Everything you need to know about blood cancer treatment in Bangkok

[CharlieH]

 

Blood cancer can affect anyone at any moment, and getting a diagnosis can leave us with a million questions swirling in our heads. What treatments are available? How will life change?

But here’s some encouraging news: blood cancer is highly treatable, especially when you catch it early, Dr Udomsak Bunworasate, a haematologist and transplant physician at MedPark Hospital Bangkok, tells The Thaiger. Thanks to the vast improvement in blood cancer treatment, there is reason for optimism. Here’s everything you need to know about blood cancer, its diagnosis, and its treatment.

What is blood cancer?

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Also known as haematologic cancer, blood cancer is a group of cancer that affects your blood cells and typically starts in the bone marrow (the spongy tissue in the centre of your bones where blood cells are produced).

Your normal blood cells have an important role in your body. They carry oxygen, control bleeding, and fight infection. Blood cancers occur when there’s an uncontrolled growth of abnormal blood cells, which interferes with the function of normal blood cells. As a result, you may experience symptoms like persistent fever, fatigue, unusual bleeding or bruising, bone pain, unexplained weight loss, and frequent infections.

Types of blood cancer

 

Dr Bunworasate explains that blood cancers can be categorised into three main types:

 

1. Leukaemia: This type of blood cancer develops when abnormal white blood cells grow out of control. The abnormal amount of white blood cells cannot fight infection and interferes with your bone marrow’s ability to produce red blood cells and platelets. Leukaemia manifests in two forms: acute, which progresses rapidly, and chronic, which advances more slowly. It can impact either lymphocytes (known as lymphocytic leukaemia) or other immune cells (referred to as myeloid leukaemia). It’s the most common blood cancer for children.
2. Lymphoma: Lymphoma is cancer that affects a type of white blood cell known as lymphocytes. Overproduction of cancerous lymphocytes results in their accumulation within the lymph nodes and tissues of the body. This alters the function of your immune system. Lymphoma can be divided into two types, Hodgkin’s and non-Hodgkin’s lymphoma, It’s the most common type of blood cancer in adults.
3. Myeloma: Often called multiple myeloma, this type of blood cancer attacks affects your plasma cell, which is a type of white blood cell that makes antibodies to fight diseases and infections. Since myeloma cells spread through your bone marrow, it can damage your bones and overwhelm your normal blood cells. Myeloma cells also produce antibodies that can’t fight off infection, weakening your immune system and increasing your risk of infection.

How does MedPark Hospital diagnose blood cancers?

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Effective treatment of blood cancer starts with an accurate diagnosis. That’s why MedPark Hospital Bangkok provides high-quality diagnostic tools and skilled medical professionals for their patients.

The medical professionals at MedPark Hospital Bangkok use a test called complete blood count (CBC). This test shows how many white blood cells, red blood cells, and platelets are in your blood. They also perform biopsies to look at your bone marrow by taking a sample to check for normal and abnormal cells. By checking your bone marrow cells’ DNA, they can see if there are any changes that could be causing the cancer to grow.

Cutting-edge diagnostic tools for further investigations

MedPark Hospital Bangkok also uses advanced technologies to figure out exactly what’s going wrong in your body so they can give you the best treatment possible. Dr Bunworasate explains:

“We use state-of-the-art technology, including immunophenotyping, cytogenetics, and molecular genetics studies such as next-generation sequencing. We use these tools to better define diagnosis, prognosis, and define the target for treatment selection for individual patients.”

Immunophenotyping involves examining blood or bone marrow samples to determine if cancerous cells originate from B or T lymphocytes. This helps the medical professionals at the hospital diagnose specific types of leukaemia and lymphoma.

Cytogenetics is another essential tool MedPark Hospital Bangkok uses to study chromosomes in tissue, blood, or bone marrow samples. With cytogenetics, they can identify changes such as broken, rearranged, or extra chromosomes that could indicate genetic diseases or certain types of cancer. Additionally, the hospital’s molecular genetics studies, like Next-Generation Sequencing (NGS), allow them to analyse cancer-related genes and pinpoint specific mutations for targeted therapy.

Radiological testing for more accurate diagnosis

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Imaging scans or radiological testing, such as PET-CT scans, are also used in MedPark Hospital Bangkok. These tests can be more helpful for some types of blood cancer than others. Besides helping diagnose the type of cancer more accurately, these tests can also tell if the cancer has spread to other parts of the body.

But when should you get checked for blood cancers?

Regular check-ups and being proactive about your health are key in catching any potential diseases early on. Be aware of common blood cancer symptoms like fatigue, frequent infections, and unintentional weight loss. While these symptoms may mirror other conditions, it’s a good idea to go see a professional for blood cancer.

How does MedPark Hospital Bangkok treat blood cancers?

Image by Marcelo Leal via Unsplash

When an American tourist experienced a severe relapse of acute myeloid leukaemia during her New Year’s vacation in Thailand, she was referred to MedPark Hospital Bangkok. Despite previous stem cell transplants and the complexity of her condition, the team at MedPark managed to stabilise her infections and acquire a new targeted treatment from abroad. This collaborative effort, involving consultations with specialists from Stanford, resulted in the patient achieving complete remission and returning home safely.

This case demonstrates MedPark Hospital Bangkok’s ability to handle complex and severe cases with a high level of expertise and how they offer a full spectrum of treatment for blood cancer patients.

“We specialise in treating malignant lymphoma, both Hodgkin’s and non-Hodgkin’s lymphoma, as well as acute and chronic leukaemia in both myeloid and lymphoid subtypes, and plasma cell disorders like multiple myeloma,” says Dr Bunworasate.

From traditional methods to innovative therapies

MedPark Hospital Bangkok personalizes blood cancer treatment on a case-by-case basis. They focus on the unique characteristics of each patient, such as the type of cancer, the patient’s age, whether the cancer has spread to other parts of the body, and how fast the cancer is progressing.

Chemotherapy and radiation are the standard treatments and are often the first line of defence against blood cancer. Chemotherapy and radiation are commonly used as initial treatments to treat blood cancer. It involves using drugs to block the growth of cancer cells. Plus, the hospital also offers radiation therapy to destroy cancer cells or alleviate symptoms like pain and discomfort.

Hematopoietic stem cell transplantation is also a treatment option at MedPark Hospital Bangkok. This procedure involves transplanting healthy stem cells into the body to help fight off the cancerous cells effectively. The hospital performs both autologous and allogeneic transplants. An autologous transplant uses the patient’s own stem cell. On the other hand, an allogeneic transplant uses transplants from a donor, either a match-related or unrelated donor.

A multidisciplinary team

Comprehensive care for patients with blood cancer requires a dedicated multidisciplinary team. Blood cancer, affecting the blood and immune system, often leads to compromised immunity. Therefore, blood cancer patients are susceptible to various infections such as bacterial, fungal, or viral.

The medical team at MedPark Hospital Bangkok boasts extensive experience in managing immunocompromised individuals, particularly those undergoing stem cell transplantation. The team includes experts like transplant haematologists and infectious disease doctors who are well-versed in treating these complex cases. They also have BMT (bone marrow transplant) nurses and healthcare professionals.

Moreover, the multidisciplinary team also work together to take care of complex cases such as patients with multiple cancers. So in addition to haematologists, infectious disease doctors, and BMT nurses, the team also includes medical oncologists, radiation oncologists, diagnostic radiologists, interventional radiologists, surgeons, pathologists, geneticists, and oncology nurses.

A very safe and supportive environment

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“Dealing with blood cancer is a very difficult journey. That’s why we try as much as we can to give a positive experience during our patients’ treatment. We believe that we are able to give the best treatment with fewer side effects and take care of our patients until they can hopefully live a long and healthy life,” says Dr Bunwarosate.

MedPark Hospital Bangkok’s state-of-the-art facility boasts the latest technology to provide top-notch treatment and support for those battling this challenging disease.

One of their key offerings is their blood bank facility, which ensures access to crucial blood products, including irradiated options, 24 hours a day. In addition to the advanced medical services, MedPark Hospital also prioritises the safety and well-being of their patients. To create a safe environment for immunocompromised individuals, they have implemented various measures such as HEPA filters and positive pressure systems, as well as precise temperature and humidity controls in patient transplant rooms.

Although the thought of having cancer can be scary, detecting blood cancer early gives you a better chance of successful treatment. The renowned medical professionals at MedPark Hospital Bangkok are equipped to provide expert care and support if needed. Remember that a diagnosis of blood cancer doesn’t mean the end – many people with this condition achieve remission and live long, healthy lives.

Apart from blood cancer, Dr Bunworasate and the skilled haematology team at MedPark Hospital Bangkok also treat a wide range of blood disorders. These include conditions like anaemia, thalassemia, sickle cell disorder, various white cell disorders, and platelet disorders. They are also proficient in managing bone marrow disorders and issues related to blood clotting and bleeding abnormalities.

 

If you or a loved one is facing a blood disorder, visit MedPark Hospital Bangkok’s website to learn more about their services and get in touch with the team today.

Get expert guidance on Blood Cancer Treatment at MedPark Hospital Bangkok

 

 

 

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[John49]

The bad news about blood cancer treatments is the high cost.

The imported drugs are mostly very expensive and may well be justified on the high cost of research and development.

 

My personal experience here in Thailand was that one blood cancer drug that is already available generically, was sold to me at 95% of original manufacturer price, yet it was actually a much cheaper generic sourced from India.

This was at a public hospital.

Later, I ordered directly from India at a much, much lower price.

 

Some months earlier, I made an appointment at one of Bangkok lesser known private hospitals, one of several offering blood cancer treatments.

The appointment was for 4pm and I had like 20 people in front of me.

The doctor had still not arrived at 5.30pm, so I left.

At about 7pm that night, I had a call from the doctor apologising for being late.

The doctor wanted me to visit again as he had the latest drug treatment that showed great promise.

 

I was already well aware of the drug and the astronomical cost, so I declined.

I had already had a similar experience a month earlier in Singapore where the doctor got quite excited that he could put a new patient on this latest expensive drug “until disease progression” i.e. when the drug stops working, and could potentially involve years of treatment with the new drug.

 

I appreciate the above informative and useful post, drawing attention to treatment options.

I wanted to add comment about my personal experience of the high costs involved.

Also, I believe a number of hospitals offer similar blood disorder treatments, partly as it’s a great money spinner involving very expensive imported drugs and I believe low capital investment costs in set-up.

Of course, at the same time, it does offer patients hope and respite, with a possible cure in a some cases – important when suffering from a potentially terminal disease like cancer.

 

[Srikcir]

On 6/26/2024 at 11:06 AM, John49 said:

Later, I ordered directly from India at a much, much lower price.

American Mark Cuban's costplusdrugs.com sells Imatinib 400mg 60 count tablets from Aurbindo in India for about $65 that includes 15% markup and pharmacy labor. US Retail price at other US pharmacies is about $19,500. Catch is that Cuban must receive prescription from a US doctor and drug mailed to a US address after online payment.

 

Thailand has very restrictive laws about importing medications. I wasn't aware that an individual in Thailand can order directly from a foreign pharma and receive directly in Thailand. Some foreign pharma's have Thai partners in Thailand through which orders can be placed that is in compliance with Thai FDA. Even Thai hospitals must order through the government for foreign drugs such as covid vaccines.

To that end I'd like to know how you can make a personal direct order to a foreign pharma from Thailand.

[John49]

Limited quantities of drugs for personal use can be purchased from IndiaMart, for delivery in Thailand.

For more information:

https://aseannow.com/topic/1326443-buy-medicines-from-indiamart-possible-legal/

 

There are a few other threads in AN that discuss similar issues.

 

These drugs purchased from third parties via IndiaMart are produced in India by well established Indian companies like Dr Reddy and Cipla, etc.

 

Of course, the ones that are the ‘best buys’ are the drugs produced by Indian companies that received permission to produce generics in India.

Can be dramatically cheaper than original manufactures products available for purchase in Western countries.

 

However, I believe that only a few drugs for cancer patients are available as generics (?).

Western pharmaceutical companies only give permission for others to produce generics after the drugs have been in the market for many years (?).

The latest and usually the most effective drugs, are not yet available as generics.

[FritsSikkink]

8 minutes ago, John49 said:

Limited quantities of drugs for personal use can be purchased from IndiaMart, for delivery in Thailand.

For more information:

https://aseannow.com/topic/1326443-buy-medicines-from-indiamart-possible-legal/

 

There are a few other threads in AN that discuss similar issues.

 

These drugs purchased from third parties via IndiaMart are produced in India by well established Indian companies like Dr Reddy and Cipla, etc.

 

Of course, the ones that are the ‘best buys’ are the drugs produced by Indian companies that received permission to produce generics in India.

Can be dramatically cheaper than original manufactures products available for purchase in Western countries.

 

However, I believe that only a few drugs for cancer patients are available as generics (?).

Western pharmaceutical companies only give permission for others to produce generics after the drugs have been in the market for many years (?).

The latest and usually the most effective drugs, are not yet available as generics.

From that link by Sheryl:

"It is illegal to import any sort of medication without an FDA license. That said, small quantities of non-controlled drugs often (but not always) get through if sent by regular mail (never ever use a courier -- and never try this with a controlled drug). Some Indian suppliers are apparently knowledgeable about how best to ship to Thailand, but I do not offhand know which."

[John49]

After payment of an importation tax, Thai customs have always handed over my limited quantities drugs for personal use, without any mention of licenses or illegality.

 

One time, they did say that next time they would want to see my Thai doctor’s script.

I do have a Thai doctor’s script as backup.

I did not have it with me as it’s not been asked for previously.

 

If I imported a pallet full of drugs (obviously commercial, not for personal use) then I believe the drugs would be held back until an import license was produced.

 

Living in Thailand, we learn how to evaluate risk?

Sometimes I get nervous walking on the pavement with my back to the traffic.

 

Need for the drugs plus major cost savings, balanced against potentially forfeiture of the drugs. 

For me, it was an easy, sound decision.

[FritsSikkink]

5 minutes ago, John49 said:

After payment of an importation tax, Thai customs have always handed over my limited quantities drugs for personal use, without any mention of licenses or illegality.

 

One time, they did say that next time they would want to see my Thai doctor’s script.

I do have a Thai doctor’s script as backup.

I did not have it with me as it’s not been asked for previously.

 

If I imported a pallet full of drugs (obviously commercial, not for personal use) then I believe the drugs would be held back until an import license was produced.

 

Living in Thailand, we learn how to evaluate risk?

Sometimes I get nervous walking on the pavement with my back to the traffic.

 

Need for the drugs plus major cost savings, balanced against potentially forfeiture of the drugs. 

For me, it was an easy, sound decision.

"Under section 12 of the Drugs Act, B.E. 2510 (1967), no person shall manufacture, sell, import or order into the kingdom any modern drug unless such person receives a license from the licensing authority. Thus, bringing drugs or ordering drugs to be shipped into Thailand by post is not allowed."

and

"In the case of a traveler traveling into Thailand, you may bring with you any modern drug for personal use for no longer than 30 days according to section 13 (4) of the Drugs Act, B.E. 2510 (1967) and its amendments. The drug should be kept in its original container and should be accompanied by its prescription from the doctor."

 

FDA THAI : Food and Drug Administration, Thailand (moph.go.th)

 

 

[John49]

Speaking about Thai law in general, I have heard it said many times that "prostitution is not legal and does not exist in Thailand".

 

There can be a disparity between law and reality.

[Sheryl]

2 hours ago, John49 said:

After payment of an importation tax, Thai customs have always handed over my limited quantities drugs for personal use, without any mention of licenses or illegality.

 

One time, they did say that next time they would want to see my Thai doctor’s script.

I do have a Thai doctor’s script as backup.

I did not have it with me as it’s not been asked for previously.

 

If I imported a pallet full of drugs (obviously commercial, not for personal use) then I believe the drugs would be held back until an import license 

 

Nothing in the law allows you to import medications if you have a prescription from a Thai doctor. This is just a customs official making up his own rules (not unusual in Thailand).

 

If sent by regular mail  small quantities of medications usually get through, often without even an import tax. No guarsntee, but so far this had largely been people,'s experience.

 

Use of a courier like Fedex or DHL  on the other hand, guarantees problems and they will insist on FDA licence. Never use a courier. 

 

Indian companies that regularly ship to Thailand know this. 

[Srikcir]

On 6/26/2024 at 11:06 AM, John49 said:

yet it was actually a much cheaper generic sourced from India

My.indiamart.com

A commercial platform in India for pharmaceuticals that sell a wide range of generic cancer medications. Typically up to 90% cheaper than from a Thai retail supplier. 

[Lacessit]

Part of my treatment for non-Hodgkin's lymphoma and chronic lymphocytic leukemia was a drug called Venetoclax.

 

In Australia, the subsidized medication scheme ( PBS ) meant a month's supply cost AUD 7.50.

 

IIRC Sheryl told me the same drug is USD 7000 per month in America, and it was not available in Thailand.

 

That was about 18 months ago, treatment options may have changed in Thailand. I doubt the costs have.