A Guide to Stage 4 Cancer Treatment in Germany

According to a recent report published by WHO, more than 6 lakh new cases of cancer are diagnosed annually in Germany, most of them being in advanced stages. Dealing with a stage 4 cancer diagnosis is a daunting challenge. It could be the worst nightmare anyone can face. 

There were times when cancer was considered untreatable, especially in advanced stages. But gone are those days. With the advancements in medical technology and continuous research & development, various innovative cancer treatment options have arrived. These include PLUVICTO, Dendritic Cell Therapy, TACE, and Biological Immunotherapy.

Stage 4 cancer requires a comprehensive and personalized treatment approach. While various options are available worldwide, Germany has emerged as a leading destination for cutting-edge cancer treatment. In this blog post, we will have a glimpse at the advancements and opportunities available for stage 4 cancer patients in Germany.

What is Stage 4 Cancer?

Stage 4 cancer is metastatic cancer, which means it has spread to other body parts and surrounding lymph nodes. It is the most advanced stage of cancer, having a poor prognosis. A complete cure for cancer is not possible when it has reached its final stages, and the treatment majorly focuses on slowing down the progression and relieving the symptoms. 

Some of the most common organs where stage 4 cancer develops and their signs & symptoms are mentioned below.

• Lung Cancer: Shortness of breath, coughing up blood, chest pain.
• Liver Cancer: Weight loss, yellowing of the skin, abdominal swelling. 
• Prostate Cancer: Painful urination, swelling in the legs, blood in semen.
• Stomach Cancer: Loss of appetite, blood in stools, lumpiness in the stomach.
• Brain Cancer: Persistent headache, blurred vision, changes in mood, and loss of ability to think. 
• Breast Cancer: Bone pain, headaches, shortness of breath.
• Pancreatic Cancer: Back pain, jaundice, pancreatitis. 
• Neuroendocrine Tumors: Skin flushing, a growing lump under the skin, tiredness. 

Earlier, treating cancer was difficult, but now various treatment approaches are being used to improve the patient's survival rate and quality of life. Some of the conventional and newer treatments available are mentioned in the following sections. 

What are the Standard Approaches for Treating Stage 4 Cancer?

The standard treatment of stage 4 cancer involves palliative care, radiation therapy, chemotherapy, and surgical tumor extraction. The treatment approach for advanced cancer generally consists of combining these remedies.  

• Palliative care focuses on improving patients' quality of life with end-stage cancer. Its main objective is to improve disease symptoms and minimize the side effects of other treatments. Palliative care addresses physical issues (pain, fatigue, nausea, vomiting, loss of appetite) and emotional issues (depression, anxiety, fear). 
• Chemotherapy is a type of drug treatment in which highly potent medicines are used to kill cancer cells. Chemotherapy drugs can be administered alone or in combination with other medications. More than 100 chemotherapeutic drugs are already available in the market, and new ones are also being developed.
• Radiation therapy is a medical procedure in which high-energy X-rays or other particles are used to shrink the tumor and destroy the cancer cells. In stage 4 cancer, radiation therapy is generally given with other treatments, like chemotherapy and surgery, to kill any remaining cancer cells. It helps in relieving the symptoms and improving the quality of life.   
• Surgical treatment of cancer: In advanced stages of cancer, surgical removal of every tumor is not possible. However, if the sites of spread are not many and the size is not large, they can be removed along with the primary cancerous lesion. It helps in preventing the cancer from spreading further. 

What are the New Innovative Treatment Methods for Stage 4 Cancer in Germany?

The prognosis of fourth-stage cancer is not very good, but still, patients can live for years. Thanks to the advancements in medical technology, especially in the field of oncology. 

Medical centers in Germany are involved in extensive research and thus offer the latest treatment approaches that are not readily available anywhere else. Let's briefly discuss some of the new innovative methods used to treat stage 4 cancer in Germany.

• Dendritic Cell Therapy: It is a type of immunotherapy that has been recently developed. It is based on the concept of antigen loading and is done by generating dendritic cells from monocytes, activating them with cytokines, and injecting them back into the patient. These cells then produce an immune response to destroy cancer cells.

• TACE for Unresectable Cancers: Transarterial chemoembolization involves delivering chemotherapy locally to the cancer site, followed by blocking the blood vessels using synthetic embolic agents. TACE has an added advantage over conventional chemotherapy. The drug stays in the tumor for a longer period of time, and embolization reduces the blood flow, inhibiting the washout of chemotherapeutic drugs. It is frequently used for liver cancer but can also be used in patients with unresectable tumors of other organs.
• Biological Immunotherapy: Biological therapy works by activating the immune system of the body to recognize and attack cancer cells. Immunotherapy produces fewer side effects than other cancer treatments. Various types of biological immunotherapy available in Germany are T-cell therapy, oncolytic virus therapy, monoclonal antibodies & immune checkpoint inhibitors, and cancer vaccines.
• PLUVICTO is a novel radiopharmaceutical marketed by Novartis AG. It is developed specifically to treat stage 4 prostate cancer in adult patients. The FDA has approved using PLUVICTO from March 2022 for PSMA-positive metastatic castration-resistant prostate cancer.
• CyberKnife Treatment is an advanced form of radiotherapy that delivers high doses of radiation precisely to the tumors within the body. It is a non-invasive and painless procedure in which a robotic arm is used to deliver highly focused and targeted beams of X-rays that have the potential to destroy cancerous lesions.
• Selective-Internal-Radiation-Therapy (SIRT) is a type of internal radiation therapy in which tiny radioactive beads are placed directly into the tumor through arteries. These beads send radiation inside the tumor, reducing its size.
• High-Intensity-Focused-Ultrasound: HIFU is a minimally invasive procedure that uses ultrasound waves to treat tumors of various organs like bones, kidneys, esophagus, breast, brain, lungs, pancreas, and prostate. It is a relatively safer procedure that uses high-frequency sound waves to destroy cancerous tissue.

Life Beyond Treatment: Rehabilitation and Follow-up Care

After completing treatment, Germany ensures that patients receive adequate rehabilitation and follow-up care. Rehabilitation programs aim to restore physical and emotional well-being, helping patients regain strength and adapt to life after cancer. 

Regular follow-up appointments and monitoring ensure that any potential recurrence or side effects are addressed promptly.

Germany's Healthcare System: A Global Benchmark

Germany is known for its medical expertise, world-class facilities, and highly skilled healthcare professionals. The country's healthcare system is among the best in the world, consistently delivering outstanding outcomes in cancer treatment. 

The emphasis on research, innovation, and collaboration has positioned Germany as a global leader in oncology.

• Multidisciplinary Cancer Centers: Germany boasts numerous multidisciplinary cancer centers that bring together a team of specialists from various fields to provide holistic care. These centers promote collaboration among oncologists, surgeons, radiologists, and other healthcare professionals, ensuring patients receive personalized treatment plans tailored to their needs.
• Alternative treatment: Using alternative medicine for stage 4 cancer can also be beneficial for coping with the pain and general side effects of the conventional treatment. Some of the common therapies available in Germany are Multivitamin Therapy, Metabolic Therapy, CBD oil or Cannabis, Amygdalin (vit. B17), Yoga, and Gerson Therapy.   
• Research & Development: Germany actively participates in clinical trials and research studies, offering stage 4 cancer patients opportunities to access innovative treatments before they become widely available. These trials can provide patients with potential breakthrough therapies and give them hope for improved outcomes.

What are the Costs Associated with Stage 4 Cancer Treatment in Germany?

The country has gained popularity among national and international patients for offering cost-effective treatment. International authorities have accredited the hospitals in Germany for following excellent quality standards. 

Cost of various medical treatments in Germany are:

• Chemotherapy: USD 9,100-13,500 (including the initial examinations, scans and consultations, and 1st dose of chemo - Outpatient)
• Targeted Therapy: USD 13,000-27,000 (depending on the drug being used)
• Radiation Therapy: USD 19,450-37,800 (6 weeks of outpatient radiotherapy)
• Transarterial chemoembolization (TACE): USD 8,650-17,300 
• CyberKnife Treatment: USD 17,250-37,800 

Top Hospitals for Stage 4 cancer treatment in Germany

• Helios Hospital Berlin-Buch: The hospital has more than 70 departments, with oncology and neurosurgery being the best in Europe. It uses an interdisciplinary approach for better patient outcomes. Some of the services offered by the hospital are robot-assisted surgery (DaVinci System), innovative radiation therapy, proton ion therapy, stem cell transplantation, and psycho-oncology.
• Meoclinic Hospital, Berlin: Established in 2000, Meoclinic Hospital is one of the country's most research-intensive medical institutes. It has four surgical rooms that are equipped with high-end technologies. Meoclinic has achieved a mortality index of less than 4% in Germany using innovative medical techniques and a patient-centric approach.
• University Hospital Frankfurt am Main, Frankfurt: The University Hospital Frankfurt was founded in 1914. It has over 30 departments and clinical institutes, employing around 7500 healthcare workers. The hospital offers cancer treatment using the latest medical technologies like HIFU, SIRT, CyberKnife, and Immunotherapy. 
• Ludwig Maximilian University Hospital, Munich: It is a multispeciality hospital with 2000 beds and a 500-year-long tradition. The hospital has 48 specialty departments, including the Oncology Center of Excellence, offering comprehensive treatment to its patients.  

Conclusion

Germany stands as a beacon of excellence for stage 4 cancer patients seeking high-quality and advanced treatment options. Its renowned medical expertise, state-of-the-art facilities, multidisciplinary cancer centers, modern medical technology, clinical trials, and patient-centered approach make it an ideal destination for cancer care. 

While the journey may be challenging, Germany recognizes the importance of holistic care and alternative treatment for cancer patients. Integrative medicine, including complementary therapies, nutrition counseling, psychological support, and pain management, is integrated into treatment plans. If you or any of your loved ones have been diagnosed with stage 4 cancer and are looking for a cost-effective treatment without compromising quality, Germany would be the right choice.