Oncology In Thailand

[dynamic]

A family member was diagnosed this week with adenocarcinoma of the

cervix, and possible involvement of the uterine lining.

We are Stateside at the moment, and have urgently scheduled a consult

with a well reputed gynecologic oncologist to talk about this finding. Our

guess is that the recommendation will be immediate radical hysterectomy,

possibly with radiation and/or chemo.

In general, our trust in the US medical-industrial complex is not high. We

have seen some brilliant care delivered in America, and have also seen

completely brutish, hamfisted medicine that would shame a tribal witch

doctor. The overall balance tilts strongly towards the bad side.

And we are not talking about experience in backwater rural America. Our

bad experiences have been in major teaching hospitals in affluent large

US cities. We have seen multiple serious cockups at Stanford Medical

Center, for example. At the hands of doctors with great paper credentials:

Harvard, Hopkins, you name it. They still made obvious errors in care.

We both have a reasonably good education in fundamental biology and

we learn new topics in medicine fast. We can and do read the same

textbooks and journals that physicians themselves read. Big words don't

scare us. And we don't think that MD stands for Minor Deity. We can and

do ask tough questions of our doctors.

In the past, we have both been to Raffles in SG and to Bumrungrad for

routine workups, exams and blood panels.

Both of us had a uniformly positive experience with Raffles doctors. But

B-grad was mixed. A few of the physicians there were excellent. One of

the (older male) opthalmologists was a total quack. He told me that I had

perfect vision in my left eye after only a few seconds of testing. (The eye

in question actually is myopic with 20/50 vision.) That guy should move his

practice to America, where he can charge even more to deliver crappy care.

But in general we liked the atmosphere and the staff at Bumrungrad, and

the prices were at that time cheaper than those of Raffles. It is nice to be

able to say, "I think we should run an XYZ test," and have the doctor

nod and order it right up. US physicians tend to parse any patient

suggestion as being some sort of a rude challenge to their authority.

Someone scoffed and said, "Asian hospitals will do whatever you want,

just so long as you keep paying." I don't mind that as a motive, just so

long as they do the necessary work and can be talked out of anything

that is not necessary. It's not as though our US medicine at home is

any kind of a bargain: it is by far the costliest care in the world.

We are interested in any feedback which people might be able to provide

about the current state of cancer care in Thailand -- whether in Bangkok

or not, whether at Bumrungrad or Samitivej or any other hospital that is

friendly to Anglophone tourists.

I do know that Raffles has a big oncology practice which was filled with

Japanese while we were there. My Singaporean internist said, when I

asked him about that, "Oncology care in Japan is really bad." He blamed

old cultural taboos in Japanese culture about openly discussing cancer.

Hard to develop a good care plan when everyone dances around the topic.

Are there any comparable issues of which one should be wary while in

Thailand? It's been a couple of years since we were last at Bumrungrad;

is their reputation still good? Prices still reasonable?

I suppose that the last question for a ThaiVisa forum is about, well, how

to go about getting a medical visa. If she is undergoing active cancer

treatment, that 30-day limit is going to pose a potential problem.

Thanks in advance for any and all opinions. We are both a bit distressed,

obviously, but are trying to keep our humor and our wits about us.

--

[Erwin1011]

Currently under treatment in Samitivej, and to date very satisfied. With some doctors it is a bit difficult to communicate but if you keep asking the questions you will get the answers.

Regarding costs : the moment you are using medical equipment, scanners etc, prices tend to sky rocket, at least for Thai standards, not for Europe or USA.

If you want to undergo treatment on a longer time interval than the visa exemtion 30 days allow, go for a 60 day tourist visa. At the application mention "medical" for the reason for visiting. They will note that on your visa. You can then after 60 days go for an extension of 30 days at the Bkk immigration office. You have now 90 days, if you need more, tell your doctor to fill out a statement that you need treatment for x time and that you have difficulties in traveling, because of your illness.

A doctor at Immigration will have a look at you ask you some question about your disease and treatment. I've followed that route and got 3 months extension on my "medi" tourist visa, with the a comment from the Immi doctor to come back in 3 months for another extension if necessary.

[leisurely]

There is a topic running currently in the ladies section that would probably be of interest to you.

Good luck with it all

Leisurley

[farangene]

A family member was diagnosed this week with adenocarcinoma of the

cervix, and possible involvement of the uterine lining.

...

Thanks in advance for any and all opinions. We are both a bit distressed,

obviously, but are trying to keep our humor and our wits about us.

--

I don't know anything about the cancer center at Bkk hospital but have been impressed with the doctors, staff and facilities I have experienced in other depts.

Here is a url to the cancer center:

http://www.bangkokhospital.com/eng/Wattanosoth.aspx

Also, look into the Chengwattana card which might save you some money if you choose Bkk Hosp.

Good luck.

[Sheryl]

I too second the recommendation for Samitivej and specifically recommend Dr. Panon, you can check out his qualifications at this web site:

http://www.samitivej.co.th/samitivej_front...20221&Img=1

I have been very impressed with him both in terms of state of the art competency and colleagial approach with the patient. He specializes in gyn oncology.

Costs are higher than they used to be, plus the baht has risen to the dollar so it will cost more than you remember but still much less than the US of course. Bring ALL diagnostic tests done with you (actual films etc) to avoid any unnecessary repeats. The other thing that you can do to help keep costs down is do as much as possible on an out-patient basis, even if it means staying at a hotel near the hospital and going in daily...the room rates are high. And it's nicer at a hotel, anyhow. ut of course some duration of hospital stay is unavoidable for surgery. You can get an estimate of the cost of the surgery by emailing the hospital and asking the cost for 1) simple hysterectomy and 2) radical hysterectomy. Your relative will certainly need a hysterectomy and possibly a radical one, and radiation may also be advised.

Dr. Panon is quite good about not recommending anything more drastic than is really necessary and also at taking patient concerns into account.

Good luck, and feel free to PM me if I can be of any further help