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Treatment of colon cancer with embolization or chemoembolization (program ID: 689324)

University Hospital Halle (Saale)

location_on Halle, Germany
9.6/10 from 78 Votes
Specialized hospital
Walter Wohlgemuth

Head Physician
Prof. Dr. Dr. med.

Walter Wohlgemuth

Specialized in: adult and pediatric diagnostic, interventional radiology, neuroradiology

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

Program includes:

  • Initial presentation in the hospital
  • Clinical history taking
  • Review of available medical records
  • Physical examination
  • Laboratory tests:
    • Complete blood count
    • General urine analysis
    • Biochemical analysis of blood
    • Tumor markers
    • Inflammation indicators (CRP, ESR)
    • Coagulogram
  • Ultrasound​ scan
  • CT scan / MRI
  • Preoperative care
  • Embolization or chemoembolization, 2 procedures
  • Symptomatic treatment
  • Cost of essential medicines
  • Nursing services
  • Elaboration of further recommendations

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.

Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.

When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.

Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.

After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.

After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.

Required documents

  • Medical records
  • Esophagogastroduodenoscopy (EGD), MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)
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About the department

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology at the University Hospital Halle (Saale) 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. The department is headed by Prof. Dr. Dr. med. Walter Wohlgemuth.

One of the priorities of the department’s work is interventional radiology, which makes it possible to carry out various diagnostic and therapeutic manipulations using percutaneous accesses under the guidance of imaging devices. One of the clearest examples of this focus is digital subtraction angiography (CSA), which can image vessels  with the best possible accuracy without overlapping images. Along with the imaging of blood vessels for diagnostic purposes, this method also allows for therapeutic interventions. For example, it can be used to restore (when treating thrombosis and arterial stenosis) or to block (in aneurysms or the risk of bleeding from tumor vessels) blood flow in the vessels. Both types of procedures – diagnostic imaging and interventions–  can be applied to all parts of the body.

The department also has in its arsenal a digital two-level angiography, which allows to simultaneously perform two series of images using a single injection of a contrast agent, which reduces the radiation load on the patient and shortens the examination time. Also, two-level angiography offers a significantly higher safety with the introduction of a catheter for neuroradiological interventions (for example, removal of blood clots in acute stroke using a stent retriever and microcatheter).

The service range of the department includes:

Diagnostic radiology

  • Computed tomography (CT)
    • Cardiac CT with coronary angiography and assessment of calcium levels
    • CT angiography
    • Virtual colonoscopy
    • CT-guided puncture
    • CT-guided pain therapy (for example, periradicular therapy for back pain)
  • Magnetic resonance imaging
    • Vascular MRI
    • Magnetic resonance cholangiopancreatography (imaging of the bile ducts and pancreatic duct)
    • Breast MRI (diagnostics and tissue sampling for further testing)
    • Cardiac MRI (perfusion diagnosis, registration of the frequency of contractions, registration of indicators to determine the risk of infarction, various quantitative indicators)
    • Small and large intestine MRI
  • Conventional X-ray examinations
    • Lung and thoracic organs
    • Abdominal and pelvic organs
    • Bones and joints
  • Dynamic radiography with a contrast agent
    • Esophagus
    • Stomach
    • Small and large intestine
    • Urinary tract
    • Veins
    • Fistula imaging
    • Hysterosalpingography
  • Mammography to diagnose breast cancer
  • Other methods of diagnostic radiology

Interventional radiology

  • Angiographic diagnostics (arterial and venous, global, selective and super selective)
  • Recanalization procedures
    • Local fibrinolysis
    • Thrombectomy
    • Percutaneous transluminal angioplasty (vascular dilatation)
    • Endovascular implantation of prostheses, stents in the abdominal and renal arteries, peripheral arteries (arms and legs), central arteries (neck and brain)
    • Other services
  • Treatment of vascular obstruction
    • Coiling in aneurysms, arteriovenous fistulas, malformations
    • Preoperative reduction of tumor vascularization
    • Treatment of bleedings/ hemorrhages into the tumor
    • Uterine artery embolization for the treatment of uterine myomas
    • Intra-arterial chemotherapy: transarterial chemoembolization, selective internal radiation therapy in liver cancer
    • Other treatments
  • Special intervention procedures
    • Blood test for hormones/functional studies (adrenal glands, parathyroid glands, pancreas)
    • Cava filter implantation
    • Percutaneous removal of a foreign body (for example, fragments of a catheter, remnants of electrodes)
    • Percutaneous transhepatic cholangiodrainage
    • Transjugular intrahepatic portosystemic shunting (TIPS)
    • Other services
  • Services in the field of extravascular interventional radiology (pain therapy)
    • Sympathetic ganglion blockade
    • Periradicular therapy
    • Facet joint blockade
    • Obturator nerve block
    • Other treatments

Pediatric radiology

  • Ultrasound examinations (including contrast-enhanced ones)
  • Magnetic resonance imaging
  • Conventional X-ray diagnostics
  • Fluoroscopy
  • CT scan
  • Bone mineral density measurement
  • Other services

Neuroradiology

  • Magnetic resonance spectroscopy
  • Functional MRI
  • X-ray examinations of the head and neck
  • Treatment of brain and spinal cord tumors with neuroimaging systems
  • Treatment of cerebral hemorrhages and aneurysms
  • Other services

Curriculum vitae

Education

Prof. Wohlgemuth studied medicine at the University of Regensburg, the Technical University of Munich and Ludwig Maximilian University of Munich, as well as Health Economics at the University of Bayreuth.  In 1994 Admitted to medical practice, medical graduation from the Technical University of Munich in the same year.  He worked as an Assistant Physician in the Department of Diagnostic Radiology and Neuroradiology, as well as in the Department of Neurology and Clinical Neurophysiology, Augsburg Hospital, and Department of Radiology, Ingolstadt Hospital.

Professional Career

  • Since 2001, Chief Resident in Angiography, and since 2003 Senior Physician and Head of the Department of Vascular and Interventional Radiology.
  • 2006 Accreditation as Neuroradiologist.
  • Since 2002, Research Assistant at the Institute of Medical Management and Health Sciences at the University of Bayreuth.
  • 2005 PhD defense at the Faculty of Economics, University of Bayreuth, Habilitation and Venia Legendi for "Medical Management and Health Sciences".
  • From 2009 to 2011, Head of the Center for Vascular Malformations at the Augsburg Hospital.
  • Since October 2011, University Professor and Head of the Department of Interventional Radiology at the University Hospital Regensburg.
  • From 2012 to 2017, Head of the interdisciplinary Center for Vascular Anomalies at the University of Regensburg.
  • From 2015 to 2017, Founder and Head of the first interdisciplinary Center for Pediatric Interventional Radiology in Germany.
  • 2014 Research Fellowship at the Children’s Hospital in Boston, Harvard Medical School, and Children's Hospital in Philadelphia.
  • Since June 2017, Head of the Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neroradiology at the University Hospital Halle (Saale) and Full Professor at the Martin Luther University of Halle-Wittenberg.

Memberships

  • Since January 2017, President of the German Interdisciplinary Society for Vascular Anomalies.

Photo of the doctor: (c) Universitätsklinikum Halle (Saale)


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