Tratament cancer (oncologie) - PlusMedical

Cancer is a devastating disease, the frequency of which is increasing worldwide. Although it differs depending on the type of cancer and where it occurs, cancer can be cured if it intervenes correctly at the right time. The right treatment, assisted by professionals and the right technology can provide critical life support to cancer patients.

However, this situation also means that cancer patients have to go through a long and complicated process. Cancer patients receive the most important support from medical institutions. Those institutions specialized in the treatment of cancer must have staff with experience and specialization, a multitude of medical knowledge, devices made with the latest technology, modern medical methods and infrastructure systems that allow coordination between specialists. By adopting this approach, PlusMedical's international partner hospitals have made great strides toward cancer treatment.

The most common types of cancer

  • Oral cavity cancer
  • Lung cancer
  • Tumors on the brain
  • Skin cancer
  • Throat cancer (larynx)
  • Liver cancer
  • Bone tumors
  • Colorectal cancer
  • Lymphoma
  • Breast cancer
  • Bladder cancer
  • Stomach cancer
  • Cancer pancreatic
  • Pediatric oncology and hematology
  • Prostate cancer
  • Endometrial cancer (uterus)
  • Uterine cervical cancer
  • Thyroid cancer
  • Ovarian cancer

Usually, when someone feels bad, they go to the doctor. If the cause of the condition is not detected by the usual tests or consultations, the doctor will indicate some more detailed tests. Or, sometimes, when you do a screening test for another disease, some formations can be detected that can be tumors. Depending on the medical history, the clinical examination and any symptoms, the specialist doctor recommends performing a series of laboratory tests, scans or other specific procedures.

It is important to keep in mind that only after several complex tests and tests, this disease can be diagnosed, not only if a set of tests goes wrong.

Laboratory tests

High or low levels of certain substances in the body can be a sign of cancer. In conclusion, laboratory tests of blood, urine or other body fluids that measure these substances can help doctors provide a diagnosis. However abnormal lab results are not a sure sign of cancer. Laboratory tests are an important tool, but they are not a solid or sufficient basis for diagnosing cancer.

Imaging procedures

Imaging procedures create images of areas inside the body that help the doctor to see if there is a tumor inside it. These images can be taken in several ways:

  • CT scan: An X-ray machine connected to a computer presents a series of detailed images of the organs. You may be given a colorant or other contrast material to highlight the areas inside the body. The contrast material helps to facilitate the reading of these images.
  • Nuclear scanning: For this scan you will be given an injection with a small amount of radioactive material. It flows through your blood and is collected in certain bones or organs. A car called a scanner will detect and subsequently measure the level of radioactivity. The scanner creates images of bones or organs on a computer screen or on a movie. Your body quickly gets rid of the radioactive substance. This type of scanning is also called radionuclide scanning.
  • Ultrasound: A certain ultrasound device sends out sound waves that people cannot hear / perceive. A computer uses these echoes to create an image of the areas inside the body. This image is called a sonogram.
  • MRI: A powerful magnet attached to a computer is used to take detailed pictures of areas of our body. The specialist doctor can view these images on a monitor and print them on film.
  • PET-CT scan: For this type of scan an injection with a tracer will be given. Later, a car will take 3D pictures that will show where the tracer is drawn in the body. These scans show how organs and tissues work.
  • X rays: Radiographs use low doses of radiation to create images of the interior of the body.
  • Biopsy In most cases, doctors have to do a biopsy to diagnose cancer. A biopsy is a procedure in which the doctor removes a tissue sample from the body. A pathologist then analyzes the tissue under the microscope to determine whether or not it is cancer. The sample can be extracted in several ways: (1) With a needle: The doctor uses a needle to extract tissue or fluid. (2) With an endoscope: The doctor examines the areas inside the body using a thin, illuminated tube called an endoscope. The scope is introduced through a natural opening, such as the mouth, after which the physician uses a special tool to remove tissue or cells through the tube. (3) Through surgery: The surgery can be excisional or incisional. In an excisional biopsy, the surgeon removes the entire tumor. Often, some of the normal tissue around the tumor is removed. In an incisive biopsy, the surgeon removes only part of the tumor.

Medical oncology is a branch of science that covers not only the treatment of cancer patients, but also cancer prevention, cancer scanning and early diagnostic applications. In other words, every stage of cancer is a problem of medical oncology.

Moreover, in the diagnosis and treatment of cancer, there is cooperation between different fields such as surgery and radiology. Patient approach is planned as a multidisciplinary, according to the scientific data. The treatment is performed with the help of intravenous or oral medicines. However, this practice varies depending on the type of cancer.

Treatment planning changes depending on the type of cancer cell, the organ in which it first appeared and the areas in which it has spread. The treatment is performed as an adjuvant treatment to reduce the risk of recurrence, as a neo-adjuvant treatment to make the volume available for surgery or to protect the organs, or as a palliative treatment to extend life in higher stages and to quality of life increases. The treatment can be performed individually or in combination with other therapies.

Radiation therapy is one of the procedures of medical oncology, which uses ionized radiation to destroy cancer cells and stop their division. Along with chemotherapy, radiation therapy reduces the risk of cancer cells reoccurring after surgery, but is a technique used to relieve the symptoms of this disease.

In the international partner hospitals of PlusMedical, the specialists in medical oncology provide the following patients:

  • Simulators (conventional, CT-Sim, PET-CT)
  • Treatment planning systems (Eclipse, Helios, Rapidarc)
  • PET-CT, MRI fusion
  • Linear accelerators (Clinac DHX, Trilogy)
  • 3D radiotherapy
  • IMRT (Modulated intensity radiotherapy)
  • Volumetric modulated arc therapy (Rapidarc)
  • Respiratory Gating System
  • Stereotactic radiotherapy
  • Imaging guided radiotherapy
  • Imaging On board
  • Online portal imaging
  • Brachytherapy (internal radiotherapy)
  • Ultrasound and X-ray imaging (for brachytherapy applications)
  • Stereotactic radiosurgery
  • Gamma Knife

Gamma Knife, the most effective cancer radiation technology

GammaKnife is the most valuable standard in the treatment of brain tumors. This treatment is a highly concentrated form of radiation treatment, which greatly increases efficacy and decreases side effects. Gamma knife is used in the treatment of different brain tumors, vascular malformations and functional procedures.

  • Cyberknife radiotherapy
  • TrueBeam radiotherapy

Curative surgery is used as part of medical oncology. However, the main condition for oncological surgery is that the tumor is limited only to the organ or tissue where it first appeared. For the successful surgical treatment of cancer, as a curative purpose, there should be no metastasis. Tumors can be completely removed if their margins are well determined. There are cases in which the tumor cannot be completely removed, in these cases being applied reduction oncology surgery. At the same time, the surgical removal of the metastases, few in number increases the patient's chance of healing.

Da Vinci Robotic Surgery
The surgical treatment of laparoscopic cancer, with the help of the 'Da Vinci Robot', brings a number of advantages to the patient. Besides the general ones, of all the laparoscopic surgeries, such as pain reduction, minimal scarring, short hospitalization period, diminished bleeding, increases the success rate of the operation. DaVinci robotic surgery is used in gynecology, thoracic surgery, oncological surgery, urology, cardiovascular surgery, general surgery and ENT surgery.

The surgical treatment of cancer is multidisciplinary

The specialists of general surgery, radiology, anatomy-pathology, medical oncology and oncological radiology work together through a multidisciplinary approach in the planning of breast cancer treatment. In particular, the first specialist to evaluate the patient is the oncologist surgeon. It is also important that before and after treatment, the patient is evaluated psychologically and psychiatricly.

In which situations do you use oncology surgery?

The first option for breast cancers, found in an early stage, is oncological surgery. Within the surgical method, the tumor is excised from the breast tissue, around its tissue, or by excision of the entire breast. Also, to understand whether the tumor has spread to the armpit or not, lymph nodes are also excised. By performing the surgical treatment for cancer, the stage of the disease is detected, as well as the additional therapeutic requirements (radiotherapy, hormone therapy, chemotherapy).

Today, due to the development of oncological surgical treatments and the improvement of adjuvant treatments, many patients have excellent results.

Protective breast surgery

Breast cancer patients are lost due to systemic recurrence, in other words, spread (metastasis) and not recurrence in the breast. In this regard, removal of the tumor-affected tissue by the method of protective breast surgery in appropriate cases with a single tumor outbreak is preferable to mastectomy instead. In breast protection surgery, the tumor tissue is excised by about 1-2 cm from the normal breast tissue around the tumor (large excision, tumorectomy).

Other techniques based on larger excisions of the breast region are known as "sectorotomy" or "partial mastectomy".

Regarding nodules that are not considered to be palpable and malignant and marked with wire under mammographic or ultrasound guidance, they are filmed after excision by wire guide or ROLL (Radiolabelled localization of occult lesions) techniques and are controlled whether or not excisable .

A) Surgical treatment of cancer that involves removal of the entire breast (mastectomy)

Mastectomy is a method applied in situations where protective breast surgery is not possible. Although it was common in the past, today mastectomy is preferred by patients with tumors unsuitable for protective breast surgery, large diameter and / or indicating a large distribution within it (tumors with multiple outbreaks). Again, depending on the patient's situation, it is possible to discuss the modified radical mastectomy (excision of the whole breast and a large part of the axillary lymph nodes). In this case, due to excision of a large part of the axillary lymph nodes, there are side effects such as arm swelling, numbness, tingling.

B) Oncological surgery for the evaluation of axillary lymph nodes

Breast cancer indicates an extension especially to the axillary lymph nodes. In the past, excision of all axillary lymph nodes was preferred to determine the stage of the disease, to determine their degree of disease and to provide good local control (axillary dissection). Because patients often complained of side effects such as swelling of the arm (lymphedema), restriction and deformation of the shoulder, low power and cushioning of the arm, medical oncology specialists gave up this technique. In recent years, the "sentinel lymph node biopsy technique" is the method of excision of most lymph nodes, due to the identification of tumor cells.

What is the surgical treatment of biopsy of the sentinel lymph node?

In this technique, before the surgery, a radioactive substance called 99mTc is injected into the breast, including the tumor. By activating the highly radioactive substance, it is possible to monitor the lymph node (either in the afternoon one day before the operation or in the morning of the operation) by lymphoscintigraphy, then the excision is performed by a radioactive or counter-tool detector called the gamma probe. Subsequently the sample is sent to the anatomical-pathological laboratory for analysis during the operation.

It is also possible to inject blue dye into the breast, including the tumor, during the operation. In this case, the blue lymph nodes or lymph nodes can be excised as sentinel lymph nodes by finding the blue lymph channel and following it; and these being sent to an anatomopathologist during the operation, in the same manner.

If the sentinel lymph node has been involved, all axillary lymph nodes must be excised. It was found negatively during the operations, that there were lymph nodes that were considered not affected and were not excised. As such, side effects such as lymph node edema, restricted shoulder movement, or arm dampening are rarely seen in patients who have undergone only sentinel lymph node biopsy. But these sentinel lymph nodes are treated by special procedures and more, the negative sections of the patients are subjected to staining with special coloring agents. Thus, if the minimal involvement of the lymph nodes is established, the patient should be operated a second time for a further dissection of the axillary area, in other words, all the lymph nodes are excised.

Breast reconstruction

Breast reconstruction is performed to restore the initial shape of the breast lost due to breast cancer. From this point of view, breast reconstruction is not considered as plastic surgery, but rather as reconstruction, an operation to replace a lost limb due to the disease. Through new medical science, surgeons can now generate a breast similar to the natural one. In developed countries, breast cancer treatment and surgery teams include plastic surgeons, who specialize in reconstruction. They perform operations for the natural transformation of the breast, when required.

What are the benefits of breast reconstruction?

Breast loss affects many women psychologically. Thus, the result of breast reconstruction operations may be a new beginning for most patients. The family relationships and sex life of these patients become compatible. Moreover, by improving the mood of patients, they can more easily fight the disease.

What stages are there in breast reconstruction?

Breast reconstruction has 3 fundamental stages. In order, the generation of breast tissue, the reconstruction of the nipple and areola, ensuring the symmetry between the breasts.

I - Regeneration of breast tissue

In general, the regeneration of the lost breast can be done in two ways:

1- Breast prosthesis

2- The patient's own tissue (autogenous tissue).

Many factors, such as the general health of the patient, the age, the body characteristics, the characteristics of the mastectomy surgery performed, the administration or lack of radiation therapy, the status of the other breast, the patient's preferences, the surgical experience and the abilities of the plastic surgeon, play an important role in choosing the method of operation and reconstruction time.

1- Breast prosthesis

Breast prostheses are usually of two types: filled with gel or filled with saline (salt water). In both types of prostheses, the outer surface consists of a silicone wall. Depending on the patient's condition, reconstruction can be performed by placing the prosthesis directly (in the case of simultaneous reconstructions) or first by placing a balloon called a "tissue dilator" to expand the soft tissues of the chest wall, remove the balloon and fix the permanent prosthesis. This method is especially preferred in late reconstructions.

2 - Breast reconstruction with the patient's own tissue (autogenous tissue)

Breast reconstructions with autogenous tissue are accepted as more complex and require experience.


Dermal tissue and subcutaneous fatty tissue are completely removed from the abdomen, dorsal area or region of the hips, connected to the veins that feed them by the method of free tissue transplantation in the case of breast reconstruction, and the survival of the veins is ensured by sewing with the veins of the recipient location. it must be experienced with regard to microsurgery for this type of operation because sewing of the thin veins from one another can only be performed under the microscope.

II - Reconstruction of the nipple and areola

Sometimes it will take a few operations to get the image of a natural breast. The first operation (breast tissue regeneration process) is the most difficult. Regarding the second operation, the regeneration of the nipple and areola (dark area around the nipple) is easier, performed under local anesthesia. The nipple is made of tissue from the same region. For the dark colored area around the nipple, you can call on the tattoo or skin removal from the opposite nipple or in the groin area.

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Medipol University Hospital is the Turkey’s largest private health investment as a university hospital incorporating General, Cardiovascular Surgery, Oncology and Dental hospitals, Medipol University Hospital attracts attention with its modern architecture intelligent building technology and advanced medical equipment and bears the distinction of being one of Turkey’s best hospitals with a new generation of technology. Medipol University Hospital, is a new reference center in the health sector in both national and international arenas. Medipol University Hospital, being the justifiably proud of Medipol Education and Health Group in Turkey and in the world, resulting in this spirit, is a health complex having JCI standards accepting patients from all over the world. Medipol University Hospital takes firm steps forward with the big investments and advances in preventive / curative health services to improve the community’s quality of life. Medipol University Hospital has capacity of 470 beds 133-bed Intensive Care Units (General, Coronary, CVC, Neonatal Intensive Care) all serving with an infrastructure equipped with intelligent systems and technology. Medipol University Hospital , having the highest number of departments within the hospitals in Turkey, presents patient-centered superior service approach. The hospital is also is configured with a new generation of technology being capable of performing simultaneous operations in 25 operating rooms. Away from the usual hospita architecture, Medipol University Hospital is a complex which may become an example in the world with its “Healing Hospital Architecture” and original scape in order to make patients and their relatives feel better. Medipol University Hospital has 15 acres of gardens, 26 thousand square meters of 5 storey under ground car park, 100 thousand square meters of indoor area and 1,500 people of employment capacity. Holding the comfort and convenience of the patients at the forefront, Medipol University Hospital host patients and their relatives in the comfort of home environment. There are totally 470 beds involving spacious and modern physical areas, terrace garden suites, suites and normal rooms. Patients can benefit from multimedia services (TV, DVD, internet) in rooms equipped with LCD screen . In addition to the any kind of comfort of modern life that the patient and their relatives may need, a high – quality meal service is also supplied.

Acibadem Healthcare Group, Turkey's first-ever healthcare institution, has been providing quality medical services since 1991 with state-of-the-art technology. 

Acibadem has nearly 12,000 employees, of whom 2,200 are physicians, in various locations in the network of 22 general hospitals, 19 medical centers and central laboratories. 

It is an internationally accredited health care group located in the central part of Turkey, with preponderance in the beautiful city of Istanbul. 

Acibadem, which, through its current investments, is continuously expanding its health care institutions, has reached a total of 85 operating rooms and a capacity of 2,200 hospital beds in 400,000 square meters.

Spitalul Acibadem Altunizade

An institution that fueled dozens of worthwhile projects in Turkey, Anadolu Foundation made another dream real by founding Anadolu Medical Center. Relying on the valuable heritage of Anatolia that boasts of thousands of years of medical knowledge and was home to many valuable people of medicine, our hospital uses this knowledge to contribute to human health. Working in strategic cooperation with Johns Hopkins Medicine for the improvement of education and quality, our hospital provides services in all branches including in particular, oncologic sciences, cardiovascular health, gynecology and IVF, neurological sciences, surgical sciences, internal medicine, diagnosis and imaging. Established on an area of 188.000 square meters and an indoor area of 50 thousand square meters with a capacity of 201 beds, our hospital provides services with JCI (Joint Commission International) accreditation, ESMO (European Society for Medical Oncology), ISO (18001, 14001 and 9001) certifications. Anadolu Medical Center continues to provide healthcare services also at Ataşehir with its Outpatient Clinic. Procedural archives of patients who receive services at the Outpatient Clinic are kept in the virtual environment. Having started to render service in June 2010 within the structure of the hospital, the Bone Marrow Transplantation Center performs bone marrow transplants for 22 patients at the same time. Our patients are always the number one priority at our hospital. For this reason, we give value to the needs and expectations of our patients, and make every effort to ensure that they have a peaceful treatment process and feel at home.

Anadolu Medical Center

Hisar Hospital Intercontinental based in İstanbul, is one of the nation’s largest and most comprehensive private hospitals, with offers highest quality diagnosis and treatment in the most comfortable, safe and patient oriented environments, employing the latest and best medical technologies.

The Hospital was founded on closed area of 35,000 square meters and it offers services in Ümraniye, İstanbul. That is only 20 minutes to Sabiha Gökçen International Airport, 5 minutes to Bosphorus and at the joint of the continents, Asia and Europe. It’s aimed to supply the patient satisfaction at the highest level with its diagnosis and treatment units using advanced medical technology. With 170 patient bed capacity and 7 operating rooms where all kinds of specialized operations including Cardiovascular Surgery can be carried out and a total of 36 Intensive Care beds that can provide special care to each patient in single rooms. 

Since 1992, Medicana Health Group sustains its progression on the way to determine the standards of future healthcare services. Today, Medicana Health Group, which carries on its activities especially in Istanbul and Ankara, constantly provides the most advanced healthcare services in all aspects of health in Konya, Samsun, Sivas and Bursa through its 13 hospitals and 6500 employees on average. Medicana Health Group not only pioneered the development of health tourism in our country, it also became one of the important centers in treatment of international patients in multidisciplinary healthcare. In order to provide sustainable healthcare services, many offices have been established at important locations of the world.

Israel's Herzliya Medical Center (HMC) is a state-of-the-art medical institution offering a wide range of medical services to all international peacekeeping organizations in Israel: UNDOF, UN, UNIFIL, UNTSO & MFO. 

Herzliya Medical Center cooperates with organizations in the U.S. and other organizations worldwide since 1984. The latter have chosen to cooperate with the Herzliya Medical Center for the latest generation of medical services including: state-of-the-art diagnostic facilities, modern laboratories, advanced imaging institutes, reputable physicians and highly trained surgeons , exclusive hospitalization standards, first class rehabilitation services. 

Since 1999, U.N. and UNDOF chose the private hospital at Herzliya Medical Center (HMC), Israel's first healthcare provider. The assessment includes the level of medical assistance provided, physician qualifications, operating room standards, and intensive care unit. Herzliya Medical Center is located in Herzliya, an attractive seaside town with a stunning beach. The convenient location of the hospital allows employees in U.N. to arrive in southern and northern Israel in a few hours.

Centrul Medical Herzliya Israel

A symbol of excellence in medicine, Liv Hospital Istanbul combines the quality of care services with the high level of training of the team experienced by specialists, surgeons and nurses.
The center has the most advanced methods of diagnosis and treatment, using the latest equipment and technology.

Wiener Privatklinik, the largest private hospital in Vienna, dating back to 1871, set the goal of providing patients with first-class medical expertise and an individualized care center for patients – all delivered in a sophisticated ambience. Due to the proximity of the University Hospital, WPK is the seat of the most renowned medical experts who teach and practice at the University Clinics. This guarantees our patients evidence-based services, state-of-the-art technology and personalized care. The hospital has 145 beds, an operator block with 4 operating rooms, advanced imaging services (the only private hospital in Vienna with PET CT and nuclear medicine), physiotherapy and medical recovery at international standards. The medical team consists of over 250 reputable Viennese experts who apply an interdisciplinary approach to each case.

wiener privatklinik 2

Assuta is Israel’s largest and leading private medical services center, comprising eleven clinics and hospitals across Israel and providing innovative surgeries and diagnostic procedures in all fields of medicine, including cardiology, oncology, gynecology, urology and more. Assuta Hospital in Tel-Aviv was established in 1934, and over the past 70 years has become renowned as the most advanced hospital in the Middle East. Assuta specialists and surgeons undergo a thorough selection process, which means at Assuta you can expect the highest medical and professional standards. Assuta employs the latest cutting-edge technologies both from Israel and abroad. Our senior physicians possess solid experience in the implementation of modern technologies and techniques, so you have a choice of the most advanced treatment that is suitable for you. The use of modern technologies, devices and prosthetic materials minimizes both the duration of the surgery and the recovery period, adding further to the patient’s quality of life.
Spitalul Assuta din Tel-Aviv a fost infiintat in 1934, iar in ultimii 70 de ani a devenit renumit ca fiind cel mai avansat spital din Orientul Mijlociu.

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