Lung cancer surgery

[mls]

Can anyone recommend a specialist lung cancer surgeon who can do minimally invasive surgery on stage one lung cancer in Bangkok.

Would be grateful for any help as need to get this sorted as soon as possible.

Thanks

[Jai Dee]

Topic moved to the Health Forum where you're much more likely to get some serious replies.

 

/Moved.

[banK]

I had lung cancer in 2016 stage 1. Two thirds of my right lung taken out (should only have been one third but the surgeon said that he couldn't separate the top portion otherwise he would have done).

I was lucky the evaluation from pathology was "cured".

Have a scar on my back not sure if they do minimally invasive ops.

 

I had mine done in the Bangkok medical centre. Pleased with the result.

 

Don't hang around - get it done asap.

 

Good luck

 

banK

[Sheryl]

Bangkok Hospital's Wattanaosth Hospital (Cancer Hospital) is excellent but it is expensive. Are  you insured? It could come to well over 1 million baht.

 

BanK do you recall the name of your surgeon?

 

this Harvard trained surgeon at Bangkok Hospital specializes in minimally invasive surgery for stage 12 lung cancer

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=6823&doctor=Dr._PADUNGKIAT_TANGPIROONTHAM

 

https://www.bangkokhospital.com/index.php/en/diseases-treatment/lung-cancer-surgery-using-vats

[mls]

Hi Sheryl,

Thanks for the information. I do have insurance but only for 1 million baht and have already used 200k for previous treatment at Bangkok Hospital Pattaya of unrelated problem which showed up the cancer. I presume that Bangkok hospital is cheaper than Bumrungrad.

My cancer is very small stage 1 and was lucky to pick it up on chest x-ray, then CT and then PET/CT which I had done at Bangkok hospital so hopefully the surgery will be minimal. I haven't seen a surgeon as yet so will need to contact and find out what can be done and the cost.

Am told that as it is so small the prognosis is good for simple removal.

Thanks for the links. Will follow those up.

mls

 

[Sheryl]

55 minutes ago, mls said:

Hi Sheryl,

Thanks for the information. I do have insurance but only for 1 million baht and have already used 200k for previous treatment at Bangkok Hospital Pattaya of unrelated problem which showed up the cancer. I presume that Bangkok hospital is cheaper than Bumrungrad.

My cancer is very small stage 1 and was lucky to pick it up on chest x-ray, then CT and then PET/CT which I had done at Bangkok hospital so hopefully the surgery will be minimal. I haven't seen a surgeon as yet so will need to contact and find out what can be done and the cost.

Am told that as it is so small the prognosis is good for simple removal.

Thanks for the links. Will follow those up.

mls

 

Is your limit per event or per year? If  it is per event the prior 200K claim doesn't matter. If it is per year then of course it does if within the same policy year.

 

I'd still recommend you got to Bangkok Hospital (Bangkok) and consult the surgeon mentioned.  But get clear quotes and be prepared for the fact it may exceed your insurance.

 

In Thailand the less invasive techniques, like VATS, while entailing much shorter hospital stays, usually  cost more, not less. This is because length of hospital stay is nto a main cost driver. Room charges are a tiny fraction of the total. The main cost will be the surgery itself (more expensive if it involves high tech equipment), medications and supplies.

 

 

[mls]

Actually my limit is per disability and have 3 months then can claim again on the same problem, so the previous claim wouldn't matter, as you say and I should be able to get check ups later.

I will do as you suggest and get clear quotes but if it does exceed my insurance then so be it. More important to get it sorted now than worry about the cost. Hopefully if it's done quickly and everything is removed it should be a relatively good prognosis.

Thanks again

[moonseeker]

I will pm you in next few hours... Sorry to hear. Have excellent Prof. in Wattanasoth. Details will follow. All the Best.  MS>

[Kenchamp]

15 hours ago, mls said:

Actually my limit is per disability and have 3 months then can claim again on the same problem, so the previous claim wouldn't matter, as you say and I should be able to get check ups later.

I will do as you suggest and get clear quotes but if it does exceed my insurance then so be it. More important to get it sorted now than worry about the cost. Hopefully if it's done quickly and everything is removed it should be a relatively good prognosis.

Thanks again

And very good luck with your treatment. Please report back when you are up to it and let us know the outcome.

[Sheryl]

Yes. All the best and keep us posted.

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

[mls]

Will let you all know how it goes. Keeping fingers crossed and everything else possible!

 

[banK]

23 hours ago, Sheryl said:

Bangkok Hospital's Wattanaosth Hospital (Cancer Hospital) is excellent but it is expensive. Are  you insured? It could come to well over 1 million baht.

 

BanK do you recall the name of your surgeon?

 

this Harvard trained surgeon at Bangkok Hospital specializes in minimally invasive surgery for stage 12 lung cancer

 

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=6823&doctor=Dr._PADUNGKIAT_TANGPIROONTHAM

 

https://www.bangkokhospital.com/index.php/en/diseases-treatment/lung-cancer-surgery-using-vats

The name of the surgeon was Chokchai Suwanakijboriharn M.D. DR. His card says he was a Lt. Col I presume in the army. A Deputy Hospital Director.

Total estimated cost  850,000 - 1,060,000 Baht.

[mls]

Thanks

[mls]

Just to update you all. Went to see surgeon Padungkiat Tangpiroonth at Bangkok Hospital. 

Was very impressed with him and how well he explained everything.

So am now booked in for surgery on 18th of this month. Having a short delay for me to stop smoking and improve my lung function with breathing exercises.

Looks likely that I will have sufficient insurance to cover as long as there are no serious complications.

Will be in for two or three days, so will update again when I'm home.

mls

[Sheryl]

Glad to hear it.  We'll be thinking of you on the 18th.

 

Out of curiosity (and for future reference) how much were you quoted for this?

[Sheryl]

How are you, @mls? I see logged to TV earlier in this week. Maybe at your convenience you can update us on how it all went.

[mls]

Hi,

Sorry taken time to get back to you all.

I was quoted at 7-800k for the op and it came out at just under the 800k so covered on my insurance.

The op went well. The tumour was removed and was confirmed as cancer so the right upper lobe of my lung was taken out. I have a 3 inch scar about 4 inches below my right armpit. I was discharged on 21st. Subsequently the pathology wasn't as clear as would have liked. 'Poorly differentiated adenocarcinoma' so stage 1A, as was 2cm (7th edition), though surgeon says it's 1A2 (8th edition). All the other specimens show no malignancy.

The surgeon seems to think I should have chemo to be 100% certain (my partner seems to think I shouldn't need chemo if everything was taken out) but will see an oncologist on Monday when I return for check up and to have my stitch (where the drain was) removed.

Not sure about chemo either and whether needed since the rest of the lung is clear...

I have breathing exercises to do inhaling to move 3 plastic balls! Could manage all 3 before but only 2 now.

Have to say haven't felt brilliant since the op, hence no communication. No pain now except a little round the wound site, but am totally exhausted and need to have a rest most afternoons. Friends I have seen say I look well, even though I don't feel it.

Difficult to tell if the exhaustion is from the op or from previous problem. I was admitted in January at Bangkok Pattaya for chronic diarrhoea and fatigue and had a miriad of tests including the x-ray which showed up the lung problem. My GI doctor seems to think it's malabsorption but not so sure as the fatigue came on quite suddenly, but nothing else to explain it.

Anyway, will see what oncologists say on Monday and give you an update. 

If I do need chemo will probably get them to refer me to Pattaya as trip up to Bangkok is really wearing.

mls

 

 

 

[colinneil]

13 minutes ago, mls said:

Hi,

Sorry taken time to get back to you all.

I was quoted at 7-800k for the op and it came out at just under the 800k so covered on my insurance.

The op went well. The tumour was removed and was confirmed as cancer so the right upper lobe of my lung was taken out. I have a 3 inch scar about 4 inches below my right armpit. I was discharged on 21st. Subsequently the pathology wasn't as clear as would have liked. 'Poorly differentiated adenocarcinoma' so stage 1A, as was 2cm (7th edition), though surgeon says it's 1A2 (8th edition). All the other specimens show no malignancy.

The surgeon seems to think I should have chemo to be 100% certain (my partner seems to think I shouldn't need chemo if everything was taken out) but will see an oncologist on Monday when I return for check up and to have my stitch (where the drain was) removed.

Not sure about chemo either and whether needed since the rest of the lung is clear...

I have breathing exercises to do inhaling to move 3 plastic balls! Could manage all 3 before but only 2 now.

Have to say haven't felt brilliant since the op, hence no communication. No pain now except a little round the wound site, but am totally exhausted and need to have a rest most afternoons. Friends I have seen say I look well, even though I don't feel it.

Difficult to tell if the exhaustion is from the op or from previous problem. I was admitted in January at Bangkok Pattaya for chronic diarrhoea and fatigue and had a miriad of tests including the x-ray which showed up the lung problem. My GI doctor seems to think it's malabsorption but not so sure as the fatigue came on quite suddenly, but nothing else to explain it.

Anyway, will see what oncologists say on Monday and give you an update. 

If I do need chemo will probably get them to refer me to Pattaya as trip up to Bangkok is really wearing.

mls

 

 

 

Chin up mate, be strong, hope all goes well for you in the future.

ONly 2 balls, thats damned good mate, i was using one of them and it took me over 6 months to be able to manage two and a half.

Edited March 1, 2019 by colinneil

[banK]

Hi,

The worst is over.

From here on in concentrate on exercise. The most important part of recovery. 

 

I bought a treadmill after my lung op. in 2016 and have used it daily when at home - start small and build up. I only use it in the walking mode (I am getting on a bit -71)

 

As for the balls - practice a few times a day  - you will soon be keeping all 3 up! -it needs determination and not to give up. 

 

As for pathology - looks like no lymph node malignancy if so very good sign.

Not sure about your tumor type = mine was "non small cell", and was stage1 "cured".

 

I am currently under going adjuntive (sic) chemo. for pancreatic cancer (stage 1B) moderately differentiated.

Had a whipple operation a few weeks ago. The same type of tumor as yourself. Pathology was mainly encouraging.

However, the oncologist recommended adjunctive chemo for 6 cycles - Monday is the end of the first cycle.

 

Take no chances.

 

The cost of chemo is around 160,000 baht/cycle, (met by my insurance). This in the Bkk Bkk hospital.

 

No doubt vastly cheaper in Govt. hospital.

 

VERY best of luck

 

banK

[Sheryl]

1 hour ago, mls said:

Hi,

Sorry taken time to get back to you all.

I was quoted at 7-800k for the op and it came out at just under the 800k so covered on my insurance.

The op went well. The tumour was removed and was confirmed as cancer so the right upper lobe of my lung was taken out. I have a 3 inch scar about 4 inches below my right armpit. I was discharged on 21st. Subsequently the pathology wasn't as clear as would have liked. 'Poorly differentiated adenocarcinoma' so stage 1A, as was 2cm (7th edition), though surgeon says it's 1A2 (8th edition). All the other specimens show no malignancy.

The surgeon seems to think I should have chemo to be 100% certain (my partner seems to think I shouldn't need chemo if everything was taken out) but will see an oncologist on Monday when I return for check up and to have my stitch (where the drain was) removed.

Not sure about chemo either and whether needed since the rest of the lung is clear...

I have breathing exercises to do inhaling to move 3 plastic balls! Could manage all 3 before but only 2 now.

Have to say haven't felt brilliant since the op, hence no communication. No pain now except a little round the wound site, but am totally exhausted and need to have a rest most afternoons. Friends I have seen say I look well, even though I don't feel it.

Difficult to tell if the exhaustion is from the op or from previous problem. I was admitted in January at Bangkok Pattaya for chronic diarrhoea and fatigue and had a miriad of tests including the x-ray which showed up the lung problem. My GI doctor seems to think it's malabsorption but not so sure as the fatigue came on quite suddenly, but nothing else to explain it.

Anyway, will see what oncologists say on Monday and give you an update. 

If I do need chemo will probably get them to refer me to Pattaya as trip up to Bangkok is really wearing.

mls

 

 

 

For stage II onward chemo is definitely recommended, and also often for stage 1 if 4cm or more. for a tumor your size and stage 1 the evidence is much less clear.  Ask the oncologist pointed questions about likely benefit in statistical terms.

 

Adenocarcinoma is the most common type of lung cancer.

 

 

[mls]

24 minutes ago, Sheryl said:

For stage II onward chemo is definitely recommended, and also often for stage 1 if 4cm or more. for a tumor your size and stage 1 the evidence is much less clear.  Ask the oncologist pointed questions about likely benefit in statistical terms.

 

Adenocarcinoma is the most common type of lung cancer.

 

 

Thanks Sheryl,

Will try and get all the information I can from the oncologist.

[mls]

44 minutes ago, banK said:

Hi,

The worst is over.

From here on in concentrate on exercise. The most important part of recovery. 

 

I bought a treadmill after my lung op. in 2016 and have used it daily when at home - start small and build up. I only use it in the walking mode (I am getting on a bit -71)

 

As for the balls - practice a few times a day  - you will soon be keeping all 3 up! -it needs determination and not to give up. 

 

As for pathology - looks like no lymph node malignancy if so very good sign.

Not sure about your tumor type = mine was "non small cell", and was stage1 "cured".

 

I am currently under going adjuntive (sic) chemo. for pancreatic cancer (stage 1B) moderately differentiated.

Had a whipple operation a few weeks ago. The same type of tumor as yourself. Pathology was mainly encouraging.

However, the oncologist recommended adjunctive chemo for 6 cycles - Monday is the end of the first cycle.

 

Take no chances.

 

The cost of chemo is around 160,000 baht/cycle, (met by my insurance). This in the Bkk Bkk hospital.

 

No doubt vastly cheaper in Govt. hospital.

 

VERY best of luck

 

banK

Just had another go at the balls and actually got the green one to move about an inch! So definitely improving.

Sorry to hear you have pancreatic cancer and the Whipple procedure sounds complicated. I've no doubt that took it out of you and the chemo.

If I do need it I have a little left on my insurance for this treatment stage but would hope that if I have it done at Bkk Pattaya it will be a bit cheaper than Bkk Bkk.

Not sure I would trust a Govt hospital.

Good luck with your treatment bankK. I hope it turns out well for you and thanks for all the info.

mls 

[Sheryl]

BPH is not usually cheaper than Bangkok Hospital on Bangkok. If anything, the opposite.

There is a government cancer hospital in Chonburi town. Not easy to be a patient at, how3ver (as regards comfort and convenience).

When does your policy year begin and end? As the maximums are often per yrar (check the kanguage though. In some it is per event/illness without a time frame).

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

[banK]

50 minutes ago, mls said:

Just had another go at the balls and actually got the green one to move about an inch! So definitely improving.

Sorry to hear you have pancreatic cancer and the Whipple procedure sounds complicated. I've no doubt that took it out of you and the chemo.

If I do need it I have a little left on my insurance for this treatment stage but would hope that if I have it done at Bkk Pattaya it will be a bit cheaper than Bkk Bkk.

Not sure I would trust a Govt hospital.

Good luck with your treatment bankK. I hope it turns out well for you and thanks for all the info.

mls 

There you go- persistence with the balls.

 

Actually, had the whipple 14th Jan. started chemo 15th Feb. Apart from 1 day of nausea no effect from the chemo so far. Most difficult thing was eating, didn't feel like eating very much at all. however, persisted and now eat ok.

 

As for exercise - am not at home but in Bkk so I am walking each day an avg. of 7 or 8 km/day.

I feel fit and maybe this will help in alleviating the effects of chemo.

 

The chemo injections are what they are - injections. All you need is a knowledgeable oncologist.

Actually, my oncologist works part time in the Bkk Bkk hospital, one  day/week. I think her full time job is in a govt. hospital.

 

Thanks for good wishes 

 

banK

[mls]

34 minutes ago, Sheryl said:

BPH is not usually cheaper than Bangkok Hospital on Bangkok. If anything, the opposite.

There is a government cancer hospital in Chonburi town. Not easy to be a patient at, how3ver (as regards comfort and convenience).

When does your policy year begin and end? As the maximums are often per yrar (check the kanguage though. In some it is per event/illness without a time frame).

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

My policy is per 'disability' so per event/illness - not yearly - so limit nearly used for this particular event. I can reclaim again after 90 days without a claim for that particular illness.

Not sure how I'd manage at a government hospital since I know the waiting times can be ridiculous and getting to see the right doctor is not that easy either.

Interesting that you say BPH is not cheaper than Bangkok. Will have to see what the oncologists say and hope for the best. If I do need chemo will have to get quotes from both hospitals. Just don't relish the drive up and down to Bangkok each time.

mls

[mls]

Hi,

Update time.

Saw oncologist Professor Sudsawat at Bangkok hospital on 4th. She said that they would not normally recommend chemo for my 1a stage cancer, but she wanted to check that it was not small cell so needed some extra staining tests and discussion with her team.

Went back on 18th and results were good. Not small cell, just adenocarcinoma. So no need for chemo, just need to have regular check ups. Surgeon said I was very lucky and it's thanks to my GI doctor at Pattaya who checked every possible thing. She probably saved my life. 

Lucky I don't need the chemo since my insurance is used up until 90 days from last visit. Will see surgeon again then for CT scan and oncologist for blood tests.

Huge relief!

mls

[Sheryl]

Great news!  Thanks for updating us.

 

You are indeed very fortunate that your cancer was caught so early. Few lung cancers are.

[Petit Ulysses]

5 hours ago, mls said:

Hi,

Update time.

Saw oncologist Professor Sudsawat at Bangkok hospital on 4th. She said that they would not normally recommend chemo for my 1a stage cancer, but she wanted to check that it was not small cell so needed some extra staining tests and discussion with her team.

Went back on 18th and results were good. Not small cell, just adenocarcinoma. So no need for chemo, just need to have regular check ups. Surgeon said I was very lucky and it's thanks to my GI doctor at Pattaya who checked every possible thing. She probably saved my life. 

Lucky I don't need the chemo since my insurance is used up until 90 days from last visit. Will see surgeon again then for CT scan and oncologist for blood tests.

Huge relief!

mls

 

Just to relief you even more, the worldwide known US Cancer protocol by NCCN does not recommend any chemo nor radiotherapy for Stage IA non-small cell lung cancer. Be it IA1, IA2 or even IA3. It only recommends now to visit a doctor and to have a CT chest (with contrast, if possible) every 6 months for the next 2-3 years. And a yearly doctor + low-dose CT w/o contrast afterwards. So, be healthy!

[Petit Ulysses]

When talking about oncology, can someone, please. help me with some medication prices, please? They can be checked in hospital, I suppose. Unfortunately, I can't go there.

HERCEPTIN 440MG, PERJETA 420MG, ALECENSA 150/240, ZELBORAF 240/56, KEYTRUDA 100MG, OPDIVO 10ML, TECENTRIQ 1200MG

Can someone check these prices for me, please? At least, some of them. You will really help.

 

Thank you all!

[Sheryl]

I cannot tell you the price of these other than that they are very expensive as they are imports plus can only be gotten from a hospital, and in the case of private hospitals there is a substantial hospital price mark up (anywhere from 50 - 500%).

 

There is a duty tariff on all imported pharmaceuticals in Thailand. Thailand is not a good source for such medications.

 

In addition hospital pharmacies do not sell to the general public. The only way to get these drugs from a hospital in Thailand would be to be a patient  treated at that hospital, which means doctor and hospital fees on top of the cost of the drug.

 

I am not sure why you are asking since these drugs treat different types of cancer, Obviously not asking in behalf of just one patient.

 

If you operate a medical facility and are looking for a source to purchase these drugs you should directly contact the respective manufacturers. Buying in Thailand is neither cost effective nor feasible.