Surgery In Germany

[PCUK Nurse Jeni]

Hi everyone,

I just wanted to post something in response to Linda's post about concerns her consultant had about surgery in Germany:

"One thing the consultant was a little concerned about, was when I started talking about this operation in Germany. He said he's heard so much about it of late and it's giving people false hope. He said for every operation which the German's say are successful, at least two are not successful and the cancer comes back. He was so annoyed at the way this has been portrayed has some miracle operation.... I don't know about that, all I know is that it wouldn't help me."

The operation which is being referred to here is the Whipple's operation, or a similar operation to remove a pancreatic tumour. I need to stress here that this is not "some miracle operation". The same criteria applies in Germany as it would anywhere, even in the UK, EXCEPT for the fact that it appears that some surgeons in Germany are more willing to operate where there are complex veins to be resected. We are trying to find out more about the treatment in Germany, but it is not yet clear why this is, it may be that they have slightly different parameters in Germany than in the UK. It DOES NOT mean that they will operate on everyone, and certainly where there is spread of the disease to other organs, then an operation is very unlikely, and could even speed up the spread of the disease.

So, as for the operation giving false hope, I would say that in Germany it is likely that they have very specific criteria to determine whether the patient is suitable or not. What a patient has done to them is really down to their own INFORMED choice, which is the key here. Whenever we operate on a cancer, be it colorectal, lung, breast etc..., we cannot predict 100% whether this will "cure" the person, or whether the cancer will come back. We can do everything possible for the patient, and it can still come back, sometimes years later. And yes, I agree that for every person who has a successful operation, there will be more who don't. But, that is the same as here in the UK. I have personally, and I am sure Di has, looked after patients who were eligible for surgery, without complex vessel involvement, and whose disease recurred within 6 months of the operation. And there will be more cases like this in the UK, where they have operated, but the cancer has still come back.

So, in essence, it is all a risk, and it is the choice of the person whether they want to pursue this route, and if they are able to. It may not be something all medical professionals agree with, but I stress, that as long as an INFORMED decision is made, and that the patient is not under any illusion, or false pretences, then the risk is theirs to take.

Only time can tell what the outcomes of these operations are going to be. If the outcomes from this type of surgery in Germany are proven to be very successful then hopefully these different surgical techniques will influence practice in the UK.

Jeni.