Oncologist recommendation/ hospitals in Thailand

[Summer Skye]

Hi,

 

My partner and I are desperately looking for information and little guidance about cancer treatment and Thai hospitals. Her Mum has been diagnosed with stage 4 pancreatic cancer. She was diagnosed in France while visiting one of her daughters but is going to Thailand for treatment so she can be near her family (she is Cambodian).

 

We would greatly appreciate it if anyone can recommend the most suitable/ qualified Oncologist in Thailand to seek for consultation/treatment.

Are there any Oncologists who specialise in pancreatic cancer in Thailand?

 

If she needs further diagnosing in Thailand, we would prefer to avoid delays getting all the information her mum and family needs to make the next decision. If required, we are thinking of having further diagnosis and a treatment plan done at a private hospital, then if she wants to go ahead with treatment, doing this at a public hospital (also due to limited funds). Would this be a feasible option and would there still be delays at the public hospitals to begin treatment if we have all of the diagnosis paperwork from a private hospital/ France? 

 

We are also wondering if treatment for stage 4 pancreatic cancer is an option in Thailand? We've been researching stage 4 pancreatic cancer treatment and it seems in some countries doctors are more willing to treat it with chemo/radio therapy than others, and we haven't come across any accounts of people being treated for pancreatic cancer in Thailand at all.

 

If anyone can shed some light on any of this it would mean a lot to us. Thank you

[Sheryl]

I am sorry to hear about this, and I am afraid what I have to tell you is going to be difficult to hear.

 

Stage IV pancreatic cancer is a terminal diagnosis no matter what is done. Even the most aggressive efforts at chemotherapy will at best add a few more months of life and will do so at the cost of spending much time in and out of hospitals undergoing unpleasant procedures and weathering difficult side effects. In many cases it does not extend life at all - pancreatic tumors are notoriously resistant to chemo.

 

Most people in this situation opt to instead make the most of the time remaining to them and not undergo chemo, and while an oncologist will provide it if requested, even the most aggressive of oncologists will not argue against foregoing it with this diagnosis. (There are other cancers where the potential gain from chemo is more, but not this one). The recommended approach for Stage IV pancreatic cancer is purely palliative.

While it is her mother and her family's decision, it is important that it be an informed decision. They may otherwise waste valuable family resources to no avail and indeed, end up regretting having put their mother through needless additional suffering and keeping her in a foreign country to boot.

 

Oncologists in Thailand will not usually spell this sort of thing out in very direct terms, especially if the patient does nto ask pointed questions (such as : "how long will I likely live with and without chemo?").  They will treat if the patient seems to want it, even knowing it is nto really going to be worth it.

 

For palliative care, there is no advantage to being in Thailand, it is a very weak aspect of Thai medical care. It is not great in Cambodia either, of course, but at least she'd be with her family and in her native land, and there is an NGO there which works in this area and may assist- 

http://www.douleurs.org/nos-pays-dintervention/cambodge/

Tel: 023 430 334

Tel023 214 954

Email:[email protected]

Email:[email protected]

They are I think based out of Calmette Hospital, and among other things provide home-based pallative care

 

If nonetheless you want to pursue treatment options in Thailand, given limited resources, I suggest she go to the Chulabhorn Cancer hospital in Bangkok. https://www.facebook.com/Chulabhorn-Hospital-143178505731188/

It is a government hospital and costs are reasonable.  You will not save any time going first to a private hospital given that the diagnosis has already been made. (You should however get all the medical reports/records, if in French, translated into English before she comes, as almost without exception, Thai doctors cannot read French.)

 

But if you do want to go to a private hospital for say just a consultation/advice, then I suggest Wattanasoth Hospital (cancer hospital which is part of the Bangkok Hospital complex).

 

There are no oncologists specializing just in pancreatic cancer (here or pretty much anywhere - it is not a common enough cancer for that) but any medical oncologist  can treat it (to the extent that it is treatable - which at Stage 4 it basically is not).

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=268&doctor=Dr._WIROTE_LAUSOONTORNSIRI

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=3102&doctor=Dr._POTJANA_JITAWATANARAT

 

Bangkok Hospital also has doctors specializing in palliative care/pain management and IMO it would be more worthwhile to  consult one of them than an oncologist.

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=4885&doctor=Dr._PORNPAN_CHALERMKITPANIT

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=7014&doctor=Dr._DARIN_JATURAPATPORN

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=649&doctor=Dr._LAKSAMEE_CHANVEJ

 

If it were me, I would consult only a  palliative care specialist for pain management and try to get them to prescribe sufficient meds to bring back to Cambodia with the intent of dying at home with family (in particular, ask about fentyl patch to use when she is no longer able to swallow pills. Can be bought in Cambodia but hard to find and very expensive).  I would not, personally, consult an oncologist or seek chemo given how very little difference that is likely to make with this type of cancer. (And I say this having been an oncology nurse!)

 

The average survival for Stage IV is about 5-6 months, though of course that is just a average and some people are much less and some much more though it would be very unusual to exceed a year. As mentioned, even the most aggressive chemo (which would come at quite a price in terms of quality of life) will not add more than a couple of months to this.