Treatable Cancers

Name of Disease Download Head and neck tumors (otological area such as nose and face) Particle beam Radiation Therapy Referral FAX Form Head and Neck Tumor Check Items/Test Items [Word format(46kB)]　　　[PDF format（130kB）] Skull base tumor Particle beam Radiation Therapy Referral FAX Form Skull Base Tumor Check Items/Test Items [Word format(44kB)]　　　[PDF format（129kB）] Non-small cell lung cancer 　Particle beam Radiation Therapy Referral FAX Form Peripheral Lung Cancer (Stage I) Check Items/Test Items [Word format(46kB)]　　　[PDF format（132kB）] Chest Wall Invasion/Pancoast Type Lung Cancer Check Items/Test Items [Word format(45kB)]　　　[PDF format（131kB）] Mediastinal tumor Particle beam Radiation Therapy Referral FAX Form 　Mediastinal Tumor Check Items/Test Items [Word format(45kB)]　　　[PDF format(129kB)] Liver cancer (liver cell carcinoma) Particle beam Radiation Therapy Referral FAX Form Small-sized Liver Cancer Check Items/Test Items [Word format(46kB)]　　　[PDF format（139kB）] Locally Advanced Liver Cancer Check Items/Test Items [Word format(46kB)]　　　[PDF format（135kB）] Pancreatic cancer Particle beam Radiation Therapy Referral FAX Form Pancreatic Cancer Check Items/Test Items [Word format（45kB）]　　　[PDF format（132kB）] Kidney cancer Particle beam Radiation Therapy Referral FAX Form Kidney Cancer Check Items/Test Items [Word format(44kB)]　　　[PDF format(129kB)] Prostate Cancer Particle beam Radiation Therapy Referral FAX Form Prostate Cancer Check Items/Test Items [Word format(48kB)]　　　[PDF format（135kB）] Rectal cancer postoperative local recurrence Particle beam Radiation Therapy Referral FAX Form Rectal Cancer Postoperative Local Recurrence [Word format(46kB)]　　　[PDF format（129kB）] Vaginal cancer Particle beam Radiation Therapy Referral FAX Form Vaginal Cancer Check Items/Test Items [Word format(45kB)]　　　[PDF format(128kB)] Metastatic tumor (single tumor) Particle beam Radiation Therapy Referral FAX Form Metastatic Tumor Check Items/Test Items [Word format(46kB)]　　　[PDF format（130kB）] Bone and soft tissue tumor Particle beam Radiation Therapy Referral FAX Form Bone and Soft Tissue Tumor Check Items/Test Items [Word format(45kB)]　　　[PDF format（127kB）]

All of the telephone inquiries and outpatient consultations to discuss whether or not you can receive particle-beam radiation therapy are conducted here at Hyogo Ion Beam Medical Center.

To make an appointment for an outpatient for consultation regarding receiving particle beam therapy, all communications should be done via fax. To receive a consultation, you need to submit two fax forms below.
・Particle-beam Radiation Therapy Indication Consultation Fax Form (1) (General)
・Particle-beam Radiation Therapy Indication Consultation Fax Form (2) (By disease)

Please give your primary care physician these two fax forms together with "Request to the Primary Care Physician" below, and ask him/her to fill out and send them back to us via fax. For details, please see How to Receive a Consultation.

In some cases, the patient cannot receive particle beam radiation therapy due to medical and technical reasons, even though all of the criteria are met. We normally do not recommend particle-beam radiation therapy if not all the criteria to receive the therapy are met. However, if we determine that the case is difficult to treat by other treatments or other treatments are not considered very effective for the case, we may accept the request for particle-beam radiation therapy.

If any of the following applies, you are not eligible to receive particle-beam radiation therapy at our center.

• You have received radiation therapy in the same location of your body before.
• The location where the particle beam is applied has an infection.
  (Excluding type B, type C chronic hepatitis)
• You have another cancerous focus, and you are currently receiving a treatment or you have a recurrent cancer that has not been cured..
• You have another serious complication.
• You are determined medically or psychologically ineligible by a doctor.