Folfox 4 Chemo

[wcr]

Dear forum,

I was diagnosed with colon cancer and had the tumor cut out in a standard colon cancer op in November last year. I was told I was at stage 2, no spread of the cancer into other organs or lymph nodes.

I have been to see the oncologist at Bangkok Pattaya Hospital who recommended Folfox 4 chemotherepy. This is every 2 weeks and involves a 3 day stay in hospital and last for 12 cycles. They quoted me a whopping 120,000 Baht per cycle.

I went to see an oncologist at the Chonburi Cancer Centre. He also said that Folfox 4 was the correct chemo for me and quoted a price of 60,000 Baht per cycle. He also said that as stage 2, he thought it wasn't neccessary to have chemo. If money wasn't a problem then I should consider having it, but there was mixed opinions from doctors about if it would benefit me or not at stage 2.

I have read a recent report on the internet about the trail results for Folfox 4 on 5 year and 6 year survival rates. It says that for stage 2 cancer the survival rate goes up by an average 3.8% and for a high risk stage 2 cancer up by 7%, the same as the stage 3 results. I don't know if I am a high risk stage 2. It also says that it dosen't recommend Folfox 4 chemo for non high risk stage 2.

So, I am interested if anyone else here has been through this. Do you know what a high risk stage 2 is? I frankly don't trust Bangkok Pattaya Hospital in their advice. I could return home (UK) and receive the treatment for free (if they recommend it).

[Mobi]

WCR, I am so sorry to read about all your problems.

I have no answers, but considering the ongoing 'legal' problems you have posted about in the Pattaya forum, I suggest that it may be time to get on a plane and return to the UK for treatment.

However, before doing so, please ensure that under current regulations regarding expats who have been out of the UK for more than 3 months, that you will be accepted under the NHS. Do you still maintain a UK address, and are you registered with a GP there? If not you may have problems. I don't think they will refuse to treat you, but you may end up with yet another bill.

[Tammi]

Sorry to hear this.

I would recommend taking one more opinion at Bumrungrad Hospital - you don't need to mention the 2 opinions already got - then go with the cheapest. Put together a list of all the questions you want answers to - much like you have asked above. Dr. Narin Voravud at Bumrungrad is very good.

Which cancer marker (blood test) did Pattaya hospital do? Was it raised or within normal limits? I ask because I have known oncologist to test CEA and even though normal not do the other cancer markers and I think not doing them is a big mistake.

And for everybody else reading this - please get health insurance if at all possible. Cancer treatments can run into millions of baht over just a couple of years. 12 million baht s not unusual.

Edited January 19, 2008 by Tammi

[taxexile]

ask your doctor about the possibility of him referring you personally to chulalongkorn cancer centre in bangkok.

my mother in law , diagnosed and operated on for breast cancer at bumrungrad , was recommended a long course of chemo to follow the surgery. the costs would have been enormous , and after discussing this with the doctor he referred her to chula , where she is receiving the same treatment for 1/3 of the cost.

wishing you a full recovery.

[Sheryl]

As far as I know this is all from one recent study, which you can review here:

http://www.medscape.com/viewarticle/567716

You will note that the conclusions are still somewhat tentative.

Between this and the fact that the data suggest a comparatively small benefit, cannopt assume NHS will pay for it. Better checvk first before flying home.

Good luck. As you no doubt know, with only stage 2 cancer you have reason to be hopeful so stay positive.