Treatment of uterine cancer in Germany is performed by a multidisciplinary team that includes gynecologic oncologists, surgeons, nurse practitioners, social workers, dietitians, etc. The multidisciplinary approach allows choosing the treatment scheme that will be the most beneficial for a certain patient.
Treatment of uterine cancer in Germany is performed by a multidisciplinary team that includes gynecologic oncologists, surgeons, nurse practitioners, social workers, dietitians, etc. The multidisciplinary approach allows choosing the treatment scheme that will be the most beneficial for a certain patient. For instance, if a woman wants to have children in the future, ovarian tissue is harvested prior to radiotherapy. Hospitals in Germany offer a full range of therapeutic options and can meet the expectations of all patients.
Comprehensive and sparing surgery
Hysterectomy is the most common procedure for uterine cancer surgical treatment. Depending on the cancer stage, a surgeon may perform a simple hysterectomy (which is removing uterus with its cervix) or a radical hysterectomy (which is removing uterus with its cervix in combination with the upper part of the vagina, and adjacent tissues).
In menopausal women a surgeon typically supplements uterus removal with a bilateral salpingo-oophorectomy (removing both fallopian tubes and ovaries). This serves as an additional measure of relapse prevention. There are few modes of the hysterectomy performing which are by abdominal incision (open procedure), by laparoscopy, by robotic intervention, or by vaginal approach.
Simultaneously with hysterectomy, a surgeon may remove the adjacent lymphatic nodes. This helps to determine if the tumor has spread beyond the uterus. Lymphatic nodes are examined with the help of less invasive sentinel lymph node biopsy (lymph nodes sampling) or lymphadenectomy (lymph nodes removal).
Diverse radiation therapy regimens
Radiotherapy is typically performed after the surgical intervention in order to destroy any remaining malignant cells. In certain clinical cases radiation therapy may be given prior to the surgery, as it causes tumor shrinkage. If a woman cannot tolerate surgery, a doctor may recommend course of irradiation for alleviating symptoms.
Modalities of radiation therapy in uterine cancer treatment scheme include the following:
- Whole pelvis irradiation.
- Irradiation of the vaginal cavity, i.e. vaginal brachytherapy.
MRI-guided radiotherapy is another innovative technique. During this procedure, an MRI system is combined with a linear accelerator (system for delivering radiation therapy). The MRI produces real-time pictures of the target area, so the irradiation is directed exactly at the tumor. This allows reducing exposure of healthy tissues to the radiation.
Pharmacotherapy with diverse agents
In uterine cancer treatment, the systemic therapies are given in courses, intravenously or orally. There are four main groups of the relevant pharmacological agents:
- Chemotherapy is used for treating high grade and recurrent cancers, stage I and II endometrial tumors do not require chemotherapy performing. Typically, 2 or more of the following drugs are combined: paclitaxel, doxorubicin, carboplatin, cisplatin, and docetaxel.
- Hormone therapy is used in the therapy of certain tumor types that have receptors to the hormones on their cellular membranes. Hormone therapy typically involves a high dose of progesterone in pills or implantation of hormone-expressing intrauterine devices.
- Targeted therapy is aimed at tumor specific proteins or genes. Anti-angiogenesis therapy and mammalian target of rapamycin inhibitors are used in endometrial cancer therapy.
- Immunotherapy is mainly efficient in advanced tumors with mismatch repair defects. Pembrolizumab is approved for the treatment of such tumors regardless of their location.
Treatment of uterine cancer in the leading German clinics
The specialized hospitals in Germany admit patients regardless of their origin country. For those people who will have to travel abroad for receiving treatment of uterine cancer in Germany, it is better to contact Booking Health in advance. Booking Health is the medical tourism operator that facilitates endometrial cancer treatment for women from 75 countries.
Booking Health assists in:
- Making a choice between the best clinics and doctors.
- Understanding the preliminary diagnostic or therapeutic program.
- Booking the appointment or surgery date.
- Monitoring of the diagnosis and treatment by independent medical experts.
- Providing costs for medical services (saving up to 50% of the price for the foreigners).
- Receiving medical reports after the therapy completion, arranging control tests.
- Control of the final calculation and the unspent funds return.
- Booking plane tickets and accommodation, transfer organization.
- Services of the interpreter and personal coordinator.