Treatment

Choosing to get treatment overseas can be a daunting task without a little help.  We have tried to simplify the process for those patients and caregivers who are interested in seeking treatment in Bad Berka.  The advice and recommendation presented here are compiled from many visit by different patients and caregivers.  On this page you will find all articles relating to the treatment process, you can also use the menu on left to go directly to a topic of interest.  If you have any suggestions or additions we are happy to hear from you, just click on this link and let us know.

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 If a person is scheduled for PRRT before coming to Bad Berka, then the most common schedule is as follows. Note that the exact order and day plan may vary depending upon the patient's type of treatment (Y90, LU177 or both)  or how busy the ward and/or other departments are.

• Sunday Afternoon -- Check in to the Zentralklinik.  Usually a patient must make arrangements to pay for treatment with finance before they check in to the Klinik. Enterance / Registration Desk-New- Patients will recive a ID wristband as of summer 2012.
After check in you will go to Nuclear Medicine Ward to get room assignment, blood test and general instructions. Also, you will get an electronic FOB that will give you access to the Ward while you are there. Only patients are allowed in the Ward. 

• Monday morning – begin tests and scans. Typically the renal testing is first, followed by the 68-Gallium PET/CT scan. If other tests are needed such as an Ultra Sound or echocardiogram, then these may be done throughout the day or on Tuesday.

• Monday Afternoon. Once the results of the renal and 68-Gallium tests are reviewed by Dr. Baum and his staff, Dr. Baum meets with the patient (and a patient caregiver or companion, if present).  It is Dr. Baum's practice to explain the next steps for the PRRT. Depending upon the outcome of the scan and tests, this consultation can last from 30-45 minutes. Typically Dr. Baum discusses the findings from the various tests and scans, most especially the 68-Ga PET/CT scan, but also the other tests that have a bearing on receiving the PRRT. The patient is told what kind of isotope treatment they are likely to receive.

• Tuesday – Depending upon the type of isotope to be used in the treatment, a patient may receive PRRT on Tuesday afternoon or on Wednesday. The past pattern has been for Lu-177 to be done on Tuesdays and Y-90  or combination of the two to be done on Wednesday. Once the treatment is given, the patient must remain in their own room for 24 hours except when going to a scanning room that is in the Ward. Several scans are done during this time frame.

• Wednesday – If the patient receives PRRT on Tuesday, then they will remain in the room until the expiration of the 24-hour time period. After 24 hours, the patient can go into the Nuclear Medicine Ward and is free to move about. Patients never have visitors in the ward, but friends or companions can bring things to the Ward and a nurse will get items to the patient. The day after treatment the patient will do several body scans during the day to determine how well the radioactive material is getting to the body. tumor and dissipating in the

Once a patient has a PRRT, then they should return to Bad Berka for a re-evaluation. This is done to assess how well the PRRT is working and to determine if another treatment is necessary. Typically patients return 3-4 months following their first treatment. This is commonly referred to as restaging.

Checking in – the usual schedule for restaging starts on a Monday. Patients can check in on Sunday in the late afternoon (after 5pm) or early Monday (8 am) morning by going to the reception area in the Zentralklinik and checking with the finance people. The same process is followed as when the original PRRT was done.

Usually the first test is the renal/kidney test. This is followed by the 68-Gallium PET/CT scan and any other tests that the

Dr. Baum and his team will want to receive the most current case information about the patient to include the most current doctors reports, reports from tests and scans and actual scan images from current CT, MRI or Octreotide scans that should exist on CD or DVDs.

Depending upon a patient's case history, some historical records could be needed as well. Dr. Baum normally will advise the patient or the patient's physician as to the specific information needed. It will greatly facilitate the evaluation if the patient has all records in a digital format for easy and speedy sharing of the information.

There are a number of ways that an evaluation for PRRT can be achieved. This can be coordinated with Dr. Baum and his team by the patient or through the office of the patient's own physician. The preference is for a referring physician, but this is not always the case. Please see section on How To Contact Dr. Baum's Office.

Dosimetry is used by many centers that preform PRRT. Wikipedia defines Dosimetry as "the measurement of the absorbed dose delivered by ionizing radiation, the term is better known as a scientific sub-specialty in the fields of health physics and medical physics, where it is the calculation and assessment of the radiation dose received by the human body."

Below is a talk given by Christiane Schuchardt on how the Theranostics Center in Bad Berka use dosimetry in there daily patient management.