PAE

[hagai]

Good evening to all

I am trying to help a German neighbor who seems to suffer quite a bit with his enlarged prostate. He insists to be overall healthy but can hardly walk a few steps, depends on a wheelchair and is constantly on medication (real medication, not alcohol). There is some type of treatment called PAE (Prostatic artery embolization) that seems to be not only more gentle, but also less risky than other operation. I did read most of the prostate post here and must say that I learned quite a bid about a part of my body I did not even know I had.

There are many places that are doing this PAE procedure, but none is mentioned in Thailand. India would be my first choice, but for a person in a wheelchair, even with a caretaker, can be very stressful.

Thailand claims to be a medical hub and it is hard to believe that they are missing out on this PAE procedure.

Does anybody here know if PAE is done in Thailand and how to contact this place?

 

Thanks for your help

Hagai

 

[Sheryl]

Please see this thread

https://www.thaivisa.com/forum/topic/908942-enlarged-prostate-new-treatment/

 

This treatment is still considered experimental and not suitable for everyone nor does it always work. No place in Thailand doing it that I know of.

 

With enlarged prostate, it is important to distinguish between benign enlargement and prostate cancer. If it is benign, the first line of treatment is with medication, of which there are several different drugs that can be used. Only when all medication options have failed would other treatments be considered. Not knowing the details of your friend's treatments, no way to know if this is the case with him.

 

There is no substitute for seeing a really good urologist.

 

Regarding his need for a wheelchair etc and inability to walk, this would not be due to a benign enlargement of the prostate. Either he has advanced prostate cancer (which can spread to the bones) or some other unrelated health problem, and PAE will not help either one.

 

I think you need to get much more information in order to help your friend.

 

[hagai]

Hello Sheryl

Thanks for answering. I did not mention that the guy has Parkinson, so his prostate is not to make responsible for his walking problems, but Parkinson could be reason for his prostate problem.  He did visit some doctors but seems to dislike all of them.  He is also a fan of alternative medicine and is not really thinking rational about his future treatment.

A Clinic in Germany and Hospitals in India seem to be very eager to perform PAE on him, so it can not be that experimental. Fortunately they demand some kind of screening of the prostrate before PAE to exclude cancer, so he is having at least this done in a few days.

I completely agree with you that a good doctor and medication should be the first choice of treatment, but having seen some of the medical professionals in Thailand, I would rather have surgery done in India.

There surely is a professional Urologist some where, but even if you could get to him, it would be hard for him to figure out whether an enlarged prostate or Parkinson is the troublemaker.

Dispite PAE might not be completely approved, in cases like this it would be the best procedure. Even if the culprit is not the prostrate and the patient’s condition does not improve after the operation, not much harm will be done.

 

Thanks again

Hagai

[Sheryl]

Parkinsons does not cause benign enlargement of the prostate, but does seem to increase the incidence of prostate cancer. Almost all men past a certain age have enlargement of the prostate,

 

Parkinsons does causes  various urinary problems/symptoms, but nothing to do with the prostate. The mechanism is neurological. See http://www.parkinson.org/sites/default/files/Urinary Problems in Parkinson's Disease.pdf

 

Needless to say PAE will not in anyway help with urinary problems due to Parkisons's disease. There are however specific  medications that can help.

 

PAE IS experimental still, and any clinic eager to do it without even having seen or examined the patient is one I would steer well clear of.

 

There are many treatments which can be given for Parkinsons and it sounds like he has probably not seen either a really good specialist in Parkinsons nor a really good urologist. By which I mean trained in a western country, board certified, etc etc. Such doctors do exist here (mostly in Bangkok, Chiang Mai) but one has to know where to go and specifically seek them out. Simply going to a hospital and asking for a doctor will indeed often lead to sub-standard care, but it does not have to be done like that.

 

 

[hagai]

Hi Sheryl

I did some searching for the PAE procedure when reading first about it.

Oldest article PAE was mentioned is 10 years old.

PAE seems to have FDA approval now and the procedure is done in quite a few countries.

It seems that PAE is not really that experimental anymore in other parts of the world.

I do not know how expensive prostate medication is, but with about 15 million patients in the US alone the Pharma Industry has all reason to fear a simple prostate treatment.

 

http://www.mountsinai.org/patient-care/service-areas/radiology/areas-of-care/interventional-radiology/what-we-treat/prostate-artery-embolization-for-bph

 

https://patient.info/forums/discuss/has-anyone-out-there-had-a-prostate-artery-embolization--301859?order=latest&page=0#topic-repliesI

 

but back to the real case. He knows that the urinary problems could be Parkinson related, but is convinced they are not.  I did read most of the older treats recommending Hospitals and rare Specialists; there where even discussions about prostate medications and where to  buy them cheapest. He has all this Information, but processing them and planning the next step is the problem.

It seems that Parkinson is not only affecting the body.

Hopefully he is having some kind of prostate screening. If there is cancer PAE is out of the question anyway.

Should there be no cancer his Thai wife will soon find out how cold the winter in New Delhi can be.

 

Thanks a lot

Hagai