Best Medical Facility For Uterine Cancer?

[baccaruda]

Hi, my name's Andy and I'm in Spokane, Washington USA.

I am posting on behalf of an American friend of mine who will be visiting Thailand soon - she is currently teaching English in Nanchang, China.

I have posted regarding this on ajrnforum.net and am condensing the information I received therein for this post. I was directed to find Sheryl here on thaivisa.com for expert advice in choosing a medical facility. From searching the HB&M section here I am optimistic about the advice we hope to get, and thanks in advance.

Here's the situation:

She was recently diagnosed in Nanchang Hospital via ultrasound with a uterine tumor which for obvious reasons should be dealt with fairly soon. She described the hospital and China itself as very dirty and unhygienic; her immune system also isn't the strongest (she suspects a predisposition to lupus). Also, earlier in the USA she had pap smears which revealed abnormal cervical cells which warranted monitoring, but the hospital in nanchang was unable to repeat these test results. I seriously doubt their competency as well as their cleanliness standards (I asked someone I know with teaching experience in both countries and I was told "You may as well operate on yourself" if contemplating surgery in China) and I am trying to guide her toward getting treatment in Thailand by getting this info lined up; I have more internet-ninja skills than her, and more spare time than her as she is in the middle of finals grading and is terrifically stressed out and exhausted from her workload, isolation, and this tumor issue.

Someone suggested that she return back to the USA but the cost of an immediate flight back here is prohibitive; the cost of having this treated in America is REALLY prohibitive - she also told me that she has run afoul of our lovely "pre-existing condition" BS before when seeking health insurance in the US. Having this occur while overseas, while adding to the stress, may be a blessing due to the relatively lower costs for care.

She plans to visit Chiang Mai for her second time soon, and will stay for a month to a month and a half; she is open to getting rediagnosed and having her surgery/treatment while in Chiang Mai but is worried about a NASTY tuberculosis problem reportedly cropping up in Thailand; her mother told her about it 2 days ago over the phone so I could perceive some motherly worry in there. I also feel that a secondary infection is far from impossible in China according to the disgust she felt at the conditions there.

Poster "Killing Me Softly 101" on ajarnforum.net suggested travelling to Bangkok instead of Chiang Mai, particularly to Bangkok Hospital / Wattanosoth Cancer Hospital, or Chulalongkorn; she also linked to a study of cervical cancer at Chulalongkorn which is recruiting participants but I don't know if that's useful yet.

link to page about trial: clinicaltrials.gov/ct2/show/NCT00741533

This is also the person who suggested that I find Sheryl.

I would greatly appreciate information regarding the severity of the tuberculosis situation, regarding specific hospitals in Thailand to seek out or avoid, and regarding the general cleanliness of said hospitals. Thanks a lot.

Any info about antibiotic-resistant tuberculosis in Thailand?

[Sheryl]

There is antibiotic resistant TB in the West too. But the odds of her getting it are minute, here or there. Contrary to what some people think, TB is not that easy to catch, it requires close contact with an infected person usually ovber extended time.

The hygiene in most Thai hospitals is excellent.

You say "uterine tumor", these are most commonly benign meiomas. Is there some reason to believe it is malignant and if so based on what?

In any case I recommend highly Dr. Panon Kasemsorn at Samitivej Hospital in Bangkok. He is a US trained specialist in gyn cancers and very, very good. Samitivej is a top end "international" hospital, very good standrad of care but and should she need surgery would be far from inexpensive. But take it step by step, Dr. Panon will not recommend surgery unless it is absolutely necessary.

If it is and if she cannot afford Samitivej she should ask if he has admitting privileges elsewhere, most doctors have privileges at more than one hospital.

http://www.samitivejhospitals.com/Doctor/D...ctorId=11920221

[baccaruda]

Thank you All that is known is that their ultrasound detected it. I imagine that a biopsy would be performed at some point. The doctor in Nanchang just drew a circle on a piece of paper to indicate the size and, through an interpreter, told her that she needed to have it removed soon if she ever wanted to have children.

I am emailing the link to this thread and will continue to push her toward Bangkok. She has asthma; that coupled with her probable predisposition toward lupus are why she is worried about TB. But as I said, I feel that a secondary infection is far from impossible in Nanchang Hospital.

Sheryl, thank you very much. I will update this thread occasionally as warranted.

Andy

Edited December 30, 2009 by baccaruda

[Sheryl]

Thank you All that is known is that their ultrasound detected it. I imagine that a biopsy would be performed at some point. The doctor in Nanchang just drew a circle on a piece of paper to indicate the size and, through an interpreter, told her that she needed to have it removed soon if she ever wanted to have children.

Andy

It is impossible to tell from this what is going on.

I suggest she bring the ultrsound itself (film or on CD) to an English speaking doctor in Bangkok. Can start with Dr Panon as I recommended but if it is a benign myoma (commonly called "fibroids") then a change of specialists would be in order. Need first to figure out whether this is a suspected malignancy or just a myoma, in which case treatment is only necessary if it is exceedingly large or if she is very symptomatic, and there are both surgical and non-surgical options.

[baccaruda]

I agree; I think I will suggest a new goal for her of getting a biopsy and a diagnosis / Q&A session with an English-speaking specialist. Thank you so much.

It is impossible to tell from this what is going on.

I suggest she bring the ultrsound itself (film or on CD) to an English speaking doctor in Bangkok. Can start with Dr Panon as I recommended but if it is a benign myoma (commonly called "fibroids") then a change of specialists would be in order. Need first to figure out whether this is a suspected malignancy or just a myoma, in which case treatment is only necessary if it is exceedingly large or if she is very symptomatic, and there are both surgical and non-surgical options.

[lioness]

Samitivej is very expensive. Thonburi Nung has an excellent gynacology department and specialist trained in America

speaks English perfectly. I have been more than happy with my treatment and therefore would recommend.