Located on the UW Medical Center Northwest campus at 1570 N 115th St., Seattle, WA 98133
Monday – Friday, 8 a.m. to 5 p.m.
Phone: 206.306.2800
Fax: 206.374.2645
Email: info.proton@fredhutch.org
At Fred Hutchinson Cancer Center, we want to make it as easy as possible for you to get proton radiation therapy. The first step is to talk with one of our patient care coordinators to find out if protons would be appropriate for your type of cancer.
We will walk you through each step in the process, making sure you know what to expect and that all your questions get answered.
Medical Review Process
First, a group of physicians from Fred Hutchinson Cancer Center – Proton Therapy will look at your case to see if proton radiation therapy may be right for you.
Getting Your Medical Information
Your exact diagnosis and other information will help us decide if proton therapy could help you. When you call about getting care here, our patient care coordinator will ask you about your medical history. We will help you gather the documents and details we need so our experts can look at your case.
Based on your type of cancer, we will need information like:
- Imaging or diagnostic records from your physician
- Any cancer treatment you have already had
- Pathology reports
- Medications you are taking now
- Family medical history
- Insurance information
- Availability for treatment
- Referral for radiation therapy
See a checklist of items you will need for your first call with us by disease: brain tumor, breast cancer, childhood cancer, gastrointestinal cancer, head and neck cancer, lung cancer, ocular melanoma, prostate cancer and sarcoma.
Physician Review Process
A physician review board from Fred Hutchinson Cancer Center – Proton Therapy will review your case in detail. Then, we will contact you to talk about the next steps. If our physicians believe proton therapy is not right for you, we will recommend other treatment options that are available at Fred Hutch.
Checking Insurance Coverage
During the medical review process, your patient care coordinator will contact your insurance carrier to check your plan’s coverage. They will also help you understand the amount you may have to pay. Proton therapy is covered by most private insurance plans, Medicare and, in many cases, Medicaid. If your insurance doesn’t cover all of your expenses, your patient care coordinator can help you find financing options.
Consultation
At your consultation — either in-person or telehealth — you will meet with your physician and nurse to talk about your treatment plan and get answers to your questions.
Our consultation process is designed to help reduce your stress and get you ready for what comes next.
During your visit, your physician may decide you need more tests to plan your treatment. For example, you may need blood work, magnetic resonance imaging (MRI) or positron emission tomography (PET) scans. Your nurse will help you schedule any tests. If you do not have a local primary physician, your nurse will make sure you get the services you need at Fred Hutch or Seattle Children’s. Your nurse will let you know your test results.
Your care team also includes your radiation therapists. Your team will be with you throughout your treatment and stay involved during your follow-up care. Having the same team throughout therapy helps make sure you get consistent care.
Telehealth
Telehealth visits are available for Washington state residents. If you prefer to have a telehealth consultation rather than an in-person consultation at our Seattle clinic, please let your scheduler know when you are making an appointment.
Simulation and Planning
After your consultation and any tests you may need, we will schedule you for a computed tomography (CT) simulation scan. We use the images to make a treatment plan that’s right for you.
Your scan will happen at Fred Hutchinson Cancer Center – Proton Therapy. The visit may take up to two hours, including prep time. During the visit, your nurse will explain the treatment process.
The purpose of this scan is to gather images of your tumor and normal tissue from many angles. Your doctor and dosimetrists use these images to plan your specific treatment and make sure you are positioned correctly in the machine during your upcoming proton therapy. To help with positioning, they may use special immobilization devices such as masks, leg molds, head rests, sponges and pillows that are customized for your body.
Based on the location of your tumor, you may receive a contrast agent, or dye, before your CT scan so the tumor is easier to see. The dye may be injected through an intravenous (IV) line, taken orally (by mouth) or given through a catheter.
We also use a robotic positioning system, which is approved by the U.S. Food and Drug Administration, to move you into the right position before each treatment.
Scheduling Your Treatment Sessions
Treatment planning is complex and may take up to two weeks (usually less). Once your personal treatment plan is done, a member of your care team will contact you. They will tell you how many treatments your doctor prescribed and will schedule your first treatment session.
Your care team will explain when to arrive for your first treatment and may give you special instructions. For example, some patients need to have a full or empty bladder or they may need to not wear deodorant or lotions.
At the end of each treatment week, you will get your schedule for the next week. After treatment starts, your physician may recommend more treatments or breaks in your treatment schedule. We will keep in close touch with you about any changes.
A number of factors impact scheduling, including the time required to set up equipment, the need to prioritize morning appointments for pediatric patients who can’t eat or drink before treatment, and staffing levels. Because of this, you will likely be offered only one or two appointment times for each visit. We will do our best to accommodate you, but please know that due to these complexities, available appointment times are limited.
Arriving for Your Treatment Sessions
When you arrive for your treatment, check in with the patient navigator/concierge. We will give you an ID badge to wear each time you visit Fred Hutch. The patient navigator/concierge will give you your badge and let your treatment team know that you are ready for your appointment. A member of your care team will greet you and take you to your treatment or a changing room.
Some patients need to change into a gown, robe and slippers, which we will have for you. We have secure lockers where you can store your clothing or other personal items. If you need to change clothes, please come about 10 minutes early to get ready.
If it’s part of your treatment plan, the care team will ask you to drink a certain amount of fluid shortly before your treatment.
During Your Treatment Sessions
Your radiation therapist will have everything ready for you before your session begins. You will lie down on a treatment bed and be moved into position with our robotic positioning system. Your radiation therapist will make adjustments. Your treatment setup must be very accurate. This is why we use devices to help hold parts of your body still (immobilization devices). We will ask you to lie still during setup and while the proton beam is on, which usually takes about one minute.
During the actual treatment, you will not feel or see the proton beam. You may hear some clicking from the equipment around you. After a few treatment sessions, most patients stop noticing the sounds. Most patients do not feel pain or discomfort during treatment. If you feel uncomfortable, let your care team know.
Your radiation therapists will leave the room while the beam is on. They will watch you through a video monitor. They will stay close by and can easily talk with you.
The entire session will take about 30 minutes. No recovery time is needed. You can go back to your normal routine right away. You will not need to stay overnight in a hospital or stay at the proton therapy facility.
Few Side Effects
Most patients have few or no side effects from proton therapy. When side effects do happen, they are usually minor and happen only after many treatments. Depending on where your tumor is, side effects may include skin irritation in the path of the proton beam, tiredness and hair loss in the area being treated.
Before you start treatment, your physician will talk with you about side effects you might have. Your nurse will help you manage any side effects.
Meeting With Your Doctor
Once a week (or every five treatments), you will have a meeting, called an on-treatment visit (OTV), with your radiation oncologist to talk about how your therapy is going. This is a good time to ask any new questions you may have. In some cases, your physician may order more tests, such as blood tests, CTs, MRIs or other scans. We do our best to schedule your OTVs around treatment sessions, so there is no need to make an extra trip to Fred Hutch.
If you ever need to see your physician more often or if you have questions, please let one of your care team nurses know. They will help you set up more visits when needed.
Staying in Touch With Your Care Team
If you have questions between appointments or after hours, you can reach us at these numbers:
- General questions about proton therapy at Fred Hutch: Call 206.306.2800
- Questions about your care during business hours: Call your nurse’s direct number or 206.306.2803
- Questions about your care after hours or on weekends: Call 206.598.6190 to talk with an on-call radiation oncologist or leave a message and be called back
Traveling to Seattle for Treatment
We welcome patients and their families from outside Seattle for proton therapy. Our proton therapy facility has a patient navigator/concierge to help with your travel-related needs — from lodging with special rates to transportation to ideas for exploring the city.
Support After Treatment
At Fred Hutchinson Cancer Center – Proton Therapy, we’re here for you while you’re getting treatment and after you leave. Follow-up care is very important. Your care team will stay in touch with you and your referring physician after your treatment is done.
We will ask you to have a new scan before you come back to Fred Hutch for your follow-up appointment, which is usually three months after your treatment is complete.
When your proton therapy sessions end, we focus on giving you what you need to return to a normal life as quickly as you can. We celebrate each patient’s final treatment with a graduation presentation, that includes a diploma and a challenge coin with a number that is unique to them.
Costs and Coverage
Proton therapy is covered by many private insurance plans, Medicare and many state Medicaid programs. You will have a Fred Hutchinson Cancer Center – Proton Therapy financial coordinator to help with issues about insurance and costs.
A patient care coordinator will help you understand and work with your insurance coverage. They will also help estimate the out-of-pocket costs (what you will pay) for your treatment, coordinate insurance payments and find other financial solutions if you don’t have insurance coverage.
Keep in mind:
- Answers about insurance coverage can be very different, based on many things. These include your cancer type and stage, your insurance company or carrier, the benefits under your plan or policy and the state where the insurance company is based.
- Your insurance plan may require pre-authorization before you start proton therapy. We will help with this.
Financial assistance is available to those who live in Washington and who fall below certain income levels. A patient care coordinator can help you find out if you qualify and fill out applications.
To talk with a patient care coordinator, please call 206.306.2800.
Here are answers to some common questions about costs and coverage.
During your intake call, we will ask for your insurance information. Before your in-person or telehealth consultation, we will go over your insurance benefits and estimate your out-of-pocket costs (what you will pay). We will go over this with you during your financial consultation after we decide that you are a candidate for proton therapy. Sometimes the insurance company requires pre-authorization or prior authorization before treatment can begin. If yours does, we will ask for this authorization.
In general, all insurance will allow coverage of proton therapy for certain cancer types. However, the types that are covered can be very different with different insurance companies. During your financial consultation, your patient care coordinator will explain how your insurance decides if they will cover your treatment. We want you to know before treatment starts about the chances that it will be covered.
Most insurance plans cover proton therapy for childhood cancers and ocular cancers. Sometimes they deny coverage for other cancer types at first. When this happens, our appeals coordinator can work to have the denial overturned. Appeals win rates can be very different, depending on cancer type and insurance company. We will want to talk with you one-on-one about the chances of winning your appeal.
Only about 15% of our patients receive an initial denial, which we then appeal.
It can take up to 18 months to complete an appeal.
Almost all of our patients choose to have treatment even if they have an initial denial. Our appeals coordinator may have options to help get your treatment covered after a denial by your insurance.
The cost for each patient can be very different, based on the insurance company and the policy. Our patient care coordinator will estimate your out-of-pocket cost and explain it to you at your financial consultation.
We hope we have answered most of your insurance-related questions. If you have other questions, please call us at 206.306.2800.
Proton Therapy Social Media Channels
Stay connected by following us on our proton therapy social media channels, where we share patient stories and the latest research by our physician-scientists. Along with our public social media accounts, we have a private Facebook group for patients; to join, please email concierge.proton@fredhutch.org.
We also have a monthly Fred Hutch – Proton Therapy newsletter to keep in touch with our community. Sign up for Proton Therapy Once-a-Month Newsletter.