Blood cancer treatment

Malignant processes of the organs of hematopoiesis and the lymphatic system are called hemoblastosis. For most people, another name is more familiar — blood cancer. This is a numerous group of different processes that affect children and adults. In developed European countries, such as Germany, the diagnosis and blood cancer treatment, which means all forms of cancer hematopoietic system is based on an individualized approach and application of the most modern methods of hemoblastosis control.

Diagnosis of blood cancer in Germany

All hemoblastoses are divided into two broad categories of malignant processes: leukemias (leukemias) and hematosarcomas (lymphomas). Each of the categories includes several separate diseases with their own characteristics.

The main goal of the first stage of blood cancer treatment is to accurately establish the form of the disease and its stage.

Notice the first signs of pathology in most patients can be detected by clinical blood tests: the number of leukocytes jumps significantly above the norm. Unfortunately, this is not always the case, and then the disease remains undetected and progresses.

In order to find out all the necessary details, a number of examinations and tests are required. In Germany, thanks to the specialization of individual clinics in the field of oncohematology, all examinations can be performed in one place, practically on an outpatient basis.A typical diagnostic algorithm includes these techniques:

A typical diagnostic algorithm includes these techniques:

• a complete blood count;
• biochemical studies;
• bone marrow puncture (trepanobiopsy);
• lymph node puncture or removal;
• immunohistochemical, molecular genetic study of the punctate or removed node.

Bone marrow puncture has the greatest diagnostic value. In adults, the sample is taken from the pelvic iliac bone and in children from the sternum. This operation in Germany is performed under local anesthesia or short-term general anesthesia.

Additional instrumental examinations are required to obtain data on the extent of the tumor:

• puncture of the spinal canal to obtain a portion of liquor (cerebrospinal fluid);
• CT and MRI with contrast;
• Abdominal ultrasound.

Such techniques should be classified as auxiliary, because the main clinical value is clinical and biochemical tests, immunohistochemical and molecular genetic studies of bone marrow biopsy: only thanks to them it is possible to establish the exact type of tumor.

The links of erythropoiesis and thrombocytopoiesis undergo cancerous transformation very rarely. This is why the experience of the physician is so important, who will detect the disease at the beginning of its development, when treatment is most effective.

Leukemias

This includes all malignant processes originating from hematopoietic cells in the bone marrow. At a certain point, the hematopoietic system begins to produce many young and immature leukocytes, and the processes of their maturation (differentiation) are inhibited or stopped.

The main pathologic processes in leukemia, are as follows:

• anaplasia — cells that have left the bone marrow are immature and unable to fulfill their assigned function;
• hyperplasia — the generation of such leukocytes is very active, an analogy with tumor growth in other forms of cancer, not related to blood pathology is appropriate;
• dysplasia — pathologically altered cells gradually displace less active healthy sprouts with normal hematopoiesis from the bone marrow;
• Metaplasia — leukemia cells, similar to metastases, create foci of abnormal hematopoiesis in the spleen, lymph nodes.

In terms of course, leukemias come in:

1. Acute, include 10 distinct nosologies, are characteristic of pediatric and adolescent patients.
2. Chronic — 11 variants of pathology, more common in mature individuals.

Hematosarcomas (lymphomas)

Primary foci of such tumors are localized in lymph nodes. But later, by analogy with metastasis, leukemization occurs — deposition of malignant lymphoma cells in other parts of the body, including the bone marrow.

Lymphomas also fall into two broad categories: lymphogranulomatosis (Hodgkin’s) and more than 30 types of non-Hodgkin’s lymphomas.

Professional analysis of diagnostic data allows doctors in Germany to create an individualized plan to combat the detected disease.

Methods of blood cancer treatment in German clinics

Unfortunately, there is still no universal method that would help with all forms of cancer of the hematopoietic system. Complicating the treatment of such tumors is the inability to perform radical surgery to remove the pathological node.

Therefore, the main methods of treatment remain conservative:

• chemotherapy;
• radiation therapy.

Surgical intervention is considered when bone marrow transplantation is necessary. German doctors have a very rich experience in successfully performing such operations.

Chemotherapy

The traditional use of drugs is aimed at stopping the uncontrolled division of malignant cells. Cytostatics play a major role in this, but some forms of blood cancer are resistant to them.

Immunohistochemical examination of bone marrow puncture specimens can avoid such situations, doctors can refuse to use obviously ineffective drugs for chemotherapy, prescribing those to which the tumor remains sensitive.

This technique is called targeted chemotherapy and is very widely used in Germany. It demonstrates good efficacy in different forms of cancer and helps to save money and time.

Therapy for acute leukemia consists of several phases:

• Induction – highly active chemotherapy drugs are used to destroy all malignant cells in all foci. The duration of this stage in the center of oncohematology is several weeks.
  
• Consolidating – ensures the consolidation of the achieved effect. Treatment lasts about a year and includes outpatient and inpatient periods.
  
• Supporting – is prescribed for acute lymphoblastic leukemia, aimed at preventing infectious diseases that can cause cancer relapse.
  

Different chemopreventive drugs are used at each stage.

Modern oncohematology clinics in Germany actively use the innovative therapy of blood cancer with monoclonal antibodies. Such treatment is devoid of the side effects of classical chemotherapy, and its effectiveness is an order of magnitude higher.

Radiation therapy

It involves the delivery of beams of ionizing radiation aimed strictly at the identified neoplastic foci. Radiation therapy is also used in preparation for stem cell transplantation.

Surgical intervention

Stem cell transplantation may not be called an operation, the term «intervention» is more appropriate. Indications for such a procedure are strictly individual.

First, the patient’s diseased bone marrow is killed with chemotherapy drugs or harsh radiation, and healthy stem cells of the hematopoietic system are replanted in the vacated space. The material is taken either from a suitable donor or from the patient’s own bone marrow.

In such cases, tumor cells are filtered out using special immunosorbents with monoclonal antibodies, and the remaining healthy cells are transplanted.

How much does it cost to treat blood cancer in Germany

The full cost of all stages of hemoblastosis treatment, from diagnosis to the final stage of treatment, is formed individually.

Name of service	Price, €	Additionally
Consultation with an oncohematologist	250	—
Laboratory tests	500	—
Lymph node biopsy	120	—
Transplantation of the patient’s stem cells	30000	—

The induction therapy phase costs the most, the subsequent phases are less expensive.

Stages of blood cancer

Leukemias and hematosarcomas develop by different mechanisms and therefore the stages are different in these categories of cancer.

Lymphomas are staged according to the criterion of prevalence:

1. Localized. The stage is initial, one group of lymph nodes or two but contiguous groups are affected.
   
2. Regional. In this stage, the process affects two or more bundles of lymph nodes, not necessarily close but on one side of the diaphragmatic muscle.
   
3. Generalized lymphoma stage. Nodes are affected on both sides of the diaphragm, involving the thymus gland, lymphatic pharyngeal ring, and spleen.
4. Disseminated stage. There is damage to organs other than the lymphatic system — kidneys, intestines, pleura, lungs and so on.
   

As for acute leukemia, it is classified by period:

1. Elementary.
2. A period of full development.
3. Remission period.

Lack of treatment causes the fulminant stage to progress to terminal stage, with a difficult prognosis.

There is another option — precancerous diseases of the hematopoietic system. These are myelodysplastic syndromes. But at this stage, unfortunately, hemoblastosis is detected very rarely. More often people turn to the development of noticeable symptoms of blood cancer.

Symptoms of blood cancer

The main manifestations of any form of hemoblastosis are due to the fact that a large number of defective cells accumulate in the human blood. In this case, five main symptom complexes develop:

1. Immune disorders. Disguised as sore throat, rheumatism, acute respiratory viral infections.
2. Anemia or anemia. It is manifested by weakness, fatigue, muscle aches and other similar manifestations.
3. Proliferative syndrome. The lymph nodes and spleen are enlarged.
4. Dyspeptic disorders. Caused by a build-up of lymphoid tissue in the small intestine.
5. Bleeding. Hemorrhagic syndrome is caused by a decrease in platelet synthesis, there are blood impurities in feces, urine.

Some patients experience neurological symptoms such as poor memory, emotional lability, nystagmus, facial nerve paresis.

The appearance of such symptoms is a reason to take clinical tests. Such examination will show changes in the leukocyte formula, will give impetus to further diagnosis, clarification of the diagnosis. And the earlier it is possible to find cancer, the easier it is to treat it.

Effective treatment of hemoblastosis depends closely on the timely diagnosis of the disease, the completeness of the examination and the application of the most effective therapeutic regimens. All this is offered by German oncohematology centers.

The main thing is to seek qualified help. In modern conditions it is not difficult. Experienced professionals will help guide you in choosing the most appropriate clinic.

The staff is English-speaking, which greatly facilitates communication and planning of all details: from the initial consultation to arranging tickets to Germany and back. The success of treatment is guaranteed by the rich experience of German oncologists and the developed technological and pharmaceutical industries of this country.