Liver Cancer Treatment by Percutaneous Embolization (coiling)
Prof. Dr. med. Thomas Vogl is Professor and Head of the Department of Adult and Pediatric Diagnostic and Interventional Radiology at the University Hospital Frankfurt-am-Main. He conducts online consultations about the possibility of treatment of stage 4 cancer in Germany.
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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 all modern methods of high-precision imaging diagnostics and minimally invasive imaging-guided therapeutic procedures. The department meets all radiation protection standards, which are especially important in the diagnostics of children and adolescents. The basis of successful clinical practice of the medical facility is a progressive technological base and the best highly qualified specialists.
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.
Department of Diagnostic and Interventional Radiology, Nuclear Medicine
The Department of Diagnostic and Interventional Radiology, Nuclear Medicine offers the full range of diagnostic and therapeutic procedures in the areas of its specialization. The department has high-tech equipment for all types of modern imaging tests, image-guided therapeutic procedures, as well as radioisotope examinations and treatment of thyroid diseases using radioiodine therapy. The patients are provided with both inpatient and outpatient medical care. However, hospitalization is usually required only in the case of complex therapeutic interventions. The patients' health is in the good hands of the highly qualified doctors. The specialists regularly undergo advanced training courses, attend medical congresses and symposia, where they find out about innovations in the area of their specialization and share their experience with colleagues. To provide maximum safety for patients, the department strictly adheres to radiation protection standards.
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 Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of modern radiological diagnostics and minimally invasive treatment both on an inpatient and outpatient basis. It has advanced equipment for conducting radiological studies in adults and children, as well as minimally invasive procedures under the guidance of imaging systems. There is maintained close cooperation with many departments of the hospital, which provides an interdisciplinary approach to treatment and comprehensive medical care.
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 Neuroradiology
The Department of Neuroradiology provides the full range of diagnostic and therapeutic services in the areas of its specialization. The team of the department's doctors deals with the diagnostics and treatment of brain and spinal cord pathologies. The department has at its disposal state-of-the-art medical equipment, including systems for CT, MRI and myelography, thanks to which specialists can comprehensively assess the state of the nervous system, detect pathological processes at the initial stages and provide effective treatment. Among the department's therapeutic options, a special focus is on the interventional treatment of acute stroke – thrombectomy. Another important focus of the specialists' work is the treatment of cerebral vascular malformations, stenosis of the arteries of the brain and spinal cord, and cerebral aneurysms. In addition, the department provides CT-guided interventional pain management to relieve chronic back pain. The department's neuroradiologists cooperate closely with doctors from the related medical specialties: neurologists, neurosurgeons, ophthalmologists, otolaryngologists and radiation therapists. The specialists strive to provide each patient with high quality medical care meeting his needs and wishes.
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. To ensure the accurate diagnostics and effective treatment, the department has state-of-the-art medical equipment, particularly 64-slice CT scanner, two 1.5 Tesla high-performance MRI devices, modern equipment for digital subtraction angiography (DSA), pulsed fluoroscopy and many other devices. All medical services are carried out in strict accordance with the protocols of professional societies.
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 Clinical and Interventional Neuroradiology
The Department of Clinical and Interventional Neuroradiology offers the full range of services in the relevant medical fields. It provides high-precision diagnosis and effective treatment of diseases of the central nervous system, that is, the brain and spinal cord, meninges and vessels that supply these organs.
Department of Interventional Radiology
The Department of Interventional Radiology conducts high-precision imaging diagnostics of all the organs and anatomical structures of the body, and also offers many interventional image-guided therapeutic procedures. Particular attention is paid to angiography to assess the state of the vascular system and patency of the blood vessels, skeletal X-ray scanning and comprehensive diagnostics of oncological diseases. The department cooperates with the specialists from all medical fields of the hospital, providing them with its technical resources for examining their patients. The department's doctors also specialize in image-guided interventional minimally invasive procedures for the treatment of certain diseases, such as vascular pathologies. The doctors of the medical facility work on state-of-the-art equipment, which guarantees a high safety of manipulations and a compliance with radiation protection standards. The department's patients most often undergo their diagnostic examinations and treatment on an outpatient basis, which is an indisputable advantage.
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 Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of services in the areas of its specialization. The department has state-of-the-art equipment, thanks to which doctors successfully carry out imaging diagnostics allowing them to determine the diagnosis as accurately as possible and develop the most effective treatment regimen. The department performs X-ray studies, ultrasound scanning, computed tomography (CT), magnetic resonance imaging (MRI), angiography, mammography and a combined method of computed tomography with positron emission tomography (PET-CT). Cardiac CT and MRI are also carried out in cooperation with the Department of Cardiology. The department is one of the few medical facilities of this kind in Germany specializing in the imaging diagnostics in children. The range of the department's services is complemented by minimally invasive image-guided therapeutic procedures. In the field of interventional radiology, the focus is on the treatment of pain syndromes, vascular diseases, benign and malignant tumors, as well as metastases. The department's radiologists strictly adhere to the radiation protection standards, so all diagnostic and therapeutic procedures are absolutely safe for patients.
Department of Diagnostic and Interventional Radiology
The Department of Diagnostic and Interventional Radiology offers the full range of image-guided diagnostic and interventional therapeutic procedures at the highest level of modern medicine. Medical care can be provided both on an inpatient and outpatient basis. The department's specialists annually perform more than 70,000 diagnostic tests, and therefore they have tremendous experience and guarantee an accurate diagnosis, which determines the success of follow-up treatment. Radiologists have state-of-the-art systems for digital radiography, digital fluoroscopy, sonography, mammography, computed tomography, magnetic resonance imaging, angiography and other examinations. The doctors use in their work a modern picture archiving and communication system, thanks to which the specialists from various departments of the hospital have access to the results of patient's diagnostic examination at any time. The radiation protection standards are strictly observed in the department's clinical practice.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of imaging diagnostic tests and image-guided interventional therapeutic procedures. Medical care is provided on an inpatient and outpatient basis. The team of the department's doctors provides its services to both adults and young patients. The department has at its disposal high-tech equipment, which allows the doctors to detect the slightest impairments in the anatomical structures of the human body. The diagnostic results are considered at regular boards with the participation of all necessary specialists in related fields. In addition, the department uses an innovative system for storing and managing diagnostic data, allowing doctors in all departments to have unhindered access to the patient's imaging results at any time. The department's radiologists strictly adhere to the current radiation protection standards, and therefore the radiation has a minimal effect on the human body.
Liver cancer is a malignant tumor of the liver that develops from its structures under the influence of various factors. Percutaneous embolization (coiling) allows depriving the primary tumor and metastases from nutrients due to the blood flow blockage. The procedure is minimally invasive and is associated with lower risks compared to the conventional surgery.
Content
- Overview
- Stages
- Symptoms
- Diagnostics
- Treatment
- Where can I undergo percutaneous embolization (coiling) abroad?
- The cost of treatment abroad
- How can I undergo percutaneous embolization (coiling) abroad?
Overview
Liver cancer is one of the leading causes of death in oncological practice. A liver cancer diagnosis indicates that some healthy cells of this vital organ have turned into tumor cells. Liver cancer can be both primary (that is, it appears and develops directly in the liver), and secondary (in this case, liver cancer appears due to the metastases of other tumors in the body that enter the liver via blood or lymphatic vessels). Liver cancer caused by metastases develops much more often than primary tumors. This is due to the peculiarities of blood circulation and liver function. As a rule, metastatic liver cancer is more dangerous than the primary tumor itself.
Primary liver cancer has the following types: hepatocellular carcinoma, angiosarcoma, hepatoblastoma, hemangiosarcoma, and cholangiocarcinoma.
Liver sarcoma is a rare and dangerous health condition. The tumor develops very quickly, spreading to nearby organs. A feature of sarcomas is their occurrence mainly in young people and children. In particular, angiosarcoma of the liver is a rare form of a malignant tumor. The neoplasm has an aggressive course, with very rapid growth, and a high frequency of metastasizing.
Cholangiocarcinoma, or bile duct cancer, can develop both in the area of the liver and outside the organ. A tumor can form anywhere in the bile duct. Depending on the localization of the formation, there are three groups of neoplasms, including cancer of the intrahepatic ducts, cancer of the bile duct in the area of the porta hepatis, and cancer of the distal bile ducts.
The causes and mechanisms of the development of liver cancer have not been sufficiently studied yet. The influence of geographic location, climate, diet, and certain medications were studied. In patients with alcoholism, primary hepatic cell carcinoma often develops on the background of cirrhosis. Liver cancer can develop at any age, although more often it is found in patients over 40.
Some of the risk factors of developing liver cancer include:
- Chronic hepatitis B and C (hepatitis B and C are detected in 80% of patients with liver cancer)
- Cirrhosis of the liver
- Alcoholic and drug hepatitis
- Regular intake of carcinogens in food
- Cholelithiasis
Stages
The first stage of liver cancer involves the formation of the tumor itself. At this stage the tumor has not had time to spread, to penetrate the vessels. At this stage, liver cancer has no metastases. It is rather difficult to diagnose a tumor at this stage of liver cancer, since the symptoms are virtually absent. For this reason, it is advised to undergo a full medical examination every six months.
At the second stage of liver cancer, the tumor increases in size significantly and affects the blood vessels. Pain sensations appear which increase even with minor loads.
The third stage of liver cancer is more severe. This stage of the development of oncology has very poor perspectives for treatment. It is subdivided into three stages: 3A (the tumor has grown around the hepatic vein), 3B (liver cancer has spread beyond the liver), 3C (malignant cells have spread to the lymph nodes; liver cancer has metastasized to other organs).
The fourth stage of liver cancer is the most severe since this is the advanced stage. Usually, at this stage, the tumor grows to half of the size of the liver or bigger, and metastases spread throughout the body.
Symptoms
Liver cancer has certain symptoms. It is true though, that at the early stages it is extremely difficult to determine. The primary and secondary types of malignant tumors have identical signs of liver cancer. Therefore, if this disease is diagnosed, a mandatory examination of other organs of the abdominal cavity is carried out.
The symptoms of liver cancer are non-specific and usually can be easily confused with other diseases of this organ (with gallstone disease or exacerbation of chronic hepatitis). Still, at early stages patients can experience:
- Bloating and discomfort
- Diarrhea or constipation
- Nausea, which may be accompanied by vomiting (this is one of the most common symptoms in liver cancer)
- Decreased appetite
- Constant feeling of tiredness and malaise
- Chills and fever are sometimes the signs of liver cancer
These are the most common symptoms of liver cancer.
Diagnostics
In the best hospitals in the world modern methods of diagnosing liver cancer that meet international medical standards are used such as:
- Ultrasound scanning. Ultrasound examination can detect the tumor and in some cases suggest its type.
- Tumor biopsy. Tumor biopsy is the most reliable method for diagnosing liver cancer. As a rule, a thin long needle is used, which is inserted through the skin directly into the tumor area under the control of an ultrasound monitoring. If cancer cells are found during the examination of the harvested tissue under a microscope, the diagnosis of liver cancer is confirmed.
- Computed tomography (CT). Computed tomography (CT) is very effective in diagnosing liver tumors, as it can detect even small neoplasms that are invisible during the ultrasound scanning. To improve the image informativeness, a CT scan with contrast is sometimes performed. A contrast agent is injected intravenously, which makes it possible for specialists to study the location of blood vessels in the liver. During computed tomography, the machine takes images of liver sections, which allows specialists to carefully examine the structure of the organ and identify even small tumors.
- Laparoscopy. The laparoscopic method allows an accurate and correct diagnosis making. The method is sparing, fast, and painless for patients. Through a small incision, under short-term anesthesia, the doctor inserts a special device into the abdominal cavity. He examines the tumor on the monitor, and takes a piece of tissue for histological examination.
Treatment
Surgical treatments are the only methods for the improvement of long-term survival in patients with liver cancer. However, by the time a malignant tumor is diagnosed, radical removal is possible in 5-15% of patients, in other cases only palliative treatments are performed. Tumor recurrence within 3-5 years after resection is observed in 70-90% of patients. The effectiveness of systemic antitumor chemotherapy for inoperable liver cancer does not exceed 20% with a survival rate of 3-4 months. With intravenous administration of a chemotherapy drug, the therapeutic concentration is achieved only for a short time, and in some cases it does not have the necessary effect on tumor cells. The significant liver damage, the difficulty of achieving a therapeutic concentration of the chemotherapy drug in the affected areas, and the high toxicity of anticancer drugs put question on the success of traditional systemic drug chemotherapy for liver cancer treatment.
Achievements of X-ray endovascular surgery allow using the modern methods of selective embolization to treat liver cancer with the help of introducing special devices (coils) directly into a vessel that is feeding a malignant tumor.
Embolization procedure for liver cancer treatment is the modern minimally invasive interventional method of treatment.
After performing local anesthesia, special endovascular catheters are inserted directly into the vessels of the liver that feed the tumor under the control of an angiography (a modern digital X-ray examination). After that, the blood flow in these vessels is blocked by introducing coils through the lumen of the catheter. After the cessation of blood supply, the tumor stops its further growth and decreases in size.
Besides, coils introduced through the lumen of the catheter directly into the tumor vessels have demonstrated the effectiveness in liver cancer treatment according to the latest clinical trials.
Embolization procedure is an effective minimally invasive method for liver cancer treatment that is considered an alternative to conventional surgery. Moreover, when large single and multiple liver tumors are detected, embolization procedure is the only possible cancer treatment method, since resection of large areas of the liver is associated with high risks and is often not possible.
The effectiveness of the embolization procedure for liver cancer treatment is based on the peculiarities of the blood supply to liver tumors. Normal liver parenchyma has a blood supply from the portal vein and from the hepatic artery. Up to 95% of the tumor nodes have an intense arterial blood supply. This makes it possible to selectively make injections directly into the tumor, significantly reducing their effect on healthy liver cells.
Embolization for liver cancer treatment is a modern promising surgical method of treatment that refers to high-tech types of cancer care. Long-term results of liver cancer treatment with embolization are assessed as satisfactory. Most patients show positive results, confirmed by the diagnostic methods. The low incidence of complications and low toxicity allow performing embolization in debilitated patients with various malignant liver tumors.
Where can I undergo percutaneous embolization (coiling) abroad?
Health tourism is becoming more and more popular these days, as medicine abroad often ensures a much better quality of percutaneous embolization (coiling).
The following hospitals show the best success rates in percutaneous embolization (coiling):
- University Hospital Saarland Homburg, Germany
- Memorial Bahcelievler Hospital Istanbul, Turkey
- University Hospital Halle (Saale), Germany
- University Hospital Muenster, Germany
- University Hospital Oldenburg, Germany
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 percutaneous embolization (coiling) 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 with percutaneous embolization (coiling) or chemoembolization in Germany is 24,200-40,900 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 percutaneous embolization (coiling) 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 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 percutaneous embolization (coiling) in the best hospitals. 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 are aimed at undergoing percutaneous embolization (coiling) safely and successfully.
Health 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 reviewed by an expert in the field of medicine Prof. Dr. med. Thomas Vogl
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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