Prostate Cancer-PIRADS 4

[Sheryl]

10 hours ago, Gabe H Coud said:

to be clear im due to have my third if not fourth biopsy next week since diagnosis in 2016

 

it will be my second MRI Fusion TRUS biopsy in 20 months where they use the MRI scan to pinpoint exactly where to take samples

 

 

 

this is to check the progress of the cancer

 

 

 

 

OP - from the sounds of it you have been managed conservatively and appropriately, striking an appropriate balance between avoiding unnecessary treatment on the one hand and not taking too much risk on the other.

 

I suggest you follow the recommendation to have this third biopsy, especially as you are concerned to avoid surgery if possible.

 

While it is possible that after the results are in treatment will need to go forward, it is also possible that results will still indicate a slow growing tumor allowing continued conservative management.

 

As for your original concerns about "a good pay day at 125, 000 baht", most of that money does not go to the doctor but is rather for the use of the extremely expensive equipment - which costs the hospitals over a million dollars to purchase and which cost has to be recouped within a limited time period. There is profit to the hospital built into that price as well, of course, but far far less than you may assume. The doctor will be paid adequately for his time but is certainly not going to get rich off this procedure. And from how he has managed you so far he is not basing his treatment on profit considerations.

 

That said, costs here are not small and costs of treatment will be even more so.  As you still have a house in UK going back is certainly an option. You said you had been registered with a GP. No reason to think you are nto still, but if in doubt why not call and ask? Just call and ask for an appointment explaining that you have been diagnosed with prostate cancer while abroad and see how soon they can slot you in.

[Gabe H Coud]

41 minutes ago, Sheryl said:

OP - from the sounds of it you have been managed conservatively and appropriately, striking an appropriate balance between avoiding unnecessary treatment on the one hand and not taking too much risk on the other.

 

I suggest you follow the recommendation to have this third biopsy, especially as you are concerned to avoid surgery if possible.

 

While it is possible that after the results are in treatment will need to go forward, it is also possible that results will still indicate a slow growing tumor allowing continued conservative management.

 

As for your original concerns about "a good pay day at 125, 000 baht", most of that money does not go to the doctor but is rather for the use of the extremely expensive equipment - which costs the hospitals over a million dollars to purchase and which cost has to be recouped within a limited time period. There is profit to the hospital built into that price as well, of course, but far far less than you may assume. The doctor will be paid adequately for his time but is certainly not going to get rich off this procedure. And from how he has managed you so far he is not basing his treatment on profit considerations.

 

That said, costs here are not small and costs of treatment will be even more so.  As you still have a house in UK going back is certainly an option. You said you had been registered with a GP. No reason to think you are nto still, but if in doubt why not call and ask? Just call and ask for an appointment explaining that you have been diagnosed with prostate cancer while abroad and see how soon they can slot you in.

Yes my pay day comment was a little misleading. I know it's high tech equip and has to come from Bkk too(to HH) about once per month. 

 

After the last Fusion biopsy the conclusion was PIRADS 3. Then after the MRI scan last week he concluded PIRADS 4. So my gut reaction was 'do we still need the biopsy then?' 

 

Anyways, further reading suggests it's wise 

 

Thanks again and for UK GP comment 

 

 

PS to all.... how do I get these godforsaken video adverts off my feed(mobile)?? ????????

 

[simple1]

16 hours ago, simon43 said:

Which is why I don't understand why older men who require hormone reduction do not opt for orchiectomy (surgical removal of the testicles).  This kills testosterone production stone dead, is a simple 30-minute local anaesthetic outpatient operation, and is a common procedure in developing countries where they can't afford Big Pharma hormone treatment.

Subcapsular orchiectomy is perhaps a better method, which was the path my surgeon used. However, neither methods cure prostate cancer if it is advanced stage prostate cancer at the time of surgery.

 

https://www.healthlinkbc.ca/health-topics/orchiectomy-prostate-cancer#:~:text=An orchiectomy is done to,the front of the scrotum.

[simon43]

44 minutes ago, simple1 said:

Subcapsular orchiectomy is perhaps a better method, which was the path my surgeon used. However, neither methods cure prostate cancer if it is advanced stage prostate cancer at the time of surgery.

 

https://www.healthlinkbc.ca/health-topics/orchiectomy-prostate-cancer#:~:text=An orchiectomy is done to,the front of the scrotum.

Yes I agree - it is not a cure, but another step to prolong life if the prostate cancer has spread.  I think the stats show that this syrgery prolongs life by on average 80 months.  If one has prostate cancer that is wholly contained within the prostate, then a prostatectomy should give you at least 7 more years (stats tell me that 25% of patients have cancer reoccurrence after 7 years). Then zap it with radiation therapy and the stats suggest another 7 years, then chop your 2-veg off and another 9 years.  If I go down this route, it seems that I might live longer than someone who never has cancer!! ????

[Will B Good]

23 hours ago, Gabe H Coud said:

See above, sorry my bad i definitely ahve Prostate Cancer

 

The biopsy will probably reveal more but the last one concluded i was PIRADS 3

 

So after the MRI a few days ago he said i was PIRADS 4, i thought well now we know that is there any point in the biopsy? Hence asking others of their experiences

 

there probably is(a reason) so im awaiting his(Urologist) reply 

 

 

Hope all goes as well as can be expected.....

[Sheryl]

3 hours ago, Gabe H Coud said:

Yes my pay day comment was a little misleading. I know it's high tech equip and has to come from Bkk too(to HH) about once per month. 

 

After the last Fusion biopsy the conclusion was PIRADS 3. Then after the MRI scan last week he concluded PIRADS 4. So my gut reaction was 'do we still need the biopsy then?' 

 

Anyways, further reading suggests it's wise 

 

Thanks again and for UK GP comment 

 

 

PS to all.... how do I get these godforsaken video adverts off my feed(mobile)?? ????????

 

I had not realized you were doing this in Hua Hin. Yoh can probably save a bit by having it done in Bkk instead and as that is where you'd need to go for treatment there would be an advantage to having it done by same doctors who might then manage your treatment. 

 

Suggest you take all records up to Siriraj and see Prof. Sittiporn. Thus will also slliw a second opinion re utility of another biopsy. 

[Gabe H Coud]

8 hours ago, Sheryl said:

I had not realized you were doing this in Hua Hin. Yoh can probably save a bit by having it done in Bkk instead and as that is where you'd need to go for treatment there would be an advantage to having it done by same doctors who might then manage your treatment. 

 

Suggest you take all records up to Siriraj and see Prof. Sittiporn. Thus will also slliw a second opinion re utility of another biopsy. 

Ssliw(a second opinion)?? 

 

Also actual cost is 115, 000 not 125 as I originally thought 

 

Isn't Siriraj the place that's almost impossible to get seen at as a non Thai speaking farang ? I've have a feeling that I tried them the last time(fusion biopsy) and just couldn't get them to respond. And if memory serves me rightly that was a private patient. But I like you're thinking, just wondering if practically possible 

 

Clearly something makes you think it might be cheaper.... 

 

 

Edited February 13, 2023 by Gabe H Coud

[Sheryl]

2 minutes ago, Gabe H Coud said:

Ssliw(a second opinion)?? 

 

Allow a second opinion

 

(Typo)