Your first visit to our clinic
First of all, you will be admitted to the outpatient clinic by the ladies at reception, your previous treatment records will be taken over and a personal file will be created.
Admission examination by a doctor at our clinic
During this initial consultation with a detailed examination, a doctor from our clinic will gain an impression of your illness, your previous treatment and your physical condition. In order to obtain a complete overview of your personal situation, it is absolutely essential that all important medical documents (e.g. doctor's letters, operation reports, histological findings, etc.) are available at this examination. As a rule, these documents will be made available to us by the medical colleagues who referred you to us or will be given to you personally. However, it may be necessary to carry out additional examinations or to consult other medical specialists from other disciplines in order to fully clarify your clinical picture.
The doctor examining you will decide whether radiotherapy would be helpful in your case ("indication"). He or she will then explain the treatment concept to you in detail, informing you about the aim of the treatment, the course of the therapy, possible side effects and their treatment, as well as optimal behaviour during radiotherapy. If appropriate, you will also be informed about alternative treatment methods. Under certain circumstances, it may be medically necessary to use chemotherapy ("combined radiochemotherapy") in addition to radiotherapy in order to further improve the chances of recovery.
During this consultation, you will have ample opportunity to ask questions and receive information about all the circumstances surrounding your illness. We would always appreciate it if you were accompanied by someone you trust.
At the end of this consultation, once you have given your consent to the planned treatment, your doctor will usually arrange an appointment for further planning of the radiotherapy. In addition to this appointment for further planning, you will also be given the start date for the radiotherapy treatment. You will receive an individual consent form, which you should read through at home, sign and bring with you to the appointment for further planning (radiotherapy planning).
Radiotherapy planning
In almost all cases, radiotherapy planning begins with a computer tomography (CT) scan, which is not used to search for tumour metastases, but is required exclusively for radiotherapy planning. This provides us with precise information about the individual anatomy of each patient as well as the extent and location of the tumour to be treated. In preparation for radiotherapy planning, a computed tomography cross-section of the body is created every 1-3 mm. In each cross-section, the area to be irradiated ("target volume") and the organs that require special protection are marked with millimetre precision.
Once the radiotherapy planning has been completed, skin markings and small tattoo dots are applied, which enable us to correctly locate the radiotherapy site to within a few millimetres during the course of the radiotherapy sessions, which often last weeks. Please help us to maintain these markings. You may shower daily, but not take a hot bath or go to the sauna. During the radiotherapy sessions, these markings may be renewed by the medical-technical radiology assistants using special pens.
The data from the computed tomography radiotherapy planning is then transferred to the radiotherapy planning computer, where a medical physics expert works with a radiotherapy specialist to create the optimum radiotherapy plan for you. The aim of this radiation plan is to apply the highest possible radiation dose to the tumour and at the same time to protect the surrounding normal tissue as much as possible in order to minimise possible side effects.
The technique in which you are to be irradiated and how the healthy organs can be optimally protected is then finalised in a precise consultation between the specialist and the medical physics expert.
The first radiotherapy session ("initial setting")
The so-called initial setting is particularly important because the radiotherapy plan, which has been drawn up in the meantime and independently checked by another medical physics expert, is transferred to your body and the radiotherapy fields are marked during this session. This first adjustment is always carried out by a doctor together with an MTRA and, if necessary, a medical physics expert. State-of-the-art techniques are used to check whether the radiation fields correspond to the specifications. Image-guided radiotherapy is used for this purpose. For special techniques, our linear accelerators are equipped with computer tomographs, which make it possible to carry out a high-precision position check before starting the radiotherapy. After checking the correct position of the fields, they are marked on your body. This marking is done so that even the slightest deviations can be recognised immediately during the subsequent radiotherapy sessions. These can then be corrected.
You lie on the treatment table in a large, well-lit room. The radiation source is located at a distance of one metre from you and moves around you at this distance. There is visual and mutual voice contact at all times via monitors and microphones when the actual irradiation is taking place.
Please allow 30-45 minutes for the first treatment. The irradiation itself then only takes a few minutes. You will not be able to see, hear or smell the beam.
After this first irradiation, the daily irradiation will take place. As a rule, radiotherapy is carried out 5 times a week from Monday to Friday. You will always receive three appointments in advance so that you can plan for the following days of radiotherapy. Please discuss your individual treatment requirements with the staff at the radiotherapy unit, which we can usually cater for from 08:00 in the morning until around 16:30 in the evening. Only between 12.30 and 15.00 is it not possible to routinely irradiate patients, as this is when new patients are admitted for treatment. If you are urgently unable to attend, please let us know in good time. We will endeavour to find an alternative appointment for you. If possible, treatment breaks should be avoided.
Medical care during radiotherapy
At regular intervals, at least once a week, you will be examined by medical colleagues for possible side effects, blood counts and laboratory tests will be carried out and further examinations will be arranged if necessary. Should you personally wish to seek medical advice on current issues, please ask the staff to introduce you directly to the doctor in charge. This is possible at any time.
End of radiotherapy
A final consultation will take place on the last day of radiotherapy. You will be examined and asked about possible side effects. A final report will then be drawn up, which will be made available to the referring doctors and, of course, to you personally if you wish. Finally, an appointment will be made 6 weeks after the end of radiotherapy to assess whether the acute reactions have subsided.
Follow-up treatment
As a rule, patients are entitled to follow-up treatment (comparable to a cure) at the end of radiotherapy. At Ulm University Hospital, this is organised centrally by the social services. The social services can be contacted by telephone during normal daily office hours (Tel.: 0731 - 500 69056, Mrs Neubronner). If you are unsure about how to proceed, please ask the staff who will be able to help you. In principle, any follow-up treatment should be initiated as early as possible at the start of treatment, as it must begin no later than five weeks after the end of treatment.
Centralised opinion management
You will find forms at all central points of the clinic, which you can use to contact the clinic management directly with complaints, but also with requests, suggestions and even praise. If necessary, please ask the employees.
If you have any further questions, you are welcome to contact the senior consultant Dr Thamm(reinhard.thamm[at]uniklinik-ulm.de) or the medical director directly(thomas.wiegel[at]uniklinik-ulm.de).
We wish you a pleasant stay in our clinic and a speedy recovery.