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

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

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.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

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.

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.

University Hospital Saarland Homburg

9.8/10
location_onGermany, Homburg

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.

HELIOS University Hospital Wuppertal

9.8/10
location_onGermany, Wuppertal

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.

University Hospital Oldenburg

10/10
location_onGermany, Oldenburg

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.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

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.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

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 studies and imaging-guided minimally invasive therapy for the treatment of various diseases. Of particular interest to the experienced medical team of the department is individual minimally invasive therapy of oncological diseases, treatment of pain syndromes and vascular pathology. The department works in close cooperation with all other departments of the hospital, thereby providing interdisciplinary, comprehensive medical care at the highest level of university medicine.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

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.

University Hospital Duesseldorf

9.45/10
location_onGermany, Duesseldorf

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.

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

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.

University Hospital Jena

9.5/10
location_onGermany, Jena

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.

University Hospital Tuebingen

9.13333/10
location_onGermany, Tuebingen

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.

University Hospital Würzburg

9.8/10
location_onGermany, Würzburg

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.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

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.

Helios Hospital Hildesheim

9.5/10
location_onGermany, Hildesheim

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.

Lung cancer is the most common disease in oncology. Moreover, it is one of the most dangerous, prognostically unfavorable cancers. The most effective treatment method is surgery, but neoplasms are usually detected at the advanced stages, so only 20% of patients are operated on. Other people receive chemoradiation therapy. Bronchial artery embolization is increasingly used in Europe for the treatment of inoperable lung cancer. As a result of the procedure, the tumor sometimes decreases in size and the doctor can remove it surgically in an attempt to cure the disease.

Content

  1. In what cases can embolization be used
  2. Mechanisms of action of chemoembolization
  3. Embolization in combination therapy for lung cancer
  4. How is the procedure performed
  5. Embolization in palliative cancer treatment
  6. Embolization results
  7. Why is it worth undergoing embolization abroad
  8. Treatment in Europe with Booking Health at an affordable price

In what cases can embolization be used

 

Late diagnosis or low lung functional reserves are the main reasons for refusing surgery. Although surgery is the most effective treatment method and in fact the only one, which gives a chance to cure the disease, radical surgical interventions are not performed in most patients.

In such cases, chemoradiotherapy becomes the main method of lung cancer control. However, it has many disadvantages: high toxicity, frequent complications.

Doctors increasingly use additional methods of local tumor control, namely ablation and embolization. Embolization is considered one of the best methods in terms of the ratio of effectiveness and safety. This is a minimally invasive procedure, which reduces the tumor size and stops pulmonary hemorrhage.

This technique for lung cancer treatment has the following advantages:

  • Suppression of the tumor due to three mechanisms: the closure of blood vessels, the destruction of cancer cells by cytostatics and an increase in the immune response.
  • Minimally invasive procedure, which is performed through the blood vessels.
  • Low risk of complications.
  • Good treatment tolerance.
  • Technique can be combined with any other treatment methods for lung cancer.

Mechanisms of action of chemoembolization

 

If the only purpose of the procedure is to stop pulmonary hemorrhage, then it involves only closing the lumen of the bronchial, less often other arteries. However, other goals are more often pursued. These may be reducing the size of the tumor, achieving a state of resectability (the possibility of surgical removal), and stabilizing the size of the neoplasm. Therefore, artery embolization for lung cancer patients is usually combined with regional chemotherapy.

The mechanisms of action of chemoembolization are as follows:

  1. Ischemic tissue necrosis. The tumor receives much blood and quickly grows. If the blood flow is stopped, the cells quickly die due to the lack of oxygen.
  2. The impact of chemotherapy agents. They are injected into the tumor through the arterial network at a high concentration. With the use of drug-eluting microspheres, the drugs are released gradually over several weeks. Regional chemotherapy is more effective than systemic chemotherapy. This is due to the fact that a large concentration of cytostatics is created in the tumor. It would be impossible to create it with intravenous administration of drugs due to the unacceptable toxicity of high dosages of drugs.
  3. Closure of bleeding arteries. Hemoptysis is the main problem of patients. It limits the possibilities of treatment, since ongoing bleeding and a weakened condition of patients are contraindications not only for surgery, but also for radiation therapy. While stopping bleeding, embolization prevents the fatal complications of lung cancer and makes it possible to use other treatment methods.
  4. Stimulation of antitumor immunity. It is achieved by stimulating the inflammatory process. A few days after embolization, the patient develops bacterial bronchitis. Immune cells, namely macrophages and T lymphocytes migrate to the inflammation area. They produce factor-alpha (cachectin) tumor necrosis. This substance destroys cancer cells. In addition, cachectin blocks angiogenesis – the formation of new vessels that supply the tumor.

Embolization in combination therapy for lung cancer

 

Bronchial arterial chemoembolization is used in cases when the patient is considered inoperable. However, as a result of a successfully performed procedure, some patients can achieve a resectable state.

Surgery is the preferred treatment option. If it is impossible to carry out radical intervention, this actually means the impossibility of curing the disease. Therefore, the efforts of doctors are aimed at reducing the size of the tumor, its metastases, and achieving a resectable state of the tumor. One of the options for achieving this goal is chemoembolization.

The procedure is performed using microspheres saturated with chemotherapy drugs. It is also possible to use oily chemoembolization – the vessels are blocked with a solution of lipiodol with chemotherapy drugs. When the embolization agents are injected into the bronchial artery, the tumor stabilizes (stops growing) in about half of the patients. In one in three cancer patients, the tumor is reduced enough that doctors may suggest radical surgery to try to cure cancer.

Resectability is even more often achieved if patients receive radiation therapy after embolization. Doctors use high doses of radiation to reduce the tumor. As a result, radical surgery can be performed in half of the patients.

With unresectable cancer, embolization can be combined with ablation. This is a treatment method, which involves the destruction of the tumor by heating it. Radiofrequency ablation is used more often, microwave ablation is less often carried out.

With the combination of these two techniques, the first is endovascular embolization. The lumen of the vessels is closed, so a significant part of the tumor dies off. Reduction of the tumor blood supply is an important condition for the success of radiofrequency ablation. The procedure is performed a few days after bronchial artery embolization. The doctor inserts a probe into the tumor and heats it up to destroy the remaining cancer cells. The combined technique allows the doctors to reduce the tumor by 2-3 times. It increases life expectancy, eliminates pulmonary hemorrhage and restores bronchial patency.

How is the procedure performed

 

Artery embolization for lung cancer is performed through a small incision in the groin. The doctor inserts a catheter into the femoral artery and reaches the bronchial artery. The doctor carries out angiography: clarifies the characteristics of the blood flow in the tumor. He injects a contrast agent into the vessels and then takes a series of X-rays to assess the movement and distribution of the contrast agent.

Most lung tumors are supplied from the bronchial artery. They branch out at the edge of the neoplasm and become wavy, penetrate into the thickness of the tumor node and form a rich vascular network.

However, in different people, the vessels of the lung are arranged in different ways. Some have only one bronchial artery for each lung, others have several, ranging from 2 to 4. They can extend from the thoracic aorta, while in other patients from the intercostal artery. In 30% of cases, the bronchial arteries have an aberrant discharge: their sources are the subclavian arteries, intercostal arteries, brachiocephalic arteries, lower phrenic arteries and even branches from the abdominal aorta. The vessels can supply blood not only to the bronchial wall, but also to the adjacent fiber, lymph nodes, and nerves.

The blood supply to the tumor is also different. Sometimes it receives almost all of the blood from the basin of one large artery. Other patients have multiple sources of blood supply. In this case, the embolization procedure is less successful, and therefore doctors often refuse to carry it out. In addition, the procedure becomes dangerous if anastomoses (connections) of the bronchial artery with the vertebral, spinal, intercostal or cervical arteries are detected.

If chemoembolization is possible, then the embolization agent is injected into the vessels supplying the tumor. Their lumen closes and the cancer cells die. An area of fibrosis (scar tissue) is formed in the place where the tumor is located.

Embolization in palliative cancer treatment

 

Cancer patients receive palliative care at the advanced stage. It can increase life expectancy, but it is aimed primarily at improving its quality.

The main problems of patients at the advanced stage of the disease are shortness of breath due to obstruction (closure of the lumen) of the bronchi, hemoptysis and pulmonary hemorrhage, accumulation of effusion in the pleural cavity. Embolization is one of the palliative treatment options, which in combination with other procedures and surgeries, can help eliminate most of the symptoms and complications.

First of all, embolization is used to combat pulmonary hemorrhages. They cause anemia, make it impossible to carry out chemoradiation therapy, and in some cases become the direct cause of the patient's death. Doctors perform an endovascular procedure to close the lumen of all bronchial arteries supplying the tumor. In this case, the hemorrhage is stopped almost instantly. The procedure is successful in 96% of cases. In case of failure, the manipulation can be repeated.

Massive pulmonary hemorrhage is very dangerous without treatment – it has a mortality rate of up to 50%. Hemorrhage with a loss of more than 200 ml of blood per hour requires embolization, first of all. If the patient has respiratory failure, then even coughing up 50 ml of blood per hour is considered dangerous. In 90% of cases, the source of this hemorrhage is the bronchial arteries, which are usually closed during embolization.

This procedure is usually combined with various methods of restoring the patency of the bronchial tree. Doctors use laser, radiofrequency ablation, photodynamic therapy, and other techniques. After the destruction of the part of the tumor, which blocks the bronchus, it is possible to implant a stent, which prevents recurrent neoplastic obstruction.

Embolization results

 

Thus, embolization and chemoembolization are effective treatment methods for unresectable lung cancer. Depending on the stage of the pathology, the goals of the procedure and its results vary significantly in different patients. As a rule, the results are as follows:

  1. Achievement of tumor resectability. Previously, cancer could not be removed, so the patient had no chance of defeating the disease. However, there is a possibility of a significant reduction of the tumor size as a result of chemoembolization. If successful, the procedure is followed by radical surgery to remove the malignant lung tumor. The prognosis is better in patients with blood supply to the neoplasm via one bronchial artery.
  2. Increased life expectancy. Even if surgery is not possible, the tumor can be controlled for several more years. As a rule, doctors use a combination of several techniques. Embolization is most commonly combined with chemotherapy, radiation therapy, and cancer ablation.
  3. Arrest of hemorrhage. Pulmonary hemorrhage is possible even in patients with small lung tumors. In this case, they make it impossible to carry out surgery or irradiation. In advanced stages of cancer, lung hemorrhage is one of the main causes of death for patients who usually die not from blood loss, but as a result of asphyxiation (suffocation), since blood blocks breathing. Embolization allows the doctors to stop even the most severe hemorrhage and eliminate hemoptysis for at least several months.

Why is it worth undergoing embolization abroad

 

Cancer hospitals abroad have state-of-the-art equipment. They employ specialists with vast experience in performing bronchial artery embolization. You can be confident that the treatment in Europe will ensure the best results with the lowest risk of complications.

There are several reasons for you to undergo embolization for lung cancer in Europe:

  • Vast experience in carrying out embolization and chemoembolization in lung cancer.
  • The use of new methods of chemoembolization, including the use of drug-eluting microspheres.
  • Highly accurate diagnostics of lung cancer, allowing for perfect planning of the procedure.
  • During embolization, doctors perform angiography and accurately assess the blood flow in the tumor to avoid complications caused by penetration of embolization agents into non-target vessels.
  • Doctors combine chemoembolization with other lung cancer treatment methods to make the tumor resectable and maximize the patient's life expectancy.

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 Healthcompany. On our website, you can see the cost of treatment in different European hospitals, compare prices and book a medical care program at an affordable price. Embolization of arteries 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 provide consultation about the treatment in Europe. Booking Health will take care of the organization of your trip. We will provide the following benefits for you:

  • We will select a hospital for treatment in Europe, whose doctors specialize in the treatment of lung cancer patients and achieve best results.
  • We will help you overcome the language barrier, establish communication with your attending physician.
  • We will reduce the waiting period for 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 decreased due to the lack of 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 medical care program and translate medical records. You do not have to undergo previously performed diagnostic procedures.
  • We will provide communication with the hospital after treatment in Europe.
  • We will organize additional 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 be treated by the best doctors in the world. The Booking Health specialists will help you reduce the cost of treatment and take care of all organizational issues, and you will only have to focus on restoring your health.

Authors: Dr. Vadim ZhiliukDr. Sergey Pashchenko




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