TOP Doctors for Oncology

Success of oncology disease treatment depends mostly on timely and quality diagnostics. It is not always easy to detect the initial localization of the process and it is even more difficult to suspect it at its first stages. Timely diagnosis and early treatment are highly important and allow maximizing your chances of success. Cancer treatment in Germany starts with the process of diagnostics.

To start treating cancer, it is necessary to diagnose the disease correctly. Modern technology and examination methods help a lot in that.

Radiographic examination allows detecting a new growth in cavitary organs; it mostly often focuses on pathology of gastrointestinal tract. It can be performed in combination with contrast study and angiography or bronchography.

In many countries mammography is not only a simple diagnostic method, but also a screening examination. It is performed with minimal exposure to radiation and allows detecting even the tiniest indurations in mammary gland which can be a sign of the development of pathologically malignant process.

Doppler ultrasound allows determining the placement and direction of pathologic growths, as well as defining blood supply level of a damaged organ, which is highly important for starting the adequate cancer treatment.

Isotopic scanning of all body structures (bone and soft tissues, organs) is conducted.

PET CT is a very important modern examination allowing to detect the development of a pathologic process, its localization and biological processes taking place in the new growth. It is of great importance for coordination of cancer treatment.

Laboratory examinations ranging from general blood tests to cancer-specific markers are also significant aspects of diagnostics.

Due to modern technologies and latest practices cancer treatment has become much more efficient and accessible. Many fatal oncology diseases have passed into the category of chronic pathological processes. In case the new growth can be eradicated and does not disseminate, the patient can be almost fully recovered. In any case, cancer treatment requires individual solutions because the process runs differently in each specific case.

Modern German clinics offer complex and combined cancer treatment. Some of the treatment techniques are the following:

Surgical treatment of cancer is used in 40% of cases. Surgical operation can be radical (eradication of the new growth within healthy tissues) or palliative (allows to alleviate the symptomatology, increases life span, but does not fully eliminate the pathological process).

Radiation therapy of cancer. Tumour cells are irradiated with gamma rays. This kind of irradiation destroys the new growth and does minimal damage to surrounding healthy tissues.

dication affecting tumour cells is used for chemotherapeutic cancer treatment. In some cases it is performed as a preparatory procedure for subsequent surgical treatment of cancer (diminishing the tumour down to operable size). It is also used after surgical operation or in combination with radiotherapy so as to detect and eliminate any hidden nidus of malignant process. During chemotherapy the body needs extensive pharmacologic support, as cancer treatment weakens it on the whole because of the powerful influence of chemotherapy medications. Another option is palliative chemotherapy which considerably improves the patient’s life quality and is highly important for cancer treatment.

Radiosurgical method of cancer treatment implies one-time irradiation of the tumour by high-ionization emission. As a result, the process of tumour development is stopped or inhibited.

Hormonal cancer treatment covers malignant processes which are closely connected with hormonal changes, such as pathology of mammary gland or prostate. In this case, hormonal or antihormonal medication is used for cancer treatment.

Immunologic method of cancer treatment takes into account immune reactions of human body aimed only at the new growth. This method stimulates the immune system so that it destroys pathologic cells. Based on this method, “smart” medication for cancer treatment has been created: it contains antibodies selectively destroying tumour cells only.

Transplantation of bone marrow or stem cells: autologous or allogenic transplantation; allogenic transplantation from unrelated donor, selected by histocompatibility; allogenic transplantation in case of partial match.

Advanced methods of cancer treatment available for German clinics allow improving life quality and prognosis for the run of the disease. Due to latest technologies, malignant tumour is no more a dooming prognosis; it is now a disease which you can successfully combat – this fact has been proved by thousands of medical cases.

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Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy. 2019-05-01 Oncology
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Immunotherapy against cancer: "The development is rapid"


Peter Jacob had already had several chemotherapies, but the cancer did not go away. Two years ago, the now 70-year-old from near Schweinfurt in Lower Franconia was diagnosed with multiple myeloma, an aggressive form of bone marrow cancer. The subsequent therapies brought nothing in the long term. "Today I feel healthy and have hardly any limitations in the quality of life," said Jacob at a press conference at the University and University Hospital Würzburg. Jacob was treated in mid-December with the so-called CAR-T cell therapy.

According to the Würzburg researchers, Jacob is the first successfully treated patient with this type of cancer in Germany. In a patient treated at the same time, the therapy did not work so well.

In CAR-T cell therapy, the patient is bled and a portion of the white blood cells, the T cells, are genetically engineered to recognize and destroy cancer cells. Thereafter, the patient gets the cells re-administered.

The therapy has been researched for some time, but was first approved in Europe in August 2018. It is also being investigated and partially applied in other cities, such as Cologne, Heidelberg, Munich, Frankfurt and Regensburg. The number of ongoing studies is increasing. "The development is currently rapid," says Michael Hudecek, head of the CAR-T-cell program in Würzburg.

According to Hudecek, about 100 patients have already been treated in Germany, just over 20 in Würzburg alone, of which more than half are successful. How many patients have exactly received the therapy in Germany, according to the German Cancer Research Center (DKFZ) in Heidelberg difficult to say.

So far, the therapy is mainly used in various forms of blood and lymph node cancer. It has not been well transmitted to solid tumors such as breast, colon and skin cancer. In addition, the side effects of the therapy are not fully understood. A well-known side effect are fever episodes. Peter Jacob had her too. "They gave themselves quickly," says Jacob. The fever episodes are at the same time signs that the therapy strikes.

In the course of treatment, it can also lead to neurotoxic reactions, such as inflammation in the brain or to so-called cytokine towers, a kind of flooding of the body with certain messengers. There were also deaths. "It is not a simple therapy and strong side effects are possible," says Stefan Eichmüller from the German Cancer Research Center (DKFZ) in Heidelberg. "But she is the most effective we have right now."

At present, the therapy is only given to patients in Germany as therapy patients. In the US and China, CAR-T-cell therapy has been used for some time. "It is very important that we do not lose the connection here," said the Würzburg oncologist Hermann Einsele on Thursday.

The world's most famous CAR T cell patient is the girl Emily Whitehead from the USA. She was the first person to be treated with the new immunotherapy in 2012. Today Emily is a teenager and, according to the Emily Whitehead Foundation, cancer free since the end of treatment. In 2017, she was ranked by the scientific journal "Nature" among the ten people who played a crucial role in science.

Whether Peter Jacob really healed, has yet to show. Cancer can basically come back. But it is a particular advantage of T-cell therapy that the "drugs" remain in the body: the once activated CAR-T cells should then possibly fight the following cancer cells.

New therapies in the fight against cancer


Secondary tumors, as medical specialists call them, can be found in certain types of tumors over 80 percent in the vertebral body. They continue to spread in the bone, cause severe back pain and, in the worst case, lead to paraplegia. Prof. Dr. med. Andreas A. Kurth, medical director and orthopedic oncologist at the Hospital Ratingen, explains what changes cancer causes in the body, shows diagnostic procedures and describes treatment approaches.

Each of the over 200 cancers triggers different warning signs. Examples of the most common types such as breast, prostate and colorectal cancers include breast lumps, testes thickening and stool blood. But changes in the skin, loss of appetite, persistent cough, chronic fatigue, dysphagia and pain of unknown origin indicate possible cancer. Secondary tumors in the spine may cause pain, numbness or paralysis due to the nearby nerve structure.

"The gradual destruction of healthy bone material increasingly affects the musculoskeletal system through fractures," says Prof. Dr. Kurth.

After doctors have determined the type, size and location of the malignant tumor, they initiate appropriate therapies. These include chemo, radiation and anti-hormone therapy. In the former, cell toxins inhibit the proliferation of cancer cells, but also attack healthy tissue. In order to more effectively damage tumors, physicians rely on radiation therapy in which they bombard malignantly altered structures with X-rays or electric radiation. Certain breast and prostate cancers can be affected by blocking hormones that stop growth.

The surgical removal of tumors proves to be particularly difficult for secondary tumors in the backbone. "There are further developments here," explains Prof. Dr. med. Kurth and describes the procedure: "With the help of the so-called STAR ablation, we melt away spinal metastases, destroying radiofrequency energy, ie heat, selectively malignant tissue, without endangering sensitive neighboring structures.

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