Cancer Therapies

A therapy can be used under curative, adjuvant, neo-adjuvant and palliative considerations. In the context of an adjuvant therapy, a chemotherapy, hormone therapy, immunotherapy or radiotherapy is used. Curative therapies are used to cure, palliative therapies to prolong and to improve quality of life. As a rule, one tries to treat curatively where possible. This includes eliminating the tumor (e.g. with surgical intervention), and considering how the risk of relapse or metastasis is, and how this risk can be reduced by using e.g. a neoadjuvant or adjuvant therapy (e.g. anti-hormone therapy or chemotherapy), which is then evaluated and used, if necessary. If a cure is not possible, a palliative therapy is performed. The aim of a palliative therapy is to alleviate disease-related symptoms, to inhibit the progression of the disease, to achieve a relief of disease-related symptoms and the highest possible quality of life, and to maintain this as long as possible. Chemotherapy prior a surgical intervention with the aim of shrinkage of a tumor (to make it operable), is called neo-adjuvant.

To determine for the most effective therapy approaches that fit the individual characteristics of the patient’s medical history and condition, we would like to take a closer look at the different forms of therapies available.

A hormone receptor test/analysis enable to identify the sensitivity of cancer cells to hormones, like e.g. estrogen to breast cancer cells. Certain tumours, in which hormone receptors have been detected in the tumour cells can often be successfully treated with anti-hormone therapy over many years. Anti-hormone therapies are used to reduce the production or effect of e.g. estrogen or testosterone in the body.

The chemotherapy uses substances that exert their damaging effect as specifically as possible on certain disease-causing cells or microorganisms and kill or inhibit their growth. In cancer therapy, these substances are called cytostatic drugs. In the treatment of malignant tumor diseases, most of these substances utilize the rapid ability of tumor cells to divide as they are more sensitive than healthy cells to cell division disorders. However, they have a similar effect on healthy cells with similar good ability to divide, which can lead to side effects such as nausea, hair loss or diarrhea.

Targeted cancer drugs are designed to interfere with specific molecules that the tumor needs for growth and progression. Traditional cytotoxic chemotherapy usually kills rapidly dividing cells in the body by interfering with cell division. A main goal of targeted therapies is to eliminate cancer cells with more accuracy and therefore fewer side effects. Over the last decade, the discovery and development of small molecule cancer drugs has been revolutionised. Most importantly, we have moved from a general approach that mainly involved cytotoxic chemotherapy to a personalised medicine strategy that focuses on the development of molecular drugs in order to target specific genetic characteristics of cancer cells. While monoclonal antibodies target specific antigens found on the cell surface, such as transmembrane receptors or extracellular growth factors, small molecules can penetrate the cell membrane to interact with targets inside a cell. Many small molecule drugs that inhibit critical cancer targets have been developed, e.g. several epidermal growth factor receptor (EGFR) kinase inhibitors that inhibit EGFR in patients with non-small cell lung cancer (NSCLC); EGFR/ERBB2 inhibitors for ERBB2-positive breast cancer; or for example vascular epidermal growth factor receptor (VEGFR) kinase inhibitors that are used in kidney cancer. Also, several inhibitors including ALK, BRAF, MEC, cMET, ROS, and RET have recently been approved for specific cancer types.

SIRT (also called radioembolisation) is using numerous beta-emitter prepared globules that are directly given into the tumours. This therapy is used in order to reduce size and number of liver metastasis. TACE (Transarterial chemoembolization) is a combination of transarterial embolisation and regional chemotherapy with the major advantage that chemotherapeutic drugs remain in the tumour tissue for a longer period at a higher concentration, while the embolotherapy interrupts the arterial blood flow to the tumour and inhibits washout of the injected chemotherapeutic drugs. TACE has been widely used in liver cancer, where selective arterial obstruction induces ischemic tumour necrosis while minimizing damage to the liver tissue, but can also be administered to other cancer-affected organs. The use of combination therapy results in lower systemic drug levels and therefore less toxicity. Thus, the combination of embolotherapy and regional chemotherapy offers a promising treatment option with synergistic and anti-tumour effects. High intensity focused ultrasound (HIFU) is a non-invasive technology used to treat tumour masses by high intensity ultrasound that induces coagulative thermal necrosis due to the absorption of ultrasound energy in tissue. HIFU is being used to treat a variety of solid malignant tumours, including tumours of the pancreas, liver, prostate, breast, uterus, and certain sarcomas. Its main advantage are non-invasion, non-ionization, and fewer complications after treatment. Microwave ablation (MWA) is also a form of thermal ablation that uses electromagnetic waves to produce tissue-heating effects, ultimately generating tissue necrosis within solid tumours, while cryotherapy is the application of extremely low temperatures to destroy abnormal cell growth, and is widely used during surgeries and ablations.

Radiotherapy (radiation) is the medical application of ionizing irradiation to humans to cure or delay the progression of disease. The resulting free radicals are highly toxic and react chemically with cellular components. The resulting damage to the genetic material of tumour cells, in particular DNA double-strand breaks, are responsible for the destructive effect. Damage, beyond the ability of the tumour cell to repair, prevents it from multiplying (mitosis) or even directly lead to apoptosis. I.e. CyberKnife is one of the most advanced and unique form of radiosurgery that uses highly sophisticated computer technology to deliver radiation with extreme precision to tumours anywhere in the body, without the use of uncomfortable screws or frames to immobilize patients during the procedure. During CyberKnife treatment, radiation beams target the tumour while sparing the surrounding healthy tissue. Unlike surgery, tumours are not removed, but destroyed by a precise dose of radiation. No incision is made. Another major advantage is that the radiation beams adjust in real-time to a patient's breathing cycle, which is important, as some tumours keep moving during treatment application. CyberKnife is a highly effective non-invasive alternative to surgery in the treatment of certain cancers.

The radio-peptide therapy opens a promising new treatment option for neuroendocrine cancer patients. Peptides are labelled with therapeutically effective radioactive emitters, enabling an internal radiotherapy, which selectively affects the tumour cells and extensively protects the healthy tissue (i.e. PSMA-therapy).

As part of our comprehensive treatment concept we aim to improve the general well-being of our patients. In doing so, we put emphasis on identifying and addressing existing deficits. It is well-known that patients with a malignant and progressive disease often feel tired and exhausted, due to suffering greatly, e.g. from side effects of cytostatic or chemotherapeutic agents, as well as from immunotherapies. This can lead to depressive mood changes, lack of motivation, restlessness, loss of vitality or appetite, among others. When we perform a blood test on these patients upon arrival, it often turns out that many patients have deficiencies e.g. a Vitamin D deficiency, electrolyte deficiency, or the liver shows some significant reaction to e.g. cytotoxic agents. A tailored and supportive infusion program to address these deficiencies can provide relief to the patient. Supportive measures including infusions can lead to a much better tolerance of targeted treatments. Our experience has shown that patients who receive a supportive infusion program in parallel to chemotherapy and/or immunotherapy experience less side effects, leading to more motivation, positivity, and life quality. As with all our therapies at the Hallwang Private Oncology Clinic, the infusion program is tailored to the individual patient’s requirements and needs.

Furthermore, a good nutrition is important for our health. The goal of orthomolecular medicine is to provide the optimal molecular environment for the brain and other organs by changing/improving the intake of nutrients such as vitamins, minerals, trace elements and other naturally occurring substances. Orthomolecular is a term that comes from the Greek word for "correct" (ortho) and "molecule," so it literally means the "right molecule." According to Nobel Prize winner and molecular biologist, Linus Pauling, Ph.D., orthomolecular medicine involves the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body. Orthomolecular medicine aims to restore the ideal and beneficial environment of the body by correcting molecular imbalances, and this approach is used in cancer, infections, depression and atherosclerosis, among others.

Micronutrients are substances often referred to as vitamins or minerals. They are required only in minuscule amounts, but are important for production of enzymes, hormones and other substances that are needed for proper growth and development. Even though only little amounts are needed, their deficiency has severe consequences. Important micronutrients are for example iodine, vitamin A, iron, folate and zinc. At Hallwang Private Oncology Clinic, we follow the principle of orthomolecular medicine that medicine and patients are individual - not only is every patient unique but also his or her nutrient requirements and the response to treatment. For every patient, we provide a balanced mix of micronutrients, in oral or high-dose intravenous form.

For Ozone Therapy - ozone is a powerful oxidizing agent. While high concentrations can be toxic, small ozone doses may increase naturally occurring antioxidants in the body. Antioxidants help to eliminate malignant calles and are needed to keep the body healthy. Ozone used for treatment is known for its bactericidal, fungicidal and virostatic properties. It also stimulates circulation and immune functions, and revitalizes the body.

Hyperbaric oxygen therapy is used to treat several medical conditions. It is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, skin lesions or radiation injury. Wounds for example need oxygen to heal properly, and exposing a wound to 100 percent oxygen can improve and speed the healing process. This has been shown in a number of studies. The goal of this treatment is to increase the amount of oxygen your blood can carry in order to restore normal levels of blood gases and tissue function to promote healing and cure infection. During Hyperbaric oxygen therapy you breathe 100% oxygen while under increased atmospheric pressure.

Whole body hyperthermia can be applied in a number of different diseases, including malignant, immunological, viral and other diseases. The aim of WBH is the destruction of malignant cells by induction of apoptosis via hyperthermia along with elimination of malignant cells that have become resistant to chemotherapy. With the help of WBH, effects of other treatments, including chemotherapy and immunotherapy, can be enhanced.

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So which option is the right one for the patient? One should not insist on one specific therapeutic intervention. But how to determine for the way to go? 

Important: Our oncological team is happy to talk to you by phone to get a deeper understanding about your specific case, enabling to provide you with a provisional treatment plan and cost estimate. Our oncologists will provide you all the details on medications, therapeutics and treatments including underlying mechanism and side effects. After a physical examination and an in-depth discussion with you on-site, the definite treatment plan will be discussed. Please understand that complex medical processes as mentioned above can only be explained through a thorough consultation on-site.



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