Road to Basel, A New Experience for me
By Terry Y. Updated January 2013
Attention: I have been advised of changes in the University Hospital Basel Nuclear Medicine staff, new treatment charges effective in 2013, and a few other important items to be aware of in planning for PRRT in Basel, Switzerland. Please note these changes as they have been updated since my visits and this story were written in 2009. These changes are summarized here and reflected in the document below.
1. The University Hostel will be closing December 31, 2012. The hospital has no other accommodations for patients or family members. (Nearby hotels are plentiful.)
2. Effective January 1, 2013 the costs of treatment will be increasing.
a. For Y90 PRRT the charge will be 9,800 Swiss Francs.
b. For Lu177 PRRT the charge will be 8,200 Swiss Francs.
c. Effective February 1, 2012 Professor Dr. Dr. Damien Wild was elected as the new Head of the Nuclear Medicine Department.
e. The three nurses that will be involved in PRRT patient care are Martin, Pierre and Kerstin.
f. The hospital's Wi-Fi network is fully operational for the use by PRRT patients.
Michael Neal and his wife Sherrie have written an excellent record of their experiences during PRRT in Basel. Please go to www.roadtobasel.com and read Michael's latest description first. What I have done here is to just add another perspective as I prepared for and conducted the trip myself as a patient in May and July, 2009.
My Diagnosis: Since each person displays their neuroendocrine cancer in various ways, here was my condition at the time just before PRRT treatment:
• 5.3x5x8 cm islet cell tumor on the pancreas head, mostly non-productive, displays some characteristics of a glucagonoma.
• Liver mets estimated to be causing a 10-15% liver tumor burden.
• No octreoscan detectable mets elsewhere.
• My most prominent symptoms were diarrhea and hyperglycemia.
• I was not taking Sandostatin before the treatment, which would complicate the PRRT preparation process a little bit more.
I exhibit high affinity somatostatin receptors (SSRT2) on the neuroendocrine cancer cells, as shown by the octreoscan. This feature and a relatively low liver tumor load are important factors and good predictors of the potential benefit of the PRRT.
As an aside, I was taking oral meds for high blood pressure, high cholesterol, and hyperglycemia years before even being diagnosed in February, 2006.
Since I had been in a RAD001 trial with Dr. Thomas O'Dorisio at the University of Iowa, I was fortunate to continue as his PNET patient for regular treatment after the trial ended. Dr. O'Dorisio has had a long term relationship with the European nuclear medical physicians, especially the University of Basel (over 300 patients referred for PRRT in total), he was well acquainted with the qualifying criteria for PRRT. He required these preparatory exams and qualifiers.
Submitting the test results for qualification to Basel included:
• current CT scan (within the past 60 days)
• current octreoscan
• liver ultrasound
• bone marrow biopsy (see note)
• blood work, (CBC, CMP, tumor marker results, etc.)
• patient history
• letter from referring physician (if applicable, or you are not self-nominating)
Note: Since I had had four rounds of standard chemo previously, there was some possibility that one of the drugs, the Streptozocin, could have caused permanent damage to the bone marrow. Luckily, I had none going into the PRRT. Additionally, the biopsy also checked to make sure I had no cancer cells in the marrow.
It took from December 17, 2008 until January 22, 2009 to complete the tests. On January 30 the packaged results had been assembled and sent via FedEx to Basel.
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