2023-08-11 20:08:33
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Doctors can help more and more patients in the fight once morest cancer. University chief physician Prof. Jens Werner explains the ten most important advances in recent years.
With more than 60,000 new cases each year, colorectal cancer is one of the most common types of cancer in Germany. In recent years, however, research and individualized therapies have made enormous progress. Doctors save lives and quality of life every day. And more and more often even severe cases in advanced stages of the disease are being cured. This is confirmed by the surgeon Prof. Jens Werner. He is Director of the Clinic for General, Visceral and Transplantation Surgery at the LMU Klinikum – one of three nationwide excellent surgical centers of excellence for the treatment of intestinal diseases. Here, the internationally recognized Munich specialist reports on the ten most important advances in diagnostics and therapy in recent years. The dramatic case of a Bavarian father shows how much patients can benefit. Read Felix G.’s story here.
1. Prevention: 180,000 cases of colon cancer prevented
Colonoscopy is the safest method of detecting risky colon polyps. In this way, 180,000 cases of colon cancer have been prevented in Germany over the past ten years.
2. New technology: Tumor removal is often possible as part of the colonoscopy
Thanks to new diagnostics and technology, even larger, mostly benign tumors can often be removed with the colonoscopy without any problems.
3. Surgical robot: It enables doctors to operate gently
Minimally invasive techniques are now standard in the surgical treatment of colorectal cancer. It can be performed as a laparoscopy (abdominal reflection) or with the help of a surgical robot. Optimum image resolution and magnification as well as a special staining of the tissue ensure the exact preparation of the tumor and protection of affected organs and the finest nerves – even if the robot has to work in the smallest of spaces.
Renowned surgeon and cancer specialist: Professor Jens Werner from the LMU Klinikum in Munich. © Stefan Wartini
4. Chemo/radiation therapy: New concepts for success
In some cases, pre-treatment with radiation or chemotherapy is so effective today that the tumor disappears completely. This successful concept is called “Total Neoadjuvant Therapy” (TNT).
5. Immunotherapy: Great hope for certain genetic conditions
Immunotherapy, which is still in its infancy, is already achieving great success in the fight once morest colon cancer. The body’s own immune system is stimulated by specific antibodies in such a way that it can attack the tumor on its own without further therapy or surgery. The prerequisite for this is microsatellite instability (MSI) – a genetic defect that allows these new drugs to destroy the cancer and metastases. About 20 percent of all patients are eligible. MSI is checked using a tissue sample from the tumor.
6th tumor conference: interdisciplinary collaboration between specialists
Thanks to innovative therapy concepts that result from the interaction of surgery, gastroenterology, oncology, radiation therapy and radiology, a considerable proportion of colorectal cancer patients with distant metastases – for example in the liver, lungs or peritoneum – can be cured today. At tumor conferences, the specialists design tailor-made forms of therapy – another great strength of the specialized centers.
Germany’s second largest university hospital: The LMU Klinikum, here with the Großhadern location. © imago classic
7. Recurrence concept: Opportunities even if the tumor returns
Tumors can return. In the past, such recurrences were often classified as no longer curable. Today, specialists can in many cases achieve long-term freedom from tumors and symptoms, particularly in the case of rectal cancer (rectal carcinoma). Specialists from several departments such as surgery, radiology/radiation therapy, gastroenterology and oncology work together. The procedure itself is carried out by an interdisciplinary team of surgeons and urologists/gynaecologists.
8. Precision Oncology: Here the focus is on the patient
Personalized medicine – also known as precision oncology – focuses on each individual cancer patient. Targeted cancer therapies only inhibit tumor cells with certain properties. In specialized tumor conferences, it is also decided, for example, whether examining the entire genetic material of a tumor might benefit the patient.
9. Center medicine: High success rates even with metastases
Highly specialized centers at university hospitals are a prerequisite for high success rates. Therapy standards are further developed here and studies with the latest drugs are offered. Specialists from all departments work hand in hand there. Since a quarter of all colorectal cancer patients already have metastases when they are first diagnosed and up to 50 percent develop distant metastases in other organs, it is all the more important to be treated at a center.
10. Preparing for surgery: an important safety factor, especially for older patients
Prehabilitation is the term for the optimal preparation of patients for the surgical procedure. Older and previously ill patients in particular are brought into the best possible shape with breathing and cardiovascular training and special nutrients. In this way, they can survive their operation well and often return home earlier.
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