Brain cancer treatment in Switzerland: diagnosis, therapy and surgery

Every year tens of thousands of medical tourists travel to Europe; many of them are looking for the first-class brain cancer treatment and diagnosis in Switzerland.

The country of best watches and highest medical technology offers treatment of all cancer types.

High-tech diagnostic imaging, complex neurosurgery, the latest drugs and rehabilitation.

Brain tumors are a group of multifactorial disorders that are characterized by uncontrolled proliferation of a certain cell type.

In Central Europe, 8-10 cases of this disease per 100 thousand inhabitants are diagnosed each year. Especially often cancer is found in people aged 60+ years.

The five-year survival rate for brain cancer in Switzerland is considered one of the highest in Europe, along with Germany, Belgium, Austria and Norway.

Because of the rapid neurodevelopment process, brain cancer in children account for 20% of all pediatric oncology. For comparison, in adult patients it makes up only 1% of all cancers.

Oncologists classify CNS tumors according to their behavior into benign and malignant tumors (cancer itself). The latter are distinguished by aggressiveness and the ability to occupy healthy organs and tissues giving rise to metastases. Brain malignancies sometimes originate in other parts of the body, outside the CNS. In these cases doctors talk about secondary (metastatic) tumors. Their cells are brought here with blood.

The most frequent sources of secondary brain tumors are:

• lung cancer
• breast cancer
• malignant melanoma
• colorectal cancer
• other malignancies

With metastatic cancer, the prognosis worsens dramatically, and a complete cure is unlikely.

Symptoms of the disease are diverse and depend on the affected area of the brain. Most often, patients have epileptic seizures, headache, personality changes, sensory disturbances. Diagnosis of brain cancer in Swiss clinics is based on high-tech imaging techniques, including magnetic resonance imaging and PET / CT scan.

Successful treatment requires a well-coordinated multidisciplinary approach involving a medical oncologist, neurologist, neurosurgeon, radiation oncologist, and other experts. The choice of therapy depends on the type, location and stage of the cancer.

The main treatments options for brain cancer include:

• neurosurgical resection (if possible)
• high-precision radiotherapy (radiosurgery)
• chemotherapy (including intrathecal route)
• targeted therapy (bevacizumab)
• immunotherapy (vaccines)
• palliative treatment

Most methods are used in combination, based on the study results and many years of clinical experience. There are dozens approved regimens for brain cancer treatment in Switzerland. Survival rate and prognosis for brain cancer depends on the stage and tumor localization (which parts of the nervous system are affected). Some malignancies are less aggressive and develop over the years, others can kill a patient in a few months.

For example, meningioma grows slowly from the meninges, gradually pushing normal tissue and causing neurological symptoms. Meningiomas can grow large enough before patients feel uncomfortable and go to the hospital for an examination.

Other highly malignant tumors (glioblastoma) grow rapidly, destroying the surrounding tissues. These neoplasms are quickly manifested by neurological symptoms, such as paralisys or speech disorders (aphasia). Clinical presentation depends on the affected area.

Comprehensive Cancer Center Zurich

This renowned clinical center works closely with the University Children's Hospital (UCH) Zurich and the University Hospital Balgrist. There are qualified specialists and the necessary equipment for the treatment of all cancer types in children and adults. CCCZ combines all the advantages of Swiss medicine: the uncompromising quality and professionalism of doctors and nurses, high technology and strict discipline.

Patients of Comprehensive Cancer Center Zurich can:

• get cancer screening and diagnosis
• undergo treatment at any stage of the disease
• get the second opinion of leading oncologists
• take part in clinical studies

CCCZ has been certified according to strict standards of the German Cancer Society. Perfect rehabilitation programs in resorts in the middle of the picturesque Alps will continue therapy. By the way, the most common language of communication in Zurich and Bern clinics is German. However, most doctors and nurses speak foreign languages, including English and French.

Brain cancer diagnosis in Switzerland

When a patient is admitted with suspicious symptoms, Swiss doctors widely use modern equipment. Diagnosis of brain tumors is based on the results of laboratory tests and medical imaging.

Consultation of the best neurologists in Zurich and Bern cost about 500-600 dollars.

Neuropathological diagnosis (Neuropathologische Diagnostik)

The only way to confirm the diagnosis and determine the specific type of tumor is a laboratory examination of a tissue sample obtained during a biopsy or neurosurgical resection.

The tissue sample is examined under a microscope, and also treated with various antibodies to determine the tumor subtype. Sometimes so-called molecular markers (genetic changes of cells) are additionally determined. This information may be required to participate in a clinical trial, as well as to choose an appropriate targeted therapy.

Neuroradiological diagnosis (Neuroradiologische Diagnostik)

You could understand that brain visualization is one of the most important steps of diagnostic process. The scans show the tumors number, size and location. Unfortunately, without laboratory tests, imaging is not enough to classify the tumor and choose the optimal treatment. Studies such as magnetic resonance imaging will have to be repeated regularly. Tumor visualization is required to monitor the development of the disease, assessing treatment results, and neurosurgical planning. Swiss doctors consider MRI the best imaging technique for neuro-oncology.

Computed tomography is less time-consuming. CT may be preferred for certain types of brain tumors, as well as for patients with an implanted pacemaker or defibrillator.

The approximate cost of brain cancer diagnosis in Switzerland:

• computed tomography: 500-1500 dollars
• magnetic resonance imaging: 700-2000 dollars
• PET / CT scan: 1300-4000 dollars

During course of disease, images are regularly compared to clearly document the response to chemotherapy or radiotherapy. If the tumor resumes growth, therapy is adjusted.

University Children's Hospital in Zurich

The UCH affiliated with the University of Zurich is the largest pediatric hospital in Switzerland. Moreover, it is one of the leading clinical centers for children and adolescents in Europe. Here are available unique clinical studies and tissue-sparing treatments aimed to keep neurodevelopmental potential of the child after therapy. University Children's Hospital Zurich have opened the country's first research center devoted exclusively to research in the field of pediatrics.

The clinic accepts foreign medical tourists, offering little patients and their parents comfortable accommodation, quality services and safety. Unlike most European children clinics, 30+ medical specializations and the most complex procedures are available here.

Brain cancer treatment in Switzerland: technology and drugs

Neurosurgical surgery is usually required for accurate diagnosis (benign or malignant tumor) and the choice of further treatment strategy. Like 20 years ago, today surgery remains the gold standard for treating brain and spinal cord tumors.

Neurosurgical treatment (Neurochirurgie)

Swiss neurosurgeons are known worldwide for advances in microsurgical techniques.

Minimally traumatic and the most complete removal of a tumor under the control of a microscope with confirmation on an early MRI scan is the goal of brain cancer rosurgery. Such treatment can be performed only in specialized center equipped with intraoperative navigation systems. For the success of a risky procedure, experience of the neurosurgeon, proper planning and risk management are extremely important.

Among the best neurosurgery clinics in Switzerland, we recommend you the University Hospital of Bern “Inselspital” and the University Hospital of Zurich, where an impressive experience has been gained in treating brain tumors.

The cost of brain surgery at leading Swiss clinics is $20,000-30,000.

However, success depends on many factors, including the location and size of the tumor.

If vital areas of the brain are affected, your neurosurgeon may refuse to operate. Then modern radiosurgery, chemotherapy, targeted agents and other available options come into play.




It should be understood that any neurosurgical treatment is always associated with certain risks, including motor, sensory and other disorders, including permanent ones. By agreeing to surgery, you put yourself in the hands of the doctor. You rely on his professional skills and experience.

Radiotherapy (Strahlentherapie)

In many cases, especially with aggressive tumors, radiation therapy is recommended after surgery. Irradiation delays the further growth of malignant cells and reduces the risk of metastasis. Computed tomography (CT) or magnetic resonance imaging (MRI) is usually used to prepare for radiotherapy. Scanners accurately determine the size and shape of the tumor in order to precisely direct the energy of radiation beams. This is called computed planning.

Sometimes the entire brain must be irradiated (for example, with multiple metastases).

Radiotherapy always involves side effects because ionizing radiation affects healthy tissues. Among the negative effects are hair loss, skin burns, weakness, fatigue, cognitive impairment. Most of them disappear soon after the end of therapy.

Swiss hospitals widely use stereotactic radiosurgery (stereotaktische Radiochirurgie), which is based on high-precision delivery of large doses of radiation. SRC can cope with inoperable tumors in just one session, which lasts from several minutes to an hour.

The approximate cost of stereotactic radiosurgery (cyber-knife) is about $20,000.

Brain cancer chemotherapy (Chemotherapie) in Switzerland

Aggressive brain tumors are treated with chemotherapy, usually in addition to radiation therapy.

For malignant gliomas, especially glioblastomas, first-line therapy includes temozolomide (Temodal) oral suspension, which slows the growth of malignant cells.

Chemotherapeutic drugs can’t always penetrate the blood-brain barrier that surrounds the brain and spinal cord. Sometimes drugs have to be administered intrathecally or intraarterially (directly into the blood vessel feeding the tumor). As you understand, this route of administration requires neurosurgical intervention. Because chemotherapeutic agents damage any rapidly dividing cells and travel throughout the patient’s body, they affect different tissues, including the digestive tract, blood, heart, and lungs.

Fortunately, Swiss oncologists have learned to effectively control the side effects of chemo with special drugs. Modern brain cancer chemotherapy is not so terrible as it was 20-30 years ago.

The cost of brain cancer chemotherapy in Switzerland is $4,000–12,000 per course.

Targeted therapy (gezielte Krebstherapie)

In addition to standard chemotherapy, targeted drugs are often used in recent years. They act on specific proteins found of malignant cells. This class is more effective and less toxic. European researchers say this is the future of oncology, along with cancer immunotherapy. One of the first targeted drugs for brain cancer is bevacizumab (Avastin). It is an antibody that interferes with the formation of blood vessels. Avastin is used to deal with cancer recurrence.

Targeted therapy is often combined with other treatment regimens.

University Hospital of Bern (Universitätsspital Bern), Switzerland

Specialized neuro-oncology center operates on the basis of this well-known clinic, providing innovative scientific solutions for virtually all brain tumor types and stages.

The center is certified by the German Cancer Society (2016) and meets the strict international criteria ISO 9001: 2015.

The latest (including experimental) protocols for brain cancer recurrence treatment are available. The University Hospital of Bern “Inselspital” is actively introducing into clinical practice the best developments of Swiss scientists which are not available in other countries.

Participation in European and international research projects ensures the high quality and safety of treating patients with brain and spinal cord tumors. According to statistics, local patients enrolled in clinical trials live longer and maintain a higher quality of life.

If you are looking for modern neuro-oncology, Inselspital is one of the best choices.

Palliative care for brain tumors

Palliative care is aimed at maintaining the quality of life. Palliative care for brain and spinal cord tumors in Switzerland combines a variety of techniques and drugs that alleviate the symptoms of the disease, but do not stop its progression.

These include:

• neurosurgery (CSF shunting)
• corticosteroids, NSAIDs and painkillers
• diuretics to reduce brain swelling
• antibiotics for infections
• anticonvulsant therapy
• antiemetics, etc.

According to Swiss oncologists, for most CNS tumors the concept of palliative care should not be limited to the last stage of life. It is necessary at all stages of the disease. Over time, the clinical presentation changes, as does the individual needs of every patient.

Headache

In brain cancer, headache can occur as a result of increased intracranial pressure, as the tumor grows displacing the healthy structures and disrupting the cerebrospinal fluid flow. Sometimes pain is a side effect of treatment, including neurosurgery and radiation therapy. Finally, patients can still suffer from typical migraine or tension headache.



In these cases, effective pain relievers are available. Corticosteroids help to reduce brain swelling. Neurosurgery (CSF shunting) is considered to restore the circulation of cerebrospinal fluid.

Nausea and vomiting

When nausea and vomiting occur along with a headache, the main cause is an increased intracranial pressure. These symptoms also occur as a result of chemotherapy or radiation therapy. There are effective antiemetics in tablets and injections, as well as cortisone and antipsychotics, which will help to cope with condition.

Epileptic seizures

Tumor masses can disrupt the electrical activity in different areas of the brain, causing epileptic seizures. According to various sources, seizures occur in 20-80% of brain cancer patients. Their severity varies from mild attacks with short-term nausea or sensory disorders to severe epileptic seizures with loss of consciousness and convulsions throughout the body. Such seizures are traumatic and dangerous for the patient.

In order to control epileptic activity, Swiss neurologists use anticonvulsants and even special medical devices that suppress the activity of key brain regions.

Modern therapy successfully solves the problem in most, although not all patients.

Weakness and fatigue

Physical and mental exhaustion with cancer is not uncommon. Weakness and fatigue may be associated with intoxication with tumor products, and may be a side effect of chemotherapy.

The causes of weakness in brain cancer are manifold:

• intoxication
• severe anemia
• chronic insomnia
• hormonal imbalance
• side effects of drugs, etc.

Drug treatment in this case is usually limited. The focus is on the correction of lifestyle, moderate physical activity, and proper nutrition.

Focal neurological symptoms

The central nervous system is involved in the management of all life processes. It is not surprising that CNS tumors have such a diverse and unpredictable clinical presentation. As the tumor mass grows, memory and thinking deterioration, personality and behavior changes, motor and functional deficiencies, loss of vision and hearing can occur. Proper comprehensive rehabilitation plays an important role in these cases: exercise, massage, memory and speech training, occupational therapy to maintain the independence.

The cost of hospitalization and palliative care in Switzerland is considered high compared with the same clinics in the Middle East, but the quality of services are definitely worth the money spent.

Psycho-oncological aspects

The doctor words "brain cancer" changes the life of patients forever.

What awaits me?
Death?
Disability?
Pain and suffering?

Potentially deadly disease is a source of concern and uncertainty for patients and their relatives. Therefore, in Europe, traditionally, much attention is paid to psycho-oncological care. It is important not only to save a person’s life, but also to protect his mind. This may require consultation of psychologists and drug treatment, including sedatives and antidepressants.

Hirslanden Clinic in Zurich

The Hirslanden Clinic is one of the best private centers for brain cancer treatment in Switzerland.

Here exclusive procedures and services are available, as well as second opinion of the best experts in neurosurgery, neurology, oncology and different areas of medicine. Other specializations include cardiology, gynecology, orthopedic surgery.

The Hirslanden Clinic works closely with dozens of leading centers of expertise in Europe and the rest of the world, offering its patients the latest technology and treatment protocols. Hirslanden is an impeccable professional reputation and a high level of cancer care.

Being one of the most comfortable medical institutions in Switzerland, Hirslanden is located in a picturesque Lake Zurich area. Here patients and their relatives will be comfortable.

© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator