Carbon ion therapy documents are the only basis on which a carbon ion cancer center in Japan or Europe decides whether it can accept an international patient. Across the criteria these centers publish, three items are always required: a referring doctor's report written within the last three months, CT/MRI images in DICOM format with their reports, and the biopsy (pathology) result. A complete file speeds up the review and makes the cost estimate more accurate. International patients are generally treated as self-pay care. If you would like your records checked for eligibility and expected cost first, please send a document review and cost consultation request.
Why do carbon ion therapy documents matter most?
Carbon ion therapy (heavy ion therapy) accelerates carbon ions and concentrates the dose in the tumor. The principle is explained in What Is Carbon Ion Therapy?. Eligibility depends on the tumor's location, size, spread and previous treatment, so international patients are first reviewed on paper before they travel.
QST Hospital (National Institutes for Quantum Science and Technology, Chiba) states on its overseas patient page that the physician in charge makes the final decision after reviewing the data. Gunma University Heavy Ion Medical Center gives a preliminary opinion based on records collected by medical coordinators, then confirms it with examinations after the patient arrives in Japan. The first gate is always the documents; missing or outdated material can add weeks of back-and-forth.
When the right material is sent from the start, the review finishes faster and the treatment schedule in Japan can be set sooner. Which cancers are eligible is summarized in our carbon ion therapy eligibility article.
How do document requirements differ by center?
The table summarizes the international patient criteria published on official websites of carbon ion centers in Japan and Europe, checked in October 2026. Wording differs, but the core material is almost the same.
| Center | Application route | Published required material | Language and format |
|---|---|---|---|
| QST Hospital (Chiba, Japan) | Email inquiry via a registered guarantor (medical coordinator or travel agency) | Referral letter, CT/MRI results, histology report | State name and country of residence in the email |
| Gunma University Heavy Ion Medical Center (Japan) | Designated medical coordinators only | Coordinators collect medical records | Coordinators reply within five days; 24-hour English help-line |
| CNAO (Pavia, Italy) | International Patient Office, signed form | Histology, recent CT/MRI (report + DICOM), referring doctor's report, surgery report and pre-operative imaging within 12 months, prior radiotherapy report | English, within 3 months |
| Heidelberg University Hospital (Germany) | Telemedicine portal upload | Detailed medical report, histopathology, current lab results, surgery report, DICOM imaging with reports | German or English, typed, within 3 months, Gregorian dates |
European centers state their conditions in numbers. Japanese centers receive files through coordinators, so not every condition appears on the public page, but material prepared to the same standard is usually accepted. See Japanese Institutions and 7 carbon ion therapy hospitals in Japan.
How to prepare imaging CDs and pathology materials
Imaging (CT, MRI, PET)
A few photos of the screen are not enough. Ask the radiology department for a copy in DICOM format and always request the written imaging report. CNAO and Heidelberg do not accept material older than three months. If you had surgery, keep the pre-operative images as well.
Pathology (biopsy)
The pathology report proves the cancer type. In its overseas pathology consultation guide, the National Cancer Center Hospital (Tokyo) asks for all slides made at the previous hospital, and for rare or difficult cases 10 to 20 unstained slides or the tissue block. Glass slides must be packed in a sturdy case with cushioning, and are returned through the coordinator. Not every carbon ion center asks for physical slides, but learning the loan procedure early saves time if a re-review is requested.
Doctor's report and treatment history
The report should include the diagnosis, stage, all surgery, chemotherapy and radiotherapy with dates, and current condition. Prior radiotherapy records with site and dose are essential for judging re-treatment. Heidelberg does not accept handwritten reports and asks that each document carry a title, date and patient name.
Costs that start at the document stage
Carbon ion therapy cost usually means the treatment fee, but costs begin with document preparation. Below are published amounts and items for which you should get written quotes. Amounts can change, so always confirm the latest estimate.
| Item | Published amount (institution, date) | Notes |
|---|---|---|
| Carbon ion treatment fee (overseas patients) | 5.786 million yen incl. tax (QST Hospital overseas page, no date shown, checked 2026-10-25) | Per course; coordinator fee excluded |
| Hospitalization, consultations, tests | 33 yen per medical fee point incl. tax (same QST page) | Varies with tests and length of stay |
| Overseas online pathology consultation | 148,500 yen incl. tax; 181,500 yen with additional staining (National Cancer Center Hospital, updated 2026-04-06) | Reference example, not a carbon ion center fee; about 2 weeks |
| Medical coordinator, translation, interpreting | No hospital-published amount | Compare written quotes |
| Flights, accommodation, living costs | No hospital-published amount | Count preparation plus treatment period |
Treatment fees are often set per course regardless of the number of sessions. A hospital-by-hospital comparison is in Carbon ion therapy cost in Japan.
If your reports and imaging CD are ready, we can help sort out which documents go to which center. Contact us or call +82-2-517-5117.
What happens in Japan once the documents are accepted?
Once a center says you may be eligible, scheduling and travel preparation begin. For longer stays or repeated visits, consider Japan's Visa for Medical Stay. According to Japan's Ministry of Foreign Affairs, it requires a certificate of planned medical services from the medical institution, documents from a registered guarantor, and proof of financial capacity such as a bank statement. Non-family members may also accompany the patient.
At QST Hospital, the first consultation reviews the referral letter, CT/MRI results and histology report, and consent is signed. An immobilization device is made and a planning CT is taken. QST says it takes about 10 days from planning CT to treatment, leaving about 1 to 2 weeks of free time before treatment starts; patients who travel home must return by the day before treatment. Session numbers and stay length by cancer type are in Carbon ion therapy treatment period.
Document checklist before your consultation
- Referring doctor's report: diagnosis, stage, treatment history with dates (within 3 months)
- CT/MRI/PET: DICOM CD or files with reports (within 3 months)
- Pathology report; whether slides or tissue blocks can be loaned
- Surgery report and pre-operative imaging (if surgery within 12 months)
- Prior radiotherapy records: site, dose, dates
- Recent blood tests and current medication list
- Passport copy and companion details (for visa and lodging)
- Questions: eligibility, number of sessions, need for admission, total cost, payment and refund terms
English translations can be used for both Japanese and European centers. Eligibility criteria by cancer type are under Applicable Cancers.
Frequently asked questions
Do carbon ion therapy documents need translation?
Yes. CNAO accepts English only, and Heidelberg German or English. In Japan, medical coordinators often handle translation. An English set can be reused for several centers.
How recent must the imaging be?
CNAO and Heidelberg use a three-month limit. New imaging may be requested if time passes during review, so share the date of your latest scan when you start.
Does a document review alone cost money?
It depends on the center and route. Coordinator and translation fees are not published by hospitals, so get written quotes. The QST Hospital treatment fee for overseas patients is 5.786 million yen including tax.
How long from submitting documents to starting treatment in Japan?
By published figures, Gunma's coordinators reply within five days, and QST takes about 10 days from planning CT to treatment. Actual timing depends on your documents and the hospital schedule.
Can I apply if I already had radiotherapy?
Yes, but records of the previous site and dose are essential, and the physicians decide on re-treatment. See Carbon ion re-irradiation after radiotherapy.
Related articles
Wondering if carbon ion therapy is possible for you, and what it costs?
We help you prepare consultations with Japanese institutions and provide medical interpreting.
Free consultationCall +82-2-517-5117Sources
- QST Hospital — Overseas patients (fees, procedure)
- QST Hospital — Process of carbon ion radiotherapy
- Gunma University Heavy Ion Medical Center — Overseas Patients
- CNAO — Access to treatment inquiry
- Heidelberg University Hospital — Treatment inquiry & appointment
- National Cancer Center Hospital — Pathology consultation for overseas patients (Japanese, updated 2026-04-06)
- Ministry of Foreign Affairs of Japan — Visa for Medical Stay
General information based on public sources; not a substitute for diagnosis or treatment. Eligibility is decided by the treating physicians. Written by the FTH editorial team.