Lung Cancer Treatment in Germany

Doctors start lung cancer treatment in Germany only after in-depth diagnostics and an interdisciplinary consultation. German clinics are often visited by patients with advanced forms of cancer, which necessitates the development of complex, multi-stage courses of therapy.

The advantages of lung cancer treatment in Germany include the use of the latest methods: robotic surgeries, immunotherapy and other innovations in the field of oncology. This gives patients hope for a full recovery and improved quality of life.

The lungs are a paired organ in the chest. The right lung is larger and has 3 lobes. The left lung is smaller (because the heart is next to it) and is divided into 2 lobes.

 When a person breathes, air passes through the mouth or nose into the trachea, a tube that connects the throat and lungs. The trachea branches into two smaller tubes – the bronchi. These enter the lungs and continue to divide into even thinner tubes called bronchioles. At the ends of the bronchioles are small bubbles called alveoli. The alveoli take in oxygen from the air and give out carbon dioxide. This is the main job of the lungs – to provide our bodies with oxygen and get rid of carbon dioxide.

Lung cancer is a disease in which malignant tumors appear in the cells that make up the bronchi and other parts of the organ. They can grow and spread through a variety of pathways, including through the lymph and blood. 

The rate at which the disease develops depends on the type, stage, location of the tumor, and other factors. Some types of lung cancer, such as small cell lung cancer, have a more aggressive course and metastasize early. Other types, such as squamous cell cancer, grow more slowly and go longer without showing symptoms. Therefore, quality diagnosis plays a key role in identifying the type and techniques for lung cancer treatment in Germany.

According to international protocols, lung cancer diagnosis in Germany includes the main methods:

• chest radiography and computed tomography;
• bronchoscopy;
• sputum and pleural fluid tests;
• laboratory blood tests;
• tumor or lymph node biopsy. 

For a more detailed examination, German oncologists prescribe patients:

• MRI – the machine takes clear pictures of internal organs using magnets and radio waves. MRI helps to see what the lungs and other tissues in the chest look like. It also shows if the cancer has spread to other areas of the body.
• PET – during diagnosis, uses a special substance that glows under a camera. This substance hits cancer cells more than healthy cells. This imaging helps to know where the tumor is located and whether it has spread to other organs.
• PET-CT – combines two imaging diagnostic technologies. It gives the most complete picture of what is happening in the lungs and other structures in the body.

Some types of advanced lung cancer diagnosis in Germany:

• Endobronchial ultrasound (EBUS) is a way to look at the chest cavity using a thin device that is inserted into the lungs through the mouth or nose. At the end of this device is an ultrasound transducer that emits sound waves and shows on a screen what the lungs and surrounding tissues look like. The EBUS can be used to take samples from suspicious areas for analysis.
• Mediastinoscopy is a procedure that requires putting the patient under anesthesia. A small incision is made in the neck through which a lighted device called a mediastinoscope is inserted. With its help, you can look at the space between the lungs (mediastinum). There are lymph nodes that may be affected by cancer. Pieces of tissue from these nodes can be taken for further analysis.
• Video thoracoscopy (VTS) is an examination that allows the doctor to look at suspicious areas of the lungs.
• To do this, through a puncture in the chest wall, the surgeon inserts an endoscope – an optical device in the form of a flexible probe with a video camera at the end – into the pleural cavity. Using surgical instruments, the doctor can cut out as much tissue as needed for examination. The pathologist can immediately look at the sample under the microscope while the patient is still asleep under anesthesia. If the tissue turns out to be cancerous, the doctor can remove it.
• Bronchoscopy is a diagnostic method in which the doctor inserts a thin, flexible tube with a built-in camera into the bronchi and lung tissue. This provides visual access to the organ and allows a biopsy to be taken. Bronchoscopy can detect dangerous tumors even in the early stages of the disease.
• A wedge resection is a surgery in which a triangular piece of tissue with a nodule or tumor is cut out. This is done to see if the nodule is cancerous. This surgery tries to preserve as much healthy tissue as possible.

When a cancerous tumor is found, doctors in Germany will in some cases give patients special tests for cancer markers. 

What’s important to know about cancer markers. Oncomarker tests are not used universally in patients with lung cancer. However, there are studies showing that the sensitivity and specificity of oncomarkers in lung cancer are higher or at least similar to values obtained in other malignancies. Such tests may be useful in diagnosis, prognosis, and monitoring of therapy in certain situations.

Some lung cancers can be detected by screening, but most cases are detected because they cause symptoms. The actual diagnosis is made by examining a sample of the organ’s cells in a laboratory. If you have possible signs of lung cancer, contact the coordinators at Experts Medical to arrange a trip to Germany for diagnosis.

How do I test a tissue sample for cancer in a specialized laboratory?

In advance, patients with suspected lung cancer can have their results tested abroad. In this way, the data can be used for treatment planning.

The German laboratory CeGaT tests blood and tumor samples for the presence of malignant cells. This information is important for the doctor to understand what type of lung cancer he or she will be dealing with.

The advantage of going to the CeGaT laboratory is that the patient does not have to leave his country until the results are obtained. That is, it is possible to send the test material directly to Germany with the support of Experts Medical.

German cancer centers use various treatment methods for lung cancer. They are divided into two categories: therapy (without surgery) and surgery. Depending on the stage of the disease, doctors may use a combination of methods that will include non-invasive therapy and surgery.

Main types of therapy for lung cancer:

• chemotherapy with the latest generation drugs;
• immunotherapy to stimulate the patient’s immune system to distinguish and fight pathological cells;
• biological therapy to suppress tumor activity;
• radiotherapy on devices equipped with a 3D visualization system, which ensures delivery of the radiation beam with an accuracy of 0.5 mm.

Surgical treatment methods are aimed at excision of the part of the organ where the tumor is located. In some cases, it may be necessary to remove a lobe of the lung.

In international medical practice, surgery for lung cancer is divided into 4 types:

• Marginal resection is the removal of the tumor with a small amount of nearby tissue. This method is used for small tumors that do not affect the bronchi or blood vessels.
• Segmental resection – a larger piece of tissue, called a segment, is removed along with the tumor. Surgeons perform this operation when the tumor is located in one segment of the lung and does not penetrate other lobes.
• Lobectomy – resection of a lobe of the lung. This surgical technique is the most common and effective, as it allows you to remove most of the tumor tissue and prevent its recurrence.
• Pulmonectomy – the lung is completely removed. This type of surgery is used in cases where the tumor occupies a large part of the organ or spreads to neighboring structures such as the heart, esophagus or spine.

Surgeries can be performed using an open thoracotomy (a large incision in the chest) or thoracoscopy (several small punctures between the ribs). Thoracoscopy is a more gentle method, as it requires less tissue damage and provides faster recovery after surgery.

Robotic surgery

This is a modern method of treating lung cancer, which uses special robotic installations. This is a minimally invasive surgery option, meaning it does not require a large incision in the chest. It is most often used to treat early stages of non-small cell lung cancer (NSCLC).

Robotic surgery may be equivalent to other treatment modalities such as video-assisted thoracoscopic surgery (VATS) or traditional open resection.

After surgery, German oncologists prescribe therapy to patients that reduces the likelihood of relapse. The use of modern and high-quality therapeutic techniques makes it possible to destroy small metastases in the body that cannot be surgically removed.

Oncologists at German clinics use modern drugs for cancer therapy that have passed all clinical trials. In addition to the high-quality chemo- and targeted therapy drugs that are standard for Germany, the country’s specialists also offer other methods of non-surgical treatment for lung cancer.

Proton therapy for lung cancer

True proton therapy is available in a small number of clinics around the world. This is due to the fact that proton therapy requires special conditions that cannot be arranged in a regular hospital. Germany is one of the few countries where such treatment is available to patients with cancer. Proton therapy and other treatment options for lung cancer are available at the University Hospital Essen.

Proton therapy is a special type of radiation therapy that uses beams of high-energy particles and their ability to emit ionizing radiation as they penetrate the body. Unlike gamma or X-rays, which continue to spread after passing through the body, the depth of penetration of proton therapy beams can be adjusted. When the charged particles reach their end point, they deposit all of their energy within the tumor, minimizing the radiation dose to surrounding tissue.

Since the lungs are located in close proximity to vital organs (heart, esophagus and spinal cord), the accuracy of the radiation direction is critical. With conventional radiation therapy, the high doses required to kill tumor cells can also damage these vulnerable structures. Reducing radiation exposure to the esophagus, heart, and healthy parts of the lungs reduces the risk of treatment side effects such as fibrosis, dysphagia, and pain.

One of the best proton therapy clinics in the world is located in Essen. This is the West German Proton Therapy Center, where individual treatment protocols are developed for patients. At the center, doctors can combine proton and chemotherapy to achieve the best results.

Radiation therapy and radiosurgery

Modern devices for radiation therapy provide high accuracy, efficiency and safety in the treatment of malignant tumors. They specifically destroy cancer cells while minimizing the radiation dose to healthy tissue.

In leading German clinics, patients are offered radiation therapy using linear accelerators Synergy, TrueBeam STx, as well as the CyberKnife radiosurgical system. In Germany, the latest generation of devices are used to treat cancer. That is, patients receive the highest quality radiation therapy that is possible today. Such medical services can be obtained in leading German clinics such as Asklepios, Nordwest and Helios Berlin-Buch.

Radiotherapists in Germany use different types of radiotherapy. For example, these may be IMRT (Intensity Modulated Radiation Therapy), IGRT (Image Guided Radiotherapy), DIBH (Breathing Assisted Radiation Therapy), 3D-CRT (3D Conformal Radiation Therapy), SBRT (Stereotactic Radiation Therapy), IORT (Intra-Operative Radiation Therapy) , proton beam therapy, brachytherapy and radioiodine therapy.

CyberKnife M6 and VSI are TOP modifications of the CyberKnife installation. The entire process is automated, which eliminates medical errors. The system stores data about the patient, the body plan during the procedure, and the required radiation dosage.

How much does lung cancer treatment cost in Germany using linear accelerators?

The estimated cost of radiation therapy averages $9,000-$13,000. Treatment of lung cancer in Germany at a price per course of radiotherapy is regulated by the legislation of the country.

Therapy with targeted drugs

Targeted therapy for lung cancer in Germany works by interfering with the growth and spread of cancer cells that have specific mutations. Targeted therapy differs from standard chemotherapy in that it targets abnormalities in cancer cells while minimizing damage to normal cells.

How targeted therapy works to treat lung cancer:

• Targeted therapy involves analyzing a tumor sample obtained through surgery or biopsy to identify specific abnormalities or mutations.
• Tumor or blood tests can determine whether the cancer is in the category that responds to targeted therapy.
• One example of targeted therapy for lung cancer is tyrosine kinase inhibitors (TKIs), which are used in the presence of growth factor receptor (EGFR) mutations. EGFR is a protein that, when mutated, can stimulate the growth and spread of cancer cells. TKI blocks this abnormal signaling pathway.

Angiogenesis inhibitors

To reproduce, cancer cells, like healthy ones, require constant access to oxygen and nutrients. The growth of a tumor depends on the formation of new blood vessels in the body, which provide it with blood supply and nutrition. The process of new blood vessels appearing is called angiogenesis. Drugs that block angiogenesis processes prevent the formation of new vessels. Thus, they stop the growth of the tumor.

Angiogenesis inhibitors are a targeted therapy option. They have little effect on healthy cells of the body. Therefore, the risk of side effects from such drugs is relatively low.

Therapies that effectively complement the treatment of lung cancer

In leading oncology departments, patients have access to the following innovative treatment for lung cancer in Germany:

• Immunotherapy drugs enable the human immune system to fight cancer cells. They can be used instead of or in combination with traditional chemotherapy drugs.
• Laser ablative therapy can also be used to treat lung cancer. Laser therapy uses a laser to remove or shrink tumors in the lungs. Ablative therapy uses high-energy current (radiofrequency ablation) or cold (cryoablation) to kill cancer cells.

According to data published in The American Journal of Managed Care, in 2022-2023, more than 90% of lung cancer cases will be diagnosed at advanced stages. A combination of surgical resection and adjuvant therapy remains the main treatment strategy for the disease. However, only 20% of patients are suitable for surgery, and 80% of patients relapse and ultimately die after surgery.

Leading oncologists in Germany provide their patients with the most advanced treatment for lung cancer in advanced stages. One of the most important factors is determining the substage of the disease: 4A or 4B. Staging is carried out according to the international TNM classification. This system is used in foreign clinics, including German ones. This is necessary for the correct preparation of a treatment program depending on the severity of the disease.

Prognosis for a patient at stage 4 lung cancer

Treatment for stage 4 lung cancer is more focused on prolonging a person’s life. Modern medicine has made progress in improving the quality and life expectancy of people at the terminal stage of the disease. Patients who used innovative treatment, instead of the few months promised in their country, live for years.

Immunotherapy and the use of targeted monoclonal antibody drugs for the treatment of stage 4 lung cancer have been highly popular. However, these treatments have limitations, which has led to the development of CAR-T cell therapy.

Depending on their intracellular structure, CAR-T cells are divided into 5 generations. The effectiveness of 5th generation CARs is currently being investigated, while 2nd generation CAR-T is the most widely used and offers a more consistent treatment effect for lung cancer.

In 2020, the FDA approved two CAR-T therapies for widespread use. They differ from each other in the method of producing modified T-lymphocytes and in the ways in which an enhanced anti-cancer effect is achieved. These drugs are available to patients in German clinics, for example at Helios Krefeld.

Scientists suggest that thanks to the continuous improvement of protocols for the use of CAR-T cells, this method will become the main method for treating lung cancer in the near future.

Doctors in German clinics can offer patients with advanced forms of lung cancer two options for radiation therapy:

• Stereotactic high-dose radiotherapy (SIRT). It is prescribed to control brain metastases, eliminate pain, pulmonary hemorrhages, and difficulties with breathing and swallowing.
• Brachytherapy (contact radiation therapy). The radiation source is placed inside the body near or inside the tumor. This allows higher doses of radiation to be delivered precisely to the target. Brachytherapy helps relieve unpleasant symptoms and slow down the development of tumors.

If you combine such radiation therapy techniques with the use of special medications, the patient can return to their normal lifestyle. In medical practice, there have been cases when patients with stage 4 lung cancer overcame the 10-year mark. This is possible if there is access to the most effective drugs and the sensitivity of cancer cells to them. At the same time, modern devices for radiation therapy minimize the harmful effects on the entire body and do not aggravate the general condition of a person.

Embolization (blockage) of tumor vessels is a minimally invasive operation. It is carried out to block blood flow in the vessels feeding the malignant tumor.

For stage 4 lung cancer, endovascular surgeons most often close the lumen of the bronchial arteries. This procedure does not require general anesthesia, since there are no nerve endings in the vessels.

Embolization can slow tumor growth in the lungs and improve survival rates for patients with advanced cancer.

The cost of treatment for lung cancer in Germany is the totality of all medical procedures that doctors perform at the following stages:

• remote and face-to-face patient consultations;
• diagnosis of the disease;
• preliminary (preoperative) therapy;
• surgical intervention (the method and complexity of the operation affects the price);
• therapy after surgery;
• the use of innovative drugs for a prolonged effect in later stages.

Diagnosis and treatment of lung cancer in Germany with price examples:

• PET-CT – from $2000;
• revision of histology – about $800;
• proton therapy – from $50,000;
• surgery using the Da Vinci robot – from $17,000.

The cost of chemotherapy with the latest generation of drugs is the same in all countries with developed medicine. Chemotherapy for the treatment of lung cancer in Germany does not differ in price from the cost in other world clinics.

When planning a visit to a foreign clinic, each patient can first get acquainted with the opinions of people who have already undergone therapy in foreign medical centers. The Experts Medical website contains reviews from real patients about lung cancer treatment in Germany.

Among the key advantages of lung cancer treatment in Germany, reviews most often highlight:

• availability of all necessary equipment for accurate diagnosis of the disease;
• laboratory capabilities of clinics for selecting the most effective drugs for immune and targeted therapy;
• experience of surgeons who remove tumors using minimally invasive methods;
• high-quality rehabilitation after applying basic treatment methods;
• luxury medical service.

German radiotherapists are members of medical societies such as ESMO (European Society of Medical Oncology), EORTC (European Organization for Research and Treatment of Cancer), ASTRO (American Society of Radiation Oncology). Therefore, the quality of radiation therapy for accelerated treatment of lung cancer in Germany, according to patient reviews, is at a high level. Often, people in Asian and Eastern European countries cannot receive such treatment without significant harm to the entire body.

To go for treatment in one of the best German clinics in a short time, leave a request on this page. The coordinating doctor will accept your request and with the support of Experts Medical you will be able to receive:

• online consultation with a German oncologist;
• preliminary cost of diagnostic procedures and individual treatment plan;
• preparation of all necessary documents for the trip;
• booking plane tickets and accommodation near the clinic;
• comprehensive support from company specialists.

Use the special form on the website or request a call back so that Experts Medical coordinators can help you choose a hospital for the treatment of lung cancer in Germany.