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Treatment of rectal cancer with embolization or chemoembolization (program ID: 689740)

University Hospital Oldenburg

location_on Oldenburg, Germany
10/10 from 33 Votes
Specialized hospital
Tobias Kowald

Head Physician
Dr. med.

Tobias Kowald

Specialized in: adult and pediatric diagnostic, interventional radiology

Department of Adult and Pediatric Diagnostic, Interventional Radiology

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
  • 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 at the University Hospital Oldenburg 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. The department is headed by Dr. med. Tobias Kowald.

The department carries out all diagnostic imaging tests. Thanks to the modern digital system, the specialists of any department of the hospital can promptly get access to their results, which provides an interdisciplinary approach and selection of the optimal type of therapy.

The department's therapeutic options include minimally invasive treatments, such as stent implantation for vascular stenoses, non-surgical treatment of cancer, pain therapy, treatment of vascular diseases, including aneurysms and aortic dissection.

In addition, much attention is paid to the diagnostics and treatment of children. The specially trained experts with deep knowledge in pediatric pathologies work with young patients. It should be noted that doctors who work with children can easily find common language with them and win their favor. The conventional X-ray examinations in children are carried out in a new separate unit, while the special X-ray examinations, such as imaging of the gastrointestinal tract or urinary tract, are carried out in the Central Department of Radiology. Recently, many diagnostic examinations in children can be performed on an outpatient basis.

The department's range of medical services includes:

  • Conventional X-ray examinations of the lungs, abdominal cavity and bones in various projections
  • Whole-body computed tomography (CT) for the accurate localization of pathological processes before thermoablation of liver metastasis, pain therapy, abscess drainage
  • Magnetic resonance imaging (MRI) for the examination of the skull and spine, musculoskeletal system, abdominal and pelviс organs. MRI is also regularly used for non-invasive imaging of the cardiovascular system, brain and spinal cord
  • Angiography (contrast-enhanced imaging of blood vessels) can be used both for the diagnostics and treatment, for example, for the treatment of vascular stenoses or thromboses using special balloons and stent implantation. Angiography can also be used for the treatment of malignant tumors of the liver or kidneys, aneurysms and aortic dissection, etc.
  • Fluoroscopy (mainly used for examining the gastrointestinal tract, imaging of the act of swallowing and for special examinations of the urinary tract). Of particular importance is fluoroscopy for diagnostics in children
  • Mammography (imaging test for early detection of breast cancer) and mammotome for biopsy in suspected breast cancer
  • Sonography (ultrasound scan)
  • Other diagnostic and therapeutic services

Photo of the doctor: (c) Klinikum Oldenburg AöR 


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