Skin Cancer

[bofhman]

Mate: http://www.cancertutor.com

I wish you well.

[bofhman]

Mate the following will answer all your questions: http://www.cancertutor.com

I wish you well.

[Sheryl]

Back to my original question...

I've been advised by a top US cancer surgeon to have a sentinel node biopsy concurrently with surgery to remove a melanoma. The location of the melanoma does not foretell which lymph node may be affected.

At Bumrungrad (or any other Thai hospitals) -- do they do sentinel Lymph node biopsies (using a Lymphoscintigraphy Spect CT) for diagnosing whether melanoma cancer cells have spread to the lymph nodes?

Thanks.

I do not know. But I do know that there are very, very few doctors in Thailand with experience treating melanoma and this would worry me far more than the technology available to them. The expertise of the surgeon counts for far, far more. Your US doctor may not have realized how rare melanoma is in Thailand.

Siriraj Hospital has the best of what little there is in that regard and would also be the most likely to have the capability to use Lymphoscintigraphy Spect CT. http://www.siphhospital.com/en/index.html is their private wing. Contact their call center and ask for names of professors with expertise in malignant melanoma - won't be more than a handful i f that - then have a consultation with one of them at which point you can ask about their technology.

But if I were you given the seriousness of this and the scarcity of experience with it in Thailand I would go back to the US for treatment -- or if you prefer, Australia which leads the world in this area.

[Tolley]

Even the sentinel node biopsy is a tricky operation so I wouldn't risk it in Thailand either.

As Sheryl as said if you can go back to your home country to get it done you should.

[bofhman]

Bill lives in Thailand. I have communicated with him several times. Here is his story and pictures regarding his cancer and it's remission from treatment:

http://www.oneanswertocancermovie.com/articles/bill_oleary_story.htm

Seriously consider ALL the alternatives before surgery and I would suggest to try the salve first. What have you got to loose? $50 bucks for the salve? If no success then surgery it is.

Sent from my iPhone using Thaivisa Connect Thailand

Edited May 16, 2014 by bofhman

[Tolley]

Bill lives in Thailand. I have communicated with him several times. Here is his story and pictures regarding his cancer and it's remission from treatment:

http://www.oneanswertocancermovie.com/articles/bill_oleary_story.htm

Seriously consider ALL the alternatives before surgery and I would suggest to try the salve first. What have you got to loose? $50 bucks for the salve? If no success then surgery it is.

Sent from my iPhone using Thaivisa Connect Thailand

Nice story.

There was some research going on here in WA where they found that the white stuff that comes off cockatoos completely cured melanoma in mice.

Probably that will never see the light of day either.

[Sheryl]

Do not mess about with quack cures for melanoma unless you have a serious death wish.

[Sheryl]

Posts advocating dangerous quackery and posts replying to them have been removed as have posts discussing Moderation.

Note that discussion of moderation in open forums is contrary to general forum rules, and that the posting of disinformation and promotion of quackery is contrary to Health Forum specific rules:

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

[NeverSure]

Agreed, I might be new to the forum but when 'so called helpful experts' throw the word 'quackery' without any first hand experience in the matter - old hand or not - it really gets my goat up ... and I know from my personal experiences within the medical industry just how endemic the conflict of interest has become so naturally now my reaction is to put them in their place very quickly for having stated something akin to fear posturing which unduly influences those who may believe, from the statement, that doctors always have their best interests in mind. That's simply not true anymore. Just follow the money. There are some doctors who truly believe in helping people such as Dr. Sircus http://drsircus.com. I don't expect people to just take my word for it so that's why I also presented links for in-depth peer group research and statistics within my last comments.

It's great that you are open minded enough to help yourself. Just keep in mind the following short presentation on TED which goes to show just how corrupt these professionals have become. https://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe

Sent from my iPhone using Thaivisa Connect Thailand

Melanoma is one that will easily metastasize. Your plan, while interesting, does nothing to address that.

The fellow in the linked story had basal cell cancer which rarely spreads throughout the body. If he did manage to kill it he might be OK - who knows?

Listen to Sheryl. This is melanoma which needs a multi-pronged approach because it can get into the system and lodge in different parts of the body, especially internally. Your salve will do nothing for that.

Frankly I'm amazed at the patience of the OP and of Sheryl with your posts.

OP, listen to Sheryl, and I wish the very best for you.

[onomataho]

Good information about skin cancer treatment in Bangkok.

I have an additional question for those in the know...

At Bumrungrad do they do sentinel Lymph node biopsies (aka: Lymphoscintigraphy Spect CT) for diagnosing whether melanoma cancer cells have spread to the lymph nodes?

Any other hospitals in Bangkok, Chiang Mai, or Pattaya do this?

A brief follow-up...

I went to Bangkok Hospital for treatment (i.e., CT Scan, Lymphoscintigraphy Spect CT, sentinel lymph node biopsies, melanoma wide excision). The treating oncologist was Dr. Tanaphon Maipang.

Fortunately, no cancer was found beyond the original scrape biopsy location.

I am very happy with the care I received,

Edited June 3, 2014 by onomataho

[Sheryl]

Thanks for the update. Glad it was good news

[sandyf]

The Cancer Hospital in Chonburi runs a screening programme for 1600 baht. You can turn up on the day with a stool sample and be out in about 5 hours. I had a biopsy after my check up and that was 1800 baht. They cannot do that immediately as you must have an HIV test first,250 baht and about a week for the results.

[fletchsmile]

People often wonder about treatment in Thailand for skin cancer compared to back home. My brother recently had to get checked out in the UK so I thought I'd just mention a few thoughts:

It's often said that UK doctors have more experience of skin cancer. I don't have any stats or data on that to back it either way. I do know that when I went to Bumrungrad, I was very happy with the specialists I saw. In terms of facilities they are top notch too at that hospital and not just for skin cancer, but also other cancers. Outside the top hospitals though, I also know the knowledge and facilities seems to drop significantly in Thailand. You can also get treated very quickly, with minimal waiting time, and it seems as long as you can pay, all/most options are open to you in top notch Thai private hospitals - although again I'm no medical expert on some of the more esoteric aspects.

For my brother in the UK, they seemed quite thorough. I do know he waited longer to get seen, and waited longer for his treatment. It was also free of course on the NHS. Also I don't think the facilities sounded as good, but then again that's comparing UK NHS to Thailand private. He also had to go back for some stitches to be redone, when they were bleeding and was sat around waiting to get seen - typical UK NHS style. Really can't see that happening in Bumrungrad.

I guess my summary would be if you're in Thailand and can afford the top end, you should be OK. If cost is a factor though, you're probably better off in the UK on NHS than a Thai government or less well kitted out Thai hospital or up in Thai provinces. Similarly if you don't want to wait around, top Thai hospitals may be preferable to UK NHS.

Cheers

Fletch

[Poppy39]

How to quickly get rid of cystic, under the skin acne?

Every now and then I get huge, painful pimples. They are under the skin and more of a red bump instead of a pimple. I currently have on that has been on my chin for about a week now.
I've tried Proactiv and nothing.
It won't go away.
what can I do?

[BangkokHank]

My absolute favorite doctor in Thailand is a dermatologist by the name of Dr. Paritas Sukriket at Samitivej Sukhumvit. He studied at Yale University in America and in addition to being a great dermatologist, he's a very nice guy.

I have an annual skin check-up with him and he tells me which things need to be attended to immediately and which things should just be observed without needing to take immediate action. One time when I went for a check-up he wasn't there so I made the mistake of letting another doctor check my skin. A blemish that Dr. Paritas had previously told me was nothing to worry about was spotted by this other doctor - who sent me into a panic, saying that it should be removed and biopsied immediately (because said doctor was about to depart for a vacation in Europe). The biopsy set me back 10,000 baht - and of course came back negative. A total waste of money, and great deal of worry for nothing. I couldn't help thinking that this doctor was just using me to help finance her upcoming trip to Europe. Since then, I have always had Dr. Paritas check my skin. I trust both his ethics as well as his competence - completely.

[islandguy]

On 5/10/2014 at 7:49 PM, fletchsmile said:

Saw Dr.Niyom today. Very good. Felt like he knew his stuff very thoroughly and also very good manner with patients. Listens. Answered questions. Wrote things down for me without evening asking. He said all of the doctors in this unit cover all the dermatology areas, but he specialises in skin cancer.

Cost for the consultation was THB 1,500

I had a small biopsy done. The cost for that was estimated at THB 8,000, and was done within half an hour of the first appointment. Wait one week for results. The total bill came to THB 6,900-ish though, so I think that if you have something additional done they're not double charging for seeing the doctor, just increasing the scope. My company has a 15% discount.

Yes he has a busy schedule. Saturday morning was booked when I arranged the appointment a couple of days back.

All in all excellent. Thanks to Sheryl and FBN for the tips

Cheers

Fletch

 

Just had a very similiar experience, I am not an easy patient to please and I was very impressed by Dr. Nyom. Cost was very close to the same amount for same services. While the overwhelming opulence there is not what I prefer, the pricing policy was transparent and I didn’t think that their prices were out of line. 

 

 A few comments:

 

Dr. Nyom no longer does micrographic surgery. My guess (and it is only that) is that he does not have enough confidence in the overall team resources that are required for this to be effective. The top doctor at Ramathibodi Hospital (also very a very impressive place, and a public hospital) who does do this procedure has a long waiting list.

 

Regarding black salve: a close friend highly recommended this as a preferred treatment to surgery and biopsy. She has had successful results using this (during the time I have known her). In checking out this option (I have a background as a health professional with studies including A&P and biochemistry) I would have considered it if the condition had been smaller. However, one recommendation I found on line was from Dr. Andrew Weil, who is America’s most famous holistic health M.D. He is Harvard educated and someone I used to spend time with. I trust both his expertise and his open mindedness. He said that while interesting, black salve was not something he would recommend for skin cancer (I think he was only referring to squamous and basal cell carcinomas), particularly as conventional medical treatment was quite effective. At that point I reviewed cure rates given by the American Cancer Society for these two conditions, and they were in the high 90’s (percentages). I am familiar and symphathetic with the arguments about the short time frames used to consider a condition cured, but that was a convincing reason in my mind to not consider alternative treatments.

[Sheryl]

By coincidence I also just had an excisional biopsy by Dr. Niyum, mine came to 13,000 baht but involved a large mole.

 

Under no circumstances should black salve or any other "alternative treatment" be used if there is suspicion of skin cancer. Knock yourself out for other skin problems, but not this.

[islandguy]

My apologies for misspelling the doctor’s name ??

[Sheryl]

On 10/24/2014 at 1:07 PM, Poppy39 said:

How to quickly get rid of cystic, under the skin acne?

Every now and then I get huge, painful pimples. They are under the skin and more of a red bump instead of a pimple. I currently have on that has been on my chin for about a week now.
I've tried Proactiv and nothing.
It won't go away.
what can I do?

Please start a separate thread as this thread is about skin cancer, not acne.

[Sheryl]

Re Thai experience with skin cancers it is indeed very limited and very, very few Thai doctors have enough experience to know when a lesion is suspicious. Indeed dermatologists who did nto train in the west may have scarcely ever seen one. Any derm who trained in the west (unless thet raining was limited to cosmetic dermatology) will have, but will not necessarily have had that much experience especially if they returned to Thailand right after their residency. Equally worrying, many pathologists have had limited experience.

 

The number of Thai doctors I feel comfortable going to or referring to for skin cancer checks can be counted on less than the fingers of one hand, and I have known even some of these to make wrong calls in the direction of missing a cancer. For this reason you should be wary of doctors telling you that a lesion is nothing to worry about and be more inclined to push for biopsy if your gut feeling is that it is dodgy.  It will mean some unnecessary biopsies but that is better than the opposite.

 

The doctor with the greatest expertise IMO is Dr. Anna Jaruwan at Bangkok Pattaya - she not only trained in the US but practised there for decades and specifically specializes in skin cancers. https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=7&depid=2

There is no substitute for such an experienced eye.

 

If you get a positive path report for a serious skin cancer (i.e. melanoma or squamous cell) I would ask for the actual slide and try to go to or send it to a Western country for a second opinion. Not worth the hassle for a BCC, definitely advisable for a melanoma.