One of our first patients came from Serbia

In November 2011 Branka's doctors found a tumour on her skull base.
The sad news came that she had a 'chordoma' - a relatively rare tumour. MRI scans soon defined its size and scope. Although the tumor was benign,  it was pressing on the bones of the skull base and had spread through respiratory areas, and areas of swallowing, on its way into the brain - and was partially occluding two of the major cerebral arteries (arteries supplying blood to the brain). Because risk of damage to vital brain centres would be too high, her surgeons decided not to risk performing surgery (she was not a candidate for surgery because of a high risk to vital brain centres).

The next logical consideration was radiation treatment - however, considering the type and location of this tumour, it would not be easy to destroy. A high dose of radiation would be required, and this would also mean increasing the risk of unwanted radiation exposure to surrounding healthy tissue. Unfortunately, conventional X-ray photon therapy in Branka's case was not possible. Although, in planning, the radiation oncologist tried various techniques (such as applying radiation from many angles and modulating the radiation beam), the computer results always warned that safe dose limits to important, sensitive brain structures would be exceeded. 

As a guiding principle, doctor's are obliged not to harm their patient's health. Conventional radiation would violate this principle and would be too dangerous for doctors to use. Her only chance was proton therapy, however this form of treatment is not currently available in her home country, Serbia.

Branka's goal however, was not to give up. She started to consider her financial resources, because Serbian health insurance does not cover oncology treatment abroad. She was left with no option but to sell her own apartment in the hope of paying for treatment. After two years, an opportunity struck her by chance. A friend living in the Czech Republic came to her with news that Prague had recently opened a new proton beam therapy center. Upon hearing this, Branka did not hesitate. After quickly communicating with specialists and confirming the suitability of proton therapy, she travelled by bus with her niece from her village in Gornja Crnuce in central Serbia to Prague. At the Centre she was met by dedicated patient managers who organised Serbian interpreter services, arranged her accommodation and transportation, and assisted her to settle in and be comfortable in Prague.

Her treatment lasted for two months, because her high dose treatments had to be administered piece by piece. She alternatively attended treatment and also had the opportunity to sightsee around Prague on days between treatment.

Due to the fact that proton therapy has minimal (or sometimes no) side effects she had the desire and physical strength to look around Prague between treatments. Even before completing treatment, her condition improved significantly. Prior to treatment Branka was almost impossible to understand when she spoke, but her speech improved as the tumour became smaller and stopped pressing her tongue to the right side. Her pain also started to disappear after a while, and she was better able to swallow - all this before even finishing her course of treatment. 

Branka felt very supported and cared for throughout her treatment, so she decided to describe her success story so that others could benefit from the new opportunity this treatment brings. "I feel better than ever before," said Branka to the staff that had cared for her throughout her treatment, as she left the facility for the final time, "and I can only hope that everything goes well."

  • Branka is due to have her follow up scans in Serbia shortly.
  • Our patient manager spoke with Branka's niece last week, and she was happy to report that Branka is feeling well.

Source: Proton Therapy Center, April 2013

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