Removal of prostate tumor metastases with a gamma probe in University Hospital Greifswald
University Hospital Greifswald
Greifswald, Germany
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan of the abdominal and pelvic organs. Based on the results, the physician will determine the number and localization of metastases, and plan the upcoming intervention.<\/p>\n\n<p style=\"text-align:justify\"><strong>On the eve of the intervention<\/strong>, you will receive an injection of radioactively labeled PSMA. PSMA is the substance that binds to the smallest prostate cancer metastases in the lymph nodes and other tissues. The radioactive label will allow the surgeon to find all the metastases during the operation.<\/p>\n\n<p style=\"text-align:justify\"><strong>Removal of prostate tumor metastases with a gamma probe<\/strong> starts with general anesthesia. After anesthesia, the surgeon makes small incisions through which he inserts endoscopic instruments, a gamma probe and a video camera into the pelvic cavity and abdominal cavity. The gamma probe detects the lymph nodes affected by metastases by a radioactive label, and the surgeon removes them endoscopically. The video camera continuously transmits a three-dimensional image of the operating field in 12-fold magnification to the monitor.<\/p>\n\n<p style=\"text-align:justify\">As the surgeon sees the operating field in multiple magnification, he preserves the nerve endings and large blood vessels. This significantly reduces the surgical risks. The gamma probe, in turn, allows detecting and removing all metastases, which minimizes the risk of prostate cancer recurrence.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the completion of the operation<\/strong>, you will be transferred back to the ward, under the supervision of the attending physician and nursing staff. Due to the minimal invasiveness of the operation and the short duration of general anesthesia, you will not need to stay in the intensive care unit for a long time.<\/p>\n\n<p style=\"text-align:justify\">Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">PSA blood test<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n\t<li style=\"text-align: justify;\">Bone scintigraphy (if available)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the hospital<\/li>\n\t<li>Clinical history taking<\/li>\n\t<li>Evaluating the available medical reports<\/li>\n\t<li>General clinical examination<\/li>\n\t<li>Urological examination<\/li>\n\t<li>Laboratory tests:\n\t<ul>\n\t\t<li>Complete blood count<\/li>\n\t\t<li>Biochemical analysis of blood<\/li>\n\t\t<li>Inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>Indicators of blood coagulation<\/li>\n\t\t<li>Tumor markers, PSA<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>Ultrasound scan of the urogenital system<\/li>\n\t<li>CT scan\/MRI of the abdomen and pelvis<\/li>\n\t<li>Preoperative care<\/li>\n\t<li>Removal of prostate tumor metastases with a gamma probe<\/li>\n\t<li>Consultations of related specialists<\/li>\n\t<li>Symptomatic treatment<\/li>\n\t<li>Cost of essential medicines<\/li>\n\t<li>Nursing services<\/li>\n\t<li>Control examinations<\/li>\n\t<li>Stay in the hospital with full board<\/li>\n\t<li>Accommodation in 2-bedded ward<\/li>\n\t<li>Recommendations regarding further treatment<\/li>\n<\/ul>\n<div class=\"program_indications_for_surgery\"><h4>Indications<\/h4><ul>\n\t<li>Confirmed prostate cancer with suspected metastasizing<\/li>\n<\/ul>\n<\/div><div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>During the first visit<\/strong>, the physician will conduct a clinical examination and go through the results of the available examinations. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan of the abdominal and pelvic organs. Based on the results, the physician will determine the number and localization of metastases, and plan the upcoming intervention.<\/p>\n\n<p style=\"text-align:justify\"><strong>On the eve of the intervention<\/strong>, you will receive an injection of radioactively labeled PSMA. PSMA is the substance that binds to the smallest prostate cancer metastases in the lymph nodes and other tissues. The radioactive label will allow the surgeon to find all the metastases during the operation.<\/p>\n\n<p style=\"text-align:justify\"><strong>Removal of prostate tumor metastases with a gamma probe<\/strong> starts with general anesthesia. After anesthesia, the surgeon makes small incisions through which he inserts endoscopic instruments, a gamma probe and a video camera into the pelvic cavity and abdominal cavity. The gamma probe detects the lymph nodes affected by metastases by a radioactive label, and the surgeon removes them endoscopically. The video camera continuously transmits a three-dimensional image of the operating field in 12-fold magnification to the monitor.<\/p>\n\n<p style=\"text-align:justify\">As the surgeon sees the operating field in multiple magnification, he preserves the nerve endings and large blood vessels. This significantly reduces the surgical risks. The gamma probe, in turn, allows detecting and removing all metastases, which minimizes the risk of prostate cancer recurrence.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the completion of the operation<\/strong>, you will be transferred back to the ward, under the supervision of the attending physician and nursing staff. Due to the minimal invasiveness of the operation and the short duration of general anesthesia, you will not need to stay in the intensive care unit for a long time.<\/p>\n\n<p style=\"text-align:justify\">Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.<\/p>\n<\/div>","is_ambulant":"0","bh_fee":0,"only_for_children":"2","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"0","clinic_icon":"5ffc1bca99500.jpg","city":"Greifswald","clinic_site":"https:\/\/www.medizin.uni-greifswald.de\/de\/home\/","department_recommend":"0","country":"Germany","country_id":"1","clinic_name":"University Hospital Greifswald","cinic_name":"University Hospital Greifswald","department_id":"3429","duration":"5","direction":"Urology","min_duration":0,"clinic_id":"2319","paketPrice":850,"paket":"<ul>\n <li>Interpreter up to 3 hours<\/li>\n <li>Translation of 2 pages<\/li>\n<\/ul>","title":"Removal of prostate tumor metastases with a gamma probe","price":{"val":"0.00","type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[{"id":"need_to_use_head_doctor","title":"Treatment by leading experts","type":"val","val":0,"req":0},{"id":"1_person_room","title":" Single room (whole period)","parent":"duration","type":"count_val","val":"145.00"},{"id":"2_person_room","title":" double room (whole period)","parent":"duration","type":"count_val","val":"75.00"},{"id":"attendant_place","title":"Accommodation for the accompanying person ","parent":"duration","type":"count_val","val":"100.00"}],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"22","distance":"197","airport_title":"Berlin-Tegel"},{"id":"9","distance":"270","airport_title":"Hamburg"},{"id":"8","distance":"290","airport_title":"Berlin"}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}
Program id #
694750
Prof. Dr. med. Norbert Hosten
Department of Nuclear Medicine, Interventional Radiology and Neuroradiology
Specialized in: nuclear medicine, interventional radiology, neuroradiology The program includes:
- Initial presentation in the hospital
- Clinical history taking
- Evaluating the available medical reports
- General clinical examination
- Urological examination
- Laboratory tests:
- Complete blood count
- Biochemical analysis of blood
- Inflammation indicators (CRP, ESR)
- Indicators of blood coagulation
- Tumor markers, PSA
- Ultrasound scan of the urogenital system
- CT scan/MRI of the abdomen and pelvis
- Preoperative care
- Removal of prostate tumor metastases with a gamma probe
- Consultations of related specialists
- Symptomatic treatment
- Cost of essential medicines
- Nursing services
- Control examinations
- Stay in the hospital with full board
- Accommodation in 2-bedded ward
- Recommendations regarding further treatment
Indications
- Confirmed prostate cancer with suspected metastasizing
How program is carried out
During the first visit, the physician will conduct a clinical examination and go through the results of the available examinations. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan of the abdominal and pelvic organs. Based on the results, the physician will determine the number and localization of metastases, and plan the upcoming intervention.
On the eve of the intervention, you will receive an injection of radioactively labeled PSMA. PSMA is the substance that binds to the smallest prostate cancer metastases in the lymph nodes and other tissues. The radioactive label will allow the surgeon to find all the metastases during the operation.
Removal of prostate tumor metastases with a gamma probe starts with general anesthesia. After anesthesia, the surgeon makes small incisions through which he inserts endoscopic instruments, a gamma probe and a video camera into the pelvic cavity and abdominal cavity. The gamma probe detects the lymph nodes affected by metastases by a radioactive label, and the surgeon removes them endoscopically. The video camera continuously transmits a three-dimensional image of the operating field in 12-fold magnification to the monitor.
As the surgeon sees the operating field in multiple magnification, he preserves the nerve endings and large blood vessels. This significantly reduces the surgical risks. The gamma probe, in turn, allows detecting and removing all metastases, which minimizes the risk of prostate cancer recurrence.
After the completion of the operation, you will be transferred back to the ward, under the supervision of the attending physician and nursing staff. Due to the minimal invasiveness of the operation and the short duration of general anesthesia, you will not need to stay in the intensive care unit for a long time.
Finally, the attending physician will evaluate the results of control examinations, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.
Required documents
- Medical records
- PSA blood test
- MRI/CT scan (not older than 3 months)
- Bone scintigraphy (if available)
- Biopsy results (if available)
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About the department
The Department of Nuclear Medicine, Interventional Radiology and Neuroradiology at the University Hospital Greifswald provides the full range of medical services in the fields of its competence. The medical facility has advanced infrastructure and equipment for imaging tests and radioisotope diagnostics. The department's doctors also successfully perform many therapeutic procedures under imaging guidance and therapy with radionuclides. CT and MRI scans, including their modern modifications (for example, diffusion MRI or perfusion MRI), angiography, scintigraphy, PET-CT, SPECT-CT, and other tests are performed in the department's diagnostic rooms. Therapeutic procedures in the fields of interventional radiology and neuroradiology are performed under imaging guidance. These are stent implantation, vascular balloon dilatation, sympathicolysis, thrombolysis, chemoembolization, etc. The specialists in nuclear medicine treat patients with radiopharmaceuticals. Of particular interest to the department's doctors is the treatment of thyroid diseases, bone metastases, and liver tumors. The department's medical team has deep expert knowledge and high professional skills to provide patients with effective care. In addition, it is important for doctors to take into account the patient's individual needs and wishes, so they pay attention to personal communication and building trusting relationships.
The Head Physician of the department is Prof. Dr. med. Norbert Hosten. Prof. Hosten is the author of a number of textbooks on radiology, including one on the X-ray diagnostics of eye tumors. He is the author of more than 250 scientific publications and has held numerous invited lectures in a broad range of subject fields, such as telemedicine, radiological diagnostics of the eye, MRI, etc.
The priority focus of the department's medical team is interventional radiology. Doctors most often perform angioplasty and stent implantation to eliminate obstructions and stenosis of the blood vessels and hollow internal organs, embolization and chemoembolization to treat malignant tumors and metastases, uterine artery embolization, and transjugular intrahepatic portosystemic shunting. All manipulations are performed under the guidance of X-ray, CT, or MRI scans, which ensure their highest accuracy. The specialists at the medical facility take a responsible approach to the choice of the treatment method, and therefore comprehensive diagnostics precede the prescription of an intervention, the results of which are assessed in cooperation with doctors from related disciplines. For example, interventional radiologists consider chemoembolization in patients with liver cancer during interdisciplinary tumor boards with oncologists, hepatologists, radiation therapists, and other specialists.
The medical facility also offers services in neuroradiology. The doctors in this specialty focus on patients with carotid artery stenosis, brain aneurysms, and dural arteriovenous fistulas. Despite the absence of severe symptoms, carotid stenosis significantly increases the risk of a stroke, so doctors strongly recommend treating the pathology in a timely manner. The department's neuroradiologists eliminate carotid artery stenosis with the help of stent implantation. The interventional procedure is performed under imaging guidance using local anesthesia. The pathological focus is approached through a puncture in the radial, brachial, or femoral artery, through which a stent (a special metal frame) is delivered to the carotid artery affected by atherosclerosis and implanted in its lumen. Doctors implant special platinum coils (coiling) to treat brain aneurysms. The implantation is performed using endovascular techniques under imaging guidance. Dural arteriovenous fistulas are treated with endovascular embolization procedures.
The department's range of services is complemented by the use of radiopharmaceuticals for treatment. Radioiodine therapy for treating benign and malignant thyroid pathologies is one of the most popular procedures in this area. Radioactive iodine therapy is indicated for hyperthyroidism and thyroid cancer (after surgery). Radioiodine therapy is the most sparing and safest for patients because radioactive iodine affects only the thyroid gland without harming other organs. A patient takes radioactive iodine in the form of a capsule or liquid. The therapeutic effect is achieved due to local radioactive irradiation, which leads to the gradual destruction of thyroid cells and metastases of thyroid tumors.
The specialists in nuclear medicine also successfully perform pain management with radiopharmaceuticals for bone metastases, for example, due to prostate cancer, breast cancer, or other cancers with osteoblastic metastases. This method improves the quality of life and relieves pain for up to 4 months. The advantages of this type of pain management include a low risk of side effects and a minor radiation exposure. In addition, the treatment is provided on an outpatient basis.
The department also offers selective internal radiation therapy (SIRT) with intra-arterial administration of Yttrium-90 to treat liver tumors. Another option for radionuclide therapy to treat liver cancer is iodine-131-lipiodol therapy. In this case, the radioactive agent accumulates only in the tumor and does not affect other organs. This ensures a higher radiation load on atypical cells, which contributes to their destruction.
The department's key clinical focuses include:
- Nuclear medicine
- Iodine-131 therapy for benign and malignant thyroid pathologies
- Hyperthyroidism caused by nodular goiter, autoimmune process, etc.
- Thyroid cancer after surgery (treatment of recurrences and metastases)
- Pain management for bone metastases
- Therapy for liver tumors
- Selective internal radiation therapy (SIRT) using Yttrium-90
- Internal radiation therapy with iodine-131-lipiodol
- Antitumor therapy with radioactive antibodies
- Iodine-131 therapy for benign and malignant thyroid pathologies
- Interventional radiology
- Angioplasty and stent implantation
- Sympathicolysis
- Embolization and chemoembolization for treating malignant tumors and metastases
- Uterine artery embolization
- Transjugular intrahepatic portosystemic shunting
- Neuroradiology
- Carotid artery stent implantation
- Coiling for brain aneurysms
- Endovascular embolization for dural arteriovenous fistulas
- Interventional pain management for chronic back pain
- Other medical services
Curriculum vitae
Higher Education and Professional Career
- 1980 - 1986 Human Medicine studies at the Free University of Berlin.
- 1986 Admission to medical practice.
- 1987 Thesis defense.
- 1987 - 1992 Internship as a Specialist in Radiology at the Westend Hospital and the University Hospital Charite Berlin.
- 1992 Board certification in Radiology.
- 1993 - 1994 Senior Physician, Charite University Hospital Berlin.
- 1994 - 2000 Head of the Department of Radiology.
- 1994 Habilitation and Venia Legendi in Radiology.
- 1999 Extraordinary Professorship at the Humboldt University of Berlin.
- 2001 Invitation to the Chair of Diagnostic and Interventional Radiology at the University of Greifswald, and Head Physician of the Department of Nuclear Medicine, Interventional Radiology and Neuroradiology at the University Hospital Greifswald.
- Since 2008 Chairman of the Board of Directors "Telemedicine in the Euroregion Pomerania".
- 2013 - 2015 President of the German Radiological Society.
Prizes, Awards and Distinctions
- October 2015 Pomerania Nostra Award for Merit in Telemedicine in Pomerania Euroregion, University of Greifswald and University of Szczecin.
Photo of the doctor: (c) Universitätsmedizin Greifswald
About hospital
According to the reputable Focus magazine, the University Hospital Greifswald is included in the ranking of the best medical complexes throughout Germany!
The hospital is one of the oldest healthcare facilities in Germany, with long traditions and an excellent reputation. The history of the hospital begins in 1456, when the Faculty of Medicine at the University of Greifswald was founded. During this time, the hospital has managed to earn recognition in the national medical arena and gain prestige abroad. The hospital has 19 institutes and 21 specialized departments. The key to successful clinical practice is the combination of state-of-the-art equipment and highly qualified medical personnel who are actively engaged in the development of effective medical techniques and implement them in everyday practice.
The medical team of the university hospital has more than 4,400 employees, including world-famous professors who regularly undergo advanced training in the leading European and American hospitals, where they share their experience with foreign specialists. The doctors at the medical facility annually treat about 180,000 patients. At the same time, the specialists often provide medical care to patients with complex clinical cases, even in those cases that doctors at other medical centers consider hopeless. The hospital has more than 1,000 beds for inpatients, and many highly-specialized outpatient clinics are available in the medical facility for counseling and outpatient medical care.
The hospital presents all the fields of modern medicine. According to Focus magazine, the medical complex is recognized as one of the best in Germany for treating bowel cancer, bladder cancer, malignant brain tumors, skin cancer, multiple sclerosis, Parkinson's disease, dementia, cardiovascular pathologies, knee and hip pathologies, as well as ophthalmic and proctologic diseases. Diagnostic and therapeutic procedures are carried out in strict accordance with national and international standards, which ensures top-class medical care.
The medical team at the hospital makes sure that each patient feels as comfortable as possible during the therapeutic process. Doctors and nursing staff show humanity and understanding, striving to support each patient in every possible way on the path to recovery.
Photo: (с) depositphotos
Accommodation in hospital
Patients rooms
The patients of the University Hospital Greifswald live in comfortable single and double rooms. The patient rooms are made in bright colors and are quite cozy. The furnishings of a standard patient room include an automatically adjustable bed, a bedside table, a TV, and a telephone. The patient room has a table and chairs for receiving visitors. There is also free Wi-Fi in the patient rooms.
If desired, patients can live in enhanced-comfort rooms. In such rooms, patients are additionally offered toiletries, a bathrobe, and a change of towels.
Meals and Menus
The patients of the hospital are offered three healthy and tasty meals a day: a buffet breakfast, a hearty lunch, and dinner. The hospital also houses a cafeteria where one can have a tasty snack, a cup of aromatic coffee, tea, or soft drinks.
Patients staying in enhanced-comfort rooms are offered a special menu with a wide range of main courses, appetizers, desserts, and drinks.
Further details
Standard rooms include:
Shower
Toilet
Wi-Fi
TV
Religion
The services of representatives of religions are available upon request.
Accompanying person
Your accompanying person may stay with you in your patient room or at the hotel of your choice during the inpatient program.
Hotel
You may stay at the hotel of your choice during the outpatient program. Our managers will support you for selecting the best option.
