Prostate Cancer Treatment

[henrylao]

Hi

I have recently been diagnosed with Prostate Cancer (PSA 5.3, Gleason 3+3). I tend having a radical prostatectomy preferably with DaVinci Technology in Bangkok. Is there anyone who can give me some advise to whom to talk or who can share some experiences?

Thx

henrylao

[Sheryl]

In terms of doctors, Dr. Thanoo at Samitivej and Dr. Viroj at Bunrumgrad are both highly recommended. See also the pinned thread on urologists in Bkk.

A number of TV members have been treated for prostate cancer in recent years. See these threads and perhaps PM some of the posters:

The robotic technique to which you refer was introduced in Thailand by Dr. Sittiporn Srinualad, a Prof at Siriraj who also has private consultations at Bumrungrad. AFAIK he and his team at Siriraj are the only ones doing it. Not suitable for everyone and I don’t know how many cases they’ve done, be sure to ask as the experience of the person using the machine is quite important.

There are a number of factors to consider in making your final choice so I’d advise consulting 2-3 different doctors before settling on procedure and surgeon.

[henrylao]

Thx for that, that is helpful.

I am really looking for Bangkok specific information as my insurance will not pay for costs in my home country, so I need to find the best here.

Cheers

henry

[bunnaag]

not so hasty.Your Cleason score is not over 6.Did you check the PSA value a few times over the last few years or was it the first time the PSA was measured?How old are you?What was the clinical value?From this value one also can determine how agressive the cancer is.How experienced is the pathologist who checked the samples?The Da Vinci method is used in Thailand since about 3 years and I dont think much experience is available not many Thais suffer from prostate cancer.It may be better to wait and check the PSA again in 6 months.

[henrylao]

Hi

I am 46 and my PSA was high for the last 6 years, Biopsy was done at Samitivei. I made the decision to go with surgery, the questions is only which one and where.

Cheers

henrylao

[bunnaag]

Hi

I am 46 and my PSA was high for the last 6 years, Biopsy was done at Samitivei. I made the decision to go with surgery, the questions is only which one and where.

Cheers

henrylao

What was your PSA value 6 years ago?Important is the rate of increase over time to see how agressive the tumor is.Get some more advise.In your age it is not convinient to run around with pampers all the time.Who told you to go with surgery?

[henrylao]

Thanks for the advise, I am in touch with a number of self help groups of men with PC

[tim armstrong]

Hi Henry,

Dr. Thanoo at Samitivej is the man. I'm one of those people Sheryl mentioned. Although I had my treatment done in Australia, I consulted Dr. Thanoo both before and since. He won't try to give you the hard sell on Samitivej, speaks perfect English and is very used to farlang. It's also very easy to get to see him.

I also think you should get his, or another second opinion as your scores may give you more treatment options. But I notice the biopsy was done at Samitivej, so maybe you have already seen him. My treatment for a Gleason score of 4+4 was a combination of hormone therapy and radiotherapy- for 6 weeks. It still is the least invasive approach, with few side effects.

Treatment options still mostly seem to depend on whether/not the cancer is localised, has spread,or has that potential. Support groups may be useful, but your condition is unique to you, so go with professional advice based on the best investigations you can get. I don't know your nationality, but treatment is free in OZ and I think also in the UK. Best of luck with it.

[henrylao]

Hi

have taken a out time. Due to another medical problem I was evacuated to Bumrungrad on Tuesday and had my 3rd surgery within three weeks yesterday.

So next week I will think about cancer again.

Cheers

henry

[Sheryl]

Good gracious!

Hope all went well and that you recover without incident.

[billinparadise]

Hi have you thought about the Green Laser ? A friend of mine had it done in Australia and was very succesfull and non invasive ,,get more opinions before making a final decision

[Artabus]

Hi

have taken a out time. Due to another medical problem I was evacuated to Bumrungrad on Tuesday and had my 3rd surgery within three weeks yesterday.

So next week I will think about cancer again.

Cheers

henry

Hello Henry

First off - sorry to hear about your troubles. It must be a hard time for you.

As some of the other posters are indicating - there are options other than surgery. Are you aware that surgical and non-surgical treatments give similar outcome rates for prostate cancer sufferers? You risk impotence with surgery, and prostate cancer can be managed in other ways. Are you quite certain that, when taking into account the specifics of your case, surgery will give you the best long term prognosis?

I have had two friends with prostate cancer - neither went the surgery route; both are still here. One has lived with his condition for ten years, the other found it went.

I also have personal experience of Bumrungrad; if you would like further info with regard to that, please feel free to PM me.

Not preaching to you, please understand that, just asking you to research - if you have not - clinical outcomes in other countries from different methods. I wish you all the best whatever choice you make.

[henrylao]

Ok

I have now consulted with Dr. Thanoo at Samitivej and Dr. Viroj at Bunrumgrad and Dr. Sittiporn Srinualad,And most likely I will go for the robotic surgey only avaialble at at Siriraj. Dr. Thanoo does not do prostate surgery any more due to his age, but believes that this is the best option. Dr Viroj seems to be a very competent urologist however he only has done about 100 prostate surgeries.He recommended the upon surgery. Dr Sittiporn has done 250 robotic surgeries so far and through our conversations it seems to me that he is the one with the most up to date knowledge in this area (e.g. the only one not recommending bone scan).

Thanks so much for your assistance and concern. I am 46 years old and have a family, my main objective is to survive and I choose the option which seems to offer the best chances. This does not mean that other options are not as good, but I can't find proof that the have the same success rates.

Cheers

henry

[Sheryl]

Dear Henry,

Thank you for the update. You have clearly gotten expert advice from 3 separate, top notch specialists and made a well-informed choice. All the best on your surgery, and please let us know how it goes.

To all the well meaning posters who have tried to dissuade this man from surgery:

- not all prostate cancers, and not all patients with prostate cancer, are the same. This man has had a biopsy and consulted not one but at least 3 different specialists. There is consensus that given his young age and his particular cancer, surgery offers him the best chance of cure. At age 46 the chances of dying of prostate cancer -- even if it is a comparatively slow growing tumor, which we do not know to be the case -- are considerably higher than it is in older men.

- prostate surgery does not inevitably lead to incontinence or impotence. Especially when nerve sparing techniques are used. The particular type of surgery he has decided upon is minimally invasive and has a particularly low rate of long-term incontinence and impotence. Not a zero rate, and the poster clearly realizes that these are risks, but the majority of patients having this particular type of surgery do regain normal bladder control and sexual function.

[henrylao]

[Ok, my surgery is schedule for 1st December at Mahadol University, in the 84th Anniversary Building 8th Floor. Anyone out there with experience who can share with me the level of care and comfort?

[mugopp]

Ok

I have now consulted with Dr. Thanoo at Samitivej and Dr. Viroj at Bunrumgrad and Dr. Sittiporn Srinualad,And most likely I will go for the robotic surgey only avaialble at at Siriraj. Dr. Thanoo does not do prostate surgery any more due to his age, but believes that this is the best option. Dr Viroj seems to be a very competent urologist however he only has done about 100 prostate surgeries.He recommended the upon surgery. Dr Sittiporn has done 250 robotic surgeries so far and through our conversations it seems to me that he is the one with the most up to date knowledge in this area (e.g. the only one not recommending bone scan).

Thanks so much for your assistance and concern. I am 46 years old and have a family, my main objective is to survive and I choose the option which seems to offer the best chances. This does not mean that other options are not as good, but I can't find proof that the have the same success rates.

Cheers

henry

If you want, you can contact me. I had the operation done at Siriraj by Sittiporn. Don't think you will like what I have to say.

Cost 110,000 Baht 4 years ago. Gary

[henrylao]

Any one who has experience with Bangkok Hospital? Especially with Dr. Kulwat Prasertsuntarasai or Assoc. Prof. Dr. Sunai Leewansangtong?