Melanoma Treatment in Germany

Melanoma is skin cancer that develops from the skin's pigment cells (melanocytes). In Russia, it accounts for 1-3% of all cancer cases and occurs even in children. More than 70% of disease cases arise at the site of a benign mole — a pigmented nevus that malignizes under the influence of unfavorable endogenous and/or exogenous factors.

Melanoma is considered the most aggressive tumor in oncology; it tends to grow rapidly and metastasize, which significantly worsens the prognosis for the patient. In this regard, early diagnosis and treatment of melanoma in Germany is particularly relevant: when therapy begins at the first stage, when the tumor is located only within the epidermis, the probability of cure approaches 100%.

The prognosis for 5-year survival with tumor thickness up to 1 mm and no metastases is more than 90%, and with penetration depth of more than 4 mm without metastasis — up to 50%. In case of distant metastases, 5-year survival does not exceed 15-20%.

Symptoms

Melanoma is characterized by changes in the size and structure of a previously existing pigmented nevus, or the appearance of an "unusual" mole that differs from others in color, shape, and surface character. The tumor appears as a round, triangular or polygonal formation of dark brown, gray, black or bluish color. The coloring is often uneven, spotted. Standard sizes range from a few millimeters to 2-3 cm.

On the surface of the pigmented neoplasm, ulceration, weeping, bleeding often occur, and healing of skin lesions proceeds with the formation of crusts. In 20% of cases, melanoma has a nodular form: it rises above the skin in the form of a mushroom-shaped formation.

Melanoma most often metastasizes to the skin and lymph nodes, and distant metastases to the liver, kidneys, brain, lungs and other internal organs are also possible.

In the clinical classification of melanoma, 4 stages are distinguished:

• Stage I — melanoma grows no more than 2 mm into the skin thickness, does not give metastases to lymph nodes or internal organs;
• Stage II — tumor thickness is 2-4 mm or more, while metastases are absent;
• Stage III — determined at any size of the primary tumor in combination with the presence of metastases in at least one regional lymph node;
• Stage IV — established in the presence of distant tumor metastases, regardless of its thickness and lymph node involvement.

Each stage has clinical subtypes, which are designated by Latin letters A, B, C. The type and stage of the tumor can be determined most accurately after an extended examination of the patient.

Diagnostics

The examination begins with a standard physical examination of the suspicious mole, collection of complaints and disease history. To quickly identify suspicious neoplasms, dermato-oncologists use the ABCDE algorithm, which takes into account asymmetry, contours, color, diameter and dynamics of tumor size changes. The following research methods are prescribed for diagnosis at the clinic:

1. Dermatoscopy. Targeted examination of the affected area with a magnifying device allows to suggest an oncological process in the mole, but does not allow making a final diagnosis. Modern computer dermatoscopy makes it possible to save images of the patient's moles to compare their size and appearance over time.
2. Cytological analysis. Examination of a smear-imprint of the tumor is performed to detect atypical melanocyte cells. This analysis is an alternative to classical biopsy, which is not performed for melanoma due to the risk of provoking metastasis or growth of the neoplasm.
3. Histological examination. The analysis is a mandatory morphological confirmation of melanoma; without it, the diagnosis cannot be made. When examining the removed tumor, the thickness of the neoplasm, the level of invasion according to Clark, the mitotic index in cells, and the presence of transit or satellite metastases are determined. If necessary, lymph node cells are subjected to histological examination.
4. Ultrasound examinations. To detect signs of melanoma metastasis, ultrasound of the lymph nodes closest to the tumor is performed, as well as ultrasound of the abdominal organs, retroperitoneal space and pelvis.
5. Other imaging methods. To clarify the localization and size of metastases, CT or MRI of the corresponding body areas is performed, and diagnosis of distant tumor foci is most informative using PET/CT in "whole body" mode.

Special attention is paid to melanoma diagnostics in Germany, since the success of treatment largely depends on the timeliness and reliability of the diagnosis. Many patients from CIS countries come to German clinics to undergo examination with unique equipment and receive an expert medical opinion in a short time.

Melanoma Treatment Methods

Surgical Treatment

Maximum possible excision of the tumor within healthy tissues is the optimal method of melanoma treatment in Germany, which shows maximum effectiveness at an early stage of cancer. With timely surgical intervention, it is possible to completely remove malignant cells to prevent disease recurrence. However, most patients see a doctor when melanoma is already progressing and metastasizing, so radical operations are not always possible.

For effective melanoma removal, doctors make wide incisions capturing 2-3 cm of unchanged skin — this way it is possible to reduce the risk of tumor recurrence in the same location. After the primary operation, cosmetic defects remain, for the elimination of which autoplasty methods with the patient's own skin flap are provided.

In German clinics, as an alternative to classical surgical treatment, modern minimally invasive methods can be used: cryodestruction of the neoplasm at an early stage, stereotactic radiosurgery for targeted and bloodless tumor excision, laser removal of malignant cells.

Chemotherapy

Classical treatment protocols prescribe immunochemotherapy with alpha-interferon drugs in adjuvant mode (after tumor removal). Chemotherapy shows the best results in patients with second and third stages of melanoma, while in the first stage treatment is possible without medication, and in the fourth — the effectiveness of adjuvant therapy has not been proven.

Innovative Methods

Melanoma treatment in Germany shows good results due to the combination of traditional and modern therapy directions. German doctors treat skin cancer using the best achievements of world medicine, and are engaged in the development and implementation of proprietary treatment methods.

The following directions are used in comprehensive melanoma therapy programs at German clinics:

1. Targeted therapy. The drugs have a specific effect on tumor cell receptors, due to which they actively destroy cancer without harming healthy body tissues. In Germany, monoclonal antibodies are widely used that selectively bind to MRP tumor proteins, destroy cells with BRAF, C-KIT gene mutations. The greatest effectiveness is shown by the combination of targeted drugs with chemotherapy and surgical tumor removal.
2. Immunotherapy. Correction of the cancer patient's own immune system function is achieved through the use of dendritic cells, checkpoint inhibitors and other methods. TIL therapy is also prescribed — introduction of specially activated killer lymphocytes. The essence of immunotherapy is to activate immunity to recognize and destroy malignant cells, which without treatment easily escape immune reactions and can freely multiply in the body.
3. Photodynamic therapy (PDT). Treatment includes taking photosensitive drugs that are selectively absorbed by tumor tissues, followed by laser irradiation. This method allows effective removal of intradermal melanoma metastases, which improves the quality of life of patients.

In addition, experimental treatment is available in some German clinics that has not yet been performed in any country in the world. Patients have a chance to participate in clinical trials of the latest drugs to receive innovative treatment for free and get a chance for success even at the terminal stage of melanoma. German doctors were among the first to develop and test in practice a unique vaccine against melanoma that changes the function of the patient's immune system. So far, this drug is only available within clinical trials.

Cost of Melanoma Treatment in Germany

The cost of the full course of diagnosis and therapy is determined individually for each patient after analysis of medical documentation by the receiving German clinic. The final amount depends on the volume of additional studies, the necessity and method of surgical operation, and the possibility of innovative methods.

Approximate prices for melanoma diagnostics in Germany start from €530, and the cost of histological examination of tumor biomaterial can reach €3000. Radical tumor removal costs from €3160, targeted treatment from €1700, and the price of modern immunotherapy directions starts from €20000.

Melanoma Treatment Clinics

Melanoma treatment is carried out at the following German clinics:

University

Ludwig Maximilian University Hospital Munich

9.7/10 from 40 reviews

📍Germany, Munich

29 specialized clinics, 12 specialized institutes, 50 interdisciplinary centers.

After Berlin's Charité, the Munich University Hospital with the Innenstadt and Großhadern campus is the largest maximum care medical complex in Germany.

University

Chief Physician:

Prof. Dr. med. Florian Bassermann

Technical University Clinic "Rechts der Isar"

9.8/10 from 70 reviews

📍Germany, Munich

Department of Hematology and Oncology

The Department of Hematology and Oncology offers a full range of diagnostic and therapeutic services in these fields. The highly qualified team of doctors provides patients with effective treatment of all oncological diseases, blood and lymph pathologies (e.g., leukemia, multiple myeloma).

Multidisciplinary

Munich Municipal Clinics

📍München, Germany

5 separate clinics with common management

A network of multidisciplinary clinics located in five districts of Munich. They provide a high-class range of medical services. The municipal clinics are academic clinics of both Munich universities.

➤ Bogenhausen Clinic
➤ Harlaching Clinic
➤ Neuperlach Clinic
➤ Schwabing Clinic
➤ Thalkirchner Clinic

Timely contact is one of the main factors for successful melanoma treatment. Leave a request in the online form on this page, and our medical consultant will contact you shortly to select a clinic and discuss all the details of treatment in Germany.