Corona virus and Cancer patients

We would like to share with you a comment in regard to the corona virus pandemia:

“Due to the current events, more information should be highlighted relating to our field of medicine, to raise more awareness to our cancer patients and their relatives.

Patients with cancer belong to the COVID-19 high-risk group due to the underlying disease and the use of cytotoxic cancer therapies. Our patients are currently asking whether cancer therapies can be postponed until the pandemia is over. Following the current statements of the Robert Koch Institute, the pandemia might take even years. Therefore, one thing should not be forgotten: The cancer will not take a break due to the corona virus pandemia. Therefore, treatment continuation is essential.

However, those affected and especially relatives who are in personal contact with the patients should take the measures identified by the countries seriously and act accordingly. Even if one is not afraid for him-/herself, one can still be a carrier and thus infect people who belong to a risk group.

When everyone not only assumes their individual fate, but also takes responsibility for the fate of others, by following the hygiene measures and instructions of the public health departments, a lot of people are helped with and lives are saved. One also needs to consider that car accidents, work accidents or surgeries still happen, and a medical treatment must continue and have to take place – intensive care beds must also be available for these patients.

People who spread panic, see local practitioners or storm the hospitals to finally be tested – please be considerate. There are people with chronic illnesses, malignant illnesses, who need to attend the hospitals for their therapies. They do not have a choice. Keep the risk as low as possible. Call the health care providers and designated test centers first if you feel sick. If one develops severe symptoms such as high fever and shortness of breath, one should call the local emergency services and explain the individual situation exactly. For cancer patients under treatments a high fever is a life-threatening situation that needs to be taken urgently.

If everyone works “hand-in-hand” by taking care of others, healthcare providers will be able to keep doing an excellent job and provide care to all patients in need of treatment.”

Dear cancer patients, further treatment is essential and necessary – even now in this time. Therefore, we recommend following the hygiene instructions, and in case of any questions and doubts, our patients are of course always welcome to contact us either via email (info@hallwang-clinic.com), or via telephone under +49 7443 964 240.

https://www.who.int/health-topics/coronavirus

January 2020

January 2020 – Up2Date in HER2-positive breast cancer: New therapy strategy available

The FDA has granted an accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu; DS-8201) for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer.

https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-fam-trastuzumab-deruxtecan-nxki-unresectable-or-metastatic-her2-positive-breast-cancer

Case of Excellent Response

Christmas and holiday time means family time. Often, it is the only time of the year everyone can get together in the same place. Nick and his family feared that Christmas 2018 would be the last after being diagnosed with nasopharyngeal cancer in July 2018 and sepsis with multi organ failure in December 2018. When the cancer spread, he was only offered palliative care. Thanks to his supportive family, friends and especially his wife, Nick came to the Hallwang Clinic early 2019 and started on combined immunotherapy including so-called checkpoint-antibodies with amazing success, allowing him to spend Christmas 2019 again with his family at home. We are so happy for Nick! Read his story here: www.mirror.co.uk

Specialized Oncology Clinic

The Hallwang Clinic

The Hallwang Clinic is a specialized oncology clinic and helps patients to navigate in a very difficult situation. In contrast to the so-called „alternative clinics“, the medical team of the Hallwang Clinic consists of board-certified oncologists. This is a basic but major quality criteria. The medical team consists of an innovative interdisciplinary team of board-certified and specialized oncologists, hematologists, internal medicine specialists, naturopaths, specialized psychologists and oncology nurses, working in a collaborative university hospital and university institute network. The board-certified oncologists at the Hallwang Clinic have gained experience at well-known university institutes and university hospitals in Germany and world-wide, including the Center of Integrated Oncology of the University Hospital Cologne and the University Hospital Bonn (Germany), the Dana Farber Cancer Institute of the Harvard Medical School in Boston (USA), the Sidney Kimmel Comprehensive Cancer Center of the Johns Hopkins Hospital in Baltimore (USA), the Walter and Eliza Hall Institute (Australia) and other renowned cancer institutes. Furthermore, the specialized medical oncologists are members of the European Society for Medical Oncology, carrying the ESMO certificate of Oncology, and /or are members of the German Society of Hematology and Oncology. Many of the physicians have an intensive research and academic background in cancer medicine, particularly Immuno-Oncology. There is always an oncology team on-site. At the Hallwang Clinic, there is also an outpatient center as well, which is also fully covered by an oncology team. The medical oncology team follows the continuously updated international guidelines for cancer therapies. Nevertheless, at the Hallwang Private Oncology Clinic there is an ability to offer further therapy possibilities for patients who need an individualized therapy approach outside of clinical trials.

At the private oncology clinic “Hallwang Clinic”, the medical staff is indeed looking for the most effective therapy approaches that fit the individual characteristics of the patient’s medical history and condition. In heavily pretreated patients, they discuss targeted therapies based on biomarker analysis leading to genetic targeted therapies and immune therapies. The application of biomarker analysis has developed rapidly in the field of oncology. Immunotherapy is a complex field and not well understood by doctors with no expertise in immunooncology and immunotherapy. Beyond doubt, the field of cancer immunotherapy needs to be in the hands of oncologists and scientific professionals, since there are so many biomarker constellations that need to be considered in the decision making process of whether a patient will benefit from targeted immunotherapy or not.  In triple negative breast cancer for example, the so-called immunotherapies are not yet approved but are achieving very promising results in clinical trials worldwide. As medical and scientific experts, the Hallwang medical team is convinced that certain patients benefit from this immunotherapy, as they have achieved for certain patients at the Hallwang Clinic extraordinary long-term therapy results, which are highly respected by medical experts world-wide. For many years, the so-called PD-L1 expression was used as a predictive marker. But nowadays, one already know more significant predictive markers, e.g. the tumor mutational burden, immune-prediction, among many others. The Hallwang Clinic is one of the first clinics worldwide that started using checkpoint antibody therapies for certain tumor entities. Navigating in a university hospital system, the Hallwang Clinic has access to the most advanced diagnostic and therapeutic strategies. They are open for complementary approaches, but the clear focus is on evidence-based treatment approaches.

The team of Hallwang Clinic

Over the last few years, the team of the Hallwang Clinic have seen that medical doctors at renowned hospitals in Europe and world-wide are willing to continue an immunotherapeutic approach after a successful initialization at the clinic. It is important that these therapies are applied and monitored by a specialized oncology team with a long standing experience in immuno-oncology like the Hallwang Clinic, since these therapies, although in general well-tolerated, can have severe immune related side-effects. Unfortunately, one will realize that most so-called experts are not able and will not be able to gain hands-on experience in the most advanced therapy possibilities due to restrictions and limitations in their home countries. 

The medical team of the Hallwang Private Oncology Clinic is able to make use of the most advanced clinical research achievements worldwide and can discuss in an interdisciplinary team whether a patient who has already exhausted all possible standard line therapies would benefit from such a new treatment approach. In Germany, they have the possibility to use extensive biomarker analysis (Next-Generation Sequencing, Immune-Prediction, Tumor Mutational Burden Analysis, Gene-amplifications-/translocations) for private patients to allow for evaluation of precision-based targeted therapies.

Too many patients face limitations in their home country health system, even though certain treatments have shown to be effective. Patients who would most likely benefit from a precision-based therapy have been denied a precision-based medicine approach, because e.g. the trial has already stopped recruiting, or the patients do not meet all eligibility criteria from the clinical trial, etc.

The Hallwang clinic is no clinical study site. The private clinic “Hallwang Clinic” is too small and the patient population very heterogeneous, so clinical trials are not possible, since obviously, the team of the Hallwang Clinic wants to offer all its patients the best treatment possible, and not based on some criteria they might not meet, but would have to be met in order to be included in a trial. Many patients indeed come to the clinic, because they were not eligible for clinical trials, due to their age, treatment history, or other chronic diseases, etc. The aim of the Hallwang Private Oncology Clinic is to find the best treatment strategy for the patient, and not exclude any patient from a treatment protocol because of the factors mentioned beforehand. Also, clinical studies often use placebo as a control or some alternative, though possibly inferior, treatment protocol, in order to compare treatment responses in two groups of patients. Naturally, at the Hallwang Clinic, a patient will always receive the treatment the medical team think is best for the patient after a thorough discussion of state-of-the-art, alternatives, possible side effects and complications of this treatment. 

Patients at the Hallwang Clinic

Patients at the Hallwang Clinic are treated with individual treatments. For example, doctors elsewhere persist on chemotherapeutic regimens and protocols that have been established years ago. These protocols may achieve a “good overall result“ – but they do not think about whether it would be possible to achieve even better or more durable results for those patients. While some patients respond well to a certain chemotherapeutic protocol, and do not experience severe side effects, others need to discontinue the standard protocol due to terrible side effects, or they progress under the standard protocol. Alternative protocols for these patients, that did not tolerate the standard chemo regimen, are limited. And if the patient then develops complications on the alternative chemo protocol, options become really scarce. In contrast, worldwide there are so many ongoing clinical trials with cancer drugs, showing amazing results in advanced clinical phases. But as long as these drugs are not approved, or only available if you pay for them privately, these drugs will not be provided to other patients who have already exhausted all available standard treatment strategies and are in immediate need for further options, as they are rapidly progressing. And this is terrible. There should be an open and honest discussion about what is known (and what is not known) about these modern drugs, what results have been achieved so far in other patients, what risks, side effects and complications can occur, so that the patient and his/her doctor can together weigh pros and cons and make an educated decision. The patient should know about his/her chances when he/she takes the drug in an experimental setting in contrast to when he/she takes no treatment at all. But the problem is that these new clinical trial drugs do not even come into question for these kind of heavily pre-treated and further progressing patients and are therefore not discussed with the patients due to country-specific limitations and laws, thus depriving patients of possibly life-extending or even life-saving treatments.

In conclusion, the Hallwang clinic is a pioneer for individualized targeted and precision-based therapies for patients who are eligible for these therapies based on a thorough biomarker analysis and who have no other guideline approved options. The Hallwang Private Oncology Clinic team has shown to be very successful in extremely difficult situations. Furthermore, they are able to provide further lines of therapeutic options due to a surrounding that offers close monitoring. You have to consider that the medical team of the Hallwang Clinic is having one oncologist for every 2-3 patients and nearly a 1:1 nurse/patient ratio, enabling therapies for critical patients which have been given no follow up therapy due to a lack of a close monitoring possibilities.

Best Treatment Strategy

Hallwang Private Oncology Clinic

The Hallwang Private Oncology Clinic in the Northern Black Forest has 16 inpatient beds, 2 luxury suites, and 6 outpatient apartments. In the Hallwang Private Oncology Clinic, the majority of patients have haematological / oncological diseases. All patients are treated in an exquisite private oncological environment with an individualized treatment concept.

The focus of the clinic is on inpatient and outpatient care of international private patients. The range of diagnostic and therapeutic services extends to chronic, internal and oncological diseases. At the Hallwang Private Oncology Clinic, the individual-focused treatment and care of patients as part of a personalized and holistic treatment strategy is of utmost importance.

The aim of the Hallwang Private Oncology Clinic is to find the best treatment strategy for each individual patient and to not reject patients based on their past medical history or chronic illness. Patient-oriented individual treatment approaches form the core of the clinic.

The Hallwang Private Oncology Clinic’s task is to develop treatment strategies that best address the patients´ tumor cells with the aid of a broad range of diagnostics on tumor cells and tissue, so that patients can be treated with a targeted and personalized treatment.

The Hallwang Private Oncology Clinic always respects the well-being of the patients in all its actions and treats each patient in a respectful and friendly environment.

The medical team of the Hallwang Private Oncology Clinic

The medical team of the Hallwang Private Oncology Clinic is characterized by international research excellence and a science-oriented education. The Hallwang Clinic has put together an innovative interdisciplinary team of oncologists, internal medicine specialists, naturopaths, specialized psychologists and nurses, working in a collaborative university hospital and university institute network. The physicians have gained experience at well-known university institutes and university hospitals, including the Center of Integrated Oncology of the University Hospital Cologne and the University Hospital Bonn (Germany), the Dana Farber Cancer Institute of the Harvard Medical School in Boston (USA), the Sidney Kimmel Comprehensive Cancer Center of the Johns Hopkins Hospital in Baltimore (USA), the Walter and Eliza Hall Institute and other renowned cancer institutes (e.g.. National Cancer Institute Mexico). Furthermore, the specialized medical oncologists are members of the European Society for Medical Oncology, carrying the ESMO certificate of Oncology, and /or are members of the German Society of Hematology and Oncology. Many of the physicians have an intensive research and academic background in cancer medicine, particularly Immuno-Oncology. The team of the Hallwang Private Oncology Clinic strongly believes that a trustful doctor-patient relationship is also key to a successful treatment, and can assure you that combining most advanced treatments at the Hallwang Private Oncology Clinic with the experience of the oncology specialized medical board will provide you a comprehensive, personalized and multi-modal/disciplinary treatment approach. The Hallwang Clinic offers most advanced and innovative treatments for haematological / oncological diseases.

The Hallwang Private Oncology Clinic highly esteems the trust it receives from patients, relatives and collaborative business partners every day. The clinic is fully aware of his role and responsibilities, and always strives for expertise, transparency and reliability.

Open communication, fairness and respectful interaction are very important at the Hallwang Private Oncology Clinic.

The Hallwang Private Oncology Clinic team deals with cancer patients every day, so achieving best quality of life and having a zest for life play an important role in the daily work at the clinic. Patients at the Hallwang Private Oncology Clinic team always have the right to ask for the best. Therefore, the Hallwang Clinic always strives to do even more. This attitude defines the team at the Hallwang Clinic and is a fundamental part of their work.

The Hallwang Private Oncology Clinic also offers the following arrangements as part of its personalized cancer therapy:

  • Care – whether physical, emotional, spiritual or cultural – your needs will be addressed.
  • The Hallwang Clinic offers a hygienic, comfortable and safe environment and makes sure that anyone, even those with special needs, can attend the clinic.
  • If you have questions or suggestions about dining at the clinic, the chef de cuisine of the Hallwang Clinic is always available to discuss your wishes.
  • Introduce your family, relatives and friends to the Hallwang Private Oncology Clinic team – they will be welcomed and treated with courtesy, friendliness and helpfulness by the Hallwang Private Oncology Clinic team.
  • The Hallwang Clinic will keep you up to date with your treatment plan and will always inform you about changes in treatment plans or appointments.
  • All open questions, concerns and suggestions will be answered by the Hallwang Clinic team. The Hallwang Clinic stands for open and honest communication with you and your family, as well as with all employees. It is important to give feedback to the Hallwang Clinic team, so that misunderstandings can be avoided. Needless to say, your right to privacy will always be respected.