Prostate Cancer Specialists- UPDATED 2021

[Gabe H Coud]

Ive seen 3 or 4 threads on this going back to 2010. Plus one more recent one in 2016 but thats now been archived

So, im looking for feedback as to the current best specialists for Protate Cancer 

I live in Hua Hin and whist there are Urologists here i doubt they they are expert enough

I here good things about a Doctor Wittaya in Phetchaburi but whehter he's a PC specialist or just a good general Urologist i dont know

i suspect the tops guys are in Bangkok obviously

Ive heard of 

Dr Viroj at Bumrungrad

Dr Sittiporn at Siriraj

DR Thanoo at?

My personal situation is has worsened considerably recently so im rapidly moving up the 'take action' scale. I want to get on board with someone who can guide me through the next difficult phase

As it seems to be 5 years since this was discussed i would appreciate any current updated feedback/experiences/costs of proceedures/ anything really related

thanks

 

 

[lopburi3]

14 minutes ago, Gabe H Coud said:

Ive seen 3 or 4 threads on this going back to 2010. Plus one more recent one in 2016 but thats now been archived

So, im looking for feedback as to the current best specialists for Protate Cancer 

I live in Hua Hin and whist there are Urologists here i doubt they they are expert enough

I here good things about a Doctor Wittaya in Phetchaburi but whehter he's a PC specialist or just a good general Urologist i dont know

i suspect the tops guys are in Bangkok obviously

Ive heard of 

Dr Viroj at Bumrungrad

Dr Sittiporn at Siriraj

DR Thanoo at?

My personal situation is has worsened considerably recently so im rapidly moving up the 'take action' scale. I want to get on board with someone who can guide me through the next difficult phase

As it seems to be 5 years since this was discussed i would appreciate any current updated feedback/experiences/costs of proceedures/ anything really related

thanks

 

 

There have been frequent threads - search with Google or check past subjects in the medical thread.  This is a current recommendation list (I had full bladder removal and Iliad conduit by Dr Charuspong Dissaraan 4 years ago and highly recommend for both skill and bedside manner).

 

[Sheryl]

Dr. Thanoo is at Samitivej. He no longer does surgery though if that is required.

 

Dr. Sittiporn is at both Bumrungrad and Siriraj and can do Da Vinci (robotic) surgery

[bkk6060]

Make sure you get several opinions if you think you need surgery.

Chopping off your testicles is not always required but seems to be a procedure done here from a few guys I know who have had it.

Good luck, my father had P cancer.  Hope you find the right Doctor.  

Edited March 10, 2021 by bkk6060

[Surelynot]

6 minutes ago, bkk6060 said:

Chopping off your testicles is not always required but seems to be a procedure done here from a few guys I know who have had it.

WHAT?.......Not heard that before.......ßloody hell.

[Gabe H Coud]

On 3/10/2021 at 2:03 PM, Sheryl said:

Dr. Thanoo is at Samitivej. He no longer does surgery though if that is required.

 

Dr. Sittiporn is at both Bumrungrad and Siriraj and can do Da Vinci (robotic) surgery

Sheryl you are clearly the best person to comment on Doctors and Surgeons in Bangkok. 

So, for a man in a delicate and extremely worrying position as myself, who are the top 3 guys for Prostate Cancer in Bangkok(I'm assuming that I shouldn't be looking anywhere else in Thailand other than Bkk.... I live in Hua Hin)???

Appreciate you may have already named two of them above. And what about Viroj?

Appreciate your expert views, thanks

 

[CharlieH]

2 minutes ago, Gabe H Coud said:

Sheryl you are clearly the best person to comment on Doctors and Surgeons in Bangkok. 

So, for a man in a delicate and extremely worrying position as myself, who are the top 3 guys for Prostate Cancer in Bangkok(I'm assuming that I shouldn't be looking anywhere else in Thailand other than Bkk.... I live in Hua Hin)???

Appreciate you may have already named two of them above. And what about Viroj?

Appreciate your expert views, thanks

 

Unfortunately Sheryl wont be available for several days.

I am sure she will respond when she returns.

[Gabe H Coud]

9 hours ago, CharlieH said:

Unfortunately Sheryl wont be available for several days.

I am sure she will respond when she returns.

Appreciated, Best Wishes to her....thanks

[Boomer6969]

On 3/10/2021 at 2:26 PM, Surelynot said:

WHAT?.......Not heard that before.......ßloody hell.

To stop the production of Testosterone, the "PC fertiliser". Alternative to hormone therapy with identical side effects. 

I am on active surveillance with Dr. Danaiphand at Bumrungrad, but also followed by a local urologist in Buriram. If I get to stage where I need radical treatment I will look at Singapore or Europe. The reason being that when I read the rare papers authored by Thai doctors there is very little focus on preserving the urinary and sexual functions. 

[Gabe H Coud]

2 minutes ago, Boomer6969 said:

To stop the production of Testosterone, the "PC fertiliser". Alternative to hormone therapy with identical side effects. 

I am on active surveillance with Dr. Danaiphand at Bumrungrad, but also followed by a local urologist in Buriram. If I get to stage where I need radical treatment I will look at Singapore or Europe. The reason being that when I read the rare papers authored by Thai doctors there is very little focus on preserving the urinary and sexual functions. 

Very interesting 

yes everyone wants to retain functionality as much as possible

are you able to share what youve seen/read/heard re Singapore or Europe thats gives you greater confidence?

[offset]

1 hour ago, Boomer6969 said:

To stop the production of Testosterone, the "PC fertiliser". Alternative to hormone therapy with identical side effects. 

I am on active surveillance with Dr. Danaiphand at Bumrungrad, but also followed by a local urologist in Buriram. If I get to stage where I need radical treatment I will look at Singapore or Europe. The reason being that when I read the rare papers authored by Thai doctors there is very little focus on preserving the urinary and sexual functions. 

Have you asked your doctor what percentages there are on  preserving the urinary and sexual functions. 

When I had my operation 12 years ago I was quoted ED of 50% and 90% good urinary function lucky for me I ended up with both functions being ok

[simple1]

On 3/10/2021 at 5:26 PM, Surelynot said:

WHAT?.......Not heard that before.......ßloody hell.

Likely depends on how advanced / aggressive the prostate cancer at time of procedure. Haven't heard of 'chopping off testicles', probably referring to removing the tubules within the testes. 

[Surelynot]

1 minute ago, simple1 said:

Likely depends on how advanced / aggressive the prostate cancer at time of procedure. Haven't heard of 'chopping off testicles', probably referring to removing the tubules within the testes. 

Still giving it a yikes!!!

[simple1]

2 minutes ago, Surelynot said:

Still giving it a yikes!!!

Better than dying.

[Surelynot]

Just now, simple1 said:

Better than dying.

I guess so....just a 'sensitive' issue at the moment......in and out of Bumrungrad having MRI's and the like due to high PSA's.......bit scary.

[lopburi3]

11 minutes ago, simple1 said:

Likely depends on how advanced / aggressive the prostate cancer at time of procedure. Haven't heard of 'chopping off testicles', probably referring to removing the tubules within the testes. 

Normally advanced penis cancer I believe.  Did have a patient who had undergone surgery to remove the penis and testicles, known as emasculation, show me the results while awaiting a bladder removal so it is done when required (and he seemed very upbeat).

[simple1]

35 minutes ago, lopburi3 said:

Normally advanced penis cancer I believe.  Did have a patient who had undergone surgery to remove the penis and testicles, known as emasculation, show me the results while awaiting a bladder removal so it is done when required (and he seemed very upbeat).

Was talking to my experience of advanced aggressive cancer surgery

[simple1]

1 hour ago, Surelynot said:

I guess so....just a 'sensitive' issue at the moment......in and out of Bumrungrad having MRI's and the like due to high PSA's.......bit scary.

I've gone though the experience in Australia. Unfortunately my prostate cancer had spread, luckily caught just in time, but had negative outcome for bladder issues and permanently on hormone treatment which is very effective with stopping further spread of the cancer. Couldn't urinate for three months after surgery without catheter, eventually resolved, but had to have a urine flow stimulus unit implanted in my lower back. Trust all goes well for you, if you wish to discuss further send me a PM. In the meantime to reassure you the side effects I underwent are relatively rare i.e. approx 2% of patients having undergone surgery. I have been informed robotic surgery is now the gold standard for prostate cancer treatment, but you would need to discuss with your specialist regarding potential risk for sexual function. There are a number of national prostate cancer advisory groups in the English speaking world for more detailed info / stats etc

[JoePai]

1 hour ago, simple1 said:

I've gone though the experience in Australia. Unfortunately my prostate cancer had spread, luckily caught just in time, but had negative outcome for bladder issues and permanently on hormone treatment which is very effective with stopping further spread of the cancer. Couldn't urinate for three months after surgery without catheter, eventually resolved, but had to have a urine flow stimulus unit implanted in my lower back. Trust all goes well for you, if you wish to discuss further send me a PM. In the meantime to reassure you the side effects I underwent are relatively rare i.e. approx 2% of patients having undergone surgery. I have been informed robotic surgery is now the gold standard for prostate cancer treatment, but you would need to discuss with your specialist regarding potential risk for sexual function. There are a number of national prostate cancer advisory groups in the English speaking world for more detailed info / stats etc

Sorry to hear that, sounds you were very unlucky.

Had my prostatectomy done in the Bangkok Pattaya hospital by a Doctor Niti and others. He is an excellent urologist and I would recommend him.

I had/have no problem taking a pi55 thankfully but as I was explained that can be down to the skill of the Doctor as there are many very small nerves in the area which can be damaged

[Surelynot]

2 hours ago, simple1 said:

I've gone though the experience in Australia. Unfortunately my prostate cancer had spread, luckily caught just in time, but had negative outcome for bladder issues and permanently on hormone treatment which is very effective with stopping further spread of the cancer. Couldn't urinate for three months after surgery without catheter, eventually resolved, but had to have a urine flow stimulus unit implanted in my lower back. Trust all goes well for you, if you wish to discuss further send me a PM. In the meantime to reassure you the side effects I underwent are relatively rare i.e. approx 2% of patients having undergone surgery. I have been informed robotic surgery is now the gold standard for prostate cancer treatment, but you would need to discuss with your specialist regarding potential risk for sexual function. There are a number of national prostate cancer advisory groups in the English speaking world for more detailed info / stats etc

Thanks for that.....just in the waiting area now......third set of PSA results due any minute!!!!

[simple1]

1 hour ago, JoePai said:

Sorry to hear that, sounds you were very unlucky.

Had my prostatectomy done in the Bangkok Pattaya hospital by a Doctor Niti and others. He is an excellent urologist and I would recommend him.

I had/have no problem taking a pi55 thankfully but as I was explained that can be down to the skill of the Doctor as there are many very small nerves in the area which can be damaged

Sounds reasonable. I had fairly extensive spread of prostate cancer, quite a lot of excising work done

[KhaoYai]

On 3/10/2021 at 6:22 AM, Gabe H Coud said:

My personal situation is has worsened considerably recently so im rapidly moving up the 'take action' scale. I want to get on board with someone who can guide me through the next difficult phase

Would you care to state where you are at now? PSA, diagnosis etc. I can't help ith specialists in Thailand but I may be able to give a few pointers.

I was diagnosed with locally advanced agressive PC in 2015 and received treatment in 2016.  My PSA at first presentation was 189. There was also a suspicion of spread into the 2 lymph nodes closest to the prostate.

I was offered a choice of either removal of the prostate or radio therapy - both have similar outcomes.  Although I was offered a choice, my Oncologist recommended radio therapy as it does not involve any intrusion. I went for that and as the lymph nodes were under suspicion, I had 'whole pelvis' external beam radio therapy.  Prior to the RT I had hormone therapy for 6 months to 'starve' the cancer and give the RT a better chance. The HT continued for almost 2 years (as long as I could stand it) after the RT.

There were no side effects from the RT but the HT was a different story.  I was first given 'Prostap' which gave me no side effects at all but did not quite bring my PSA down enough.  I was then given 'Zoladex' by way of a 3 monthly implant.  That worked but I have to be honest, its probably the worst medication I've ever taken.  There were a few mild side effects but the way it affected me mentally was a different story.  I suffered severe memory loss and can only describe it as 'I didn't even know who I was anymore' - something I'd also read about from others.

I didn't really have a choice and would do the same thing again in those circumstances - I'm just being honest about the side effects.

Both RT and HT induce loss of sexual function.  With RT, the damage can be permanent but with HT it fades in time - many people return to fairly normal, I did.

I was told that although a cure was the aim, my tumours were well advanced and there was only a small chance of success.  Following treatment my PSA fell to 0.05 and remained around that until Decemver 2019 when it started to rise slightly.  A small rise is expected as the prostate gets back to 'normal' - it may plateau.

Although still relatively low, my PSA recently jumped by almost .5 and was 2.22 in January.  My treatment plan was that further inverstigations would take place if my PSA rose above 2.0 - consequently I had a PET scan 2 weeks ago and await the results.  I have to admit, its a little scary at the moment - I'm aware that my disease is of the 'agressive' variety so the future is somewhat uncertain.

Perhaps the most important advice I can give is that you must take control of your treatment.  In a welfare state system, doctors can be constrained by set pathways and financial considerations whereas in private healthcare, they sell as well as treat.  You must make the choices so you need to get the best advice - and not just from one source.

I cannot have any further 'curative' treatment (not in the UK at least). I've already had the maximum dose of RT and other potential cures cannot be tried after RT.  However, that's the rules in the UK and, pending the outcome of my PET scan, I'll be looking abroad to see what's available.  Its confusing but you need to read and read (there's a lot of it) - make your decisions, you're in charge.

Your body does try to fight the disease a little and treatment has a better chance if you are healthy in other ways so exercise, lose weight - ect. ect. Although there is no clinical evidence, studies have shown that a positive attitue really does help.

I know that eventually, I'll be back on the HT and I dread that but it could give me another 10 years. Hopefully during that time, there will be further advances in the current studies on gene therapies etc. which may end this dreadful disease forever.

[carlyai]

On 3/10/2021 at 1:22 PM, Gabe H Coud said:

Ive seen 3 or 4 threads on this going back to 2010. Plus one more recent one in 2016 but thats now been archived

So, im looking for feedback as to the current best specialists for Protate Cancer 

I live in Hua Hin and whist there are Urologists here i doubt they they are expert enough

I here good things about a Doctor Wittaya in Phetchaburi but whehter he's a PC specialist or just a good general Urologist i dont know

i suspect the tops guys are in Bangkok obviously

Ive heard of 

Dr Viroj at Bumrungrad

Dr Sittiporn at Siriraj

DR Thanoo at?

My personal situation is has worsened considerably recently so im rapidly moving up the 'take action' scale. I want to get on board with someone who can guide me through the next difficult phase

As it seems to be 5 years since this was discussed i would appreciate any current updated feedback/experiences/costs of proceedures/ anything really related

thanks

 

 

 I THINK....Current best practice if the tumor is small enough (not sure what size that is) is using the DeVinchi Robot.

I had a kidney 4cm tumor removed with this machine and another guy in hospital had his prostrate cancer removed also with this machine. The guy who had the prostrate surgery said they just cut out the cancer in his prostrate and he didn't need a bag or anything and quick recovery time.

I did talk to a guy in Thailand who had prostrate surgery using the DeVinchi Robot at Bungradi hospital in Bangkok I think.

B2000000 all up.

[Gabe H Coud]

34 minutes ago, carlyai said:

 I THINK....Current best practice if the tumor is small enough (not sure what size that is) is using the DeVinchi Robot.

I had a kidney 4cm tumor removed with this machine and another guy in hospital had his prostrate cancer removed also with this machine. The guy who had the prostrate surgery said they just cut out the cancer in his prostrate and he didn't need a bag or anything and quick recovery time.

I did talk to a guy in Thailand who had prostrate surgery using the DeVinchi Robot at Bungradi hospital in Bangkok I think.

B2000000 all up.

Bungradi?? you mean Bumrungrad? i dont live in Bkk so you must forgive me 

google revealed nothing for Bungradi

and to be clear .....was that figure 2 million(THB)? 

thanks

[carlyai]

1 hour ago, Gabe H Coud said:

Bungradi?? you mean Bumrungrad? i dont live in Bkk so you must forgive me 

google revealed nothing for Bungradi

and to be clear .....was that figure 2 million(THB)? 

thanks

Yes bumrangrad....sorry. 

I think I remember 2 mill but that was everything.

Ring them up and ask.

The DaVinchi robot operations are not cheap but according to my kidney surgeon the best for a certain type of tumor.

[Gabe H Coud]

On 3/12/2021 at 5:59 PM, KhaoYai said:

Would you care to state where you are at now? PSA, diagnosis etc. I can't help ith specialists in Thailand but I may be able to give a few pointers.

I was diagnosed with locally advanced agressive PC in 2015 and received treatment in 2016.  My PSA at first presentation was 189. There was also a suspicion of spread into the 2 lymph nodes closest to the prostate.

I was offered a choice of either removal of the prostate or radio therapy - both have similar outcomes.  Although I was offered a choice, my Oncologist recommended radio therapy as it does not involve any intrusion. I went for that and as the lymph nodes were under suspicion, I had 'whole pelvis' external beam radio therapy.  Prior to the RT I had hormone therapy for 6 months to 'starve' the cancer and give the RT a better chance. The HT continued for almost 2 years (as long as I could stand it) after the RT.

There were no side effects from the RT but the HT was a different story.  I was first given 'Prostap' which gave me no side effects at all but did not quite bring my PSA down enough.  I was then given 'Zoladex' by way of a 3 monthly implant.  That worked but I have to be honest, its probably the worst medication I've ever taken.  There were a few mild side effects but the way it affected me mentally was a different story.  I suffered severe memory loss and can only describe it as 'I didn't even know who I was anymore' - something I'd also read about from others.

I didn't really have a choice and would do the same thing again in those circumstances - I'm just being honest about the side effects.

Both RT and HT induce loss of sexual function.  With RT, the damage can be permanent but with HT it fades in time - many people return to fairly normal, I did.

I was told that although a cure was the aim, my tumours were well advanced and there was only a small chance of success.  Following treatment my PSA fell to 0.05 and remained around that until Decemver 2019 when it started to rise slightly.  A small rise is expected as the prostate gets back to 'normal' - it may plateau.

Although still relatively low, my PSA recently jumped by almost .5 and was 2.22 in January.  My treatment plan was that further inverstigations would take place if my PSA rose above 2.0 - consequently I had a PET scan 2 weeks ago and await the results.  I have to admit, its a little scary at the moment - I'm aware that my disease is of the 'agressive' variety so the future is somewhat uncertain.

Perhaps the most important advice I can give is that you must take control of your treatment.  In a welfare state system, doctors can be constrained by set pathways and financial considerations whereas in private healthcare, they sell as well as treat.  You must make the choices so you need to get the best advice - and not just from one source.

I cannot have any further 'curative' treatment (not in the UK at least). I've already had the maximum dose of RT and other potential cures cannot be tried after RT.  However, that's the rules in the UK and, pending the outcome of my PET scan, I'll be looking abroad to see what's available.  Its confusing but you need to read and read (there's a lot of it) - make your decisions, you're in charge.

Your body does try to fight the disease a little and treatment has a better chance if you are healthy in other ways so exercise, lose weight - ect. ect. Although there is no clinical evidence, studies have shown that a positive attitue really does help.

I know that eventually, I'll be back on the HT and I dread that but it could give me another 10 years. Hopefully during that time, there will be further advances in the current studies on gene therapies etc. which may end this dreadful disease forever.

Adenocarcinoma of the prostate Gleason 3+3=6, diagnosed in September 2016, in 3 out of 6 cores from the right lower prostate with a PSA of 4.28 ng/ml.

Template biopsies July 2017 showed Gleason 3+3=6 in 3 out of 25 cores, and the MTL was 2 mm.

MRI prostate August 2016 showed T2C N0M0 and MRI July 2018 was unremarkable .

MRI in October 2020 was stable

But PSA has risen dramatically from 7.7 throughout 2020 to an average of 16 in the last 2 weeks and DRE reveals prostate no longer smooth but has nodules

A repeat MRI this week has been ordered, less than 5 months after last one, so yeah, quietly terrified....

[KhaoYai]

5 hours ago, Gabe H Coud said:

Adenocarcinoma of the prostate Gleason 3+3=6, diagnosed in September 2016, in 3 out of 6 cores from the right lower prostate with a PSA of 4.28 ng/ml.

Template biopsies July 2017 showed Gleason 3+3=6 in 3 out of 25 cores, and the MTL was 2 mm.

MRI prostate August 2016 showed T2C N0M0 and MRI July 2018 was unremarkable .

MRI in October 2020 was stable

But PSA has risen dramatically from 7.7 throughout 2020 to an average of 16 in the last 2 weeks and DRE reveals prostate no longer smooth but has nodules

A repeat MRI this week has been ordered, less than 5 months after last one, so yeah, quietly terrified....

I can understand your fear but there is a lot that can be done - especially with results like yours.

My gleason was 4 + 3 or 3 + 4 - can't remember which but they both = 7 ????. Tumours occupied 60% of one lobe of the prostate and 100% of the other - whch had just broken through the capsule. I opted for Radio Therapy rather than removal + radio therapy because of the extent of the tumour.  Being relatively young (in PC terms) at the time, ED and urinary problems were a big worry.  Modern surgery can be carried out using nerve sparing techniques which lessen the chances of ED but they are more difficult to carry out and sometimes impossible when the tumours are large. 

Temporary ED is normal with either Radio Therapy or removal but over 50% of patients return to more or less normal within 2 years of either procedure. Urinary problems seem to be more associated with surgery but not exclusively. With Hormone Therapy you can forget 'marital relations' altogether whilst your on it and for up to 12 months afterwards.  That's my biggest worry at the moment - I responded well to Hormone Therapy and being 'out of action' for a short time wasn't a problem. Its likely that I will respond well to it again and it could give me another 10 years + but as there is no further curative treatment available to me, going back on HT will be permanent and therefore, so will the resultant ED. Short 'holidays' from HT can often be taken but these only relieve the other side effects, they are not long enough for 'things' to return to normal.

As I stated previoulsy my PSA was 189 at diagnosis and to Oncologists/Urologists PSA at diagnosis seems to be all important.  Obviously the UK is a different country but here we have fixed 'pathways' that are dependent on that all important PSA at diagnosis.  I am precluded from many types of treatment because my PSA was so high - I think you will have more options.

It doesn't sound as if you have had any Hormone Therapy yet - probably watchful waiting? In which case it seems like your waiting period is over and now its time for treatment.  With such a low PSA (in comparison), many options are open to you.

Had my situation been less serious, I think I would have gone for removal with RT of the surrounding tissue as a 'mopping up', belt and braces technique - that is if I had a chance of the nerve sparing being successeful. I know a guy who was unlucky enough to get PC at 34 years old (very rare), he had removal and is now in his 60's with no further problems (although nerve sparing wasn't available then).

I can't help with recommending a good Urologist/Oncologist in Thailand but if you can't return to your home country for treatment, I would get at least 2 opinions.  Coming from a country with a welfare state, I have the ability to talk with NHS specialists who's only interest is in putting me right and private specialists who may do the same but are also driven by the profit motive.

The NHS has seemingly rigid 'pathways' from which they won't vary whereas a private specialist may have more options and greater access to the latest techniques.  Fortunately, my NHS oncologist also works privately so I can ask him to take his NHS hat off and tell me what he would advise if I was a private patient.

I suspect that you are correct and the best specialists will be in Bangkok - they follow the money. No hospital is going to state that they are bad at anything but you'd be amazed at the amount of information that's available on the internet.  I'd be looking for doctors that are involved with discussion groups on their speciality and/or give lectures outside of their normal workplace.

There's a whole range of treatments available to you at the moment but don't delay, those options diminish as the disease advances.

PS. The Bangkok Hospital in Pattaya and Bumrungrad in Bangkok keep coming up on Google searches - I didn't check any individual doctors though.

[JoePai]

15 hours ago, KhaoYai said:

I can understand your fear but there is a lot that can be done - especially with results like yours.

My gleason was 4 + 3 or 3 + 4 - can't remember which but they both = 7 ????. Tumours occupied 60% of one lobe of the prostate and 100% of the other - whch had just broken through the capsule. I opted for Radio Therapy rather than removal + radio therapy because of the extent of the tumour.  Being relatively young (in PC terms) at the time, ED and urinary problems were a big worry.  Modern surgery can be carried out using nerve sparing techniques which lessen the chances of ED but they are more difficult to carry out and sometimes impossible when the tumours are large. 

Temporary ED is normal with either Radio Therapy or removal but over 50% of patients return to more or less normal within 2 years of either procedure. Urinary problems seem to be more associated with surgery but not exclusively. With Hormone Therapy you can forget 'marital relations' altogether whilst your on it and for up to 12 months afterwards.  That's my biggest worry at the moment - I responded well to Hormone Therapy and being 'out of action' for a short time wasn't a problem. Its likely that I will respond well to it again and it could give me another 10 years + but as there is no further curative treatment available to me, going back on HT will be permanent and therefore, so will the resultant ED. Short 'holidays' from HT can often be taken but these only relieve the other side effects, they are not long enough for 'things' to return to normal.

As I stated previoulsy my PSA was 189 at diagnosis and to Oncologists/Urologists PSA at diagnosis seems to be all important.  Obviously the UK is a different country but here we have fixed 'pathways' that are dependent on that all important PSA at diagnosis.  I am precluded from many types of treatment because my PSA was so high - I think you will have more options.

It doesn't sound as if you have had any Hormone Therapy yet - probably watchful waiting? In which case it seems like your waiting period is over and now its time for treatment.  With such a low PSA (in comparison), many options are open to you.

Had my situation been less serious, I think I would have gone for removal with RT of the surrounding tissue as a 'mopping up', belt and braces technique - that is if I had a chance of the nerve sparing being successeful. I know a guy who was unlucky enough to get PC at 34 years old (very rare), he had removal and is now in his 60's with no further problems (although nerve sparing wasn't available then).

I can't help with recommending a good Urologist/Oncologist in Thailand but if you can't return to your home country for treatment, I would get at least 2 opinions.  Coming from a country with a welfare state, I have the ability to talk with NHS specialists who's only interest is in putting me right and private specialists who may do the same but are also driven by the profit motive.

The NHS has seemingly rigid 'pathways' from which they won't vary whereas a private specialist may have more options and greater access to the latest techniques.  Fortunately, my NHS oncologist also works privately so I can ask him to take his NHS hat off and tell me what he would advise if I was a private patient.

I suspect that you are correct and the best specialists will be in Bangkok - they follow the money. No hospital is going to state that they are bad at anything but you'd be amazed at the amount of information that's available on the internet.  I'd be looking for doctors that are involved with discussion groups on their speciality and/or give lectures outside of their normal workplace.

There's a whole range of treatments available to you at the moment but don't delay, those options diminish as the disease advances.

PS. The Bangkok Hospital in Pattaya and Bumrungrad in Bangkok keep coming up on Google searches - I didn't check any individual doctors though.

Bangkok Hospital in Pattaya - would suggest Dr Niti is as good as any Doctor in Bangkok

[Gabe H Coud]

A summary of Prostate Cancer Doctors in Bangkok/Pattaya

please put forward any more names if you can recommend

thanks

Dr Viroj Chodchoy at Bumrungrad
Sittiporn Srinualad - Siriraj Private and Bumrungrad 
Dr Charuspong Dissaranan at Bumrungrad
Dr Danaiphand Bumrungrad 
Dr Sarayuth Viriyasiripong Bumrungrad
Dr Thanoo at Samitivej (no longer does surgery) 
Dr Niti in Pattaya (Bangkok Hospital) 

Edited March 18, 2021 by Gabe H Coud

[Sheryl]

On 3/12/2021 at 12:11 AM, Gabe H Coud said:

Sheryl you are clearly the best person to comment on Doctors and Surgeons in Bangkok. 

So, for a man in a delicate and extremely worrying position as myself, who are the top 3 guys for Prostate Cancer in Bangkok(I'm assuming that I shouldn't be looking anywhere else in Thailand other than Bkk.... I live in Hua Hin)???

Appreciate you may have already named two of them above. And what about Viroj?

Appreciate your expert views, thanks

 

Dr. Viroj is also quite good but much depends on what treatment option you want. Dr. Viroj would be fine at explaining your options and walking you through them but unless you were to go for traditional TURP he might need to refer you to someone else for actual treatment.

For that matter any urologist will have to refer you to an intervention radiologist if you opt for brachytherapy. (which might or might not be an option in your specific case)

So it again reverts to the desired treatment approach. Which in turn depends on a variety of factors plus patient choice.