Lung 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.
Lung cancer is the most common malignant tumor worldwide, with 2.1 million new cases being recorded annually. It is also the world's leading cause of death from cancer. Men over the age of 65 who smoke are most affected. The preferred treatment options for the disease are surgery and radiation therapy, but if these are contraindicated or the tumor has recurred, chemoembolization is used in developed countries. This is a safe, minimally invasive procedure that is well tolerated, rarely causes complications, and does not require any rehabilitation.
Content
- How is lung cancer treated?
- What are embolization and chemoembolization?
- Who may be a candidate for chemoembolization?
- How is chemoembolization performed?
- How effective is chemoembolization?
- Where can I undergo treatment?
How is lung cancer treated?
Surgery is considered to be the best treatment with the highest survival rate for patients. This may be a segmental resection or an extended pneumonectomy. In developed countries, doctors also perform minimally invasive operations, such as video-assisted thoracoscopic lobectomy (VATS) and robot-assisted Da Vinci lobectomy.
Unfortunately, symptoms of lung cancer appear late, and screening for this disease is not done. Therefore, the main treatment methods for most patients are chemotherapy and radiation therapy. Doctors abroad also use proton therapy, which is an even safer method. In recent years, immunotherapy and targeted therapy have become widespread, and these are more effective than systemic chemotherapy.
Chemoembolization for lung cancer is used as an additional method of local tumor control. It causes tissue necrosis due to a lack of blood supply, damages cancer cells with chemotherapy, and at the same time prevents or stops pulmonary hemorrhages, which are a common complication in the advanced stages of cancer.
What are embolization and chemoembolization?
Doctors use both embolization and chemoembolization to treat lung cancer.
Embolization for lung cancer in Germany in its pure form is mainly carried out as a palliative procedure. It stops pulmonary hemorrhage and relieves hemoptysis. Embolization of the bleeding vessels can be performed as an emergency procedure whenever required. The essence of the method is that particles or liquid materials are administered into the arteries of the lungs through the blood vessels in the groin area, which clog their lumen. These can be microspheres, spirals, polyvinyl alcohol particles, adhesive compositions, or other materials.
The procedure is very effective. Studies show that after its performance, the risk of recurrent bleeding within 6 months of medical observation is only 8%. Should a relapse occur, the procedure can be repeated.
Chemoembolization is usually performed with drug-saturated microspheres. They contain cytostatics, such as adriamycin or gemcitabine. The technique is used not only to stop and prevent pulmonary hemorrhages but also to shrink the tumor, improve its long-term control, create conditions for subsequent systemic therapy, and increase the life expectancy of patients.
Chemoembolization works through the following two mechanisms:
- Vascular tumor necrosis due to a lack of blood supply
- Damage to cancer cells by cytostatics released from drug-saturated microspheres
Thus, this procedure is a type of regional chemotherapy. It is more effective than systemic chemotherapy by creating a greater concentration of the drug at the site of the lesion. At the same time, regional chemotherapy is less toxic because the concentration of drugs in the systemic circulation is minimal.
It is also assumed that chemoembolization enhances the antitumor immune response due to the massive destruction of cancer cells and the release of their antigens into the blood. This effect may be beneficial for patients with metastatic cancer.
Who may be a candidate for chemoembolization?
Surgery is considered the main method of local treatment for lung cancer. If it is not possible due to an advanced stage or is contraindicated for health reasons, radiation therapy will be performed. Chemoembolization is therefore usually used for stage II-IV lung cancer if surgery and radiation therapy are impossible or contraindicated. In addition, the procedure can be performed in cases where the disease recurs or continues to progress after chemoradiotherapy.
The main advantage of chemoembolization is that the treatment is well tolerated, has minimal contraindications, and is suitable even for debilitated and elderly patients. The condition for its successful performance is an established path of blood supply to the tumor. Angiography (contrast-enhanced X-ray scanning of the lung blood vessels) is required to determine whether a patient can be a candidate for chemoembolization.
How is chemoembolization performed?
This is a minimally invasive endovascular procedure that is performed under local anesthesia combined with intravenous sedation. It is done through a small incision in the groin area. The doctor performs all actions from inside the blood vessels under X-ray guidance.
The doctor reaches the blood vessels of the lungs through a network of arteries. A contrast agent is then injected to evaluate the blood supply. Microspheres containing chemotherapy drugs are injected into the blood vessels supplying the tumor, usually the bronchial arteries. In this case, other blood vessels can be temporarily closed with coils to avoid emboli getting into them.
Less commonly, the blood vessels feeding the tumor are the branches of the subclavian artery and the inferior phrenic arteries.
Microspheres with a diameter of 100-300 microns are mainly used for chemoembolization. If the contrast agent continues to enter the tumor, additional microspheres of 300-500 microns are used.
The tumor can sometimes be supplied with blood from several arteries at once. In this case, each of them is sequentially closed with emboli.
How effective is chemoembolization?
Research shows the procedure shrinks tumors in most patients and improves survival rates.
In one of the studies, the authors compared the effectiveness of chemoembolization and regional chemotherapy, which involves injecting a solution of chemotherapy drugs into a bronchial artery. It turned out that chemoembolization works better. The procedure achieved an objective response (tumor shrinkage) in 86.7% of patients, compared to 60% in the regional chemotherapy group. The six-month survival rate was also higher: 87.5% versus 52.7%.
Another study showed that chemoembolization achieved one-year survival in 67% of patients. This is a good result, considering that the procedure is performed at an advanced stage of cancer, when surgery is impossible and radiation therapy is contraindicated or has already been used previously.
Where can I undergo treatment?
Embolization and chemoembolization are technically complex procedures. It is better to undergo these procedures in advanced hospitals with extensive experience in endovascular treatment. Failures are possible at various stages. This is due to the fact that first it is necessary to determine the characteristics of the blood supply to the tumor and then to clog the arteries with emboli while avoiding embolization of non-target blood vessels. In the best hospitals for lung cancer, the procedure has a technical success rate of more than 90%, even if the tumor has a blood supply from multiple sources.
You are welcome to use the Booking Health service to find out prices for individual procedures and the total cost of treatment and make an appointment for your lung cancer diagnostics and lung cancer treatment in Germany. Clinics in Germany use advanced techniques that allow them to successfully cope with aggressive types of cancer. When you opt to undergo your treatment in Germany, chemoembolization can be successfully combined with systemic methods of therapy and palliative procedures. Although it cannot cure advanced cancer, this treatment significantly increases the life expectancy of patients and eliminates hemoptysis.
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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