Isaan network hailed as model for faster cancer treatment

[Lite Beer]

HEALTH
Isaan network hailed as model for faster cancer treatment
Wanwisa Putnak
The Sunday Nation

BANGKOK: -- The National Health Security Office (NHSO) has joined forces with the Public Health Ministry to develop a network for cancer patients' care to boost access to treatment by cutting waiting time for radiation and chemotherapy.

The public health region 10 - covering Ubon Ratchathani, Si Sa Ket, Yasothon, Amnat Charoen, and Mukdahan - was hailed as a model for fast and complete cancer treatment.

NHSO chief Winai Sawasdivorn recently led a media tour to show care for cancer patients at Ubon Ratchathani Cancer Centre and Sunpasitthi Prasong Hospital. He also led a visit to a screening unit for cholangio-carcinoma, run in cooperation with Muang Si Sa Ket Municipality.

Winai said cancer had been the top cause of death in Thailand since 1999 and in 2011 alone there were 150 cancer patients per 100,000 people. While liver and lung cancer were found the most among Thai males, cervical and lung cancer were most common among women, he said.

The World Health Organisation (WHO) expects Thailand to have 148,729 new cancer patients with 95,804 cancer deaths by 2020. In 2030, WHO expects Thailand to have 176,301 new cancer patients with 120,689 deaths.

In view of this, the NHSO and the Health Ministry developed the cancer network among hospitals to treat patients close to their homes, starting from screening, initial diagnosis, patient referral and palliative care for the terminally ill, he said.

The current rate of chemotherapy treatment was at 90 per cent while patients could be referred and wait up to two months for radiation, Winai said. There were 35 tertiary hospitals for cancer treatment in the NHSO system, he said.

The Northeast suffers most from cholangio-carcinoma with 10,000 patients a year, but only 300 can get surgery because it can take up to eight hours. So, the network was necessary to boost the hospitals' strength and resources to heal patients, he said.

Sunpasitthi Prasong Hospital expert Dr Kanokwan Mingkwan said liver cancer and cholangio-carcinoma were the health region 10's top causes of death, and had increased every year from 33.5 deaths per 100,000 people in 2007 to nearly 43 deaths per 100,000 people in 2010.

Kanokwan said each treatment was complicated and needed high technology, tools, expensive drugs, and experts. Sunpasitthi Prasong Hospital was well equipped for surgery, chemotherapy and nuclear medicine, while Ubon Ratchathani Cancer Centre was well place for chemotherapy, radiotherapy, palliative care and surgery for some diseases.

So, to get complete treatment in one area, patients needed to be referred among hospitals. Ubon Ratchathani set up a cancer network in 2004, which expanded to the other four provinces, she said. The provincial network reduced the referral rate outside the province from 89 cases in 2011 to 55 in 2012 and cut waiting time for surgery from 7-14 days to two to three days.

Dr Pongsathon Soopa-atakon from Ubon Ratchathani Cancer Centre's radiotherapy department said cooperation with Sunpasitthi Prasong Hospital saw 30 patients get operations between January 1 and June 30. The patients could opt for some cancer surgery at a hospital near home with an expert before receiving chemotherapy and radiation treatment at the two facilities.

Medical services closer to home

There was also an emergency patient referral system for radiotherapy within one to three days, while the nuclear medicine treatment also had a "fast track" that reduced patients' waiting time from one month to 7 days.

Terminally ill patients also received palliative care near home, which was convenient, fast and cut the cost for patients, he said. In 2012, there were 900 patients getting palliative care, which also got cooperation from local administrative organisations.

Ubon Ratchathani Cancer Centre nurse Nantiya Keawwongsa said there were about 90 palliative-care patients under one hospital and this centre also did house calls within a 50km radius. She cited a 62-year-old patient who had breast cancer that spread to bones, so she had got morphine (liquid) and capsules at home when she was in pain.

Nantiya said that the hospital also lent oxygen cylinders, suction machines and beds to patients, while hospital staff also ensured that tools were used properly and provided basic health checks and blood pressure before submitting patients' information to the near-home hospital and the network's hospitals could get the patients' data.

Ubon Ratchathani Cancer Centre and Sunpasitthi Prasong Hospital also acted as the network's servers, supporting other hospitals in the network in terms of medicine, tools, modern technologies and experts.

-- The Nation 2013-09-08

[AryanicAristocrat]

The actual figures of people dying from cancer in Thailand is actually much much higher. In many government hospitals, doctors usually do not even ask the patients to do the necessary cancer screening tests when symptoms are apparent and instead ask them to come back in six months or a year when everythig has become full blown and then they tell you how much time you have left and its best to just wait at home and die! Really.

Interesting is to check on the food supply chain in Thailand to find out why more thais are dying from cancer. They are many well connected Thai Chinese food companies that are controlling market monopilies that are behind this as they get away with many things. The Ministry Of Public Health is so so corrupted at all levels and is being run by buffons.

[RickeyParkany]

...playing to the Kon Thai strength: *Networking*! nice... ;-} rap.

[noitom]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

[clockman]

Do not eat anything advertised on tv, or sold in 7-11. its all junk food

[ginjag]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

Most Issan people are classed the same as Laos. Thai look upon Laos as a lower class community less educated and having a dialect different to the normal Thai.

Even Issan people do not like to admit they are similar to Laos because they are aware of the attitude towards them.

It takes something important to put Issan in the limelight, but not forget, without this area this government would NOT be in office, it is only needed when elections are due.

There are many good examples coming out of Issan, one other is the teaching hospital at Khon Khen where for example for a government hospital the orthopedic surgeon teaches world surgeons the best techniques in that field, and one day a week he actually is on duty (Friday) and sees off the street patients.

[zydeco]

The actual figures of people dying from cancer in Thailand is actually much much higher. In many government hospitals, doctors usually do not even ask the patients to do the necessary cancer screening tests when symptoms are apparent and instead ask them to come back in six months or a year when everythig has become full blown and then they tell you how much time you have left and its best to just wait at home and die! Really.

Interesting is to check on the food supply chain in Thailand to find out why more thais are dying from cancer. They are many well connected Thai Chinese food companies that are controlling market monopilies that are behind this as they get away with many things. The Ministry Of Public Health is so so corrupted at all levels and is being run by buffons.

Think of the overuse of pesticides and fertilizers. And also think back to the 2011 flood. Flood water overflowed all those industrial estates upriver from Bangkok. And the water settled all around Bangkok for two months. What was in that water? Heavy metals? Industrial lubricants? Oil? God knows. Just how poisoned might the land be?

[Bagwan]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

Most Issan people are classed the same as Laos. Thai look upon Laos as a lower class community less educated and having a dialect different to the normal Thai.

Even Issan people do not like to admit they are similar to Laos because they are aware of the attitude towards them.

It takes something important to put Issan in the limelight, but not forget, without this area this government would NOT be in office, it is only needed when elections are due.

There are many good examples coming out of Issan, one other is the teaching hospital at Khon Khen where for example for a government hospital the orthopedic surgeon teaches world surgeons the best techniques in that field, and one day a week he actually is on duty (Friday) and sees off the street patients.

I wish that I could believe that, but note that this 'eminence' works just one day per week. I have difficulty in swallowing the notion that surgeons from all parts of the World queue up to see the great man at work. In the world that I live in Thai doctors who wish to advance their knowledge go overseas to learn to how to hone their skills; the rest stay here and gouge their patients.

One swallow does not make a summer and overall the picture on health care for the majority in Thailand is a farce.

[hellodolly]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

Well it is also a source of Thaksin power that is why they are rushing treatment for cancer patient's there in Issan and not the South which is a source of power for the Democrats.

[ginjag]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

Most Issan people are classed the same as Laos. Thai look upon Laos as a lower class community less educated and having a dialect different to the normal Thai.

Even Issan people do not like to admit they are similar to Laos because they are aware of the attitude towards them.

It takes something important to put Issan in the limelight, but not forget, without this area this government would NOT be in office, it is only needed when elections are due.

There are many good examples coming out of Issan, one other is the teaching hospital at Khon Khen where for example for a government hospital the orthopedic surgeon teaches world surgeons the best techniques in that field, and one day a week he actually is on duty (Friday) and sees off the street patients.

I wish that I could believe that, but note that this 'eminence' works just one day per week. I have difficulty in swallowing the notion that surgeons from all parts of the World queue up to see the great man at work. In the world that I live in Thai doctors who wish to advance their knowledge go overseas to learn to how to hone their skills; the rest stay here and gouge their patients.

One swallow does not make a summer and overall the picture on health care for the majority in Thailand is a farce.

I didn't say that they "queue up". I said the said man is t the top of his profession in orthopedic surgery, If you cannot believe it is entirely up to you.

I actually saw this man at Khon Khen university hospital, who advised and treated me personally. I was present and during his one day had people from overseas USA, England etc watching him work with outpatients.

Swallow or not swallow this is in your mind. He is one of a multitude over the world that is brilliant in this field, so do not put him down.

When you look at the overall Thai health service, there is a general lack of these people. OK so he is a one off, BUT brilliant.

Look up the work at this teaching hospital, you may be surprised.

I bash things that I think are wrong here. but will defend strongly when in my opinion they are good. You are free to have your opinion, but get involved sometimes and you will maybe change your thinking.

[mackayae]

Liver Flukes are highly prelavent in Issan. They play a significant role in the cause of cancer with many of the patients in the Ubon and Udon cancer hospitals.

[ginjag]

Liver Flukes are highly prelavent in Issan. They play a significant role in the cause of cancer with many of the patients in the Ubon and Udon cancer hospitals.

As a young lad learning my butchering trade, we had to learn about liver flukes,if eaten from an animal and the food is not cooked properly- they live in our intestines and cause considerable damage. Of course there are different types, the main are cattle, pig, sheep when cutting a liver you can find white spots on the liver and flukes within. I doubt there is a check in the slaughter houses here, but certainly NOT a local beast killed in the village, these people eat old worn out sows, buffalo - just take note especially when buying belly pork at 140bht a kilo. just look at the size of the belly--hence OLD SOW. at top prices.

When has anyone grilled local beef--grilled pork, it's mostly as tough as old boot leather

The prices we pay here for pork and beef are way over the top, and in the UK it would be sold for animal by-products. for Thai prices we should be able to buy lean meat, and young and tender.

[Bkungbank]

Thai foods contain many herbs which very good to human body the bad news is they take with alcohol drinks which damage the liver and smoking.

[Bagwan]

rarely is Isaan ever mentioned in this newspaper. As if they aren't part of Thailand.

Most Issan people are classed the same as Laos. Thai look upon Laos as a lower class community less educated and having a dialect different to the normal Thai.

Even Issan people do not like to admit they are similar to Laos because they are aware of the attitude towards them.

It takes something important to put Issan in the limelight, but not forget, without this area this government would NOT be in office, it is only needed when elections are due.

There are many good examples coming out of Issan, one other is the teaching hospital at Khon Khen where for example for a government hospital the orthopedic surgeon teaches world surgeons the best techniques in that field, and one day a week he actually is on duty (Friday) and sees off the street patients.

I wish that I could believe that, but note that this 'eminence' works just one day per week. I have difficulty in swallowing the notion that surgeons from all parts of the World queue up to see the great man at work. In the world that I live in Thai doctors who wish to advance their knowledge go overseas to learn to how to hone their skills; the rest stay here and gouge their patients.

One swallow does not make a summer and overall the picture on health care for the majority in Thailand is a farce.

I didn't say that they "queue up". I said the said man is t the top of his profession in orthopedic surgery, If you cannot believe it is entirely up to you.

I actually saw this man at Khon Khen university hospital, who advised and treated me personally. I was present and during his one day had people from overseas USA, England etc watching him work with outpatients.

Swallow or not swallow this is in your mind. He is one of a multitude over the world that is brilliant in this field, so do not put him down.

When you look at the overall Thai health service, there is a general lack of these people. OK so he is a one off, BUT brilliant.

Look up the work at this teaching hospital, you may be surprised.

I bash things that I think are wrong here. but will defend strongly when in my opinion they are good. You are free to have your opinion, but get involved sometimes and you will maybe change your thinking.

How do you know that this guy is at the top of his profession? Are you a professor of surgery - or just a grateful patient? In the absence of any indication that you are qualified to give an informed opinion I much prefer my own counsel. If there are a multitude of brilliant orthopaedic surgeons in the world why do the less knowledgeable come to Khon Kaen of all places to further their knowledge? Why not consult and learn from somebody in their own country, or somewhere closer to hand. How do I get involved with this, in your opinion, star player? Furthermore for what reason? Should I volunteer to be his gopher? The guy is a surgeon so I trust that you were unconscious when he treated (read operated on) you and you'd be totally unaware who was present at the time.

I recognise that there are many competent doctors in Thailand in whom I would put my trust but the facts are that they are spread very thinly. I am on very good terms with a very highly qualified doctor working at one of the BKK hospitals whom I asked, that given the scandal of university education and the examination farrago, would they say that many Thai doctors are a danger to their patients? The response I received in bald terms was that they thought that I already knew the answer to that. Read what you may into that. I certainly did.

My inclination is to accept that the Government hospital at Khon Kaen has a good reputation and, being the regional hospital, is one of the better hospitals located away from BKK. I am in contact with a guy who is watching his HIV positive wife's health and wellbeing slowly ebb away, primarily because there isn't somebody who knows what they are doing within close distance to his home on the Si Sa Ket/Ubon borders. I made enquiries and found that the nearest competent doctor, there are only a dozen or so in Thailand, operated out of the main Khon Kaen hospital.

If you carefully read what I wrote you may understand that I did not put this particular surgeon down. What I did do was to state that I didn't put any great store by your assessment of his talent and capabilities.

[DeepInTheForest]

Liver Flukes are highly prelavent in Issan. They play a significant role in the cause of cancer with many of the patients in the Ubon and Udon cancer hospitals.

thanks for this tip, mackayae. Wiki says that cholangiocarcinoma is relatively rare in the West-- I had never heard of it before. Its higher incidence in SE Asia may be due to environmental factors.

from wikipedia:

Colonization with the liver flukes Opisthorchis viverrini (found in Thailand, Laos, and Malaysia) or Clonorchis sinensis (found in Japan, Korea, and Vietnam) has been associated with the development of cholangiocarcinoma. Patients with chronic liver disease, whether in the form of viral hepatitis (e.g. hepatitis B or hepatitis C),alcoholic liver disease, or cirrhosis of the liver due to other causes, are at significantly increased risk of cholangiocarcinoma.

http://en.wikipedia.org/wiki/Cholangiocarcinoma

It would seem that there are multiple factors that can increase risk, but liver flukes are prominent among them. (I claim no expertise in this area.)

Edited September 8, 2013 by DeepInTheForest