Just an update to my previous posts - my PSA now < 0.1. I am in the UK at the moment and out of interest just had my hormone injection over here it called prostap in Thailand it's called Enantone BUT both made by the same company (Takeda)

3 hours ago, Negita43 said:

Just an update to my previous posts - my PSA now < 0.1. I am in the UK at the moment and out of interest just had my hormone injection over here it called prostap in Thailand it's called Enantone BUT both made by the same company (Takeda)

 

What you are on is not actually "watchful waiting" then. You are receiving hormone therapy. There is a difference.

18 hours ago, Sheryl said:

 

What you are on is not actually "watchful waiting" then. You are receiving hormone therapy. There is a difference.

If you read my previous posts I believe I said I had had a biopsy and  radiation therapy in Thailand before

On 4/3/2024 at 8:50 PM, Sheryl said:

Rezum does not treat prostate cancer, it is used for benign enlargement. Ditto aquablation which in case is nto available in Thailand.

 

If you opt to remove the prostate, should go for endoscopic robotic approach rather than TURP. Substantially less blood loss and less risk of long term incontinence etc.

 

With Gleason of 7 and assuming PSMA-PET scan is negative,  and prostate not that big, either robotic prostatectomy or radiation treatment could be considered and ultimately your choice. Radiation treatment  has a number of different approaches, brachytherapy (implantation of radiactive pellets directly into the prostate) having the advantage of doing less damage to healthy tissue and also requiring less hospital visits. Main disadvantage of this over robotic prostatectomy is that after some years the cancer may recur whereas prostatectomy is definitive (assuming cancer did not already spread).

 

If at all concerned about cost (as it sounds like you are) I would recommend instead Siriraj hospital's private wing, will be around 25% less than Bumrungrad for same or better quality. I suggest this doctor there:

 

Prof. Sittiporn Srinuluad

https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=246&medical_id=&day=&startTime=&endTime=

 

Prof. Sittiporn also has hours at Thonburi hospital (just 5 minutes away from Siriraj) and MedPark and Bumrungrad (the last 2 being in heart of Bangkok). It can be often be quicker/easier to see him at those places but if you want to go to only one hospital then Siriraj would be the one as some treatments are not available at the other places. Though it will also work fine to see him at differing hospitals, he will remember your case, I did it that way with a friend recently.

 

 

Sheryl, 

Many thanks for the reccomendation of Prof. Sittiporn Sirunulad.  (Siriaj) 

Underwent RARP Dec. 1 /25.  PSMA scan before surgery . No mets. Bx from 2 mos. previous GL 4+4 ,grade 4, left side only, psa 4.8

Post Rarp pathology upped to 4 + 5 Grade 5.  Two months after surgery psa 0.003. ...2.5 months post surgery still some incontinence but progressing well. I am 75 y.o. caucasian. 

Prof. Sittiporn is sharp. 

1 hour ago, erectem said:

Sheryl, 

Many thanks for the reccomendation of Prof. Sittiporn Sirunulad.  (Siriaj) 

Underwent RARP Dec. 1 /25.  PSMA scan before surgery . No mets. Bx from 2 mos. previous GL 4+4 ,grade 4, left side only, psa 4.8

Post Rarp pathology upped to 4 + 5 Grade 5.  Two months after surgery psa 0.003. ...2.5 months post surgery still some incontinence but progressing well. I am 75 y.o. caucasian. 

Prof. Sittiporn is sharp. 

Thanks for the update and glad all went well. Incontinence typically improves with time but may tske many months. 

 

Can I ask the total cost of the surgety? 

On 2/16/2025 at 10:30 PM, Sheryl said:

Thanks for the update and glad all went well. Incontinence typically improves with time but may tske many months. 

 

Can I ask the total cost of the surgety? 

Sheryl,

 

is Sittiporn regarded as best Doctor at Bumrungrad?

Im seeing another Doc tomorrow(Apirak) for initial consulatation as following my 4th MRI TRUS biopsy im now off active surveillance and need treatment(Surgery/radiation)

Any other Docs at Bumrungrad you hear are very good?

i will advise cost of surgery if im informed

thanks

 

9 hours ago, Gabe H Coud said:

Sheryl,

 

is Sittiporn regarded as best Doctor at Bumrungrad?

Im seeing another Doc tomorrow(Apirak) for initial consulatation as following my 4th MRI TRUS biopsy im now off active surveillance and need treatment(Surgery/radiation)

Any other Docs at Bumrungrad you hear are very good?

i will advise cost of surgery if im informed

thanks

 

I would recommend Prof. Sittiporn if you opt for surgery.   Ask specifically about robotic surgery. 

 

He is at several hospitals (Siriraj, Thonburi, MedPark) as well as Bumrungrad so if cost is a constraint might like to have him do it at one of those but need to be sure it has the equipment, you can adk about this when you see him.

 

If you opt for radiation you'll be referred to an intervention radiologist. Prof. Sittiporn can still oversee your progress/follow up.

On 2/16/2025 at 10:30 PM, Sheryl said:

Thanks for the update and glad all went well. Incontinence typically improves with time but may tske many months. 

 

Can I ask the total cost of the surgety? 

surgery at bumrungrad with Dr Apirak costs approx 1 million baht

he said radiation treatment was broadly the same

 

3 hours ago, Gabe H Coud said:

surgery at bumrungrad with Dr Apirak costs approx 1 million baht

he said radiation treatment was broadly the same

 

I assume yhat's ronotic surgery?

 

If cost is a constraint, surgery would probably be a few hundred k less at Siriraj and pethaps 100 - 150k less at Thonburi. May also be s bit less at MedPark.

 

Radiation options are more limited as not all hospitals offer/ have the best equipment but Siriraj  for sure does. 

On 5/9/2025 at 11:31 AM, Sheryl said:

I assume yhat's ronotic surgery?

 

If cost is a constraint, surgery would probably be a few hundred k less at Siriraj and pethaps 100 - 150k less at Thonburi. May also be s bit less at MedPark.

 

Radiation options are more limited as not all hospitals offer/ have the best equipment but Siriraj  for sure does. 

robotic yes

1 hour ago, Gabe H Coud said:

robotic yes

Still seems high. Friend quoted 550k from Siriraj private wing last year. 

On 5/9/2025 at 11:31 AM, Sheryl said:

I assume yhat's ronotic surgery?

 

If cost is a constraint, surgery would probably be a few hundred k less at Siriraj and pethaps 100 - 150k less at Thonburi. May also be s bit less at MedPark.

 

Radiation options are more limited as not all hospitals offer/ have the best equipment but Siriraj  for sure does. 

but where/how does Bumrungrad rank for radiation equipment in your opinin?

15 hours ago, Gabe H Coud said:

but where/how does Bumrungrad rank for radiation equipment in your opinin?

Well equipped

 

But so is Siriraj

 

Thonburi no. Not sure re MedPark. 

 

Siriraj location less convenient though unless you live on that side of the river