conventional and novel treatment methods in Germany allows providing each
patient with the highest chance to defeat the disease. First of all, the
surgical treatment is crucial for long-term survival. Nonetheless, it typically
removes the primary tumor, without affecting distant metastases. Recent
clinical trials demonstrate that combined chemotherapy regimen improves
prevention of the postoperative atypical cells spreading.
Availability of conventional and novel treatment methods in Germany allows providing each patient with the highest chance to defeat the disease. First of all, the surgical treatment is crucial for long-term survival. Nonetheless, it typically removes the primary tumor, without affecting distant metastases. Recent clinical trials demonstrate that combined chemotherapy regimen improves prevention of the postoperative atypical cells spreading. In addition, novel targeted treatment is able to attack the unique aspects of atypical cells, therefore sparing the healthy ones.
Sparing and complete surgical removal of the tumor
Surgical intervention includes entire or partial pancreas removing, which depends on the size and location of tumor. Certain volume of healthy tissues around the visible tumor is removed as well for the relapse prevention. Surgery is aimed at having “clear surgical margins”, which means that there are no malignant cells in the edges of the removed tissue.
In Germany, surgical oncologists perform the following interventions:
- Whipple procedure. It is suitable for neoplasms in the head of the pancreas, that are removed along with part of the duodenum and stomach, and neighboring lymphatic nodes.
- Distal pancreatectomy. It is suitable for neoplasms in the tail of the pancreas, that are removed along with pancreas body and spleen.
- Total pancreatectomy. It is suitable for advanced or multi-focal neoplasms. The entire pancreas is removed along with part of the duodenum and stomach, gallbladder, and spleen.
Tumor embolization that includes blocking tumor vessels by the radioactive or coated with chemotherapeutic agent microspheres is another type of therapy, the combined one. When possible, surgical oncologists use laparoscopic techniques that are more sparing for the healthy tissues.
Choosing between radiation therapy modalities
Radiation therapy in Germany includes three basic modes of the procedure:
- Conventional fraction radiotherapy is performed during 5-6 weeks in total. Patient receives low doses of radiation daily or per fraction.
- Proton beam radiotherapy is mainly used in the clinical trials. It resembles the conventional radiotherapy except for using protons instead of x-rays. Proton irradiation is more precise, so less healthy tissues are involved and fewer undesirable symptoms arise.
- Stereotactic radiotherapy combines features of surgery and radiation therapy. It provides more precise treatment and reduces number of treatment sessions. Cyberknife, the device for stereotactic radiotherapy, directs high irradiation dosage exactly at the tumor. Along with sparing healthy surrounding tissues, Cyberknife destroys pathological foci during one or few procedures.
Radiotherapy is often administered in combination with chemotherapy, as they mutually enhance each other. For instance, radiosensitization phenomenon includes higher efficacy of radiotherapy in application after certain chemotherapeutic agents intake.
Chemotherapy as the first-line or additional option
Administration of chemotherapeutic medications is considered to be the first-line therapy in patients with advanced and metastatic pancreatic cancer. Typically, chemotherapy regimen includes few treatment cycles performed over a certain period of time. The following drugs are approved by the FDA and are used in monotherapy or combination therapy in Germany:
- Gemcitabine (Gemzar).
- Capecitabine (Xeloda).
- Fluorouracil (5-FU).
- Leucovorin (Wellcovorin).
- Oxaliplatin (Eloxatin).
Chemotherapy makes tumor shrink, prevents its growth and metastasizing. Performed in the postoperative period, it serves as the measure of secondary prevention due to killing the microscopic malignant cells that cannot be revealed by a surgeon.
Targeted treatment with fewer side effects
Targeted therapy is a treatment option that is aimed at the specific proteins, genes or the tissue environment that stimulates growth and spreading of the tumor. What is important, this treatment destroys pancreatic cancer cells while limiting affection of the healthy tissues.
Different tumors have different targets, so treatment schemes for two patients with pancreatic cancer may have significant differences. Before prescribing the specific medicine, a doctor performs a number of tests in order to explore proteins, genes and characteristics of the tumor.
Three forms of targeted therapy are available in German clinics now:
- Erlotinib (Tarceva) is intended for patients with advanced pancreatic cancer. According to the FDA approval, it is typically administered in combination with gemcitabine. Erlotinib blocks EGFR receptors (EGFR is a protein that stimulates growth and spreading of neoplasms).
- Sunitinib (Sutent) and everolimus (Afinitor) are intended for patients with advanced stages of pancreatic neuroendocrine tumors. Neuroendocrine tumors account for up to 6% of all pancreatic cancer cases.
- Larotrectinib (Vitrakvi) targets the specific genetic change – NTRK fusion. Such change is revealed in a number of cancers, including the pancreatic one.
Applying for treatment in Germany with Booking Health
You may choose to undergo pancreatic cancer treatment in Germany for a number of reasons. In absence of previous international experience, it is better to use help of Booking Health. Booking Health is the international provider of medical tourism with special focus on treatment in Germany. Booking Health will assist you in the following issues:
- Making choice between the best oncological centers and physicians.
- Booking an appointment without being on the long waiting list.
- Taking care about visa and administrative documents.
- Translating the existing medical reports into German in order to avoid examinations repetition.
- External monitoring of all program stages by our experts.
- Communication with physician after returning home.
- Control of the final calculation, avoiding overpricing (saving up to 50%).
- Booking accommodation and tickets, transfer.
- Arranging services of interpreter and personal medical coordinator.
Booking Health takes over all the organizational issues and offers comprehensive support 24/7.