Excellence Medicine at Hallwang Clinic

The Hallwang Private Oncology Clinic team stands for excellence in medicine, advanced medical research background and high-standard medical care. To achieve best results possible, we focus on interdisciplinary medical collaborations worldwide.

The Hallwang Private Oncology Clinic presents a community of medical education, clinical care, and biomedical research expertise, to provide the best care to its patients. The Hallwang Clinic is an institution dedicated to innovation, determination and sophistication, to diversity and professional development.

Today’s health challenges demand 21st century solutions: Targeted and patient-focused treatment strategies. The Hallwang Private Oncology Clinic team is poised to discover, and design optimal solutions for all patients.

Cancer is characterized by abnormal cell growth with the ability to invade or spread to other parts of the body. A neoplasm or also called a tumor is a group of cells that have undergone unregulated growth and may form a mass, but can also be distributed diffusely throughout the body.

Tumor cells show a number of characteristics, including abnormal cell growth and division absence of programmed cell death, high number of cell divisions, promoting of blood vessel formation, invasion of tissue and metastasis.

For example – in case of skin cancer, a visual examination takes place, followed by a biopsy of suspicious skin areas, while e.g. a haemocult test is often offered for detection of occult blood in the stool, as well as a colonoscopy, for a prevention check-up of colon cancer. For breast cancer prevention, also, a mammogram is recommended for women at a certain age. Preventive check-ups are crucial to detect cancer as early as possible.

When abnormalities are found, other GPs, naturopaths or the patients themselves contact us for a second opinion or a general consultation about treatment possibilities. Often, we are asked to perform certain blood tests (at specialized laboratories) to determine the number of circulating tumor cells. It is known, that these tests have their limitations too. The cells are stained with a certain antibody e.g. EpCAM in order to count the number of vital tumor cells. But in case the tumor is EpCAM-negative, determining (EpCAM- positive) cancer cells will not be possible, leading to a false readout. So these tests may only be interesting for certain tumor types and are usually used for treatment response monitoring, after the diagnosis of cancer has been confirmed, and tumor characteristics have been identified. Once you know the (genetic) characteristics of your tumor, a specific test to count circulating tumor cells (CTCs) can be designed.

One important step in cancer diagnosis is a PET-CT-Scan, which helps to see whether and where tumor masses are located. It shows us whether the cancer has already spread to other tissues (metastasis). If a mass has been confirmed, it should be biopsied in order to determine the dignity of the tumor. A histopathological analysis can determine the exact (cell) type of the tumor. There are many different types of tumors, and each of them presents unique genetic characteristics.

Some tumors can be surgically removed, if they are found to be operable, localized (not metastatic). In some cases, a chemotherapy and/or radiation are recommended beforehand or even instead of the surgical procedure.

Important: What most patients do not know is, that when the first examination on the biopsy has been performed (to determine the tumor type), the tissue is kept and stored at the histopathology department of the hospital, where the biopsy has been performed. This stored tissue material can be used for thorough (genetic) tissue analyses and in-depth sequencing at the Hallwang Private Oncology Clinic. It is known that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers, leading to potent targeted immunotherapy.

It is important to know what your options are. In our experience, many laboratories offer genetic tumor analyses. But there are differences and limitations specific for every tumor analysis. When patients show their tumor analysis report to the medical team at the Hallwang Clinic, we often notice that, due to the country-specific regulations, only the markers and mutations known in the home country, are tested. This is because many drugs are not approved everywhere, or even not available in the patients country, or just available in trials. Thus not every therapeutically relevant mutation is tested. And then it can happen that patients are told by their physicians that immunotherapy does not make sense in their case, even though their tumor tissue has not been thoroughly analyzed. Often, the physicians simply do not have access to the therapies due to country-specific regulations.  So it is most important to first find a laboratory that looks for all markers and mutations, and second, to find an oncologist who is willing to work with you in the best (and targeted) way possible.

Our aim is to carefully and thoroughly analyze your tumor tissue - We do know that e.g. some GI cancer patients or head and neck tumor patients are positive for a marker that is usually found in breast cancer patients. As the targeted therapy for this marker is only approved for breast cancer patients, it is often not analyzed in tumor tissues of patients with other cancer types, possibly missing an important treatment target in these patients. It is crucial to perform a thorough broad-spectrum screening so that the patient has a chance to explore all possibilities of a targeted treatment, may it be in a private setting or a clinical trial elsewhere.

Many patients indeed come to the Hallwang Private Oncology Clinic, because they have exhausted all treatment possibilities in their home country, or were not eligible for clinical trials, due to their age, treatment history, or other chronic diseases, etc. Importantly, clinical studies may use placebo as a control or some alternative, though possibly inferior, treatment protocol, in order to compare treatment responses between two groups of patients. It is important to bear in mind that many patients arrive at the Hallwang Clinic with life-threatening complications (e.g. sepsis, tumor-associated bleeding, bowel obstruction, leading to death in few days, if not treated). They did not receive treatment in their home country, but were sent back home because they have a progressive, metastatic tumour disease.

The aim of the Hallwang Private Oncology Clinic is to find the best treatment strategy for each individual, and not exclude any patient from a treatment protocol because of the factors mentioned beforehand.

Of course we have noted that some patients consider the Hallwang Private Oncology Clinic as a „last resort“ because of the high cost. Treatment costs depend on the treatment intensity, duration and (life-threatening) complications that need to be treated urgently, sometimes in collaboration with other hospitals, in case of surgical interventions for example (which increase costs). It is important to know that the lower the tumor burden is, the better immunotherapeutic approaches work. So, in the case of a massively progressive metastatic disease with e.g. organ failure/infectious complications, treatment concepts and costs are clearly more intense. In most of these cases, the level of nursing care delivered by our nursing staff is also much higher.

Notably, innovative treatments are purchased by the clinic at high prices as well. As we do not have contracts with statutory or private health insurance companies, and are not supported by charities, foundations, etc., treatment costs need to be settled by the patients.

The Hallwang Clinic does not publish any research papers or clinical trial statistics. Our clinic is too small and our patient population too heterogeneous in order to perform valuable clinical trials. The HPOC wants to offer all their patients the best treatment possible, and not deny patients a certain (possibly life-extending or even life-saving) treatment protocol because they do not meet clinical trial criteria due to e.g. age, certain previous treatments, specific chronic diseases etc.

At the Hallwang Private Oncology Clinic, we are able to provide the following tests on your tumor tissue:

  • Genomic profiling
  • Analysis for tumor-associated-antigens (TAA-Screening)
  • Analysis of DNA-repair/break-chain mechanism
  • Analysis of tumor mutational burden / immune predict

In some cases, should the biopsy taken no longer be sufficient to perform a comprehensive genomic profiling, and a new tissue biopsy is too hard on the patient (as it is painful, or even potentially risky for the patient), a non-invasive method - a liquid biopsy to determine for mutations and markers can be performed. It is still not fully established and comparable to analyses on the specimen itself, but it opens new doors and possibilities for patients in need.

At the Hallwang Private Oncology Clinic, our focus is on individualized treatment concepts for all patients, based on the specific information that we retrieve from in-depth diagnostic tumor tests. These tests provide information on surface markers and individual mutations presented by the patient’s tumor cells. Identification of these markers, mutations, translocations, amplifications, etc. allows us to specifically target them through a broad range of therapeutic options – depending on the outcome. You have to look at the tumor itself to understand what targeted treatment the patient needs. A treatment that might work for one cancer patient does not necessarily work for another patient, even though they have both the “same“ type of cancer.

Once we get to know you personally at the HPOC, we can work together on your individualized and personalized treatment strategy. You are unique, and so is your treatment. At HPOC.



News

27. February 2019

The Hallwang Clinic is a specialized oncology clinic and helps patients to navigate in a very difficult situation.

28. September 2018

The Hallwang Private Oncology Clinic in the Northern Black Forest has 16 inpatient beds, 2 luxury...

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