Information about the hospital system and about getting medical treatment in Germany.

Wednesday, 9 July 2014

Ion-Beam Cancer Therapy, Germany on the Forefront

Treatment of most cancer patients has three components: First the surgical intervention to try an remove the malignant cells, second chemotherapy with aggressive medication to try and eradicate any left-over cancer cells from the body and, third or simultaneously, radiation therapy to kill cancer cells that could not be removed by surgery.
For this radiation therapy, the standard is a focussed and carefully planned application of Gamma or X-rays, radiation that is well known to damage body cells nearly since Conrad Roentgen.
Medical technology has however developed new therapies using other radiation forms. Worldwide, also in Germany, proton radiation has been introduced and found beneficial for many patients with different cancers / types of tumors. The advantage is that the radiated particles are bigger (protons), thus the damage they can cause to the tissue thay are targeted on is more severe. However, the machinery needed to radiate protons are bigger, more sophisticated and more energy consuming than standard gamma-ray machines, consequently only few, big centers have been built and are available for patients.
Along these lines, but with still bigger particles, still bigger and more expensive machines, Ion-Beam Radiation has been developed in recent years and established - up to now at three centers worldwide. Here, heavy ions (carbon) are used to bombard the tumour cells and destroy them. One of these centers is the Heidelberg Ion-Beam Therapy (HIT) Center, associated to the Heidelberg University Hospital and to the German Cancer Research Center, also Heidelberg.
HIT has been chosen as the national reference center for clinical studies on the use of ion beams in cancer treatment, and of course it is also in constant exchange with colleagues at the other centers in Japan and Italy. 
HIT claims to have the following special features:

  • The world’s first ion therapy facility with intensity-modulated raster scanning, the world’s most precise radiotherapy method.
  • The world’s first heavy ion treatment facility with a 360° rotating beam delivery system (gantry).
  • Europe’s first combined treatment facility using protons and heavy ions for radiation therapy.
  • The first facility to use cooperating robots for automated imaging and ultrahigh-precision patient positioning.
Patients who are thought to benefit most from this treatment are those who have tumours
  • that are located deep inside the body,
  • that are extremely resistant to conventional radiation,
  • that are surrounded by highly radiation-sensitive healthy tissue, such as the optic nerve or bowel, which should not be damaged during treatment.
Treatments at HIT are still at the level of clinical trials and studies, but it has been shown already that in most cases, the success rate of Heavy Ion Radiation nears 90%, whereas other forms, including proton radiation has rates up to 70%. So it is estimated that in the long run, this therapy could be beneficial for about 10% of all cancer patients.

The costs of such treatments are high, about three times the cost of conventional radiation therapy. However, the center has contracted to get coverage of these costs by most German statutory health insurance companies. Patients who do not have this coverage will have to pay privately, unless they can obtain coverage from their private health insurance. There is no exclusion of international patients.

German Hospital Service will be more than happy to help international patients establish contact to the HIT center. Medical evaluation will be done by the center to ensure that the patient is a good candidate for one of the study programs. Then, a cost estimate can obtained so the patient can decide.