used for metastatic and primary liver cancer. The procedure is now used for other tumors, including kidney cancer.
It is an endovascular and radiosurgical procedure that is performed in the Department of Interventional Radiology. When performing the treatment procedure, the doctor blocks the blood vessels supplying the tumor with emboli containing drugs. Most commonly, these are lipiodol oily solutions or drug-saturated microspheres.
Thus, chemoembolization for kidney cancer in Germany works simultaneously due to the following two mechanisms: it deprives the tumor of blood supply, triggering tissue necrosis (cell death), and also damages cancer cells for a long time with chemotherapy drugs that are released from emboli.
When can chemoembolization be used?
Chemoembolization for kidney cancer is mostly used in patients who cannot undergo surgery due to contraindications or in the advanced stages of the disease. This procedure does not cure the cancer completely, but it can shrink the size of the tumor, stop its growth for a long time, and increase the life expectancy of patients. It also creates conditions for further successful systemic treatment. In addition, by shrinking the tumor, symptoms disappear and the risk of complications is reduced.
Less commonly, chemoembolization is used before surgery to reduce blood loss and lower the risk of cancer recurrence. While the reduction of intraoperative blood loss due to embolization is an established fact, the effect of this procedure on the likelihood of tumor recurrence is only suspected but not yet proven.
How is chemoembolization performed?
Chemoembolization for kidney cancer is a minimally invasive endovascular procedure that does not require a long hospital stay or rehabilitation. It is performed from inside the blood vessels through an incision in the groin area.
Immediately before chemoembolization, the doctor checks which blood vessels supply the tumor with blood. To do this, the specialist performs X-ray scanning after injecting a contrast agent into the arteries. The target blood vessels are then occluded with emboli. These may be:
- Drug-saturated microspheres, which are tiny balls containing chemotherapy drugs
- Lipiodol oily solution, which is a less effective method that occludes the blood vessels temporarily and provides a shorter duration of regional chemotherapy exposure
In recent years, physicians in developed countries have been using drug-saturated microspheres more frequently. Some of them are produced in finished form and contain chemotherapy drugs, while others are saturated immediately before the chemoembolization procedure. In the second option, the doctor can choose the drugs, which is an advantage because different patients at the time of the procedure have already undergone chemotherapy with different drugs. Tumors may already have resistance to some drugs. As a rule, microspheres for kidney cancer treatment are saturated with doxorubicin and/or platinum-based drugs (cisplatin or oxaliplatin).
Microspheres vary in diameter. Doctors use them to block blood vessels of various sizes.
Superselective chemoembolization is usually performed, which involves blocking the arteries that supply tumors. Doctors also try to minimize the impact on other arteries in order not to disrupt the blood supply to the kidney and preserve the function of the organ.
At the same time, the kidney is a paired organ, so preserving function is desirable but not necessary. There are cases when several tumors or one large tumor are found in the kidney at once. Embolization can sometimes be performed before kidney removal, which makes attempts to preserve its parenchyma pointless. In such cases, total renal artery embolization may be performed. In addition to microspheres, another embolization agent, such as polyvinyl alcohol, may be used to increase the effectiveness of the procedure.
How effective is the chemoembolization procedure?
For inoperable kidney cancer, chemoembolization is a good treatment option because it increases survival and can be used in addition to systemic drug therapy, including targeted therapy and immunotherapy.
Studies have demonstrated the high effectiveness of chemoembolization for unresectable cancer. In the work of Yonghua Bi et al., published in 2022, the treatment results of 35 patients were described. In 94% of them, the procedure was effective. Half of them achieved a partial response (tumor shrinkage by more than a third), and another half achieved disease stabilization. The median survival after the procedure exceeded 2 years.
Where can I undergo treatment?
You can undergo your kidney cancer diagnostics and treatment at a German clinic. You are welcome to check prices and make an appointment for your treatment in Germany via the Booking Health service. You can find the best hospitals for kidney cancer treatment here.
When you make an appointment through Booking Health, the cost of cancer diagnostics and treatment will be lower than when you contact the hospital directly. This is due to the absence of additional fees for foreign patients. The Booking Health specialists will help you select a hospital, arrange your trip, and provide support during your stay in Germany.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. 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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