Prostate Cancer - next step

[newbee2022]

2 hours ago, bkk6060 said:

My father had it at 79.

They chopped his nuts off saying without the hormones created in his testes the cancer would grow much more slowly.

He died 10 years later of a heart attack. 

If you look around this treatment should be carried out not only for old men suffering from prostate problems but even for rude, criminal and violent young ones. 

[john donson]

does every old man not get prostate cancer in the end , but rarely dies from it

 

one thing goes, your erection...  so is it worth it...

[Sheryl]

15 minutes ago, john donson said:

does every old man not get prostate cancer in the end , but rarely dies from it

 

one thing goes, your erection...  so is it worth it...

No, not all men get prostate cancer.

 

And while some prostate cancers are slow growing, some are aggressive. 

 

Prostate cancer is the 2nd most common cause of cancer death in men in many western countries. 

 

Recognizing that some prostate cancers are very slow growing, prostate cancer scoring systems nowadays speak on terms of "clinically significant" prostate cancer i.e. cancers requiring treatment. 

[John49]

On 4/3/2024 at 7:12 PM, John49 said:

Any personal experiences, or suggestions on where to get treatment in Bangkok would be welcomed.

 

A looks like lots of specialist doctors available at each hospital, any recommendations on doctor’s names appreciated.

 

17 hours ago, newbee2022 said:

Honestly, what do you expect here??? An online diagnosis? Any online advice?? Any specific explanation? 

All responsible and conscientious doctors here should tell you to see a second opinion but not give any comments here. This is not a medical forum for medical personnel only.🙏

 

 

If you read my statement and your statement, there is major difference in intent, and you have ‘over-interpreted’ my intent.

 

I’m looking for feedback from others – on their personal experiences with doctors and hospitals.

Without feedback from others, I would have a long journey of contacting hospital and doctors, and trying to determine their ‘competency’ for a successful outcome.

I really do question their 'competency' - most are average, some are exceptional and some (or most?) are to be avoided.

 

The feedback here has been really good, it has thrown up a few hospitals and doctors – whom I shall now contact for the diagnosis and advice.

 

Why do I go open kimono and detail my recent medical ‘history’?

This is to generate interest in my case so that those with similar ‘history’ can identify and be motivated to relate their personal stories.

 

I would like thank all for their “personal experiences, or suggestions on where to get treatment in Bangkok”.

 

A special thanks to Sheryl who contributes so much to this forum.

Sheryl gives so much with tailored “suggestions” and “recommendations” to each and everyone's medical issue.

 

[nana kid]

My advise from personal experience                      a slow growth Cancer can explode into necessary Prostatectomy in a short time.

Also do whatever you can to keep the prostate because without it you will be incontinent  ie on diapers for the rest

of your life. The Urinary Sphincter is in the Prostate.   Get rid of the Cancer ASAP no matter what the size

[newbee2022]

21 hours ago, WDSmart said:

I'm 78, and my PSA count is just a little above the danger zone. The doctors here (Thailand) wanted to test me for prostate cancer, but I checked with a few of my friends who are doctors in the USA, and they advised me against that. They told me prostate cancer was very slow-growing, so even if I had it, it would not interfere with my life unless I lived to be over 100. 

Probably you got some medicine prescribed already and go for the PSA test every year. As long as there is no significant change enjoy your life.

I will send you birthday greetings when you'll turn 100😄

[paul1804]

21 hours ago, Sheryl said:

BNH is a private hospital and on Convent Rd (between Silom and Sathorn). 

 

Bangkok Christian and St. Louis, while excellent hosp8tals, do not offer the full  range of relevant treatments.  Cannot do HoLEPS and robotic surgery for example.

Sorry guys, I got my hospitals mixed up, its King Chulalongkorn Memorial Hospital on Silom road. 

[Sheryl]

4 hours ago, nana kid said:

My advise from personal experience                      a slow growth Cancer can explode into necessary Prostatectomy in a short time.

Also do whatever you can to keep the prostate because without it you will be incontinent  ie on diapers for the rest

of your life. The Urinary Sphincter is in the Prostate.   Get rid of the Cancer ASAP no matter what the size

 

The sphincter is not in the prostate. However, the prostate surrounds it so there is a risk of damage to it (and to nerves) during prostate surgery.  Short term incontinence is common initially, and may take a few months to resolve, but only a small minority of men have long term incontinence.

 

Risk is less with robotic surgery than TURP, provided the operators are sufficiently experienced.

 

 

 

 

[MangoKorat]

All I can tell you is what worked for me - but be warned that not everyone responds so well.

 

 

Diagnosis March 2015

PSA 189

Gleason 4+3 (7) T3B

Tumour 100% of right prostate lobe, 60% of the left.

Agressive type

 

Firstly, your doctors need to determine whether or not the tumours have broken out of the capsule.  I was told that if they have, no curative treatment is available but various treatments can slow the disease down.

 

Scans revealed that the although cancers had broken through the capsule, it was minor and it was doubtful that any spread had taken place - although 2 lymph nodes close to the prostate were classed as 'slightly abnormal' and 'suspicious'.  They were too small to sample.

 

In the UK the NHS has fairly strict 'pathways' (types of treatment), many are only available if your PSA is below 20. For me that left removal of the prostate or Radio Therapy - both combined with hormone therapy.  My oncologist told me that the 5 year outcomes for both treatments were broadly the same - the decision was mine.

 

I was not old at the time and I was told that if I had my prostate removed, the chances of any activity between the sheets in the future was just about nil. The chances with radio therapy were a little better.  Sorry to raise this issue but its something a lot of men worry about.

 

I opted for Radio Therapy (RT) and began 6 months of Hormone Therapy (HT) beforehand which I was told would give the Radio Therapy a better chance. Due to the high % of tumour and the suspicious lymph nodes I was given the maximum 'safe' dose of RT which was 36 x 10 minute doses @ 70 2Gy over 7 weeks to the 'whole pelvis' beginning February 2016. I was advised to continue the HT for 2 to 3 years after RT.

 

I could write pages on the effects of HT but everybody responds differently to it.  I had a very hard time with it - so bad that I gave it up 12 months after RT.  All I will say about it is that it 'played with my head', I would look in the mirror and no know who I was.

 

My PSA after HT and on starting the RT had fallen to 8.2. By May 2016 my PSA was down to 0.15 and by April of 2017 it was down to 0.05 where it more or less stayed until September 2019 when it began creeping up again.  I was told that should it rise to 2, I would be called in for a PET scan to determine where (if any) the cancer was.

 

My PSA had rsien to 2.22 by January 21  indicating probable 'activity' and I had a PET scan around March I think.  The result showed that the 'activity' was still within my prostate and my Oncologist was of the opinion that it wasn't a recurrence, more likely that we just hadn't got it all the first time.  However, as I'd already had the maximum safe dose, further RT was out.  I could however have Brachytherapy (BT) which is targetted down to millimeters and therefore doesn't risk damaging any nearby tissue.  The technology employed to enable this is pretty amazing.  The PET scan was used to construct a map of my prostate to identify exactly where the activity was. My Oncologist wanted me to have HT again, before and after the BT but I wasn't at all keen.  After careful consideration he agreed that we could go ahead without it. I had 2 doses of BT @ 27 Gy, from memory 2 weeks apart, in October 21.

 

By April 2022 my PSA was down to .70 and has continued to fall ever since.  At my last test in February this year it was 0.57.  Given my initial diagnosis my Oncologist says my response has been pretty amazing. I'm not sure you can ever say you are 'out of the woods' but I'm in a much better place than I was in 2015 and should the cancer become active once again, there are now other treatment options available to me.

 

You will no doubt be given various options. What I would say to you is, read up all you can, listen carefully to your Oncologist and make your decision.  Stay in the driving seat all the time.  I'm not criticisng the doctors who've taken care of me, they've done a fantastic job but you have to stay in the driving seat.  I was not called in when my PSA rose to 2.22 in January 2022 as I was told I would be - I had to call them.  Remember, they are probably dealing with thousands of other patients - only you can raise your profile.

[Negita43]

3 hours ago, MangoKorat said:

 

I opted for Radio Therapy (RT) and began 6 months of Hormone Therapy (HT) beforehand which I was told would give the Radio Therapy a better chance. Due to the high % of tumour and the suspicious lymph nodes I was given the maximum 'safe' dose of RT which was 36 x 10 minute doses @ 70 2Gy over 7 weeks to the 'whole pelvis' beginning February 2016. I was advised to continue the HT for 2 to 3 years after RT.

In Korat or UK?

[MangoKorat]

On 4/5/2024 at 1:54 PM, Negita43 said:

In Korat or UK?

UK

[JoseThailand]

On 4/3/2024 at 7:52 PM, advancebooking said:

Bumrungrad has to be your best option. Probably as expensive as oz but just as good. Bring all evidence. 

 

 

Isn't it covered by Medicare in oz?

[Serenity_Now]

here is what i would do if i was kept waiting for healing 
i hope the biopsy was done with an ultrasound guided needle through the perineum
rather than the old rectal route which increases infection chances

anyway if your not allergic to fluroquines a 6 week course of ciproflaxin  500mg twice a day
diosmin and hesperin 500mg twice a day for the same period at least 
you can also add other supplements
such as berberine 
bitter gourd
Vit K2

As males we should look at changing our diets
stopping the BPH
limiting the DHT
Pumkin seeds or Oil supplements 
Broccolli Supplements
Saw Palmetto

If no cancer Lycopene 

In OPs case stay away from lycopene foods thats Water Melon Tomatoes 

I am going to include a few links but in General Cipro has been getting added to Chemo Courses

everything here is OTC except the cipro but if your in thailand no problem
just know your history if you have taken cipro before no prolem 6 weeks is lengthy but gold standard for prostrate infection, risk of tendons bursting due to collagen depletion so take it easy, dont run etc ease the load on your tendons even 4 weeks after course BLACK  BOX WARNING USA

Diosmin induces genotoxicity and apoptosis in DU145 prostate cancer cell line
https://pubmed.ncbi.nlm.nih.gov/25499067/

Hesperidin Suppresses the Proliferation of Prostate Cancer Cells by Inducing Oxidative Stress and Disrupting Ca2+ Homeostasis
https://pubmed.ncbi.nlm.nih.gov/36139707/
 

Suppression of human prostate cancer cell growth by ciprofloxacin is associated with cell cycle arrest and apoptosis
https://pubmed.ncbi.nlm.nih.gov/12632069/
 

Non Human but useful info
Protective role of diosmin against testosterone propionate-induced prostatic hyperplasia in Wistar rats: Plausible role of oxidative stress and inflammation
https://journals.sagepub.com/doi/full/10.1177/0960327119889655

Does berberine raise PSA levels?
demonstrated that high doses of Berberine (up to 100 µM) can inhibit viability of prostate cancer cells and KLK3 induction after 6 h (7). Moreover, they demonstrated induction of apoptosis and decline in PSA as well as AR protein content.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278877/#:~:text=Berberine reduced cell viability%2C effectively,(Figure 1B).

Edited April 7 by Serenity_Now
more info

[advancebooking]

On 4/7/2024 at 4:42 PM, Serenity_Now said:

here is what i would do if i was kept waiting for healing 
i hope the biopsy was done with an ultrasound guided needle through the perineum
rather than the old rectal route which increases infection chances

anyway if your not allergic to fluroquines a 6 week course of ciproflaxin  500mg twice a day
diosmin and hesperin 500mg twice a day for the same period at least 
you can also add other supplements
such as berberine 
bitter gourd
Vit K2

As males we should look at changing our diets
stopping the BPH
limiting the DHT
Pumkin seeds or Oil supplements 
Broccolli Supplements
Saw Palmetto

If no cancer Lycopene 

In OPs case stay away from lycopene foods thats Water Melon Tomatoes 

I am going to include a few links but in General Cipro has been getting added to Chemo Courses

everything here is OTC except the cipro but if your in thailand no problem
just know your history if you have taken cipro before no prolem 6 weeks is lengthy but gold standard for prostrate infection, risk of tendons bursting due to collagen depletion so take it easy, dont run etc ease the load on your tendons even 4 weeks after course BLACK  BOX WARNING USA

Diosmin induces genotoxicity and apoptosis in DU145 prostate cancer cell line
https://pubmed.ncbi.nlm.nih.gov/25499067/

Hesperidin Suppresses the Proliferation of Prostate Cancer Cells by Inducing Oxidative Stress and Disrupting Ca2+ Homeostasis
https://pubmed.ncbi.nlm.nih.gov/36139707/
 

Suppression of human prostate cancer cell growth by ciprofloxacin is associated with cell cycle arrest and apoptosis
https://pubmed.ncbi.nlm.nih.gov/12632069/
 

Non Human but useful info
Protective role of diosmin against testosterone propionate-induced prostatic hyperplasia in Wistar rats: Plausible role of oxidative stress and inflammation
https://journals.sagepub.com/doi/full/10.1177/0960327119889655

Does berberine raise PSA levels?
demonstrated that high doses of Berberine (up to 100 µM) can inhibit viability of prostate cancer cells and KLK3 induction after 6 h (7). Moreover, they demonstrated induction of apoptosis and decline in PSA as well as AR protein content.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278877/#:~:text=Berberine reduced cell viability%2C effectively,(Figure 1B).

My 2 cents worth is that if you dont want to get prostate cancer then you must ejaculate more than 21 times a month. Its on google dr. 

[Negita43]

21 hours ago, advancebooking said:

My 2 cents worth is that if you dont want to get prostate cancer then you must ejaculate more than 21 times a month. Its on google dr. 

That doesn't work I've tried it!😀

[MangoKorat]

On 4/9/2024 at 2:43 PM, advancebooking said:

My 2 cents worth is that if you dont want to get prostate cancer then you must ejaculate more than 21 times a month. Its on google dr. 

Given that the causes of Prostate Cancer are as yet unknown, that is hardly going to work.  There are a few things that appear to make it more likely that a man will get the disease at some time in his life and a genetic pre-disposition is amongst the most common but nothing is conclusive.

 

The chances of getting the disease increase as you get older so with life expectancy increasing in most nations, its inevitable that there will be an increase in case numbers.

 

Fortunately for most people, the disease is fairly low grade and quite often no treatment at all is recommended. A period of 'watchful waiting' with regular blood tests is often recommended, sometimes in conjunction with Hormone Therapy.  Interventions are only made if and when the disease increases in activity.

 

It is often said that Prostate Cancer is something you die with, not of. 

 

[thaibeachlovers]

I had radical prostatectomy and regret it since, but there are far better procedures now, that I didn't have the option for.

 

Knowing what I know now, if I got prostate cancer now ( in my 70s ), I'd have a TURP and party till the end.

I'd keep enough money for a trip to Switzerland when it got too bad or the money ran out.

I regret staying alive just to end up in a horrid nursing home.

[thaibeachlovers]

51 minutes ago, MangoKorat said:

It is often said that Prostate Cancer is something you die with, not of. 

It may be said, but it's not true. I had my op just before the cancer broke out of the prostate, so it hadn't had the chance to spread. Had I waited I'd already be dead.

[thaibeachlovers]

On 4/5/2024 at 4:37 PM, nana kid said:

My advise from personal experience                      a slow growth Cancer can explode into necessary Prostatectomy in a short time.

Also do whatever you can to keep the prostate because without it you will be incontinent  ie on diapers for the rest

of your life. The Urinary Sphincter is in the Prostate.   Get rid of the Cancer ASAP no matter what the size

I agree that incontinence is a problem post op, but not necessarily needing diapers. I make do with female incontinence pads that have a convenient sticky strip to keep them located in my ordinary boxer shorts. I use the female ones because the specifically "male" variety cost waaaaaay more and do exactly the same thing.

 

I am lucky and only have occasional leakage, not full time.

 

I still have at least one sphincter, though it doesn't work as well as it used to pre op.

Men have 2 sphincters, and internal and an external one.

[Sheryl]

18 hours ago, MangoKorat said:

 

It is often said that Prostate Cancer is something you die with, not of. 

 

 

Not quite.

What is said is that more men die with it than of it, and that's true enough, mainly because the invidence greatly increases in old age. But plenty of men die it.  2nd leading cause of cancer death in men.

 

Nowadays the diagnostic process distinguishes between slow growing  moderate and aggressive cancers of the prostate.  

[MangoKorat]

6 hours ago, Sheryl said:

 

Not quite.

What is said is that more men die with it than of it, and that's true enough, mainly because the invidence greatly increases in old age. But plenty of men die it.  2nd leading cause of cancer death in men.

 

Nowadays the diagnostic process distinguishes between slow growing  moderate and aggressive cancers of the prostate.  

My point was that autopsies often reveal that although it was not the cause of death, it was present - usually low grade.  I'm aware that its the 2nd biggest killer, I thought I'd be joining that club.

 

Its difficult to present your story without giving people either false hope or being overly morbid.  I have been extremely lucky in that I responded so well to the treatment I was given. I wouldn't want anyone to think that all you need is a course of Radio Therapy and Hormone Therapy and you'll be fine - that's just not the case.

 

The key, as with any type of cancer, is to catch it early.  With Prostate Cancer, and this is from my Oncologist and not my opinion, it needs catching before it breaks through the capsule of the Prostate and spreads. Its almost impossible, if not impossible to cure once it breaks out. Although it can be slowed down.

 

My message to all guys over 50 is to get your PSA tested regularly. That's not foolproof and there is often resistance to testing from GP's etc. but its the best we have until better detection techniques are found and screening is brought in. Some private clinics in the UK now offer PC screening and I'm sure that Thai private hospitals do the same although if my experience of private hospitals is anything to go by, you have to beware of 'upselling'.

 

Some GP's resist testing when there are no obvious symptoms because should a high PSA be found, the next step is often a biopsy (rectal) with a high risk of infection and quite often, negative results. Besides, urologists often carry out transperineal biopsies now which I'm told are less risky and the new type MRI scans reduce the need for biopsies.

 

Knowing what I know now, I wouldn't care how much my GP resisted, I would insist.

 

I went to my GP on a different matter and in passing, mentioned a few symptoms like getting up for a pee 2 or 3 times per night and reduced semen production.  Suspicious my GP suggested a urine sample as well as a PSA test.  When my PSA came back at 189 and the urine test revealed traces of blood, I was booked in for a biopsy 2 days later.

 

Not only should men get tested regulary, they should also talk to their GP about their health in general.  I've never had a problem with that but I'm told that many guys do.  I am 100% certain that if I hadn't mentioned my symptoms, whilst seeing my GP on an unrelated matter, I wouldn't be here today. I was probably within weeks/months of the cancer spreading.

Edited April 11 by MangoKorat

[dddave]

On 4/3/2024 at 8:37 PM, Negita43 said:

I'm 80 my PSA was 46 had a biopsy in a Government hospital (Korat)  - Biopsy showed Cancer restricted to prostrate  only. Gleason 3+4

Finish my radiation on friday Varian Halcyon Linac Device - very few side effects - some restriction of urine flow not serious - but more frequent

But my hormone treatment started 6 weeks ago.

Total cost so far about £10K I am impressed with this hospital.

If cost is an issue maybe look for a good Government hospital

Maharaj Govt. Hospital in Korat by chance?  I had excellent treatment there for a staff infection in my foot.  Another hospital wanted to amputate, Maharaj doctors went the extra mile to save it.  

[saintdomingo]

On 4/9/2024 at 8:43 PM, advancebooking said:

My 2 cents worth is that if you dont want to get prostate cancer then you must ejaculate more than 21 times a month. Its on google dr. 

A theory that appears from time to time but I read a debunking article stating that during the Vietnam war autopsies in the USA on young soldiers whose bodies were returned showed some very early indicators of prostate cancer.

Sounds unlikely I agree so can anybody confirm or rebut.

 

[John49]

On 4/4/2024 at 2:24 PM, DaLa said:

Have to agree with  this and just to add, my PSA was 24 and Gleeson 9 when diagnosed. I am being treated by both the Urologist and the Radiotherapist specialists at Siriraj and the latter would not suggest the brachytherapy thus it was 28 shots on the Linac (1.5T 7MV) , which is the only one of its kind in South East Asia. I will never know whether the other options would have been more successful or create less after effects. My experience led to complications with my bowel and bladder that have since ( 2 months after completing treatment) have resolved to nearly 'normal' although the 3-4 bathroom visits a night are still required. Cost wise , all in was £10k and the level of care, equipment and surroundings although a public hospital felt like a private hospital. More importantly my PSA last measured at 0.6 although I haven't had any further scans to advise on the cancer cells, however the radiologist advised the 'shots' were accurate and were having the correct impact. I'm as strong now as I was before treatment, eating well and have put on 3 kilos, possibly due to the hormone treatments; which are fun with hot flashes in this heat. There's more if you want, but that's it in a nut shell, good luck with whatever course you choose.

 

I met with two separate doctors at Siriraj Private and decided to go with radiation treatment, rather than surgery.

Next week, I will have a 3 hour simulation procedure and then (after 2 weeks) 5 radiation treatments over 10 days.

They did not insist on hormone treatment, at this stage.

The machine is a MR Linac and the machine is located in Siriraj Public (not Private).

 

When I look at your case and mine there is quite a difference, especially on the type of machine (?) and number of treatments, and with your machine being located in Siriraj Private?

Maybe they have two machines, one new and one older?

 

I visited Siriraj Public to register and meet the doctor there.

This was on referral from the radiation specialist doctor at Siriraj Private.

(BTW, this was not because I said I was looking for a cheaper solution, etc. I fully expected treatment at Siriraj Private.)

 

Siriraj Public is really overwhelming with it’s large size and equally large number of patients.

Plus, the Out Patients Department (for registration, pharmacy and payments?) is undergoing renovation and was pretty chaotic, with dozens and dozens of patients waiting on trollies, I felt for a moment that I was in Gaza.

 

This did give me some second thoughts but I’ve decided to go ahead as the MR Linac is the right kind of machine, and I don’t want to incur further delay trying to find other hospitals/treatments.

[John49]

On 4/4/2024 at 2:24 PM, DaLa said:

Have to agree with  this and just to add, my PSA was 24 and Gleeson 9 when diagnosed. I am being treated by both the Urologist and the Radiotherapist specialists at Siriraj and the latter would not suggest the brachytherapy thus it was 28 shots on the Linac (1.5T 7MV) , which is the only one of its kind in South East Asia. I will never know whether the other options would have been more successful or create less after effects. My experience led to complications with my bowel and bladder that have since ( 2 months after completing treatment) have resolved to nearly 'normal' although the 3-4 bathroom visits a night are still required. Cost wise , all in was £10k and the level of care, equipment and surroundings although a public hospital felt like a private hospital. More importantly my PSA last measured at 0.6 although I haven't had any further scans to advise on the cancer cells, however the radiologist advised the 'shots' were accurate and were having the correct impact. I'm as strong now as I was before treatment, eating well and have put on 3 kilos, possibly due to the hormone treatments; which are fun with hot flashes in this heat. There's more if you want, but that's it in a nut shell, good luck with whatever course you choose.

 

I met with two separate doctors at Siriraj Private and decided to go with radiation treatment, rather than surgery.

Next week, I will have a 3 hour simulation procedure and then (after 2 weeks) 5 radiation treatments over 10 days.

They did not insist on hormone treatment, at this stage.

The machine is a MR Linac and the machine is located in Siriraj Public (not Private).

 

When I look at your case and mine there is quite a difference, especially on the type of machine (?) and number of treatments, and with your machine being located in Siriraj Private?

Maybe they have two machines, one new and one older?

 

I visited Siriraj Public to register and meet the doctor there.

This was on referral from the radiation specialist doctor at Siriraj Private.

(BTW, this was not because I said I was looking for a cheaper solution, etc. I fully expected treatment at Siriraj Private.)

 

Siriraj Public is really overwhelming with it’s large size and equally large number of patients.

Plus, the Out Patients Department (for registration, pharmacy and payments?) is undergoing renovation and was pretty chaotic, with dozens and dozens of patients waiting on trollies, I felt for a moment that I was in Gaza.

 

This did give me some second thoughts but I’ve decided to go ahead as the MR Linac is the right kind of machine, and I don’t want to incur further delay trying to find other hospitals/treatments.

[Sheryl]

9 hours ago, John49 said:

 

I met with two separate doctors at Siriraj Private and decided to go with radiation treatment, rather than surgery.

Next week, I will have a 3 hour simulation procedure and then (after 2 weeks) 5 radiation treatments over 10 days.

They did not insist on hormone treatment, at this stage.

The machine is a MR Linac and the machine is located in Siriraj Public (not Private).

 

When I look at your case and mine there is quite a difference, especially on the type of machine (?) and number of treatments, and with your machine being located in Siriraj Private?

Maybe they have two machines, one new and one older?

 

I visited Siriraj Public to register and meet the doctor there.

This was on referral from the radiation specialist doctor at Siriraj Private.

(BTW, this was not because I said I was looking for a cheaper solution, etc. I fully expected treatment at Siriraj Private.)

 

Siriraj Public is really overwhelming with it’s large size and equally large number of patients.

Plus, the Out Patients Department (for registration, pharmacy and payments?) is undergoing renovation and was pretty chaotic, with dozens and dozens of patients waiting on trollies, I felt for a moment that I was in Gaza.

 

This did give me some second thoughts but I’ve decided to go ahead as the MR Linac is the right kind of machine, and I don’t want to incur further delay trying to find other hospitals/treatments.

The Siriraj public channel is more crowded and less convenient but quality is fine and equipment is top notch. 

 

If the radiation specialist at the private wing advised you to have the treatments done in the public, I think you can trust that. He knows what regimen/machine best meets your needs. 

[Negita43]

On 4/3/2024 at 2:37 PM, Negita43 said:

I'm 80 my PSA was 46 had a biopsy in a Government hospital (Korat)  - Biopsy showed Cancer restricted to prostrate  only. Gleason 3+4

Finish my radiation on friday Varian Halcyon Linac Device - very few side effects - some restriction of urine flow not serious - but more frequent

But my hormone treatment started 6 weeks ago.

Total cost so far about £10K I am impressed with this hospital.

Just to conclude my post - PSA yesterday O.4 (1 month later)  - watchful waiting (and I was watchful waiting for 20 years - my PSA in 2000 was 7) and then action when required pays of!!

[Ben Zioner]

On 4/28/2024 at 2:36 PM, John49 said:

met with two separate doctors at Siriraj Private and decided to go with radiation treatment, rather than surgery.

Next week, I will have a 3 hour simulation procedure and then (after 2 weeks) 5 radiation treatments over 10 days.

They did not insist on hormone treatment, at this stage.

The machine is a MR Linac and the machine is located in Siriraj Public (not Private).

Thanks for that info I didn't know that hyper fractioned RT was available in Thailand.

[Ben Zioner]

35 minutes ago, Ben Zioner said:

Thanks for that info I didn't know that hyper fractioned RT was available in Thailand.

Sorry, I meant Hypo, actually 5 sessions is  "extreme hypofractionated".

[Ben Zioner]

1 hour ago, Negita43 said:

Just to conclude my post - PSA yesterday O.4 (1 month later)  - watchful waiting (and I was watchful waiting for 20 years - my PSA in 2000 was 7) and then action when required pays of!!

Congratulations, I have been on active surveillance for 6 years now, it would be great to do as well a you.