FAQ

Frequently Asked Questions

 

Is proton therapy covered by the health insurance?

The Proton Therapy Center has concluded contracts with Czech health insurance companies, we also cooperate with Slovak and foreign insurance companies. If you are a citizen of the European Union and your insurance company is not one of our contractual partners, we will assist you in negotiating the approval of your treatment with us on the basis of current applicable legislation.

  • Are you covered by a Czech health insurance?
    By law, proton treatment is covered by public health insurance and every person who has a valid Czech health insurance is entitled to it. Your treatment coordinator will prepare the application and send it to your health insurance company for approval. This process takes an average of two to three weeks, but for most patients, the health insurance company decides quicker.
  • Are you from Europe?
    We accept the S2 (or E112) funding, which may entitle you to state-funded treatment in another European Economic Area (EEA) country or Switzerland.
  • Are you from the UK?
    We cooperate with several private health insurance providers, including Bupa and WPA. With these partnerships, patients coming to the Proton Therapy Center for treatment may be reimbursed.

What is proton therapy? 

Proton therapy is a highly effective, precise, and gentle cancer treatment with minimal side effects. Thanks to the precise proton beam targeting directly into the tumour, the irradiation of surrounding healthy tissues is minimised, and the risk of adverse effects is reduced significantly. This means that proton therapy gives patients the chance to enjoy a good-quality life even after their cancer treatment is finished without an increased risk of late toxicity.

What are the benefits of proton therapy? 

The proton beam, owing to its physical properties, can target only into the tumour and thus considerably reduces the exposure of surrounding healthy tissues and organs to radiation. At the same time, the proton beam greatly reduces the risk of the incidence of treatment complications and adverse effects. Unlike proton therapy, the conventional photon radiation affects a large part of healthy tissues surrounding the tumour where exposure to radiation is undesirable.

What is pencil beam scanning (PBS)? 

Pencil beam scanning (PBS) is the term used for the precise dose distribution of a proton beam, and it is currently the absolute pinnacle of proton therapy technology. Pencil beam scanning irradiates the target area with millimetre precision and minimal damage to surrounding healthy tissues and organs.

What is the difference between proton and photon radiotherapy in cancer treatment?

The proton beam is able to target its energy directly into the tumour with high precision, and it does not continue further through the healthy tissue. The proton beam transmits maximum energy in the tumour (Bragg peak) and thus emits considerably less energy on its way towards the tumour than conventional radiation. The impact on healthy tissues and organs behind the tumour is thus minimised, and the risk of developing adverse effects is significantly lower. On the contrary, the more commonly used photon beam emits a significant portion of its energy to regions in front of and behind the tumour, which results in undesirable irradiation of healthy tissues and organs.

Why can't you treat patients with pacemakers (ICD) and some typed of metal/ceramic implants?

Pacemakers (ICD) are sensitive electronic devices susceptible to damage by exposure to any type of radiation. Proton radiotherapy gives rise to secondary high-energy particles, which pose a greater risk of damage to electronic devices and subsequent failure of the pacemaker.

CT scanning has an essential role in radiotherapy planning. Metal materials (implants, dental fillings, etc.) create artefacts in CT scans (structures appearing in CT image that are not otherwise present in the body). This may affect the calculation of the dose for the given area, which could result in inaccuracy of radiation. At the Proton Therapy Center, we are of the opinion that the risk of inaccuracy is major and that is why we do not treat patients with implants in the irradiated area. Obviously, if there is a metal component in your pelvic area, it is not an issue if, for example, we irradiate head and neck tumours.

Do you have affiliates elsewhere in the Czech Republic?

No, there is only one Proton Therapy Center in the Czech Republic and that is in Prague.

What is the price of treatment at the Proton Therapy Center? 

Proton treatment can also be paid for as a self-payer, without the participation of the health insurance company. The price of treatment is individual and depends on the treatment regimen and/or the selected number of fractions as determined by our physicians. Based on the review of your medical documentation, we are able to confirm the number of fractions you will likely need and the cost of treatment before you come to Prague for a consultation. The assessment is free.

Do you carry out preventive cancer examinations? 

The Proton Therapy Center is an institution specialised in treatment of patients with diagnosed cancer. Only if you have urological complaints, we can offer a preventive urological examination in our outpatient department. For more information, please call +420 222 998 950.

Is it possible to have a preventive examination if I have urological problems? 

Yes, we offer preventive prostate examinations in our urological clinic. For more information, please call +420 222 998 950.

Do you conduct prostate biopsy at the Proton Therapy Center?

We don’t. Nevertheless, we can recommend you a urological outpatient department we cooperate with. For more information, please call +420 222 998 950. 

Is the Proton Therapy Center open on weekends?

The Proton Therapy Center is open to patients and visitors every weekday, from 7:00 to 19:00. It is closed on weekends.

I have heard that proton therapy has not been sufficiently tested. Is that true?

The history of proton therapy is nearly as long as the history of treatment using linear accelerators. The first patient was irradiated in the 1950s. However, the technology is much more complex, so the first clinic designed for irradiation of patients opened in Loma Linda, California in 1991. Since then, protons have been used to treat nearly 200,000 patients with various diagnoses. Experience with treatment of some types of tumours, such as prostate, brain or skull base carcinomas, dates back more than 25 years; extensive sets of case studies followed up for more than 5 years have been published. For technical reasons, some diagnoses could not be treated with protons prior to the introduction of the Pencil Beam Scanning technology. Thankfully, this changed around 2012 and since then, the expertise has been growing rapidly. In general, we can say that if the proton benefits apply to brain and skull base tumours where the experience is extensive, the same will apply to other tumour locations as well.

What are the complications after proton therapy? Is it true that they are worse than in conventional radiotherapy?

Not at all. In most cases, the complications are fewer, which is a consequence of better proton radiation distribution in the body as against photons. There are some exceptions: for example, an acute skin reaction may be a little worse with protons in head and neck tumours; nonetheless, such reactions heal well quickly.

Do the doctors/staff at the Proton Therapy Center speak English?

There is no need to be concerned about any language barrier, as the doctors and staff that you will encounter at the Proton Therapy Center speak English. Our treatment coordinators are either native English speakers or have a very high level of fluency. Some of our treatment coordinators also speak German, Serbo-Croatian, Russian, Czech, and Slovak.

I have prostate cancer and my urologist recommends surgery, while you recommend radiation. Based on what should I make my decision? 

The proper way is for the physician to describe what the pros and cons of individual therapies are and for you to decide.

Proton radiotherapy has minimal toxicity (side effects). Recent published papers describe the toxicity of treatment in less than 1% of patients in large patient populations. Compared to published data for photon therapy and surgery, this toxicity is minimal and significantly lower with proton therapy. Compared to surgical treatment, proton therapy hardly leads to impotence and thus significantly improves the quality of life of patients.

Proton radiotherapy is a fully outpatient treatment. Surgery requires general anesthesia, therefore hospitalization. During surgery, the prostate is removed with the prostate capsule and seminal vesicles, and a new connection is created between the urethra and the bladder. Although these procedures are evolving, long-term results show that risks persist.

However, the final decision on how to treat prostate cancer is up to each patient - based on complete information from their physician.