How was the tumor discovered and what were the symptoms? Has the general condition changed? Are there any previous illnesses or are there familial cancer cases and risk factors?
To determine whether a tumor is malignant or cancerous, a tissue sample is required. In a second step, the extent of the tumor is determined by the means of X-ray, ultrasound, computer tomography, magnetic resonance imaging (MRI) or skeletal scintigraphy. The precise assessment of the tumor according to tissue type and stage is central to optimal treatment.
In our Oncology and Hematology Center, we also care for patients with blood disorders. Since blood circulates throughout the body, systemic therapy, i.e. treatment of the entire body, is usually necessary. Sometimes the diagnosis can be made on the basis of a simple blood sample. However, we often need to remove an affected lymph node or perform a bone marrow puncture. The puncture is a very minor procedure that is performed on an outpatient basis with local anesthesia or mild sedation.
- Anal cancer
Bladder cancer or urothelial carcinoma results from malignant changes in the mucosal cells of the urinary bladder, the urothelium. Often, several foci grow at the same time. Urothelial carcinoma occurs three times more frequently in men than in women. The median age of onset is over 70 years.
Tumors of the appendix are rare and extremely diverse in their origin and behavior. They are neuroendocrine tumors that arise from hormone-producing cells. Appendiceal tumors can grow either slowly or rapidly and can be very aggressive.
- Blood cancer
Pleural cancer or malignant pleural mesothelioma is a rare malignant disease of the pleura and lung. It develops on the outer surface of the lungs and the inside of the ribs in the chest cavity, called the pleural pleura, and is mainly caused by asbestos. Men are most often affected.
Colorectal cancer encompasses a wide spectrum of different tumors in the lower digestive tract and is one of the most common cancers of all. If colorectal cancer is detected at an early stage, there is a good chance of cure. Regular screening examinations are therefore of utmost importance.
Colon cancer is now one of the most common cancers in the Western world. If it is detected at an early stage, there is a good chance of recovery. Whenever possible, the so-called colon carcinomas are surgically removed, often supplemented by chemotherapy.
- Small bowel cancer
Ovarian cancer or ovarian carcinoma is an aggressive and malignant tumor disease originating from one ovary. Related are malignant tumors of the fallopian tubes and peritoneum. In about 20 percent of cases, ovarian cancer is probably hereditary.
Cancer of the rectum
The treatment of rectal cancer or rectal carcinoma requires an interdisciplinary approach to achieve the best possible chances of cure. So-called rectal carcinomas are often treated with combined radio-chemotherapy before they are surgically removed.
Essential thrombocythemia, or ET, is a rare disorder of the hematopoietic cells of the bone marrow in which there is an unusual increase in the production of blood platelets, or thrombocytes.
Gastrointestinal stromal tumor
Gastrointestinal stromal tumors (GIST) are a rare cancer of the gastrointestinal tract. The tumors usually grow slowly, but can form offshoots in the body during the course of the disease. In addition to surgery, drug treatment is often necessary.
Cervical cancer or cervical carcinoma is a malignant disease of the cervix, which is almost always caused by a human papilloma virus (HPV). Due to the widespread HPV vaccination of teenagers, this tumor can usually be prevented nowadays.
Uterine cancer or endometrial carcinoma is a malignant tumor that originates from the uterine wall. Already at the beginning of the disease, symptoms such as unusual bleeding often appear. The tumor is therefore usually detected early, which is why the chances of cure are very good.
A coagulation disorder refers to any dysfunction of blood clotting. Excessive clotting can lead to the formation of blood clots and consequent vascular occlusion, while insufficient clotting results in bleeding.
Brain tumors and tumors of the spinal cord
Tumors of the brain and spinal cord are benign or malignant neoplasms that originate in the human central nervous system. They originate from the brain, the spinal cord or the surrounding meninges. Their cause is largely unexplained.
Germ cell tumors are malignant tumors in the testis that arise from defectively maturing germ cells. The testes are the male gonads where sperm are formed. The median age of onset is approximately 38 years.
- Hodgkin's lymphoma
Laryngeal cancer or laryngeal carcinoma develops in the mucous membrane of the larynx. Most frequently, the glottis is affected, which leads to hoarseness in those affected. If the disease is detected early, there is a good chance of recovery.
There are different types of bone cancer. The most common are the so-called osteosarcomas. Like Ewing's sarcomas, they mostly occur in young people - chondrosarcomas, on the other hand, tend to occur in older people. Overall, however, bone cancer is an extremely rare cancer.
Cancer with unknown primary tumor
Carcinoma of unknown primary or CUP syndrome is a rare type of cancer in which metastases, or offshoots of the cancer, are found in the body, but not the original tumor from which the disease originated.
- Cancer of the gallbladder and bile duct
Cancer of the oral cavity and pharynx
Cancer of the oral cavity and pharynx often manifests itself in the form of pain, foreign body sensation or swelling in the throat area. If the disease is detected at an early stage, there is usually a good chance of recovery thanks to various therapies.
Hepatocellular carcinoma is a malignant tumor that originates in liver cells. It occurs alone in the liver or scattered at various sites. Liver cancer is often detected during a screening examination or as an incidental finding if there are known risk factors.
Lung cancer is common and includes all malignancies arising primarily in the lung. The median age of onset is 68 to 70 years. The main risk factor is smoking, but non-smokers can also develop the disease.
Lymph node cancer
Lymphomas are malignant diseases that originate in the human lymphatic system. There are many different forms of lymphoma, which differ significantly in their course and aggressiveness, as well as in their therapy and prognosis.
The earlier a malignant tumor disease of the stomach is detected, the better the chances of recovery. However, since the symptoms often appear late, the diagnosis of stomach cancer can often only be made when the tumor is already at an advanced stage.
Multiple myeloma is a malignant disease of the bone marrow. It originates from plasma cells, which multiply uncontrollably in the bone marrow and is thus one of the cancers of the hematopoietic system. The average age of those affected is 70 years or older.
Myelodysplastic syndromes (MDS) are diseases of the bone marrow in which too few functional blood cells are produced. The consequences are anemia, an increased tendency to bleed and susceptibility to infections.
Neuroendocrine tumors (NET) develop in the cells of endocrine glands, which are found almost everywhere in the body. They can produce hormones and are responsible for numerous body functions. Neuroendocrine tumors are rare, usually grow slowly and are not very aggressive.
Renal pelvis and ureter cancer
Renal pelvic and ureteral carcinomas are malignant tumors in the covering tissue of the renal pelvis and the urinary tract draining from it, the so-called urothelium. They occur significantly more frequently in men, with the disease mostly affecting older people from the age of 50.
Kidney cancer is a malignant tumor of the kidneys. The disease mainly affects older people around the age of 70. Symptoms usually become apparent only at an advanced stage, which makes early detection much more difficult.
Polycythemia vera (PV)
Polycythemia vera, PV for short, is a rare disease of the hematopoietic cells of the bone marrow in which there is an abnormal increase in the production of red blood cells (erythrocytes), but often also of other cell series (leukocytes, platelets).
- Prostate Cancer
If the thyroid gland can be completely removed during surgery, it is possible to cure thyroid cancer. Depending on the type and stage of the disease, different treatment methods may be considered - from radioiodine to radiation to chemotherapy.
Black skin cancer
Black skin cancer arises from pigment-forming cells and is the most aggressive form of skin cancer. Early in the course of the disease, offshoots can develop elsewhere in the body, known as metastases. The number of new cases is increasing worldwide.
Esophageal carcinomas diagnosed early can often be cured. Removal is performed by surgery, if necessary in combination with chemotherapy. In the case of far advanced or unfavorably located tumors, radiochemotherapy is often suitable.
Soft tissue cancer
Soft tissue tumors can occur in various tissues almost anywhere in the body. Most of them are benign. Rarely, the malignant form of so-called soft tissue sarcomas occurs. They can sometimes be very aggressive and already occur in childhood.
White skin cancer
White skin cancer, together with basal cell carcinoma, belongs to the light skin cancers and is one of the most common cancers. If detected and treated at an early stage, the chance of a cure is high.
Three basic treatment options
Most surgical procedures are performed on site at Männedorf Hospital by the Surgical Clinic and by the Gynecological Clinic. Special, very large surgical procedures require surgery at the University Hospital Zurich, with which we cooperate closely.
Most radiotherapy treatments can be performed at the Institute for Radiotherapy of the Hirslanden Clinic, which is located on the grounds of Männedorf Hospital. Special stereotactic radiotherapies are performed at the main building of the Hirslanden Clinic in Zurich, and various center hospitals in Switzerland are available for nuclear medicine treatments.
Drug treatments are provided at our Oncology and Hematology Center. The center also offers consultations, and second opinions can be obtained at our oncology and hematology consultations and nurse consultations. For bone marrow transplantation, CAR-T cell therapies and the treatment of rare tumor diseases, we refer our patients to the University Hospital Zurich.
The choice of the appropriate treatment
Depending on the type, location and extent of cancer in the body, different treatments may be considered. Sometimes several therapies must be used simultaneously or consecutively to achieve the best possible result.
Whenever possible, a tumor is removed surgically, provided that the tumor can be localized well and has not formed distant metastases. In addition, surgery is not performed if the tumor is in an unfavorable location or if the operation is out of the question for health reasons or due to old age.
If surgery is not possible immediately, it is possible to reduce the size of the cancer by means of medication or radiation so that surgery can subsequently be performed.
Depending on the risk situation, the result of the treatment can be improved if, in addition to the operation, subsequent drug treatment and/or radiation are carried out. This treats cancer cells that have remained in the body after the operation.
Parallel or simultaneous treatment
In parallel treatment, two therapies are combined. In the case of radiochemotherapy, radiation is performed at the same time as chemotherapy, or drug treatment takes place in parallel with radiation. Radiation and chemotherapy complement each other well or even enhance each other's effect, thereby increasing the chances of curing malignant tumors. This procedure can be used neoadjuvantly or adjuvantly.
If it is clear from the extent of the cancer that the disease cannot be cured, a palliative approach is used. In this situation, too, several treatment options can be used. If one therapy does not achieve the desired goal and the disease continues to progress, the next alternative therapy available is used. The effects and side effects of a therapy are weighted more strongly under the aspect of an optimal quality of life.
In addition to symptom management, we look for appropriate forms of support to build a sustainable care environment. The goal is to provide security and promote independence. In the context of interprofessional palliative care, questions about decision-making and advance care planning are also clarified at an early stage.
We discuss which treatments are possible for your disease at one of our interdisciplinary tumor boards. Before starting therapy, we will show you the options in a personal consultation.
With the administration of various chemical substances - so-called cytostatics - the growth of the cancer cells is stopped or the cancer cells are destroyed.
So-called monoclonal antibodies bind to specific surface structures of the cancer cells. They therefore act selectively on the tumor cells or on the vessels that supply these tumor cells. Antibody therapy is often used in combination with chemotherapy.
Tyrosine kinase inhibitors, signal transducers and other molecules
These drugs stop or influence the growth signals to the cancer cells or their environment. New such targeted drugs that act inside the cell are constantly being developed.
They direct the immune system against the cancer and thus lead to tumor decay. Treatments with checkpoint inhibitors and CAR T-cell therapies are used.
Hormone lowering treatments
Certain types of cancer grow under hormonal influence. By inhibiting the hormonal growth stimulus, tumor growth is also reduced.
Drug therapies for tumors can be administered intravenously or in the form of tablets. Intravenous administration is done through venous access in the arm, through a chamber implanted under the skin with access to the central venous circulation (Port-A-Cath system), or by means of a temporary central venous access through an upper arm vein (PICC Line catheter). The best way to administer therapy for you depends on the type and duration of your treatment and will be determined in a personal consultation with you.
How does a drug-based cancer therapy work?
Before the first therapy, the medical consultation takes place and we make an appointment in the nursing consultation. In this first care consultation, you and your relatives will receive important information about the course of a therapy day.
We will discuss your personal situation and inform you again about possible side effects and the expected course of therapy. In addition, we can clarify open questions.
In addition to the highest medical standards, our primary goal is to make the treatment time as pleasant as possible. This includes individual all-round care and advice, but also the modern infrastructure with a unique view over Lake Zurich.
Thanks to its convenient location in the immediate vicinity of the train station and right next to the hospital's parking garage, the Oncology and Hematology Center is easily accessible.
On the day of treatment
Before therapy, the blood count is determined by taking a blood sample from the fingertip. With this information, the oncologist can make final adjustments to the therapy. Before the treatment, there is a short medical consultation to discuss the course of the therapy and to address your current questions.
During the treatment, which often lasts several hours, you are in a comfortable chair or in a bed. You are mobile at all times and can move around freely. WLAN is available to you and catering is also provided. After the therapy, you can return to your familiar surroundings.
Drug-based cancer therapies always affect healthy body cells and can trigger side effects. The type of therapy determines the expected severity and type of side effects.
Before initiating therapy, your oncologist will inform you about possible side effects and the recommended precautions or countermeasures. During therapy, your nurse will also refer to this again.