27-10-03
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Patients accepted for diagnosis and treatment of Head and Neck tumors
The Head and Neck Oncology Center at Orebro University Hospital offers services for the
diagnosis and treatment of Head and Neck Cancer. This center has a highly specialized and
very experienced team of physicians and surgeons and can offer a wide range of treatments.
The Center combines the strength of several departments, Head and Neck Surgery, Oncology,
Plastic Surgery and Maxillo-facial Surgery. All treatments have been systematically followedup since 1988 and treatment results are readily accessible in a database. All major treatments
are systematically assessed by a panel of professionals (physicians, nurses and a social
worker) every year. Every patient is carefully worked-up (with second opinion readings of
pathology specimens and imaging studies) before a treatment is suggested at a tumor-board.
We attempt to give the best possible treatment and care at as low cost as possible. All costs
are tracked by using a data-warehouse approach and a report system.
Lead times
Patients are almost always seen within one week after receipt of a referral and complete
documentation in English. Work-up takes three days and treatments usually start within three
weeks after the third day of the work-up period.
Treatment techniques
We use the following treatment techniques:
1) External beam radiation (three accelerators and a modern 3-dose planning system)
2) Brachytherapy (two pulsed dose rate units and one high-dose rate unit)
3) Surgery (six senior head and neck surgeons, two plastic surgeons with microvascular
anastomosis skills, three experienced maxillo-facial surgeons, a dedicated head and neck
surgical suite, CO2 laser, Neodymium-YAG laser etc)
4) Photodynamic Therapy (in clinical use since 1987 – Photofrin and Foscan as drugs)
5) Combinations of the above techniques and chemotherapy e.g. Chemoradiotherapy
6) Obstructive tumors of the upper airway are treated using high frequency positive pressure
distal ventilation. We have specialized bronchoscopes for CO2 and YAG laser resections.
Research
Ongoing research programs include: Chemoradiotherapy for advanced head and neck tumors,
photodynamic therapy for head and neck cancer, studies on the fixation of titanium screws in
radiated bone, rehabilitation of oral function after reconstructive surgery, brachytherapy for
treatment of head and neck tumors and a comparison of hyper-fractionated radiotherapy
versus conventional fractionation
More information regarding the Head and Neck Oncology Center can be found at the
following web site: www.headandneckoncology.com
Location
Örebro University Hospital is located in central Sweden. Trains run every hour to and from
Stockholm (two hours ride). An airport with daily connections to Copenhagen and Stockholm
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is located 20 minutes by taxi from the Hospital. Ambulance planes can land at the airport and
a helipad is located at the hospital.
Financial issues
The Center can offer discounts to county councils and other payers for five referrals per year
or more. Services are offered on a fee for service basis only. The estimated cost must be paid
in advance. We cannot offer gratis service as the Center is offering services at cost plus a
small charge for covering additional expenses for international patients.
It is possible to get a fixed cost for our services but this requires that all required information
is available at the time of cost-fixing and may require an on-site work-up.
We require a referral from a licensed physician with as detailed history as possible. We also
require that pathology slides and imaging studies are mailed for second opinion reading. We
need a statement regarding post-treatment care so we know what care the patient can receive
from the referring institution or physician after our treatment is carried out.
Patients receiving external radiotherapy usually stay at a low cost hotel within short walking
distance to the treatment facility until symptoms require hospital care.
The mean time in hospital for a major surgical case is 10 days. We almost always need an
additional three days for work-up including a tumor board meeting.
The mean cost for an in-hospital three-day work-up including a short examination under
general anesthesia is 3 854 EUR
The mean cost for surgical resection of a tumor with a microvascular reconstruction (removal
of half of the upper or lower jaw with a reconstruction using iliac bone or fibula and including
a unilateral neck dissection) 2003 was 44 358 EUR
Prices above include a mark-up for international patients.
For further information please contact:
Lennart Lofgren, MD, PhD
Associate Professor
The Head and Neck Oncology Center
Orebro University Hospital
Telephone: +46 19 6021468, 6026620, 6021000
FAX: +46 19 103301
E-mail: lennart.lofgren@orebroll.se
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