Cost and availability of cancer treatment

[nidieunimaitre]

A few days ago we came to Thailand for our yearly 6 months stay.

The day before we left, we went to a dentist for a routine check.

The dentist found a growth in my wife's mouth and advised us to have it checked.

Back home my wife is covered by health insurance, in Thailand not (she is Thai, 60 years old).

Tomorrow my wife will have a biopsy.

In case we have time to make a choice between treatment in Thailand / back home:

Does anybody know about cost and availability of treatment?

Or any other useful information.

Thanks.

[fang37]

I got throat cancer in 2009. It was stage 3/4. This was in CNX.

At that time only one hospital had a radiotherapy treatment centre.

I do not recollect the physical pain but I had copious amounts of morphine.

Containing constipation was a huge effort. At one time, I was hospitalized.

I had approx 25 sessions of hyperbaric oxygen therapy treatment so that they could extract all of my remaining teeth - 27.

With the morphine, I was having hallucinations - vivid.

Including 2 trips to BKK & one to my native country.

TOTAL - B3.5m

[nidieunimaitre]

I got throat cancer in 2009. It was stage 3/4. This was in CNX.

At that time only one hospital had a radiotherapy treatment centre.

I do not recollect the physical pain but I had copious amounts of morphine.

Containing constipation was a huge effort. At one time, I was hospitalized.

I had approx 25 sessions of hyperbaric oxygen therapy treatment so that they could extract all of my remaining teeth - 27.

With the morphine, I was having hallucinations - vivid.

Including 2 trips to BKK & one to my native country.

TOTAL - B3.5m

Sorry to hear about your pain - thanks for the info.

[fang37]

I suggest that you not only look @ the $$$.

Cancer has a social stigma & is a life changer eg I never played golf again. I cannot eat solid food. Less social interaction.

I think that this is a time for loved ones (not necessarily blood family) to provide emotional support.

For the sufferer to feel that he is in a safe, loving environment is of great benefit.

[nidieunimaitre]

I suggest that you not only look @ the $$$.

Cancer has a social stigma & is a life changer eg I never played golf again. I cannot eat solid food. Less social interaction.

I think that this is a time for loved ones (not necessarily blood family) to provide emotional support.

For the sufferer to feel that he is in a safe, loving environment is of great benefit.

I agree.

Treatment in Europe would mean my wife would be far from her family.

But I do not know if we can afford treatment in Thailand.

Perhaps surgery here, and radiation in Europe.

[fang37]

I didn't have surgery.

I guess that you need to do the sums.

$$$ & emotional.

Tough call!

[Sheryl]

As a Thai citizen your wife is eligible for free treatment under the universal health scheme. She has to start at the hospital which covers the location where she is listed in a tabian ban. Depending on the level of that hospital they may or may not be able to do the initial biopsy needed to determine if in fact this is cancer, which from the sounds of it is not yet known (it may well be something else altogether.) or they may have to refer her to a higher level. This process will involve a lot of time and red tape -- day long waits for each appointment are the norm -- but ultimately she will be able to obtain treatment.

To go a private route, if it proves to be malignant, would entail millions of baht. On theo ther hand, if it is a pre-malignant lesion, or altogether nion-malignant lesion, private treatment can be done as an outpatient and would not cost much. Probably under 10,000 naht.

IF she has oral cancer, whether or not she should go all out with all possible treatment is another issue to consider but cross that bridge if and when you come to it as it might not even be cancer. If it is -- she is more likely to get honest and detailed information with which to make an informed choice in Europe than in Thailand. But again, cross that bridge if and when you come to it.

A simple consultation with a specialist to assess the tumor and advise whether or not biopsy is indicated would cost under 2,000 baht at a private hospital and is probably what I would do first. If you can advise where you are located, may be able to suggest a doctor. Would also be helpful to know where in Thailand your wife is listed in a tabian ban (would probably be her family home) and what government hospital covers that area (her family would know).

[nidieunimaitre]

Thank you Sheryl.

We live 25km from Chanthaburi city.

If you have any recommendation for doctor and or hospital, we would be grateful.

When I wrote "tomorrow my wife will have a biopsy" I apparently was a little too quick - yes we should ask advise first.

The large growth is in her palate (?) - roof of her mouth. It is painless.

[nidieunimaitre]

Sheryl,

our ampur is Makham.

[Sheryl]

A large painless growth on the roof of the mouth, unless clearly a cyst, will indeed need to be biopsied so I would proceed first with that. Where is she having it done?

If it requires surgical excision she will need a head and neck surgeon. The only place in Chantaburi which would be likely to have one is the main government hospital in Chantaburi town, Phrapokklao Hospital. It is a Regional hospital so good levels of facilities. I doubt you will find a head and neck surgeon in any of the private hospitals in that area.

If her tabian ban is Makham District then she probably has to go first to the Makham District Hospital to get care under the universal care (AKA "gold card" or "30 baht" system). They will in turn refer her on, probably to Phrapokklao, since this is certainly not something a district hospital can manage. But her family will know for certain which hospital. Need to bring her tabian ban and thai ID card on first visit to that hospital if she has not been before.

[Torrens54]

Thanks Sheryl,

As an aging expat, I worry about this sort of situation.

So far, so good but I'm sure others would also have appreciated your comments while we all hope never, to have to make those decisions ourselves.

[nidieunimaitre]

Confused now!

My idea was that my wife should have a biopsy, and then we could think again.

It took 3 days of very careful arguing before my wife agreed to go to Phrapokklao Provincial Hospital.

"Ignore a problem and it will go away".

I made the mistake of not speaking with the doctor myself.

According to my wife the doctor told her not to worry, as many Thai people have this growth in their mouth.

I will ask her son to try to convince her to go to a private hospital in Chanthaburi - Sirivej hospital.

[Sheryl]

There is a type of growth on the hard palate called a torus palatinus which is common, benign and obvious on physical examination. Suggest you google pictures of it and see if itseems to be the same as what your wife has.

If not -- or if regardless you need more reassurance -- then will need to see a head and neck specialist which will likely mean a trip to Bangkok. But look into this first.

[nidieunimaitre]

There is a type of growth on the hard palate called a torus palatinus which is common, benign and obvious on physical examination. Suggest you google pictures of it and see if itseems to be the same as what your wife has.

If not -- or if regardless you need more reassurance -- then will need to see a head and neck specialist which will likely mean a trip to Bangkok. But look into this first.

I wish to thank you once again Sheryl.

And sorry for not updating earlier.

We looked into the information you suggested, and I believe now that we might be in luck...

Unless the growth changes, we will wait until we are back in Europe to have it examined thoroughly.

PS I had never heard of this torus palatinus, that seems to occur frequently in Asia.