The first consultation is always a personal meeting with your oncologist, together with your family if desired. In this meeting, you and your doctor will verify the indications, discuss treatments, consider the existing research results and work out the course of therapy and possible risks.
In order for the radiation to be exact and effective, the patient must not move during the irradiation. We, therefore, use specially prepared positioning aids, such as vacuum cushions, gypsum boards or masks. Producing and customising is mostly done during the planning phase which precedes the actual irradiation series.
We also either conduct a CT planning scan or MRI which acts as a “CT patient model” in which the attending physician and accompanying physicists can plan ahead and ‘simulate’ therapy. The development and optimisation of this treatment plan takes about 3 weeks.
The actual therapy is usually done on an outpatient basis, but divided into several short sessions (fractions). The most common distribution pattern is the treatment once a day, five times a week for a period of about five to six weeks, depending on the indication. The single portions (fractionation) helps to make therapy more acceptable. In between the fractions, the healthy tissue has time to regenerate. Although the irradiation itself lasts only about two minutes, the preparation can take up to an hour to complete.
In order for medical professionals to precisely locate the tumour, our centre is equipped with the latest image guidance: With X-ray, CT and MRI scanners, the location of the tumor can be detected before each session. After that, it is extremely important that patients do not move during irradiation so that the proton beam can accurately hit the tumour. Therefore, patients are fixed on a contour mattress with corresponding positioning aids. For irradiations on the head, a special mask is worn for the right positioning.
Once the doctors have left the room, the protons are fired at a speed of 180,000 kilometers per second to the irradiation target. The patient does not feel anything. During this procedure, there is video and voice communication.
Periodically during therapy, there will be opportunities to talk, for example with the attending physicians of the WPE. The treatment ends with a final examination. Regular follow-up appointments are scheduled at the WPE, also in consultation with other doctors.
The follow-up appointments are intended for monitoring response to treatment and collecting and treating possible long-term side effects as well as detecting a possible return of the tumour early on, also known as a recurrence.
Radiation therapy is performed locally, meaning that if there is a reaction, only the irradiated region of the body is usually affected. This can involve, for example, irritation of the skin that usually goes away after about two to three weeks after treatment; however, it can also turn into permanent scarring as a long-term side effect.
Fatigue, pain or loss of appetite may also occur in patients whose bodies are under the stress of processing the rays. The described possible side effects are, however, dependent on the irradiation and dosage and are discussed in detail during the consultation.
In Germany and in other European countries, health insurance companies usually accept a request for reimbursement without any problems as long as the appropriate expert recommendation for each indication is presented. However, the WPE wants to motivate more health insurance companies to completely takeover the costs by providing convincing research results. Therefore, the WPE uses the data of the treatments in registries studies to disclose viable arguments to insurance companies about the benefits of proton therapy, so that as many people as possible can have access to this gentle method of treatment.
Accordingly, we will inform you during the planning meeting about the current status of a possible reimbursement by your health insurance company and can assist you with the formalities.