September 30, 2019

Germany Offers Novel Options For Treatment Of Colon Cancer

health, colon cancer, German Hospitals, chemotherapy, radiotherapy, Freiburg University Hospital

German hospitals permanently take part in clinical trials aimed at prolonging life of patients with advanced colon cancer and increasing cure rates in patients with resectable tumors. Large clinical trials are evaluating combinations of currently available therapies, like treatment of colon cancer with chemotherapy added to immunotherapy or targeted therapy.

German hospitals permanently take part in clinical trials aimed at prolonging life of patients with advanced colon cancer and increasing cure rates in patients with resectable tumors. Large clinical trials are evaluating combinations of currently available therapies, like treatment of colon cancer with chemotherapy added to immunotherapy or targeted therapy. Smaller studies are evaluating new agents and techniques. At the present time preference is given to sparing and localized procedures along with medicamentous support.

Endoscopic surgical procedures
Endoscopic interventions serve for both diagnosis making and treatment performing. Their effectiveness is maximal at the early stages of colon cancer. Endoscopic procedures are more advantageous comparing to the conventional ones due to lower surgical risks.

1. Snare polypectomy is removing of the malignant or suspicious polyps with the help of wire loop. It is used in patients with pedunculated and sessile lesions of 0.5-2.0 centimeters in the diameter. According to the data of National Polyp Study, polypectomy can serve as the prophylactic measure as well.

2. Endoscopic mucosal resection is used for removing lesions of mucosa or submucosa that are not likely to affect nearby lymphatic nodes. Basically, endoscopic mucosal resection combines polypectomy with submucosal fluid injection and local mucosa removing.

3. Endoscopic submucosal dissection is used for the en-bloc resection of large intestinal lesions. These include areas of high-grade dysplasia or early cancer. The technique is applied in patients without deep submucosal invasion of the process.

Sparing and localized radiation therapy
Radiation therapy is applied in a number of treatment schemes: before or after the surgery, along with chemotherapy, as a symptomatic treatment in advanced cancer. In Germany, sparing techniques are applied for reducing irradiation of healthy tissues.
health, colon cancer, German Hospitals, chemotherapy, radiotherapy, Heidelburg University Hospital

1. Radioembolization is introducing coated with radioactive substances emboli in the tumor vessels. In addition to the irradiation of the neoplasm, embolization reduces the blood flow, so tumor receives less oxygen and nutrients.

2. Endocavitary radiotherapy is placing of the radioactive source inside the intestine for the certain time period. Usual treatment course includes up to 4 procedures, with about 2 weeks interval between them. Positioning of the radioactive source is performed under the US control.

3. Interstitial brachytherapy is mainly applied in rectal cancer. In this case irradiation is delivered by few tiny sources, the co-called “seeds”. Seeds are implanted near the tumor. Due to the short path of radiation in the tissues, its maximal dosage is concentrated exactly at the tumor.

Pharmacotherapy with chemotherapeutic and targeted agents
Chemotherapy kills cancer cells of the primary tumor and distant metastases. Treatment of colon cancer with chemotherapy in Germany is performed in the adjuvant and neoadjuvant modes. The most efficient medications are capecitabine (Xeloda), 5-fluorouracil, oxaliplatin (Eloxatin), irinotecan (Camptosar), and combination drug containing trifluridine and tipiracil (Lonsurf).
health, colon cancer, German Hospitals, chemotherapy, radiotherapy, St. Vincentius Hospital

Targeted therapy is mainly used in patients with stage IV metastatic cancer and bad response to the chemotherapy. Targeted therapy may supplement chemotherapeutic drugs or serve as the monotherapy. Schemes with panitumumab (Vectibix), cetuximab (Erbitux), and bevacizumab (Avastin) may be considered.

Immunotherapy is also mainly aimed for patients with unresectable and metastatic tumors. It may be performed as the single-agent treatment with pembrolizumab (Keytruda) or nivolumab (Opdivo). Immunotherapy can also be used in the subsequent lines of therapy in biomarker-positive patients.

Receiving treatment in German hospitals with Booking Health
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