bronchoscopy Bangkok

[hadock]

Hello,

 

 

Has anyone done a bronchoscopy recently? I just want to know what costs I have to expect. I contacted a few hospitals, so far only samitivej and bangkok hospital answered. Prices range from 70.000 to 300.000 THB.

 

 

Thank you

[Sheryl]

It cannot be 300k. I suspect whoever gave that answer did not understand what was being asked. These sort of emails are answered by clerks reading off a list.  As bronchoscpy is usually not among price packages (as it is not that common and never done as a routine screening), the only real way to get an estimate is to go to the hospital and consult a doctor.

 

Also, there is a big difference between rigid and flexible bromchospy. Rigid requires general anesthesia.

 

At a top tier private hospital I would expect something in the range of 50 - 150K for flexible bronchoscopy. Less at a moderately priced private hospital, and much less at a government hospital....but possibly also a less comfortable procedure as one  of the variables affecting cost is type of anesthetic.

 

You need to give priority to the skill of the doctor performing it, who should be the pulmonologist treating you. Who has recommended that you have this done?

 

 

[hadock]

Hello Sherly,

 

Thank you for your reply. I was a smoker for over 30 years. In the past I often had bronchitis and coughing. Since I stopped smoking it has been better, but I still cough a little sometimes. Recently I made a blood test at a Lab, i also made a test for tumor markers AFP,CEA, PSA, CA19-9 and NSE. All results were ok, except the NSE. It was unusually high with 27,3 ng/mL. So the lab suggested I visit a Hospital for further check ups.

  As far as I understand, a high NSE result is an indicator for maybe small lung cell cancer. So at the Hospital I made a low Dose Chest CT, without contrast. Result was 

- mild bilateral apical thickening

- plate atelectasis of both lower lungs.

but no signs of cancer or tumor mass

 

Doctor suggested to me to be 100% sure I should have a bronchoscopy. 

[Sheryl]

21 minutes ago, hadock said:

Hello Sherly,

 

Thank you for your reply. I was a smoker for over 30 years. In the past I often had bronchitis and coughing. Since I stopped smoking it has been better, but I still cough a little sometimes. Recently I made a blood test at a Lab, i also made a test for tumor markers AFP,CEA, PSA, CA19-9 and NSE. All results were ok, except the NSE. It was unusually high with 27,3 ng/mL. So the lab suggested I visit a Hospital for further check ups.

  As far as I understand, a high NSE result is an indicator for maybe small lung cell cancer. So at the Hospital I made a low Dose Chest CT, without contrast. Result was 

- mild bilateral apical thickening

- plate atelectasis of both lower lungs.

but no signs of cancer or tumor mass

 

Doctor suggested to me to be 100% sure I should have a bronchoscopy. 

 

I would get another opinion on the bronchoscopy given the negative CT

 

Other than arguably PSA, none of the "tumor marker" tests you had are advised for mass screening purposes. They have neither the specificity nor sensitivity needed to be suitable for that purpose.

 

The only screening tool for lung cancer currently approved by any public health agency is low dose CT  for people with hisotry of smoking like yourself.

 

NSE can be elevated in many conditions, not specific to lung cancer and is not advised as a screening measure.  A level of 27.3 ng/ml is considered "indeterminate" not elevated. Additional screenings are usually recommended only for levels of >30 in people at risk, and the CT you had would qualify.

 

If you stopped smoking less than 15 years ago, should repeat  the low dose CT screening annually. (do not repeat these "tumor markers")

 

While there is nothing at all to suggest cancer your CT does indicate collapse of small air sacs at the base  of the lung (which would also be visibleo n a simple chest Xray).  This can occur in bronchitis , due to mucous blocking small airways. It can also occur in  lower respiratory infection.  So while you do not need a bronchoscopy for cancer reasons you might be advised to have one if the atelectasis worsens or does not respond to conventional treatments. (Its progress can usually be monitored by  regular chest Xray and physical exam).

 

What doctor has been managing your bronchitis?

[hadock]

Dear Sheryl,

 

 

Thank you very much for your support. I am very grateful for this. After reading your opinion, and doing some research i will focus first on the treatment of the bronchitis and atelectasis, and i will consult another Doctor again

[PPMMUU]

I support Sheryl's opinion that you should seek another opinion regarding the necessity of bronchoscopy after a negative CT scan. It appears more likely that you have chronic bronchitis or COPD. In my humble opinion, the next step should be to start treatment and monitor the results of the treatment for such conditions.

 

I apologize in advance if this comes across as rude, but did you ask the doctor for a 100% guarantee that it is not cancer? I humbly want to inform you that there is no such thing as a 100% certainty for anything in the world, regardless of the number of tests conducted.

 

If you wish, you can seek another doctor's opinion, but no doctor or test can provide a 100% guarantee of being cancer-free. Such a guarantee does not exist.

[Sheryl]

40 minutes ago, PPMMUU said:

.....did you ask the doctor for a 100% guarantee that it is not cancer? I humbly want to inform you that there is no such thing as a 100% certainty for anything in the world, regardless of the number of tests conducted.

 

If you wish, you can seek another doctor's opinion, but no doctor or test can provide a 100% guarantee of being cancer-free. Such a guarantee does not exist.

That was my thought as well.

 

Putting doctors on the spot and demanding an assurrance there is no cancer will make any doctor uneasy and often lead to unnecessary tests. Noneo f which will be 100% conclusive and many of which carry risks.

 

Annual low dose CTs are the best that can be done in terms of screening