CharlieH

I used Wise 3 days ago, usual 3 seconds or thereabouts and all done. So whatever the problem is seems to be around your particular situation not company wide.

There are no bots applied here I can assure you. Neither the budget, resources or inclination.😀

The introduction of an Ad Free version is a recent development and there will be more on that in the coming weeks. I mention it as a possible solution that may be of interest to you.

Totally understand, as I am sure you understand why they are there. May I suggest you consider the Ad free version at $5 monthly ot &50 annually.

There’s been a data breach at Evolve Bank & Trust. Evolve Bank & Trust is a regulated bank that we worked with from 2020 until 2023 to provide your old USD account details. They’ve recently been affected by a data breach and some of your personal information may have been involved. This personal information does not include copies of any of the identification documents you’ve shared with us — these have not been shared with Evolve Bank & Trust at any point. Your Wise account is safe We no longer work with Evolve Bank & Trust, and have already strengthened our security measures. We’ve also started a thorough investigation into this data breach and can confirm that it has not impacted our systems. This means: • your Wise account credentials, including your password, are safe, and you can use your account as normal • you can continue to use your USD account details — these are no longer connected to Evolve Bank & Trust • you can continue to use any Wise cards you may have as they were not impacted by this issue – your card number and PIN are safe What you should do now We strongly recommend that you keep an eye on your financial activity outside of Wise, including any accounts you may have linked to Wise. If you receive any suspicious calls, texts or emails asking about sensitive information, please be extra cautious. Learn how to avoid phishing. Learn more about our former relationship with Evolve Bank & Trust and the information we shared with them to provide your old USD account details. We know that this news may be concerning, and we’re continuing to prioritise investigating the issue. If there are any important developments, we’ll keep you updated. Thanks, The Wise team

We generally get from the supermarket as the wife doesn't trust the local market at all, she says "you don't know what they've done to them or how old they are" she's the same with local veg "don't trust what chemicals they've used" I don't argue with the Chef! 😉

Taste same as eggs always have to me.😉 Only difference for me is how small they are here.

Please do not duplicate topics across forums. Closed.

Did you see it ? Has your opinion toward either now changed ? What was your take ? What was your standout comment ? Who came out of it the best ?

I would've thought a delay is preferable to premature. thats for sure.

Delayed ejaculation, often overlooked, affects between 1% and 3% of men worldwide. This condition involves a persistent difficulty or inability to ejaculate despite adequate sexual desire, erection, and stimulation. Despite its impact on quality of life, no medications have been approved by major health agencies like the UK’s Medicines and Healthcare Products Regulations Agency (MHRA), the US Food and Drug Administration (FDA), or the European Medicines Agency (EMA). A groundbreaking study Researchers at Anglia Ruskin University (ARU) have conducted a comprehensive review, collating research from 13 different countries dating back to the 1970s. Published in the journal Trends in Urology and Men’s Health, this study explores various treatments for delayed ejaculation, offering new hope for those affected. Promising treatments The study identified several effective treatments. Vibration stimulation therapy and psychotherapy emerged as significant non-pharmacological options. Additionally, a cream containing capsaicin and vanilloid showed promise in a randomised clinical trial. Holistic approach to treatment Delayed ejaculation varies significantly among individuals, necessitating a holistic approach to treatment. Researchers emphasised the importance of understanding a patient’s full medical and sexual history, conducting thorough physical examinations, and assessing the partner’s perspective on the disorder and their overall sexual relationship satisfaction. Photo by Kelly Sikkema on Unsplash Expert insights Dr Lee Smith, Professor of Public Health at ARU, highlighted the widespread impact of delayed ejaculation, affecting up to three percent of men and potentially tens of millions of people worldwide. Dr Smith pointed out that the condition is often not discussed, leading to a lack of awareness about potential solutions. “To date, no attempt has been made to collate and evaluate the academic literature around these treatments,” Smith said. “Our study suggests that several potentially effective solutions should be more readily available through health professionals, ranging from creams to penile vibratory stimulation and psychological treatment, to help those who are living with this condition.” The potentially effective solutions should be more readily available through health professionals, ranging from creams to penile vibratory stimulation and psychological treatment, to help those who are living with this condition.” Historical context The review traces the history of delayed ejaculation treatments, starting with case reports from the 1970s. Early treatments included penile vibrations and psychotherapy, which showed long-term success in some cases. For instance, in 1976, a 29-year-old patient with good erectile function but delayed ejaculation was successfully treated with penile vibrations, maintaining improvement for 18 months. Psychological and behavioural therapies Various psychological and behavioural therapies have been employed over the years. In 1984, Delmonte reported two cases of married men successfully treated for psychogenic delayed ejaculation with couples psychotherapy and meditative relaxation exercises over ten months. Fisher’s case study in 1987 detailed a blind man whose delayed ejaculation was treated with a multimodal sex therapy approach, including intrapsychic, systems, and behavioural methods. Role of medications The new millennium brought pharmacological treatments into the spotlight. In 2007, Nelson et al. conducted a cohort trial involving penile vibratory stimulation, showing a significant improvement in orgasm and overall sexual function. Other pharmacological options explored included PDE-5 inhibitors, bupropion-SR, and low-dosage combinations of amfetamine and dexamfetamine. Photo by Towfiqu barbhuiya on Unsplash Recent advances More recent studies have continued to explore innovative treatments. For example, a 2010 study by Hong et al. found that 25mg of PDE-5 inhibitors daily improved general sexual function and reduced anxiety. Another study in the same year demonstrated that bupropion-SR 150mg daily significantly improved control over ejaculation and overall sexual satisfaction. Mechanical treatments, such as the TENGA masturbation aid, have also shown promise. In a Japanese case series, 20% of patients were able to ejaculate intravaginally following treatment, with one achieving spontaneous pregnancy. Future directions The comprehensive review by ARU researchers underscores the need for further research and the development of approved medications for delayed ejaculation. It also highlights the importance of a personalised approach to treatment, considering the patient’s unique medical and psychological background. The groundbreaking study by Anglia Ruskin University offers renewed hope for men suffering from delayed ejaculation. With a combination of psychological, behavioural, and emerging pharmacological treatments, millions of men may soon find relief from this often-overlooked condition. As awareness grows and more research is conducted, the future looks promising for those affected by delayed ejaculation. Dr. Nikhil Prasad

Thailand Health Insurance Solutions for Long-Term Visitors Thailand is a top travel destination in Asia and a popular destination for digital nomads looking to work remotely as they explore everything the country has to offer. Digital nomads and long-term visitors with the long-stay visa can secure private health insurance to fulfill the visa requirements. Why Long-Term Visitors Need Health Insurance in Thailand Health insurance is vital for long-term visitors in Thailand due to the fact that foreigners typically do not qualify for Thailand’s public health insurance schemes available to locals. Expats and digital nomads should secure private health insurance for access to private healthcare facilities. For long-term visitors, especially those who do not speak Thai, access to the country’s private healthcare sector is more than just a quality issue. In addition to providing better services and being more well-equipped, private facilities are more likely to have English speaking staff to cater specifically for tourists and expats’ needs. What to Consider When Getting Health Insurance in Thailand As a long-term visitor to Thailand securing health insurance, there are several key factors to keep in mind when looking for a plan that satisfies your needs and requirements. Cost, coverage, benefits, and deductible / copayment options are key factors to keep in mind. Here are a few key factors to keep in mind when securing your own private health insurance plan: Cost Cost is an important factor when looking for private health insurance. Be sure to look for plans that offer deductible and copayment options to effectively manage the cost of your health insurance in Thailand. Due to Thailand’s healthcare adopting a dual pricing system which allows healthcare services to charge foreigners in the country more than locals, it is highly recommended that expats, digital nomads, and long-term travellers secure their own policy to avoid out-of-pocket payments that can add up to a significant amount. Coverage Getting a policy with the right coverage that suits your needs and requirements is vital in ensuring that you are well protected. Benefits such as medical evacuations are highly recommended, especially for digital expats staying in more remote areas, due to the best private hospitals being located in major hubs and tourist attractions such as: Bangkok Chiang Mai Phuket Pattaya Koh Samui Hua Hin Visa Requirements If you are applying for Thailand’s Non-Immigrant Visa Category O, a Non-Immigrant Visa Category O-A, or a Non-Immigrant Visa Category O-X, it is important to note that there may be health insurance requirements. Here are the health insurance requirements for Thailand’s non-immigrant visas: Non-Immigrant Visa “O-X” (Long Stay): Total sum of the insured must be no less than THB ฿3,000,000 (USD $100,000) per policy year. Cost of Health Insurance in Thailand for Long-Term Visitors Cost is an important factor to consider when securing private health insurance in Thailand. According to our Cost of Health Insurance Report 2023, the average cost for international health insurance in Thailand is USD $3,594 per year. For those looking for family policies, the average cost for a family international health insurance policy in Thailand is approximately USD $11,683. Conclusion It is vital for long-term visitors in Thailand to secure a comprehensive health insurance policy to combat Thailand’s dual pricing system which allows healthcare providers to charge foreigners more when seeking healthcare services. When buying health insurance in Thailand, it is not mandatory for foreigners to open a local bank account in Thailand. However, it is preferred by certain insurance providers, as such, long term-travelers to Thailand may consider opening a bank account in Thailand for convenience sake. Securing a plan that is right for you can be a lot of work, from conducting your own research to comparing plans and benefits. This is where Pacific Prime can help. With over two decades of experience in the industry as a global health insurance broker, we can leverage our partnerships with top insurers in Thailand to help you find an international health insurance plan that suits your needs, requirements, and most importantly, your budget. Contact us today to get free advice and obligation free quote.

Generally about 7-10 days. You can select "registered" if you need it tracked or "signed for" If its commercial they will be charged 20% VAT. Generally parcels that require duty to be paid are held at the local sorting office for payment and collection.( A card isuusally delivered telling them where to contact)

More suited to Real Estate Forum - MOVED

BISP Campus. Image via British International School, Phuket Thanks to its large global population, Thailand is home to a significant number of international schools. These schools offer a range of world-class curricula, such as the International Baccalaureate (IB), British, American, and Singapore curriculum, which attracts both expatriate families and local residents looking for top-tier education for their children. However, the abundance of options means choosing the right school can be overwhelming. So, if you’re leaning towards an international school in Thailand, we’ve compiled a list of the top 10 schools to simplify your decision-making process. 10 Best international schools in Thailand for 2024 British International School, Phuket (BISP) Robotics Day at BISP’s secondary school. Image via British International School, Phuket Address: British International School, Phuket, 59 Moo 2, Thepkrasattri Road T. Koh Kaew, A. Muang Mueang Phuket District, Phuket 83000, Thailand Curriculum: English National Curriculum, IB, IGSCE, and BTEC Website: https://www.bisphuket.ac.th/ British International School, Phuket (BISP) is where high-quality British education meets a unique educational philosophy: the Triple Helix. This philosophy focuses on Learning, Wellbeing, and Passion as key pillars of a balanced and productive life. With classes for children aged 2 to 18, BISP takes a holistic approach to education to nurture every aspect of a child’s development, including social, emotional, physical, and cognitive. In addition to the English National Curriculum, the day and boarding all-through school also offers the International Baccalaureate Diploma Programme (IBDP) in Years 12 and 13. BISP puts wellbeing at the core of their learning community to help students discover their identity and purpose for personal growth. Moreover, students are given plenty of opportunities to explore their passions, from sports and business to the creative arts and, of course, academic studies. Their 44-acre campus on the island of Phuket has top-notch facilities, such as Olympic-sized swimming pools, an athletics track, a short game golf centre, a trapeze rig, a multi-purpose art studio, an auditorium, a drama studio, an amphitheatre, among others. DLTS International School, Nonthaburi Image via DLTS Address: DLTS International School, 8 Nakhon In Rd, Tambon Bang Khun Kong, Bang Kruai District, Nonthaburi 11130, Thailand Curriculum: American Curriculum with Play-Based Learning and Project-Based Learning Website: https://denlatrilingual.com/ While English is the primary language of instruction, DLTS International School also incorporates Chinese and Thai languages in its curriculum. The school currently offers Preschool and Primary School Programmes, with plans to introduce a Secondary School for grades 7 to 9 by the year 2025. The Preschool programme follows Play-Based Learning for children 18 months to 6 years. On the other hand, the Primary School Programme follows an Enhanced American Curriculum with an emphasis on Project-Based Learning. DLTS International School is dedicated to motivating and empowering students. The school aims to help them achieve their maximum potential by providing the necessary skills, knowledge, and confidence needed to succeed in an ever-changing global environment. Therefore, their rigorous academic programme ensures proficiency in STEM subjects and fluency in English, Thai, and Chinese languages. The school’s curriculum also includes specialised courses such as Coding, Robotics, and Engineering. Krabi International School Image via Krabi International School Address: Krabi International School, 188 Nong Thale, Muang Krabi 81180, Thailand Curriculum: English / Cambridge Curriculum Website: https://www.krabiinternationalschool.com/ Entering its 10th academic year, Krabi International School is now firmly established as Thailand’s leading green school. The school prides itself on fostering a balance between environmental awareness and technological advancement. Serving an exclusive group of up to 270 students aged 5-18, its focus is quality over quantity. Krabi International School delivers the prestigious Cambridge curriculum, renowned for its rigorous educational framework. Combined with small class sizes, this means each student benefits from personalised instruction and a supportive learning atmosphere. The welcoming community fosters a sense of belonging, encouraging students to develop into well-rounded global citizens. Parents and students appreciate the school’s commitment to creating a nurturing environment where every child can thrive, set within school grounds regularly praised for their natural beauty. A state-of-the-art science laboratory, modern classrooms, and ample outdoor learning spaces promote hands-on learning across both core and foundation subjects from Year 1 to Year 13. With tuition fees among the lowest in the country and a fully qualified, experienced teaching team — most of whom come from the UK — Krabi International School is arguably the most cost-effective international school in Thailand. RIS Ruamrudee International School Image via RIS Ruamrudee International School Address: RIS Ruamrudee International School, 6 Soi Ramkhamhaeng 184, Khwaeng Min Buri, Min Buri, Bangkok 10510, Thailand Curriculum: American Curriculum Website: https://www.rism.ac.th/ Established in 1957, RIS Ruamrudee International School embodies a foundation rooted in the Christian spirit of love. The school’s motto, Ad Astra, meaning “to the stars,” aims to inspire each student to strive for excellence not only in academics but also in personal and spiritual development. Following the American Education Reaches Out (AERO) standards, RIS implements a curriculum that includes NGSS for science, NCAS for the arts, SHAPE standards for PE, and ACTFL standards for languages. This ensures a consistent educational framework from Kindergarten through grade 12. The curriculum provides challenging and authentic learning experiences at every level of schooling. Additionally, RIS is among the few schools in Southeast Asia that offers both Advanced Placement (AP) classes and the IBDP. RIS sits on a spacious 29-acre campus with well-kept grounds and separate buildings for elementary, middle, and high school. The school provides high-quality facilities for students and teachers, In addition to essential areas like the canteen, clinic, and church, students have access to art studios, music rooms, gyms, squash courts, and PE classrooms. Boarding students at Seelos Residence stay in comfortable dorms similar to college living and can enjoy all the amenities on campus. Lanna International School, Chiang Mai Image via Lanna International School Address: Lanna International School, 166 Ban Waen, Hang Dong District, Chiang Mai 50230, Thailand Curriculum: English / Cambridge Curriculum Website: https://www.lannaist.ac.th/ Located in Chiang Mai, Lanna International School is a prestigious British international school for students aged 2 to 18 (Pre-Nursery to Year 13). Following the rigorous Cambridge curriculum, the school is dedicated to shaping well-rounded individuals who are prepared to succeed in a global society. They focus on character-building through service and leadership initiatives. The school’s main language of instruction is English, but French, Chinese, and Thai are also taught. LANNA offers the widest range of A Levels and IGCEs in Chiang Mai. Since its establishment in 1993, students at Lanna International School have consistently excelled in exams such as IGCSE, A Level, SAT, IELTS, and TOEFL. Moreover, graduates from the school have been accepted into some of the top universities worldwide. In terms of facilities, LANNA has everything to support students both inside and outside of the classroom. These include a covered swimming pool free of chemicals, a splash pool, an indoor air-conditioned gym, outdoor sports fields, positive pressure systems for clean air circulation, dedicated art and performing arts rooms, an assembly hall, and STEM Labs. St. Andrews International School, Green Valley, Rayong Year 5 students and Secondary CCA hydroponic group. Image via St. Andrews International School, Green Valley, Rayong Address: St. Andrews International School, Green Valley, Koo Road, 1 Moo 7 Banchang-Makham, Ban Chang, Ban Chang District, Rayong 21130, Thailand Curriculum: English National Curriculum / IB Website: https://www.standrewsgreenvalley.com Set among a lush green landscape on the outskirts of Pattaya and Rayong, St. Andrews International School, Green Valley, offers a stimulating and child-centred learning environment for students aged 2 to 18 years old. The school integrates the British curriculum with the inquiry-based IB Programme (IB PYP and IB Diploma) to develop independent, confident, and lifelong learners. St. Andrews International School, Green Valley’s three pillars of educational philosophy includes ecoliteracy, personalised learning, and holistic education. This philosophy is encapsulated in their motto, “3Be’s”: Be Adventurous, Be Brilliant, Be Happy. The school aims to equip children with the skills needed for success in various aspects of life. The focus is on fostering well-rounded individuals who are academically successful, caring, independent, and confident. The school’s outstanding campus boasts extensive green areas and facilities to support academic and over 80 co-curricular activities for their students. These features comprise a well-equipped art studio, swimming pool, five football fields, Forest School, and sustainable gardens spanning across 30 acres of lush tropical landscape. KPIS International School Bangkok Image via KPIS International School Bangkok Address: KPIS International School Bangkok, 58 Moo 9 Soi Ram Intra 34, Tha Raeng, Bang Khen, Bangkok 10220, Thailand Curriculum: American Curriculum Website: https://kpis.ac.th/ KPIS International School Bangkok provides a tailored educational approach based on American Core Standards for students from pre-kindergarten to grade 12. The focus is on shaping students into well-rounded global citizens who excel in communication, continuous learning, and critical thinking. These skills prepare them for success at local or Western universities and in their future careers. Moreover, the school’s curriculum is designed to meet both local regulations and international standards, integrating elements of local language and culture while also preparing students for the ASEAN economic community. Accredited by both the Western Association of Schools and Colleges (WASC) and the Thai Ministry of Education, KPIS International School Bangkok offers a variety of extracurricular activities to nurture each student’s unique talents and abilities. The school also provides a range of high-quality facilities. Their learning spaces include a fully-equipped science lab, design lab, Mac lab, and auditorium, among others. NIST International School, Bangkok The Falcons Football Academy. Image via NIST International School, Bangkok Address: NIST International School, 36 Sukhumvit 15, Khlong Toei Nuea, Watthana, Bangkok 10110, Thailand Curriculum: IB Website: https://www.nist.ac.th/ NIST International School is possibly among the most popular international schools in Thailand, and it’s easy to see why. It’s the first school in Thailand to offer the full range of IB programmes for students aged 3 to 19 years. In addition to the IB Programmes, the school also integrates concept-based learning with NIST Attributes and UN Sustainable Development Goals. Plus, they provide the unique Global Citizenship Diploma to secondary students. With an Activities Programme boasting over 300 diverse options, NIST encourages students to push their boundaries and grow personally while emphasising the value of learning from challenges and making a positive impact on others. Spread across a sprawling 25-rai campus are ten buildings housing more than 90 classrooms equipped with top-notch facilities. These include a Sports Complex featuring various sports facilities such as basketball courts, volleyball courts, swimming pool, tennis courts, and a FIFA-certified football pitch. Furthermore, there’s a Creative Arts Building with a 350-seat theatre, dance studios, music rooms equipped with instruments and a recording studio for students’ creative pursuits. Singapore International School of Bangkok (SISB) Image via SISB Pracha Uthit Address: Singapore International School of Bangkok, 498 11 Rotchanamin Alley, Wang Thonglang, Bangkok 10310, Thailand (Pracha Uthit Campus) Curriculum: Singapore, British, and IB Website: https://sisb.ac.th/ The curriculum at Singapore International School of Bangkok (SISB) is a unique blend of Singaporean, British, and IB programmes, with a focus on the holistic development of each student. Beginning with the Nursery-Kindergarten years, students are introduced to education through the UK’s Early Years Foundation Stage. This sets a strong foundation for their academic journey. As they progress to the Primary years, they dive into the Singapore curriculum, which is well-known for its focus on English, Maths, and Science. In Sixth Form (ages 12 to 16), students follow a dynamic mix of Singaporean and UK curricula. They also prepare for Cambridge International Examinations during this stage. In Grades 11 to 12 at SISB, Sixth Form students are equipped with the skills needed for top university entry through either Cambridge International Examinations or the IBDP programme. The school’s curriculum is designed to cultivate global perspectives and excellence while embracing diversity. Moreover, students can explore various interests through activities like sports, Thai dance, or community service. Thus, the school offers ample opportunities to develop new skills and form lasting friendships in a supportive environment. KIS International School Reignwood Park (KISRP) Early Years section. Image via KIS International School Reignwood Park (KISRP) Address: KIS International School Reignwood Park, 888 99, Lam Sai, Lam Luk Ka District, Pathum Thani 12150, Thailand Curriculum: IB Website: https://www.kisrp.com/ KIS International School Reignwood Park (KISRP) is the only full IB day and boarding school for students aged 3 to 18 in Bangkok. KISRP builds on the success of its inaugural establishment, KIS International School Bangkok, which opened its doors in 1998. With a focus on nurturing students from early childhood through Secondary School, KISRP offers boarding options starting from Grade 4. The school welcomes both day students and boarders. Situated within the serene Reignwood Park community, students are provided with an exceptional learning environment. This environment seamlessly blends natural beauty with modern conveniences. The campus boasts state-of-the-art facilities, including a cutting-edge Performing Arts Center with a seating capacity of 1000 and an expansive indoor Sports Complex featuring a Sports Arena for another 1000 spectators. Additionally, it includes an Aquatic Center, a Golf Development Academy, a fully equipped Gymnastics Hall, and various outdoor facilities like football pitches, a baseball diamond, and tennis courts. These 10 international schools in Thailand have their own distinct features. Despite their differences, all ten schools share a common commitment to academic excellence and provide students with access to world-class facilities. These schools also offer a broad spectrum of extracurricular activities so students can pursue their interests beyond the classroom.

Reported post removed.

No foundation, pure speculation and potentially defamatory. There, I answered it. CLOSED.

More off topic deflection and responses to same removed. If people persist in trying to deflect into history or bible story etc they will be removed from this topic, or may be have their posting ability removed. Its the same people performing the same actions, and its tiresome. STAY on the actual topic of the OP. If you want to discuss a specific aspect related to it in some way, then start a topic on that and discuss/debate it all you like.

Depends who you let twist you like a pretzel ! Be careful where you go and who you let manipulate you. Very few even bother asking pertinent question or "contraindication" before such treatment. There have even been fatalities. Unless you are going for nothing more than a "feel good factor" perhaps a relaxing aromatherapy oil massage, caution is recommended. Personally, I would be very wary of the full body Thai Massage, not as a therapeutic treatment but by exactly who is doing it and whether or not their training only consisted of watching the girl in the next cubicle for an afternoon !

With elections on the horizon and politics always a popular subject of heated discussion, we have created a NEW forum to debate politics, whether it be US, UK, THai or from wherever you wish, get on the Political Soapbox and have your say. You may post news stories if you wish, provided they are NOT in the News forums and are from a credible source. Political Soapbox - Thailand News, Travel & Forum - ASEAN NOW

With elections on the horizon and politics always a popular subject of heated discussion, we have created a NEW forum to debate politics, whether it be US, UK, Thai or from wherever you wish, get on the Political Soapbox and have your say. You may post news stories if you wish, provided they are NOT in the News forums and are from a credible source. Links to outside content should always include relevant commentary. Blind links to outside content with no context or explanation may be removed. Please observe forum rules and the specific description of this forum: Respectful engagement is key. Posts with derogatory nicknames, intentional misspellings or personal remarks will be removed. Spell names correctly for all sides of the debate. Stay on topic and back up any claims with credible sources. General approach and policy. We maintain a strict policy of accepting links or content only from mainstream and recognized media sources to ensure that information posted by members is both verifiable and trustworthy. We strive to remain impartial, prioritizing content that meets these standards and removing content that, in our opinion, does not. Consequently, we do not accept content from social media platforms unless it originates from a credible, professional, and qualified source. This approach is essential for upholding the integrity and credibility of the information shared within our community."

Many would argue, most Thai females ? 😀

Blood cancer can affect anyone at any moment, and getting a diagnosis can leave us with a million questions swirling in our heads. What treatments are available? How will life change? But here’s some encouraging news: blood cancer is highly treatable, especially when you catch it early, Dr Udomsak Bunworasate, a haematologist and transplant physician at MedPark Hospital Bangkok, tells The Thaiger. Thanks to the vast improvement in blood cancer treatment, there is reason for optimism. Here’s everything you need to know about blood cancer, its diagnosis, and its treatment. What is blood cancer? Image via Freepik Also known as haematologic cancer, blood cancer is a group of cancer that affects your blood cells and typically starts in the bone marrow (the spongy tissue in the centre of your bones where blood cells are produced). Your normal blood cells have an important role in your body. They carry oxygen, control bleeding, and fight infection. Blood cancers occur when there’s an uncontrolled growth of abnormal blood cells, which interferes with the function of normal blood cells. As a result, you may experience symptoms like persistent fever, fatigue, unusual bleeding or bruising, bone pain, unexplained weight loss, and frequent infections. Types of blood cancer Dr Bunworasate explains that blood cancers can be categorised into three main types: Leukaemia: This type of blood cancer develops when abnormal white blood cells grow out of control. The abnormal amount of white blood cells cannot fight infection and interferes with your bone marrow’s ability to produce red blood cells and platelets. Leukaemia manifests in two forms: acute, which progresses rapidly, and chronic, which advances more slowly. It can impact either lymphocytes (known as lymphocytic leukaemia) or other immune cells (referred to as myeloid leukaemia). It’s the most common blood cancer for children. Lymphoma: Lymphoma is cancer that affects a type of white blood cell known as lymphocytes. Overproduction of cancerous lymphocytes results in their accumulation within the lymph nodes and tissues of the body. This alters the function of your immune system. Lymphoma can be divided into two types, Hodgkin’s and non-Hodgkin’s lymphoma, It’s the most common type of blood cancer in adults. Myeloma: Often called multiple myeloma, this type of blood cancer attacks affects your plasma cell, which is a type of white blood cell that makes antibodies to fight diseases and infections. Since myeloma cells spread through your bone marrow, it can damage your bones and overwhelm your normal blood cells. Myeloma cells also produce antibodies that can’t fight off infection, weakening your immune system and increasing your risk of infection. How does MedPark Hospital diagnose blood cancers? Image by Hush Naidoo Jade Photography via Unsplash Effective treatment of blood cancer starts with an accurate diagnosis. That’s why MedPark Hospital Bangkok provides high-quality diagnostic tools and skilled medical professionals for their patients. The medical professionals at MedPark Hospital Bangkok use a test called complete blood count (CBC). This test shows how many white blood cells, red blood cells, and platelets are in your blood. They also perform biopsies to look at your bone marrow by taking a sample to check for normal and abnormal cells. By checking your bone marrow cells’ DNA, they can see if there are any changes that could be causing the cancer to grow. Cutting-edge diagnostic tools for further investigations MedPark Hospital Bangkok also uses advanced technologies to figure out exactly what’s going wrong in your body so they can give you the best treatment possible. Dr Bunworasate explains: “We use state-of-the-art technology, including immunophenotyping, cytogenetics, and molecular genetics studies such as next-generation sequencing. We use these tools to better define diagnosis, prognosis, and define the target for treatment selection for individual patients.” Immunophenotyping involves examining blood or bone marrow samples to determine if cancerous cells originate from B or T lymphocytes. This helps the medical professionals at the hospital diagnose specific types of leukaemia and lymphoma. Cytogenetics is another essential tool MedPark Hospital Bangkok uses to study chromosomes in tissue, blood, or bone marrow samples. With cytogenetics, they can identify changes such as broken, rearranged, or extra chromosomes that could indicate genetic diseases or certain types of cancer. Additionally, the hospital’s molecular genetics studies, like Next-Generation Sequencing (NGS), allow them to analyse cancer-related genes and pinpoint specific mutations for targeted therapy. Radiological testing for more accurate diagnosis Image by National Cancer Institute via Unsplash Imaging scans or radiological testing, such as PET-CT scans, are also used in MedPark Hospital Bangkok. These tests can be more helpful for some types of blood cancer than others. Besides helping diagnose the type of cancer more accurately, these tests can also tell if the cancer has spread to other parts of the body. But when should you get checked for blood cancers? Regular check-ups and being proactive about your health are key in catching any potential diseases early on. Be aware of common blood cancer symptoms like fatigue, frequent infections, and unintentional weight loss. While these symptoms may mirror other conditions, it’s a good idea to go see a professional for blood cancer. How does MedPark Hospital Bangkok treat blood cancers? Image by Marcelo Leal via Unsplash When an American tourist experienced a severe relapse of acute myeloid leukaemia during her New Year’s vacation in Thailand, she was referred to MedPark Hospital Bangkok. Despite previous stem cell transplants and the complexity of her condition, the team at MedPark managed to stabilise her infections and acquire a new targeted treatment from abroad. This collaborative effort, involving consultations with specialists from Stanford, resulted in the patient achieving complete remission and returning home safely. This case demonstrates MedPark Hospital Bangkok’s ability to handle complex and severe cases with a high level of expertise and how they offer a full spectrum of treatment for blood cancer patients. “We specialise in treating malignant lymphoma, both Hodgkin’s and non-Hodgkin’s lymphoma, as well as acute and chronic leukaemia in both myeloid and lymphoid subtypes, and plasma cell disorders like multiple myeloma,” says Dr Bunworasate. From traditional methods to innovative therapies MedPark Hospital Bangkok personalizes blood cancer treatment on a case-by-case basis. They focus on the unique characteristics of each patient, such as the type of cancer, the patient’s age, whether the cancer has spread to other parts of the body, and how fast the cancer is progressing. Chemotherapy and radiation are the standard treatments and are often the first line of defence against blood cancer. Chemotherapy and radiation are commonly used as initial treatments to treat blood cancer. It involves using drugs to block the growth of cancer cells. Plus, the hospital also offers radiation therapy to destroy cancer cells or alleviate symptoms like pain and discomfort. Hematopoietic stem cell transplantation is also a treatment option at MedPark Hospital Bangkok. This procedure involves transplanting healthy stem cells into the body to help fight off the cancerous cells effectively. The hospital performs both autologous and allogeneic transplants. An autologous transplant uses the patient’s own stem cell. On the other hand, an allogeneic transplant uses transplants from a donor, either a match-related or unrelated donor. A multidisciplinary team Comprehensive care for patients with blood cancer requires a dedicated multidisciplinary team. Blood cancer, affecting the blood and immune system, often leads to compromised immunity. Therefore, blood cancer patients are susceptible to various infections such as bacterial, fungal, or viral. The medical team at MedPark Hospital Bangkok boasts extensive experience in managing immunocompromised individuals, particularly those undergoing stem cell transplantation. The team includes experts like transplant haematologists and infectious disease doctors who are well-versed in treating these complex cases. They also have BMT (bone marrow transplant) nurses and healthcare professionals. Moreover, the multidisciplinary team also work together to take care of complex cases such as patients with multiple cancers. So in addition to haematologists, infectious disease doctors, and BMT nurses, the team also includes medical oncologists, radiation oncologists, diagnostic radiologists, interventional radiologists, surgeons, pathologists, geneticists, and oncology nurses. A very safe and supportive environment Image via Freepik “Dealing with blood cancer is a very difficult journey. That’s why we try as much as we can to give a positive experience during our patients’ treatment. We believe that we are able to give the best treatment with fewer side effects and take care of our patients until they can hopefully live a long and healthy life,” says Dr Bunwarosate. MedPark Hospital Bangkok’s state-of-the-art facility boasts the latest technology to provide top-notch treatment and support for those battling this challenging disease. One of their key offerings is their blood bank facility, which ensures access to crucial blood products, including irradiated options, 24 hours a day. In addition to the advanced medical services, MedPark Hospital also prioritises the safety and well-being of their patients. To create a safe environment for immunocompromised individuals, they have implemented various measures such as HEPA filters and positive pressure systems, as well as precise temperature and humidity controls in patient transplant rooms. Although the thought of having cancer can be scary, detecting blood cancer early gives you a better chance of successful treatment. The renowned medical professionals at MedPark Hospital Bangkok are equipped to provide expert care and support if needed. Remember that a diagnosis of blood cancer doesn’t mean the end – many people with this condition achieve remission and live long, healthy lives. Apart from blood cancer, Dr Bunworasate and the skilled haematology team at MedPark Hospital Bangkok also treat a wide range of blood disorders. These include conditions like anaemia, thalassemia, sickle cell disorder, various white cell disorders, and platelet disorders. They are also proficient in managing bone marrow disorders and issues related to blood clotting and bleeding abnormalities. If you or a loved one is facing a blood disorder, visit MedPark Hospital Bangkok’s website to learn more about their services and get in touch with the team today. 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Recent global health reports indicate a concerning rise in the incidence of penile cancer, a rare but increasingly prevalent disease affecting men. According to researchers from Sun Yat-Sen University in China, the number of penile cancer cases is expected to increase by 77% globally over the next 26 years. This significant uptick has been noted across various regions, with Germany seeing a 50% rise between 1961 and 2012 and the UK experiencing a notable spike in cases. While traditionally more common in developing nations, this increase is now being observed across many European countries as well. The impact on Brazil and Uganda Brazil reports one of the highest incidences of penile cancer in the world, only second to Uganda. Over the decade spanning 2012 to 2022, Brazil witnessed 21,000 new cases and 4,000 deaths, with a distressing number of 6,500 men undergoing amputation due to the disease. Health experts in Brazil have linked these high numbers to insufficient HPV vaccination coverage, which remains below the ideal 90% threshold – 57% for girls and just 40% for boys. Symptoms and early detection Penile cancer can manifest through various symptoms, including discharge, a change in the colour or skin texture of the penis, and a decrease in sex drive. Early detection plays a crucial role in preventing severe outcomes such as amputation. Men, particularly those in their 60s, are encouraged to seek medical advice if they notice any unusual changes, as early stages of penile cancer are more manageable and often curable. Photo by charlesdeluvio on Unsplash Prevention through personal hygiene and safe practices Many urologist, emphasises the importance of personal hygiene and protected sexual activity in reducing the risk of penile cancer. Factors contributing to higher risk include poor genital hygiene, unprotected sexual intercourse, and not being circumcised. Circumcision, particularly if performed in childhood, has been shown to significantly decrease the risk of developing penile cancer by reducing the chance of infections and other complications that can lead to cancerous changes. The critical role of HPV and vaccination Human papillomavirus (HPV) is identified as one of the main risk factors for penile cancer. The virus, which can be transmitted during sexual contact, has different strains, some of which are more likely to lead to cancer if not cleared by the body’s immune system. Vaccination against HPV is highly effective in preventing these high-risk strains. Despite this, vaccination rates in many countries remain low due to misinformation, vaccine hesitancy, and lack of comprehensive vaccination campaigns. The global scenario The study published in the journal JMIR Public Health and Surveillance further highlights the growing prevalence of penile cancer worldwide, with the highest rates observed in Uganda (2.2 per 100,000), followed by Brazil (2.1 per 100,000), and Thailand (1.4 per 100,000). The ageing population is one of the factors contributing to this increase, as penile cancer most frequently affects older men. Photo by NASA on Unsplash Mitigating the disease burden To counteract the rising trend of penile cancer, it is imperative for global health initiatives to focus on effective prevention strategies. This includes promoting better hygiene, expanding HPV vaccination programs to reach optimal coverage levels, and encouraging safe sexual practices through education and access to protective measures like condoms. Stories from the frontline The human side of penile cancer is poignantly illustrated by the story of Martin (not his real name), a British pensioner who has been residing in Pattaya-Thailand for more than a decade and who was just recently diagnosed with the condition. Initially dismissed as a benign issue when he discovered a small wart on his penis, the wart grew and he suffered urination problems and pain. His condition was later diagnosed as penile cancer, leading to partial amputation. Not only is he currently suffering from depression and a variety of psychological issues, but his quality of life has deteriorated as he is constantly in pain coupled with issues of using the restroom etc. Martin’s experience underscores the psychological and physical toll of the disease, highlighting the importance of awareness and early medical intervention. Enhancing public health strategies Looking ahead, the Global Cancer Registries predict a significant increase in penile cancer incidences by 2050. This underscores the need for enhanced public health strategies that not only focus on treatment but also on comprehensive preventive measures. Such strategies should include improving genital hygiene, ensuring wider access to HPV vaccines, and promoting safe sexual practices. While penile cancer remains one of the rarer cancers, its impact is profound, and its incidence is on the rise globally. Addressing this issue requires a multifaceted approach involving improved public health education, better access to preventive measures, and a concerted effort to debunk myths surrounding HPV vaccination. Through these efforts, it is possible to reduce the global burden of penile cancer and improve outcomes for men worldwide, ensuring that future generations face a lower risk of this serious disease. If you suspect that you might be having penile cancer and want to seek a proper and discreet oncologist and the right medical treatments before it’s too late, contact MyMediTravel, the leading medical concierge with a wide range of options.