Laryngeal And Hypopharyngeal Cancer

[thaisabai]

anyone any experience with this?

have lost my voice and am scheduled to see a doctor at Bangkok-Pattaya hospital next week.

anyone had any Laringeal problems and any advice? should I go to Bangkok rather than Pattaya?

any comments appreciated, thanks

 

thaisabai

[Sheryl]

If there is any question of laryngeal cancer then indeed yosu hould come to Bangkok.

 

However it sounds like that is a self-diagnosis and that yo uhave not yet been seen by a doctor.

 

I suggest you proceed with the scheduled visit and then post the outcome here and I will advise from there.

 

There are many possible causes for loss of voice, including laryngeal swelling due to infection,  inflammation of the vocal chords due to gastric reflux,  non-cancerous growths on the vocal chords (cysts, polyps etc), parkinsons disease and yes, cancer of the larynx.

 

The ENT doctor will need to examine your vocal cords, either by  using a light and a tiny mirror looking into the back of your throat, or by endoscopy.  I suggest if possible that you not eat before your visit (i.e. no food after midnight the night before) as this may save time by making it possible to do an endoscopy then as opposed to scheduling it on a another day.

[thaisabai]

thanks Sheryl

very helpful. might contact you again after my visit to the hospital

 

thaisabai

[champken]

15 hours ago, thaisabai said:

thanks Sheryl

very helpful. might contact you again after my visit to the hospital

 

thaisabai

It would indeed be helpful if you could post back after your visit. I have had hoarsness and at times slight discomfort in that area for 2+ years which i think is down to LPR (not gerd) 

[altcar bob]

Id go to cancer hospital in Chennai,first class,far far cheaper than Thailand  TATA cancer institute supposedly a worlds best   visa needed

[Sheryl]

Hardly warranted to fly to a cancer hospital in India when he does not even know if he has cancer!

 

[altcar bob]

Just now, Sheryl said:

Hardly warranted to fly to a cancer hospital in India when he does not even know if he has cancer!

 

Hardly Sheryl, if he goes to Bangkok Pattaya the bill probably would be 10 times or more than he would receive India

[thaisabai]

On ‎3‎/‎11‎/‎2018 at 12:39 AM, Sheryl said:

If there is any question of laryngeal cancer then indeed yosu hould come to Bangkok.

 

However it sounds like that is a self-diagnosis and that yo uhave not yet been seen by a doctor.

 

I suggest you proceed with the scheduled visit and then post the outcome here and I will advise from there.

 

There are many possible causes for loss of voice, including laryngeal swelling due to infection,  inflammation of the vocal chords due to gastric reflux,  non-cancerous growths on the vocal chords (cysts, polyps etc), parkinsons disease and yes, cancer of the larynx.

 

The ENT doctor will need to examine your vocal cords, either by  using a light and a tiny mirror looking into the back of your throat, or by endoscopy.  I suggest if possible that you not eat before your visit (i.e. no food after midnight the night before) as this may save time by making it possible to do an endoscopy then as opposed to scheduling it on a another day.

hello Sheryl

 

have had my examination in the Bangkok-Pattaya hospital.

the result:

diagnosis: Paralysis of vocal cords and larynx

exophytic mass on rt. vocal cord with paralysis of rt. TVC

Ddx: malignancy, papilloma

Plan: CT Larynx, DL biopsy+/- tracheostomy under General anesthesia.

 

I also had to visit the cardiologist to assess if I am fit for surgery. that went well.

I understand that there will be a scar across my neck after the surgery.

 

was reading about a procedure that leaves no scar:

"Transoral Endoscopic Thyroidectomy (TOETVA)

The technique has been improved and there are very few complications. The outcomes after TOETVA are similar to those of the standard procedures. This surgical technique is no2 widely recognized and performed globally.

 

was also reading about a well known doctor for such procedures:

Dr. Nut Niyomudomwatana; he apparently works out of several hospitals in Bangkok (Bumrungrad, Samitivej etc)

 

any advice/suggestion how to proceed?

 

appreciate Sheryl, thanks

 

thaisabai

 

[Sheryl]

Thyroidectomy is an altogether different procedure. What you will have is a biopsy of a mass on your vocal cords and, depending on result, possibly further surgery. such as laryngectomy.

 

What is current being planned for you is removal of a sample for biopsy through the mouth/throat using an endscope. Only if there are complications would a tracheotomy (creation of a hole in the throat to breath through) be performed, hence the "+/-". It is customary for consent forms to include every eventuality. 

 

So at this stage you are nto looking at anything expected to leave a scar. Even if a tracheotomy were to prove necessary, if temporary it would heal with minimal scarring visible.

 

See here for clearer explanation of this procedure

http://medicaltourismguide.com/procedures/medical/direct-laryngoscopy-and-biopsy/

 

However if the biopsy comes back malignant, very extensive neck surgery might be recommended and/or radiation.

 

If it is cancer and IF it is very early, there may be the option of a  trans-oral surgical approach. This is nto possible if it is advanced.

 

The greatest expertise with this sort of thing in Thailand is at Ramatibodhi and Rajavithi Hospitals

 

- Ramatibodhi Hospital Assoc. Prof.  Chalermchai Chintrakarn and his team.  thes ecioctors can be probably be seen privately through the Ramatibodhi Preium Clinic   https://med.mahidol.ac.th/qsmc/th/service/premium_clinic-th

 

But be warned that it is only quasi-private and will retain many of the characteristics of a government hospital e.g. long waits, red tape and might have to go in person to make appointment. Though you can try by telephone 02-201-2211

 

Rajavithi Hospital - Center of excllence for Head & Neck Surgery> Profs Phakdee Sannikorn, Nut Niyomudomwatana and their staff

http://www.rajavithi.go.th/eng/_coe.php 

I think they have an after hours clinic to see the specialist privately but I do nto have the details.

 

For both of these places having a Thai speaker with you, at least initially, is crucial and be prepeared for long waits on each visit and red tape in the beginning. Costs however will be a fraction of that at private hospitals (u.e. 1/4 or 1/5 )

 

If you do not feel up to the rigors of trying to use government hospitals and have the resources (insurance or funds..this could run into millions of baht) to cover what may be very costly care at a private hospital then best option IMO would be

 

Assoc Prof.  Cheerasook Chongkolwatana

Siriraj Hospital - private wing

http://www.siphhospital.com/en/home

(also a governemtn hospital but with a truly private adjacent hospital, reported easy to book appointment on line and deal with)

 

You could also consult Prof. Nut at either Bumrungrad or Samitivej

https://www.bumrungrad.com/doctors/Nut-Niyomudomwatana

https://www.samitivejhospitals.com/en/doctors/nut-niyomudomwatana/

 

If the biopsy comes back malignant be sure to ask specifically about "transoral robotic surgery" and if you have the means, might consider going to Singapore (National university Hospital) for it as they have far more experience in it than anyone in Thailand, it is a fairly new approach.

 

 

 

 

 

 

 

[thaisabai]

thanks Sheryl

very helpful. if I should decide on Dr. Nut, does it make a difference if I go to Samitivej or to Bumrungrad (other then the different weekdays)?

if I went for instance on a Thursday early morning, would there be a chance to have the procedure done on Friday?

should I initially check into a hotel until I have a confirmed date for the surgery?

 

kind regards

thaisabai

[thaisabai]

On ‎3‎/‎14‎/‎2018 at 4:32 AM, Sheryl said:

Thyroidectomy is an altogether different procedure. What you will have is a biopsy of a mass on your vocal cords and, depending on result, possibly further surgery. such as laryngectomy.

 

What is current being planned for you is removal of a sample for biopsy through the mouth/throat using an endscope. Only if there are complications would a tracheotomy (creation of a hole in the throat to breath through) be performed, hence the "+/-". It is customary for consent forms to include every eventuality. 

 

So at this stage you are nto looking at anything expected to leave a scar. Even if a tracheotomy were to prove necessary, if temporary it would heal with minimal scarring visible.

 

See here for clearer explanation of this procedure

http://medicaltourismguide.com/procedures/medical/direct-laryngoscopy-and-biopsy/

 

However if the biopsy comes back malignant, very extensive neck surgery might be recommended and/or radiation.

 

If it is cancer and IF it is very early, there may be the option of a  trans-oral surgical approach. This is nto possible if it is advanced.

 

The greatest expertise with this sort of thing in Thailand is at Ramatibodhi and Rajavithi Hospitals

 

- Ramatibodhi Hospital Assoc. Prof.  Chalermchai Chintrakarn and his team.  thes ecioctors can be probably be seen privately through the Ramatibodhi Preium Clinic   https://med.mahidol.ac.th/qsmc/th/service/premium_clinic-th

 

But be warned that it is only quasi-private and will retain many of the characteristics of a government hospital e.g. long waits, red tape and might have to go in person to make appointment. Though you can try by telephone 02-201-2211

 

Rajavithi Hospital - Center of excllence for Head & Neck Surgery> Profs Phakdee Sannikorn, Nut Niyomudomwatana and their staff

http://www.rajavithi.go.th/eng/_coe.php 

I think they have an after hours clinic to see the specialist privately but I do nto have the details.

 

For both of these places having a Thai speaker with you, at least initially, is crucial and be prepeared for long waits on each visit and red tape in the beginning. Costs however will be a fraction of that at private hospitals (u.e. 1/4 or 1/5 )

 

If you do not feel up to the rigors of trying to use government hospitals and have the resources (insurance or funds..this could run into millions of baht) to cover what may be very costly care at a private hospital then best option IMO would be

 

Assoc Prof.  Cheerasook Chongkolwatana

Siriraj Hospital - private wing

http://www.siphhospital.com/en/home

(also a governemtn hospital but with a truly private adjacent hospital, reported easy to book appointment on line and deal with)

 

You could also consult Prof. Nut at either Bumrungrad or Samitivej

https://www.bumrungrad.com/doctors/Nut-Niyomudomwatana

https://www.samitivejhospitals.com/en/doctors/nut-niyomudomwatana/

 

If the biopsy comes back malignant be sure to ask specifically about "transoral robotic surgery" and if you have the means, might consider going to Singapore (National university Hospital) for it as they have far more experience in it than anyone in Thailand, it is a fairly new approach.

 

 

 

 

 

 

 

sorry Sheryl

disregard my last questions. after reading several more times through your advice, I now realize that the first step will be just a biopsy procedure, thus I might consider having that done in the Bangkok Hospital in Pattaya to save me traveling twice to Bangkok.

I guess depending on the result I can always go for the "big one" to Bangkok. what do you think?

or do you think it would be wiser to have both procedures at the same place, so that the doctor who does the main surgery is already familiar with the results from the initial biopsy surgery?

 

thanks again and regards

 

thaisabai

[Sheryl]

I think either way you will need treatment by experts in Bangkok, this is true even if the growth turn out to be papillona.

However most important is to move swiftly and not delay.

If you do have the biopsy in Pattaya request that they provide you with the actual tissue slide in addition to report.

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[thaisabai]

On ‎3‎/‎17‎/‎2018 at 7:09 AM, Sheryl said:

I think either way you will need treatment by experts in Bangkok, this is true even if the growth turn out to be papillona.

However most important is to move swiftly and not delay.

If you do have the biopsy in Pattaya request that they provide you with the actual tissue slide in addition to report.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

ok Sheryl

just received the answer from the doctor at BKK-Pattaya hospital:

(Insurance has already agreed to pay. estimated cost 270,000/1 night ICU 2 nights ward

as you can see, after the biopsy they would send me to Bangkok for the actual surgery.

May be I am better off going directly to Bangkok for both procedures.

 

Please find enclosed response from Dr. Nucharut below. Thank you.

 

1. Your problem needs CT scan of larynx, Direct laryngoscope with biopsy under general anesthesia,+/- tracheostomy (waiting for your insurance, you can contact International Department at [email protected] for the insurance coverage details).

2. Cardiologist will tell you about Plavix (you already seen him, but I can’t find any information about your heart condition, Plavix or pre-op prescription). Before Surgery, I will notify the cardiologist one more time.

3. Surgery is not thyroidectomy.

4. After biopsy, if you can’t maintain breathing, tracheostomy have to be done, you have to stay in ICU room 2-3days.

5. After tissue’s result, further prescription will be done at Bangkok Medical Center in Bangkok (from here, you will be referred to Bangkok).

So up to you to choose a hospital, I mean you can directly go to Bangkok Medical Center for all investigation and treatment.

Regards,

 

Nucharut Pruksaboonkosol MD

 

 

thaisabai

[Sheryl]

I agree. However Bangkok Hospital in Bangkok does nto appear to have much in the way of specialists in head and neck surgery. Suggest one of the doctors I listed in post #9

 

Since you have insurance,  I suggest not trying the govt hospitals mentioned. Rather:

 

Assoc Prof.  Cheerasook Chongkolwatana

Siriraj Hospital - private wing

http://www.siphhospital.com/en/home

(also a governemtn hospital but with a truly private adjacent hospital, reported easy to book appointment on line and deal with)

 

 Prof. Nut at either Bumrungrad or Samitivej

https://www.bumrungrad.com/doctors/Nut-Niyomudomwatana

https://www.samitivejhospitals.com/en/doctors/nut-niyomudomwatana/

 

 

[Sheryl]

It really doesn't matter which hospital you see him at IMO. Bumrungrad has a larger number if specialists and auxiluary professionals which may help if you need a referral to say speech therapist for example. But Samitivej in my experience has better quality of professional nursing care. Costs are usually about the same.

Yes, it might be possible to do the procedure next day but would depend on the doctors schedule and OR availability. Note that dictors usually operate outsode the hours listed for their availability for consultation.

I would suggest checking in for just one night initially.

Good luck....I am sure everyone reading this is rooting for you and wishing you well



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[dddave]

Wishing the OP best of luck