Lung Cancer check

[theguyfromanotherforum]

Where can I get checked for lung cancer? I want to get this out of the way.

Cost?

[NickJ]

You want a CT scan and a sputum test. plain x ray is not detailed enough. Some Govt hospitals can if they have the CT Hua Hin Hospital has one and its a Govt hospital.....Most hospitals will do a screen but doing the CT is more definitive.

[theguyfromanotherforum]

Thanks. Would Chula have a CT? I guess yes.

[NickJ]

Of course. Rhamathipbodi as well......I would prefer going there myself. straight line from Victory Monument. All the latest equipment. Govt Hospital as well. Good luck.....and something I learned in School.

When you hear hoof beats dont think about Zebras.

[theguyfromanotherforum]

Thanks man. I have breathing issues on a 24/7 basis. It's not asthma strong evidence it's reflux but just want to make sure it's not a big one.

Edited August 6, 2015 by theguyfromanotherforum

[SantiSuk]

Have been through the mill on this over the last 30 months or more - my experience may be of relevance if you do get an uncomfortable early diagnosis.

A shadow showed up on a routine UK national health service X-Ray (I asked for it as I was taking a long time shaking off bouts of bronchitis).

I was told by a UK pulmonology specialist that I had lung cancer on the strength of his follow-up X-Ray, then confirmed by a CT scan and then a PET scan (a scan that detects cancer with a higher degree of precision than a CT scan). He said it was early-stage and seemed desperate to get one third of one lung cut out.

He said I could have a biopsy to confirm it but it was not really necessary as he was so convinced of his diagnosis. I said 'do the biopsy' - they take a piece of lung with a needle under powerful local anaethsteic, while being guided by a CT scan. It showed I did not have lung cancer. He seemed shocked by his misdiagnosis but mentioned that his radiologist had told him that no surgeon would have carried out the surgery anyway without a biopsy.

I went to a top UK lung hospital for follow up, having lost confidence in him and due to the fact he did not seem to know what was the cause of the shadow and what was causing my (by now) increased sputum production and exposure to infections. They detected a malt lymphoma - a form of cancer (technically not lung cancer) that is much less invasive and in most people needs no treatment, just annual or bi-ennial monitoring. Due to my symptoms I was given a mild radiotherapy dose which puts it into long term (probably for life) remission. That was successful ("you'll die of something else before you die from this" quoth the specialist). It didn't cure the sputum/infections though and the final determination is that I have bronchiectasis - manageable with a bit of care and regular bouts of antibiotics.

The UK lymphoma specialist commented in passing that many pulmonologists in developing countries would not have the knowledge to diagnose a lymphoma (as was also the case amongst western specialists 20 years ago.

Be careful out there and don't just take the first diagnosis that comes along. Get the best pulmonologist you can.

Costs - based on Bumrungrad Bangkok (I had some work done there en passant - other privates will be less costly - dunno about government hospitals as I had UK med insurance)

X-Ray 300 baht + 1,000 baht doctor/radiologist fee

CT Scan 10,000 baht + the 1,000 baht

PET scan - dunno - I'm guessing based on half UK cost - 20,000 to 30,000 baht all up (CT guided biopsy ditto - guessing 30,000-40,000 baht)

Not many hospitals in Thailand will have PET nuclear scanners as they cost millions. I'm sure Bum does and probably the Bangkok cancer hospital - maybe big regional cancer hospitals?

Best pulmonologist in Thailand is at Sriphat Chiang Mai - see my post #142 on this thread:

http://www.thaivisa.com/forum/topic/511966-chiang-mai-doctors-and-medical-specialists/page-6

Best of luck. Feel free to PM.

Edited August 6, 2015 by SantiSuk

[Sheryl]

Bronchoscopy is another diagnostic tool to consider. In addition to visualizing (and obtaining biopsy sample) of any tumors that are within/near the bronchi, it can also take deep sputum and tissue samples to detect, for example, fungal and other infections which routine sputum exams might miss. It will also show the overall state of your airways (including any damage from reflux, and the presence.absence of COPD or asthma).

In fact from what little I know of your case, bronchoscopy would likely be the first recommendation rather than CT.

Chula can do all of this, though you will have to see a pulmonologist there and he'd have to agree the tests were indicated. If the latter proved problematic, a private hospital may be a better bet. But by all means try Chula first as cost will be much less.

[prodriver]

Santi Suk. I had a PET scan done at the Government hospital Siriraj about 3 years ago. It cost me 60,000 baht. So I would estimate that one performed at Bumrungrad would cost well in excess of 100,000 baht.

[sikishrory]

What ended up happening with this? 

I have mentioned my coughing and sometimes pain to 2 doctors who both gave me xrays. Xrays are not good for this purpose.

[lopburi3]

To add price of PET CT package at Bangkok Hospital (Wattanosoth) was 63k in January 2017 (chin to pelvis).

[Sheryl]

8 hours ago, sikishrory said:

What ended up happening with this? 

I have mentioned my coughing and sometimes pain to 2 doctors who both gave me xrays. Xrays are not good for this purpose.

Actually Xray is nto an unresonable place to start. Larger lung tumors would be evident as would common non-cancerous conditions.

 

But in the absence of any Xray findings that explain the symptoms (or if there are findings suggestive of a mass) and assuming they have persisted for some time, next step would usually be CT.  PET scans are extremely expensive so often done last,  so that they are reserved for when truly necessary - but in some cses, if the index of suspicion is very high (e.g. known risk factiors, shadow seen in Xray) a doctor might receommend going directly to a PET.

 

Please indicate

 

(1) how long the coughing and pain have been present

(2) what the pain is like and whether it is related to inhaling or exhaling

(3) where in Thailand you live

(4) what sort of doctors it is that you have consulted already/where (i.e. GP vs pulmonologist, what hospital)

[Thongkorn]

If its acid reflux maybe sleeping semi propped up, with two three pillows, that helped me, iT was giving me a cough 24/7, My body was trying to recover during the day , But as soon a si laid down the refluk would seep out and burn my throat, other than that maybe a chest infection ,