Neuroendocrine Tumor (NET) of the Colon — Embolization or Chemoembolization: treatment in the Best Hospitals in the World
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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 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 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 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 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.
University Hospital of Ludwig Maximilian University of 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.
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 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 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, 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.
Neuroendocrine tumors (NETs) are a group of neoplasms that grow from hormone-producing cells. About 60% of them develop in the organs of the digestive system. Doctors usually use surgery for the treatment of colon neuroendocrine carcinoma. However, in the advanced stages of the disease, there may be a need for additional therapeutic procedures, including embolization and chemoembolization for the tumor vessels.
Content
- What is embolization
- Features of intestinal neuroendocrine carcinomas
- In what cases can embolization be used
- Embolization of the colon vessels
- Hepatic artery chemoembolization
- Why is it worth undergoing treatment abroad
- Treatment in Europe with Booking Health at an affordable price
What is embolization
Embolization is a method of cancer treatment that closes the lumen of the arteries feeding the tumor. Cells that are deprived of blood supply quickly die.
Embolization is usually combined with regional chemotherapy, which involves intra-arterial administration of cytostatics. In this case, the procedure becomes more effective, since it additionally affects the tumor with chemotherapy drugs in high concentration.
The method is used for the treatment of dozens of types of cancer, including neuroendocrine tumors. The advantages of the method are as follows:
- Minimal invasion – embolization is performed through the blood vessels.
- Safety for the patient's health – if properly performed, complications occur very rarely.
- Good patient tolerance.
- The minimum length of the patient's hospital stay – the period of hospitalization usually does not exceed 3-4 days.
- The patient does not need rehabilitation.
- Embolization can be combined with any other cancer treatment.
- If the patient responds to therapy, then the procedure can be performed many times, so it allows restraining the progression of pathology for a long time.
Features of intestinal neuroendocrine carcinomas
Approximately 25% of neuroendocrine tumors develop in the large intestine. 9% of them develop in the colon, while 16% affect the rectum. Most neoplasms originate from L cells that produce glucagon-like peptide and tyrosine-tyrosine peptide.
But nevertheless, as for other neoplasms, neuroendocrine carcinomas are very rare. They account for only 0.4% of colorectal tumors.
Previously, neuroendocrine tumors were called carcinoids, which means neoplasms similar to cancer. Today this term is considered obsolete. In the 21st century, the term neuroendocrine tumor was introduced. Now only highly differentiated (G1) neoplasms are called carcinoids. Since 2010, NETs have been called neuroendocrine neoplasia.
For neuroendocrine tumors of the large intestine, a classification according to the tumor grade has been developed. These neoplasms are of low (G1), intermediate (G2) and high grade (G3). It is determined according to the data of histological examination, based on the proliferative activity of cells (ability to divide).
In what cases can embolization be used
The most common treatment for colon neuroendocrine carcinoma is surgery. The doctor removes part of the colon along with the tumor. This is often enough to cure the patients and no other technique is required. If the tumor is malignant, large, or metastases have appeared, then chemotherapy is additionally used. For some patients, it is prescribed prior to surgery to reduce neoplasms.
In the advanced stages, somatostatin analogs are used, which slow down the growth of neuroendocrine carcinoma. Some patients are prescribed radionuclide therapy: radioactive substances are added to somatostatin analogs, which accumulate in tumors, metastatic foci, and destroy them with radiation.
For the treatment of the disease, other methods may be required. These may be embolization or chemoembolization for the tumor vessels. They can be used for local control of neoplasms or distant metastases.
The neuroendocrine carcinoma in the colon grows very slowly. Only a tumor of the appendix gives symptoms early – it causes the same manifestations in patients as with appendicitis. At the same time, neuroendocrine carcinomas of other parts of the large intestine cause symptoms only after reaching a large size and the development of intestinal obstruction. At the time of detection of a neoplasm, 45% of patients have metastases in the lymph nodes, and 10% of them have distant metastases. Most often, colon neuroendocrine carcinoma metastasizes to the liver.
Embolization can be used in the following cases:
- Prior to surgery, to make surgery less traumatic, safer, and reduce the risk of recurrence.
- As an option for palliative therapy – in order to stop gastrointestinal bleeding.
- With liver metastases – for their destruction.
Embolization of the colon vessels
Embolization for bleeding cessation can rarely be used. This is due to the fact that the bleeding itself rarely complicates the course of colon neuroendocrine carcinoma. They are more common in patients with rectal tumors.
Prior to surgery, chemoembolization of the colon vessels can be used only in certain medical centers. The technique is not yet a standard treatment for the disease. Nonetheless, the use of embolization seems promising: it can shrink the tumor before surgery, reduce blood loss during surgery. A decreased risk of recurrence is expected, although this effect of preoperative chemoembolization has not yet been proven in clinical trials. If the procedure is carried out before the operation, then the surgical intervention will be performed after 1-2 weeks.
The manipulation is minimally invasive and well tolerated by patients. The doctor inserts a catheter through the femoral artery. He reaches the vessels, and conducts angiography to assess their structure. He then injects an embolysate to close the lumen of the target arteries.
If the technique is used to stop bleeding, it is usually pure embolization, without the use of regional chemotherapy. The doctor can close the arteries with coils, microparticles, a hemostatic sponge, alcohol, glue, or one of dozens of other methods. After the closure of the blood flow, the bleeding from the colon immediately stops. Whenever required, the procedure can be carried out even emergently.
If the procedure is performed before surgery to remove a neuroendocrine carcinoma, it is usually oily chemoembolization. Doctors use lipiodol emulsion with chemotherapy drugs. It clogs blood vessels and damages cancer cells with a large dose of cytostatics.
Hepatic artery chemoembolization
With colon neuroendocrine carcinoma, doctors most often use chemoembolization to suppress liver metastatic foci of neuroendocrine carcinoma. This procedure can be combined with colon resection surgery.
From the colon, blood flows to the liver through the portal vein system. Therefore, it is in this organ that metastasis of neuroendocrine carcinoma most often develops. If possible, they are removed surgically. Doctors abroad perform combined operations for simultaneous colon and liver resection. Nonetheless, only a few patients are candidates for such treatment. As a rule, liver metastases cannot be surgically removed. In this case, chemoembolization becomes the main treatment option.
Medical specialists in Europe use drug-eluting microspheres to perform the procedure. These are tiny balls filled with chemotherapy drugs. They block branches of the hepatic artery and block blood flow to the tumor. Then, over several weeks, drugs are released from the microspheres, which continue to destroy cancer cells.
The procedure does not usually cause significant damage to the healthy part of the liver. This is due to the fact that the organ has a dual source of blood supply. While metastasis of neuroendocrine carcinoma feeds on 90-95% of arterial blood, healthy parenchyma receives 75% of blood from the portal vein. Therefore, the closure of the lumen of the hepatic artery has a stronger effect on the tumor than on the unaffected part of the liver.
Why is it worth undergoing treatment abroad
In developed countries, the level of medicine is higher. European hospitals use state-of-the-art equipment and employ the best specialists in the world. Oncology is a science-intensive, high-tech area of medicine. These are developed countries that achieve the best cancer treatment results.
There are several reasons for you to undergo medical treatment abroad:
- Extensive experience in performing embolization for colon neuroendocrine tumors.
- High-precision diagnostics allows doctors to perfectly assess the structure of the vessels in the area of the neoplasm in order to perform the procedure without complications and with the best result.
- The use of different embolization methods, which allows choosing the best option for each patient.
- It is possible to perform vascular chemoembolization for both the primary tumor and its metastases.
- To prevent complications, during the procedure, doctors protect the non-target vessels with coils or a balloon catheter in order to prevent embolysate from entering them.
- Embolization can be successfully combined with other methods of cancer treatment: surgery, systemic chemotherapy, hormone therapy and radionuclide therapy.
Treatment in Europe with Booking Health at an affordable price
To undergo treatment in one of the European hospitals, please use the services of the Booking Health company. On our website, you can see the cost of treatment in different hospitals, compare prices and book a medical care program at a favorable price. Arterial embolization in European hospitals will be easier and faster for you, and the cost of treatment will be lower.
Please leave your request on our website. Our employee will contact you and advise you about treatment in Europe. Booking Health will take care of the organization of your trip. We will provide the following benefits:
- We will select a hospital for the treatment in Europe, whose doctors specialize in the treatment of colon neuroendocrine tumors.
- We will help you overcome the language barrier, establish communication with your attending physician.
- We will reduce the waiting time for the start of the medical care program and book a doctor's appointment on the most suitable dates.
- We will reduce the price. The cost of treatment in European hospitals will be lower due to the lack of additional coefficients for foreign patients.
- We will take care of all organizational issues: documents for entering the country, transfer from the airport, hotel, interpreting services, etc.
- We will prepare a program and translate medical documents. You do not have to repeat the previously performed diagnostic procedures.
- We will provide communication with the hospital after treatment in Europe.
- We will organize additional diagnostic examinations and treatment in European hospitals, if necessary.
- We will buy medicines abroad and forward them to your native country.
- We will help you keep in touch with the hospital and the doctor after treatment in Europe.
You will receive treatment from the best doctors in the world. The Booking Health employees will help reduce the cost of treatment and solve all organizational issues, and you will only have to focus on restoring your health.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed