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 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.
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).
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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