Malignant liver tumors occupy the fifth place by frequency among all oncological pathologies in men and the eighth place in women.
At the same time, about 25% of liver cancer cases in our country are diagnosed at late stages, when effective treatment is quite difficult. The reasons for this state of affairs are related both to the peculiarities of the pathology itself and to the imperfection of the domestic model of oncologic service.
In such a situation, it is possible to restore health and even save life by turning to highly qualified oncologists at specialized clinics in Germany. In modern conditions, there are no special technical difficulties for this: it is possible to obtain a visa, choose a clinic for treatment and coordinate all the details in advance within the framework of one comprehensive program, in one place.
Diagnosis of liver cancer in Germany
The country, which combines centuries-old medical traditions and the most modern technological achievements, confidently leads in the latest examination methods among all European countries.
The most informative traditional methods and promising innovative approaches are used in the diagnosis of liver cancer. In Germany, the diagnostic algorithm is individualized for each patient, but the general principles are also observed.
A typical screening program for patients with suspected liver cancer includes:
- interview and examination by a highly trained professional;
- blood tests for general clinical parameters and oncomarkers;
- Ultrasound of abdominal organs in the modes of routine sonography and Dopplerometry;
- multislice spiral computed tomography with contrast;
- magnetic resonance or positron emission tomography;
- fine-needle biopsy of tissue from the suspicious focus with subsequent histologic and cytologic examination of the biopsy.
Suspicion of hepatic duct involvement is an indication for endoscopic retrograde cholangiography.
As a rule, it is possible to establish the diagnosis of liver tumor by non-invasive imaging methods alone: ultrasound, CT, MRI.
Positron emission tomography is very informative about the functional activity of the tumor, helps to establish the prevalence of the node and detect metastases to regional lymph nodes, adjacent organs of the abdominal cavity
A biopsy provides data on the cellular composition of the tumor and is used in complex cases, e.g. to distinguish primary liver cancer from metastatic cancer.
The results of the examination are analyzed comprehensively and on the basis of the current state, which makes it possible to establish the most complete and accurate diagnosis. Thanks to this principle, the doctor is able to draw up an optimal program to combat oncology in an individual patient.
Methods of liver cancer treatment in Germany
Two broad categories of medical techniques are successfully utilized here: therapy, or conservative techniques, and surgery, invasive approaches.
The most appropriate method of treatment is selected individually, based on the patient’s examination data, the form and stage of cancer, depth, extensiveness of its growth, the presence of metastases.
A conservative approach includes time-tested and proven effective approaches:
- chemotherapy;
- radiation therapy.
The effectiveness of conservative treatment of cancer is determined by the form, aggressiveness of the pathological process, the depth of damage to the liver and other organs.
The experience and professionalism of doctors in Germany make it possible to predict in advance the need for invasive surgical techniques. Their inclusion in advance in an individual treatment plan helps the patient to better plan financially and the time required for a full course of treatment.
A modern conservative approach
Genetic studies of tumor cells offer good prospects. Identification of mutations typical for different types of tumor cells helps to select the most effective drugs for targeted therapy from the first time. This is the most modern approach, when a patient is prescribed drugs that act specifically on malignant cells. Healthy organs and tissues are not affected or damaged.
Immune personalized therapy is also developing at a remarkable pace in Germany. This is the administration of drugs that cause a person’s white blood cells to recognize carcinomatous cells and destroy them.
Traditional and well-established chemotherapy regimens are not being abandoned by doctors either.
In combination with drugs, German doctors actively use modern methods of radiation therapy.
Modern surgery
Interventions with minimal blood loss are preferred. Minimally traumatic and least invasive techniques are used:
- laparoscopic resection of diseased parts of the liver with the capture of healthy tissues;
- local destruction of nodules (radiofrequency ablation, laser-induced thermotherapy, cryodestruction, irreversible electroporation);
- radioembolization or chemoembolization of the vessels that supply blood to the tumor;
- selective internal radiation therapy (a variant of brachytherapy).
Ultrasound monitoring or, more effectively, real-time MRI allows precise positioning of instruments for localized interventions.
In certain situations, when the liver tissue is destroyed very seriously, one has to rely only on transplantation.
How much does it cost to treat liver cancer in Germany
Diagnosis is the first and most important step in the fight against oncology. The German school focuses on the experience of doctors and modern methods of instrumental examination. The full price for the diagnostic package is determined after consultation with an oncology specialist.
It should be taken into account that the country ranks first in the development and introduction of innovations in the production of medical equipment. High-quality equipment produced by leaders of high-tech devices for the domestic market significantly increases the informativeness of instrumental techniques.
During the treatment phase, attention should be paid to the fact that many world-renowned manufacturers of medicines and medical equipment are of German origin. This guarantees that the purchased medicines will not be counterfeit, and the operation will be carried out with the use of first-class equipment. The cost of treatment, the list of drugs and the list of necessary procedures are formed after the examination and establishment of an accurate diagnosis.
German language skills are a big plus. However, since this knowledge is not widespread, an interpreter’s services, including assistance in communicating with doctors and translating medical documents, are very useful.
The total amount is individual. But a person gets first-class service and treatment for his money, comfortable accommodation and flight, and the time spent on drawing up all the necessary documents is minimal.
The key is to seek help as early as possible: the smaller the size and number of nodes, the less time and money it will take to develop and implement a cancer control program.
| Name of service | Price, € | Optional |
|---|---|---|
|
Diagnostics |
2050–3000 |
5 days, outpatient |
|
Atypical marginal or wedge resection of the liver |
11500–15000 |
10 days, inpatient |
|
Lateral segmentectomy |
11500–15000 |
10 days, inpatient |
|
Bisegmentectomy |
11500–15000 |
10 days, inpatient |
|
Trisegmentectomy |
11500–15000 |
10 days, inpatient |
|
Embolization of tumor vessels |
5000-7000 |
5 days inpatient |
|
Extensive liver resection |
18000–25000 |
14 days, inpatient |
|
Unilateral hepatectomy |
11500–15000 |
10 days, inpatient |
|
Diagnosis and conservative treatment with 1 course of chemotherapy |
5500– 6500 |
5 days, inpatient |
Symptoms of liver cancer
In order to realize the full potential of German medicine in the field of oncology, you should pay attention to your health and not miss the first symptoms of pathology. This applies in particular to people with chronic hepatitis (HCV), with cirrhotic processes.
Unfortunately, early diagnosis of liver cancer is very difficult. The reason is that the liver has no nerve endings and starts to bother only when the process leads to stretching of the capsule, critically reduces the functional capacity of the organ or affects adjacent organs and tissues, metastasizes.
Some of the earliest symptoms are:
- chronic fatigue, weakness, asthenia;
- sensation of heaviness in the right subcostal region, upper abdomen, in the area of the right shoulder blade;
- recurrent nausea, abdominal bloating, vomiting;
- loss of appetite;
- pronounced and rapid weight loss;
- abdominal enlargement due to fluid effusion (ascites);
- yellowing of eye sclerae, oral mucosa and skin;
- darkening of the urine and lightening of the feces;
- the appearance of swelling in the right side of the abdomen.
Also with liver pathology, the blood clotting system often suffers. It can be noticed by black stools, heavy periods. In the case of seemingly harmless injuries, bleeding does not stop unexpectedly for a long time.
Comparatively rare symptoms are fever, chills.
If the process is secondary, metastatic in nature, such problems will be layered with signs of damage to other systems. Unfortunately, the opposite situation also occurs, when symptoms of primary liver cancer are not detected until metastases appear in other tissues and organs (most often the lungs).
Early manifestations
Sometimes liver tumors show hormonal activity. Then paraneoplastic symptoms may be noticed:
- increased calcium levels in the blood — lethargy, weakness, constipation;
- in men, enlargement of the mammary glands and shrinkage of the testicles;
- decrease in blood glucose (hypoglycemia)- fainting, weakness;
- elevated cholesterol;
- Erythrocytosis — excessive red blood cells.
These phenomena are nonspecific and are often mistaken for some other pathology. Patients beat the doorsteps of therapists, cardiologists and neurologists and lose valuable time. And here it is necessary to consult an experienced oncologist. Confirm or remove the diagnosis helps to confirm or remove the diagnosis of the liver ultrasound, blood tests for oncomarkers.
Stages of liver cancer
The severity of manifestations depends on the extent of the cancer process and its form. An international classification is used to assess the stage TNM:
- Stage 1 — single tumor up to 2 cm in diameter without metastases and regional lymph node involvement.
- Stage 2 — single node more than 2 cm in diameter; or smaller, but with vascular involvement; or several small nodes within one lobe. Lymphoid tissue is not involved, no metastases.
- Stage 3A — single node or multiple nodes with a diameter of more than 2 cm with invasion of vessels, without involvement of lymph nodes and without metastases.
- Stage 3B — any situation from the previous three stages, but with lesions of the lymph nodes of the portal group or hepatoduodenal ligament.
- Stage 4A — large single or multiple tumors that have invaded the liver veins or adjacent organs (except gallbladder) or peritoneum. No evidence of lymph node involvement or metastases.
- Stage 4B — any picture, but with detection of metastases to distant organs.
In terms of morphologic forms, four types of primary malignant tumors are most commonly encountered:
- Hepatocellular (HCC) or hepatic cell cancer — its source is liver cells, often combined with cirrhosis, develops against the background of chronic viral hepatitis;
- Cholangiocellular or intrahepatic bile duct cancer (IBC), it is rarely combined with cirrhosis;
- Mixed form — cells in the lesion focus have signs of both HCC and CCR, it is rare;
- Hepatoblastoma — more typical of childhood.
Primary liver cancers metastasize with the blood stream, with lymph or by implantation through the peritoneum, diaphragm. From other organs to the liver, metastasis enters by hematogenous route. Sources of dropouts often become: large intestine, stomach, mammary glands, lungs. Less frequently, metastases from the esophagus, prostate are carried with blood.
Modern German medicine offers the most advanced opportunities to detect any form of liver cancer in time, to conduct a full and comprehensive diagnosis of the disease.
The extensive experience of doctors and high-tech equipment of German clinics make it possible to cure various forms of liver oncology. The main thing is to have a timely examination and detect the disease at the earliest possible stage. Then the treatment can be limited to a gentle program of chemotherapy, radiation therapy, and minimal surgical interventions.
Many clinics in various German cities offer these medical advantages. But you should choose the most suitable one taking into account the disease profile. For example, liver cancer is successfully treated at the Munich Cancer Center.
For the convenience of patients, specialists have developed comprehensive programs that take into account all the needs of a person in a foreign country.
It is possible to organize treatment in the chosen clinic, from obtaining a visa to the return flight at the end of the course, in one place and in a short time. There are no queues or languid waiting times. This allows the patient to focus on his or her health, rather than dissipating energy and strength.