Throat Cancer stage IV

[alyx]

Well, as the second part was addressed to me, I guess it was not of interest to anyone else: so thanks for the remaining 50% (I AM JOKING )

More seriously, when it comes to compare cancer centres, the best ones (officially) are in France

Of course French are not prone to mix western and naturopathic medicine

[Lumbini]

Passing this on that I see in front page health section today ...

Fasting Restores Immune System and Mitigates Chemotherapy—Study

A surprising new study out of the University of Southern California has found that routine but limited periods of fasting up to four days at a time restores a damaged immune system by increasing white blood cell count. What’s more even more unexpected is that researchers say that fasting could be most beneficial in people with compromised immune systems, such as cancer patients and people struggling with other diseases that affect crucial cells. Fasting also mitigates the harmful effects of chemotherapy, making the study results particularly significant for cancer patients.

Fasting tells stem cells within the body to begin producing white blood cells, and in this way regenerates a person’s immune system as a whole. This happens because the person’s body is starving and thus, trying to conserve as much energy as possible. A side effect of this energy conservation is the obliteration of old, weak or otherwise damaged immune cells.

Previously, anyone looking to undertake a fast might have been given the advice to embark on a period of no food only if completely healthy. Now, it appears that advice may be incomplete. According to the study, elderly people and people in poor health might be the ones to benefit most from prolonged fasting. However, the researchers warn that any attempts at fasting should still be overseen by a person’s doctor.

The scientists who performed the study say the results are “remarkable” and indeed, the outcome contradicts previous conventional wisdom. Now it appears that fasting restores a damaged immune system and mitigates the harmful effects of chemotherapy. As with most stand-alone studies, more research is needed to determine whether these results can be replicated and therefore scientifically sound.

http://www.viralglobalnews.com/health/fasting-restores-immune-system-mitigates-chemotherapy-study/9039/

What we think we become ...

[alyx]

Allow me to doubt this published so-called trial....my spouse would be back on his feet by now

[Sheryl]

Mass media reports of scientific study findings are almost never accurate. In particular they tend to overstate conclusions.

This is the actual article http://www.cell.com/cell-stem-cell/fulltext/S1934-5909%2814%2900151-9

It was not a trial. It is preliminary research with mostly mice as subjects. So still a long way to go to determine how much it applies to humans. The researchers describe the results as "preliminary results supporting the possibility that these effects can also be translated into effective clinical applications." (italics mine)

Also note that as regards cancer the discussion hinges on whether or not a period of fasting would reduce the temporary suppression of WBCs that is a common side effect of cancer chemotherapy.

Nothing at all to do with curing cancer or changing its course.

[alyx]

I must admit I hadn't read the article ....I am through looking everywhere for hopeful paths, I guess

[Lumbini]

The Gerson Therapy : Gerson Institute

http://gerson.org/gerpress/the-gerson-therapy/?wprptest2=2

What we think we become ...

[alyx]

Well, nothing more than another diet for body conscious healthy candidates, nevertheless interesting approach

[Sheryl]

Several insenstivie posts/posts advicating quack treatments have been removed. Please note Health Forum specific rules:

"2. Quackery and Misinformation: Posters should pay particular attention to forum rule # 1) "You will not use thaivisa.com to post any material which is knowingly or can be reasonably construed as false"....

This will be strictly applied with respect to presentation as fact any statements which are clearly contrary to medical science"

and

"3. "Alternative" vs. Allopathic (Modern) Medicine: It is recognized that there are systems of medicine other than the allopathic and that TV members have the right to avail of these either instead of or in addition to conventional treatments. However, a distinction is made between non-allopathic systems of healing, home remedies, and outright quackery.

o Systems of healing are defined as actual disciplines with an established body of literature, schools of instruction and means of accrediting practitioners. Examples include, but are not necessarily limited to, chiropractic, osteopathy, homeopathy, traditional Chinese Medicine (herbal and acupuncture) etc. As long as not misrepresented as backed by scientific proof which does not in fact exist, there is no objection to the discussion of such alternative or complementary .treatments.

o Home remedies include well-known traditional measures and measures an individual poster has developed through trial and error. As long as presented on the basis of personal experience and not misrepresented as backed by scientific proof which does not in fact exist, there is no objection to the discussion of home remedies.

o Quackery, on the other hand, is defined as claims made for the absolute prevention or cure of disease unrelated to an established discipline (allopathic or otherwise) and unsupported by scientific evidence. These often occur in fads. Use of the forum to promote quack cures will not be tolerated.

Lastly, aggressive attempts to persuade other members to either adapt or abandon alternative vs. modern forms of treatment will not be permitted. Experience has shown that this invariably leads to arguments and flame fests that serve no useful purpose."

http://www.thaivisa.com/forum/topic/224498-health-forum-rules/

The subject of this thread is palliative care of a man with terminal cancer. Attempts to persuade the patient or his wife to seek out unproven therapies and therapies for which there is no scientific base are not only unhelpful, but unintentionally cruel.

[alyx]

I guess that has been answered somewhere but all I can find on this site is related to foreigners....obviously.

When the time comes I will have to deal with the last details.

If death happens in the hospital, I guess I will quickly be told what will be done and in which manner.

But if it happens at home, I am quite clueless.

Of course, I guess that Police will have to be called ( which is kind of a bother to me as I do not want to feel like our home is invaded ) but from there ...... What?

Autopsy ? Which I am not willing to let happen although I might not have any saying about it

Anyone aware of a local company dealing with that? Not the big show, just a simple ceremony ( or no ceremony at all )

Although my spouse has told me on a few occasions he wanted to be buried ( we never had a serious discussion about it, so not sure whether this was definite and now...well, cannot talk about it for several reasons): I know that the Anglican Church on Convent holds the register of the burial plots but I think that option would be quite costly. I will eventually get in touch with them some time next week when I have got more time on my hands

Regarding cremation, I guess that the local temple would do but I really can't imagine myself running around when it happens

If he is buried, well, no problems but if he is cremated am I allowed to keep the ashes ?

Can his family, who hasn't been in touch with him for weeks, could claim them ( it wouldn't be a big deal but I would prefer to know) ?

Any, sound, feedback would be appreciated

Edited June 11, 2014 by alyx

[Sheryl]

Out in the provinces the only thing needed when a Thai national dies at home is a certificate from the village chief and then the Ampur based on that. But Bangkok may be different.

Definitely no autopsy required. if you opt for cremation you can certainly get the ashes to keep (or scatter as you prefer). Burial will be more costly, though in addition to Christian there are some Chinese cemeteries .

As his wife you are the legal next of kin so are the one to authorize whatever arrangements are made, but if you anticipate flak from his family you might want to delay informing him when the time comes. I gather he and they are not that close?

I suggest you contact the following place. Although specializing in expat arrangements (in.c repatriation of remains) they can certainly inform regarding Thai law and also help make arrangements for a Thai, and their "farang" orientation might be comforting for you to deal with and save you from having to run around and try to make arrangements yourself. They are reasonably priced and response to email promptly. Khun Pim speaks very good English. http://www.funeralrepatriation.com/contact

Deaths from cancer are seldom sudden, there is usually ample time to know he is near the end. He'll be completely bedridden and unable to swallow and increasingly unresponsive. At which point he will also need intensive nursing so you might opt to have him hospitalized provided you can get an absolute assurrance that your wishes will be honored re life support etc. Perhaps discuss this with Dr. Laksamee next time you see her.

[cheeryble]

Sorry to say Sheryl my 86 year old friend you gave advice about and Nancy started to help about a pension died recently.

You may remember.....macular degeneration and a host of ailments.

I was called in the middle of the night.

Indeed no policeman was there, I kinda took charge myself, and only the local ambulance crew and I dealt with his body (collapse in bathroom) which indeed had to go to hospital for inspection as a sudden death.

Thanks again to you and Nancy for all your help.

He was unique, a mighty intellect, and knew well some of the notable minds of the twentieth century, Gregory Bateson, Alan Watts, Nisargadatta, Douglas Harding (the Man With No Head), and changed the way people thought.

Sorry to butt into yr thread Alyx but it didn't merit it's own.

Hugh Maclean 1928-2014, who knew Epictetus and Nagarjuna, Hume and Wittgenstein, Gurdjieff and Thomas Traherne like the back of his hand.

Sent from my iPad using ThaiVisa app

Edited June 12, 2014 by cheeryble

[rhythmworx]

Sorry to hear of your loss.

Your friend lived a life of longevity and sounds like an amazing person, anyone on par with people like Alan Watts get my respect.

Condolences to you and his family and friends and may he rest in peace.

[alyx]

Sorry to say Sheryl my 86 year old friend you gave advice about and Nancy started to help about a pension died recently.

You may remember.....macular degeneration and a host of ailments.

I was called in the middle of the night.

Indeed no policeman was there, I kinda took charge myself, and only the local ambulance crew and I dealt with his body (collapse in bathroom) which indeed had to go to hospital for inspection as a sudden death.

Thanks again to you and Nancy for all your help.

He was unique, a mighty intellect, and knew well some of the notable minds of the twentieth century, Gregory Bateson, Alan Watts, Nisargadatta, Douglas Harding (the Man With No Head), and changed the way people thought.

Sorry to butt into yr thread Alyx but it didn't merit it's own.

Hugh Maclean 1928-2014, who knew Epictetus and Nagarjuna, Hume and Wittgenstein, Gurdjieff and Thomas Traherne like the back of his hand.

ImageUploadedByThaivisa Connect Thailand1402592823.581834.jpg

Sent from my iPad using ThaiVisa app

Not at all

On the contrary you have she'd a new light on what I should do if that were to happen at home, answering , by doing so, my latest post

[Sheryl]

His friend was a foreigner, rules are different. In the case of death of a foreigner the body must go to a hospital morgue and cannot be released until the Embassy gives the green light. Thai nationals are a different (and easier) matter.

[alyx]

I understand but the part I am interested in, is the transfer to the hospital which would be better if anything definite happens or is about to happen at home.

Of course cancer's path is tedious and might be lengthy but stroke is a factor not to be neglected

[Sheryl]

You are probably best off calling Bkk Hospital since doctors familiar with his care are there and will easily issue the death certificate.

[alyx]

Ok, but I will have to drive him over there

[Sheryl]

Why? They have ambulance service?

[alyx]

I have always found it faster, although slightly stressful, to drive there myself. The only time I hadn't been able to do so was even more stressful.

Maybe it also provides us with more time together, alone.

[Sheryl]

I thought you were talking about after he had died, or was near the very end. In which case this would hardly apply (and you'd not be able to carry him into the car by yourself).

[alyx]

Actuelly, I was

Some staff would help me to do so as they have done in the past

[fletchsmile]

Hi Alyx

Just monitoring how things were going:

My apologies for raising the following subject as I know it is a difficult time for you both. There's another sensitive issue though I'm not sure if you have given any thought to, and one I'd recommend you give some consideration too. That is writing a will.

Please be aware that in Thailand everything does not go automatically to you as the spouse, as it may do in your home country. Basically it will be shared between you and some form of Thai relatives unless there is a will stating otherwise.

By relatives it is very broad and goes through a whole list: from children, parents, brothers/sisters all the way thru to uncles and aunts. So if no will has been made it is likely you would be sharing his assets (and his share of joint assets) with someone in the family no matter how remote the family connection. These may be neither your wishes nor your husband's

Cancer at least gives you a little time to prepare things. That should include the financial side of things and ensuring any estate/assets are distributed according to your husband's wishes and protecting you financially.

The website link below may be of some use as a starting point

http://www.isaanlawyers.com/Wills%20and%20Estate%20Planning.pdf

My apologies as I say for raising finance at this delicate time, and with the million and one other things you will be dealing with. It is something that is best dealt with in good time though, to ensure your husband's wishes would be carried out, and ensure you are left in the right financial situation.

Best Wishes

Fletch

[Sheryl]

Good point.

[Litlos]

Hi, As I am sitting here feeling morose contemplating the 5 year anniversary of my wife passing due to cancer maybe I can offer something from experience. OK that was in Australia, but I have a reasonably long experience with Thailand, and I think some things probably bridge the cultural divide. Anyway here goes for thoughts for the last few days which seems imminent:

Cancer in the terminal parts of the disease is generally very painful and distressing for the sufferer and the family, in that order, hence a lot of drugs are used to minimise the symptoms. These drugs are used to make the patient as comfortable as can be during the final stages, but will generally make the patient unable to converse with friends and family towards the end. So if you want a question answered do not wait until the last moment as some people apparently do.

Even though the patient may be drugged and comatose they can still hear. So be mindful of this when having conversations nearby. Also go for a coffee or walk occasionally as people tend not to pass when there is someone holding their hand. Not sure on the logic on this, was something I was told by nurses and have observed.

From my understanding of Thai cremations it is expected that the next of kin will claim the ashes the next day. This is what I have seen as recently as 3 days ago and apparently is normal even for foreign resident cremations.

During this period of high stress things tend to be forgotten. Maybe carry a notepad and write things down as you go. In my case it was hide a spare house key, or have the local locksmith on speed dial.

Most importantly look after yourself and take things gently. It will be a confusing time when all pressure seems to come to bear, but on later reflection will make sense. Blood pressure rises (personal experience here) and there is a lot of confusion. Try and take it as part of life's natural cycle rather than a personal affront. Because whatever you do life will keep moving on around you and will be waiting when you are ready to re-join the stream.

Cheers

[alyx]

Hi Alyx

Just monitoring how things were going:

My apologies for raising the following subject as I know it is a difficult time for you both. There's another sensitive issue though I'm not sure if you have given any thought to, and one I'd recommend you give some consideration too. That is writing a will.

Please be aware that in Thailand everything does not go automatically to you as the spouse, as it may do in your home country. Basically it will be shared between you and some form of Thai relatives unless there is a will stating otherwise.

By relatives it is very broad and goes through a whole list: from children, parents, brothers/sisters all the way thru to uncles and aunts. So if no will has been made it is likely you would be sharing his assets (and his share of joint assets) with someone in the family no matter how remote the family connection. These may be neither your wishes nor your husband's

Cancer at least gives you a little time to prepare things. That should include the financial side of things and ensuring any estate/assets are distributed according to your husband's wishes and protecting you financially.

The website link below may be of some use as a starting point

http://www.isaanlawyers.com/Wills%20and%20Estate%20Planning.pdf

My apologies as I say for raising finance at this delicate time, and with the million and one other things you will be dealing with. It is something that is best dealt with in good time though, to ensure your husband's wishes would be carried out, and ensure you are left in the right financial situation.

Best Wishes

Fletch

Hello Fletch

Thank you for bringing this on the table

Actually, the only thing we have in both names, in Thailand, are bank accounts

I did withdraw the money and opened an account in my name ( quite surprised to hear from the teller that a minimum of 5,000 baht had to be left in the Fixed account, the whole amount could only be withdrawn if the account was closed ( which cannot be done as my spouse is kind of home bound : The bank was supposed to contact me and send someone to our home to have the papers in order but it has been a week and no sign of them. I should add that in case of death it would also be difficult )

The condos are in my name. A piece of land in his hometown is in his name, as well as a 400,000 Baht car.

I am a bit frustrated about the car as we bought it two years ago, under the tax refund scheme, making it difficult to sell it. if we do so, the tax will have to be refunded ( I wouldn't mind doing that but I wouldn't know where to start )

The solution would be to have it put in my name but I guess the problem remains the same

We do have a company but not making any profit: I might ask the accountant to replace his name

Regarding the money we have abroad, the necessary transfers have been made, although his family would have a hard time retrieving the informations ( in any case nothing in his name anymore )

Please note that he hasn't been able to work, therefore earn money in years and, sincerely, I am not ready to share the fruit of a lifetime with anyone, especially not with his family, whose members have failed to make a single phone call, let alone a single visit, in the two weeks since he left the hospital

Any advice is welcome

His condition is not too good, worsening actually, but he doesn't want to go back to the hospital. I am ok with that but the pain is greater and the worrying part is that he is unable to take morphine orally as it seems to burn his throat a great deal. For now he can take tramadol ( but tonight he has quite a high fever, and I am not sure whether tramadol cause or it is infection related )

Edited June 18, 2014 by alyx

[alyx]

Hi, As I am sitting here feeling morose contemplating the 5 year anniversary of my wife passing due to cancer maybe I can offer something from experience. OK that was in Australia, but I have a reasonably long experience with Thailand, and I think some things probably bridge the cultural divide. Anyway here goes for thoughts for the last few days which seems imminent:

Cancer in the terminal parts of the disease is generally very painful and distressing for the sufferer and the family, in that order, hence a lot of drugs are used to minimise the symptoms. These drugs are used to make the patient as comfortable as can be during the final stages, but will generally make the patient unable to converse with friends and family towards the end. So if you want a question answered do not wait until the last moment as some people apparently do.

Even though the patient may be drugged and comatose they can still hear. So be mindful of this when having conversations nearby. Also go for a coffee or walk occasionally as people tend not to pass when there is someone holding their hand. Not sure on the logic on this, was something I was told by nurses and have observed.

From my understanding of Thai cremations it is expected that the next of kin will claim the ashes the next day. This is what I have seen as recently as 3 days ago and apparently is normal even for foreign resident cremations.

During this period of high stress things tend to be forgotten. Maybe carry a notepad and write things down as you go. In my case it was hide a spare house key, or have the local locksmith on speed dial.

Most importantly look after yourself and take things gently. It will be a confusing time when all pressure seems to come to bear, but on later reflection will make sense. Blood pressure rises (personal experience here) and there is a lot of confusion. Try and take it as part of life's natural cycle rather than a personal affront. Because whatever you do life will keep moving on around you and will be waiting when you are ready to re-join the stream.

Cheers

Thanks for the experience's sharing. In our case conversation is not possible but luckily enough we have spent years together and talked lightly about what should be done. I am just waiting for his departure, in the most peaceful possible way, but as I have stated in other post he is not the "go quietly" type

[alyx]

One important thing in your post: one has to be mindful that we can still hear people around us when we are "sedated"

Of course any mean of communication is worth a try

[cheeryble]

About not being able to take the morphine orally.

If his case is truly terminal and skin gel or patch cannot be used and life expectation short (do you have any idea?) I would seriously consider if it was me checking if the contents of the capsule or tablet or gel can be extracted into a liquid form for injection.

I don't know about the legality of this and I know this post may be removed and would understand it but we're talking about suffering here and relief of that may come above delicacy or pettifoggery.

[Sheryl]

Fentanyl patches are a good option but I think he already had them?

You can also try placing the morphine tablet sub-lingually (let it dissolve under the tongue). May taste a little bitter but will work.

If all else fails, you can also give the morphine rectally - press it into some butter or margarine to make a suppository. (There used to be morphine suppositories in Thailand but unfortunately no more).

As this progresses tramadol will be increasingly insufficient and morphine is best. Not only is it best for the pain but it has a very important property for terminal care: it relieves the anxiety associated with not getting enough air.

Sedatives for anxiety, if needed, can also be given the same way - sub-lingually or rectally. If he does not have any, it would be a good idea to get a script now to have on hand.

The other thing that will become necessary in the terminal stages is something to dry up his oral and respiratory secretions. Hyoscine (In Thailand, brand name Buscopan and others) is often used for this. Vescopolamine is the injectable form. It is not a controlled drug but I'm not sure a pharmacy will issue with syringes, but your doctor likely would if you asked. This too I would advise getting ahead of time so you have it on hand. You will know he needs it when he is making gurgling sounds/his breathing sounds wet, or he has uncontrollable drooling.

[alyx]

Not sure how to classify the sounds he makes when he is sleeping but a couple of nights ago his snoring whistle like woke me up. Like a little girl outcry, persistent but that didn't disturb his sleep, I think. It also happened the following night