Prostrate and Holep

[al007]

I have been aware of prostate problems for some 18/20 mths, I have had several psa tests 4 yrs ago 2.0 now 15.6, MRI scan a year ago said cancer very unlikely, Cat scan also a year ago

 

I have been seeing a urologist in KhonKaen for a couple of years, his view all the way along was unto you on treatment 

 

I need to often get up to pee four times in the night, I have no pain passing urine, also no blood

 

I am self insured at 72 premiums are very high with low limits on overall cover, I have also been suffering depression, not helped by my condition

 

So I continued investigation, wanting only the most up to date treatment 

 

There are two alternatives I believe, complete removal of the Prostrate, by non invasive Devinci, treatment, in Bangkok in excess of 650,000Batt, this is the requirement if there is cancer

 

The second if the prostate, is only enlarged, by Holep non invasive laser treatment, about half the cost, here the inside of the prostate is removed leaving the outer shell, similar to an orange with all the middle fruit removed

 

I investigate global costs and technical ability

 

Northern Thailand neither non invasive treatments available

 

Bangkok yes but expensive

 

UK free for me but waiting lists of undeterminable length, I have no where to wait in UK so not an alternative 

Global alternatives, France, South Korea, South Africa, and India

 

India has several large hospitals specialising in both forms of laser surgery, with a bigger number offering Holep

They have been doing this surgery for a long time

The costs are very competitive and 60/70% below Thailand

 

My Urologist told me he could hire the equipment from Bangkok, but he is not experienced using it, no way I thought, did I want him learning on me as the guinea pig

 

So India, I will be in hospital, 2/3 nights and remain in a hotel for a further nine days just in case

At the same time I will have a colonoscopy to check out polyps

 

The hospital requested an updated PSA which had risen to 15.2 from 13.2 six months ago

 

On receiving this, they suggested a biopsy, good idea I thought, so go to my Urologist, he is upset I am going to India, but agrees here in KhonKaen there is neither the equipment or experience to operate it

 

He arranges for a biopsy, my normal small hospital can not do it because they do not have the equipment, he suggests another private hospital, I go and check out the price they want 65,000batt just for the biopsy,(20 min procedure)half the cost of the full operation in India, unacceptable for me

 

I revisit the Urologist at his private clinic, he suggests the government hospital no anaesthetic but he gives me valium

I arrive at the hospital and changed into operating clothes, then they try to fit me onto a small table and put my legs into clamps, like a woman birth table and about the same size, I am 6ft 2in and 140 kilos

 

I am balanced on this my head over the end on my back and legs in the air

 

The they put sticky plaster on by balls to keep them out the way then try to pull it off to adjust it, by this stage I am screaming in pain, (try pulling plaster off pubic hairs, I am like a chicken being plucked or worse!)

 

All calms down doctor them comes with ultrasound probe, and gets it inside me, I am feeling pain, then he stops everything because the probe is too short for me a big man and he says my prostrate too deep inside me, (in the past finger examinations of the prostrate were possible, so has my prostrate moved! I doubt it)

 

I thought the procedure was done with patient on his side and knees  up to his chest

 

I come off the table shaking and weak, the doctor apologises, he suggests he could try the Rachapreuk hospital later, borrow the sample probe from KhonKaen, but their ultrasound does not have a probe, I enquire you will be taking samples without knowing where your sampling probe is, he say yes, I say this is madness we do not go this route

 

My bill at the Government hospital was 50Batt

 

 

I need to have a rethink, it was not possible to get the biopsy done here today, because apparently I am a large man and my prostrate is too far up my ass, the Urologist also added even if he did it there is still no guarantee there is no cancer, the sampling needles could have missed it, the hospitals in the North are also lacking equipment

 

I was not happy with the Urologist,( But he is a nice man and I like him) he knew my size and before had commented on the difficulty of examining my prostrate, he also had the MRI that showed the exact location

 

 

I am very likely to wish to proceed without biopsy if I can get agreement in India

 

One year ago MRI scan done and no evidence of cancer

 

My PSA has gone up but so has my weight

 

The percentage of people with cancer with a PSA of 15.2 is still relatively small

 

My personal feeling is I do not have cancer

 

There is no family history of cancer

 

Over the years I have had 2/3 tennis ball size growths removed from my back, all on post biopsy clear

 

I am approaching 72 and accept I will not live for ever, 5/10 yrs I would be happy. 40 yrs old maybe a different story

 

One choice is do absolutely nothing and just wait and see, being put forward by urologist here

 

If the Holep is done and even if there were cancer, my life expectancy probably the same as doing nothing

 

Post the Holep biopsies  can be done, if yes well at least identified, and I presume if I chose to do additional surgery then it could be removed at that stage, normally I understand cancer here is very slow growing, these biopsies should give a very good analysis with error rate very low

 

 

 

I have flights and hotels  booked and paid for, that complicates matters a little, so will probable go regardless

 

 

An interesting article from Mayo clinic

 

Update on HoLEP: Fast relief and maximum benefit for patients with benign prostatic hyperplasia

The challenge

For decades, transurethral resection of the prostate (TURP) has been the gold standard surgical treatment for benign prostatic hyperplasia (BPH). However, depending on surgeon experience, up to 25 percent of patients may experience some type of complication after TURP, including bleeding, hyponatremia, urinary incontinence and erectile dysfunction. TURP also subjects patients to risks inherent in any surgical procedure, as well as a hospital stay of one to four days and recovery time of four to six weeks.

Although laser ablation can provide swift symptom relief and quick recovery and minimize the risk of damage to healthy tissue, impotence or prolonged incontinence, some procedures may result in prostate swelling with temporary need for catheterization. Additionally, the long-term durability of ablative procedures has not been widely assessed, and there is a risk of prostate regrowth requiring repeat surgical intervention in some cases.

#include virtual="/images-bdyincludes/imagebdy-6262.html"

Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive treatment for BPH. With the patient under general anesthesia, the surgeon uses the laser to enucleate the prostate gland tissue, leaving just the capsule in place. The surgeon pushes the excised prostate gland tissue into the bladder and then uses a morcellation device to grind up and remove the tissue.

HoLEP offers some distinct advantages:

    •    Treatment of any size prostate gland.

    •    Complete excision of the obstructing prostate tissue down to the prostate's encapsulating structures, resulting in a re-treatment rate of less than 2 percent.

    •    Early, immediate symptom relief and fast return to normal activity. Next-day catheter removal with limited swelling generally allows patients to void painlessly and immediately. Same-day or next-day hospital discharge is possible when the procedure is performed in a 23-hour observation setting.

 

 

    •    Tissue preservation for pathologic examination. Because adenomatous tissue is excised rather than ablated, surgeons can examine specimens for prostate cancer or other abnormalities. Cancer is found in about 10 percent of HoLEP procedures, even in patients previously screened. In many cases, the cancer identified is of low malignant potential.

 

 

    •    Fewer potential complications. The low depth of penetration of the holmium laser causes little damage to healthy tissue, and the risk of excessive bleeding and erectile dysfunction associated with traditional surgical approaches is reduced.

Some studies have shown that patients who underwent HoLEP actually had improved erectile function after surgery, but almost all had retrograde ejaculation. All patients experience hematuria for one to two weeks after the procedure, but the need for blood transfusion is low, around 1 percent. Since normal saline irrigation is used for the procedure, there is no risk of hyponatremia, regardless of prostate size. Transient urinary incontinence is common, but permanent incontinence at one year after the procedure occurs in approximately 1 to 2 percent of patients, depending on the definition and type of incontinence.

Ongoing HoLEP research

Detrusor acontractility is viewed as a relative contraindication to surgical intervention for men with bladder outlet obstruction secondary to BPH. Mayo Clinic researchers are testing the use of HoLEP for men with hypocontractile or acontractile bladders.

In a prospective trial of men ages 53 to 85 years, Mayo urologists performed HoLEP on 15 participants with evidence of BPH and bladders that had very little function or contraction ability. Preoperatively, all participants had catheter-dependent urinary retention for a median of five months (range: three to 60 months). Postoperatively, all men were able to void spontaneously without need for intermittent catheterization, with 13 participants displaying a return of detrusor contractility, and two participants voiding exclusively by Valsalva efforts. At their six-month postoperative follow-up, all participants were still able to urinate. Although these findings are preliminary, they suggest that HoLEP may be a viable treatment option for men with BPH and hypocontractile or acontractile detrusor muscle.

Widely acknowledged as a benchmark BPH procedure, HoLEP requires specialized skills and training. Mayo Clinic is among the few medical centers in the United States that performs HoLEP procedures at its campuses in Minnesota and Arizona.

Points to remember

    •    Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive treatment for benign prostatic hyperplasia (BPH). Its short- and long-term outcomes are superior to those associated with transurethral resection of the prostate and suprapubic prostatectomy.

    •    HoLEP is performed transurethrally, using a holmium laser to separate the plane between the prostate gland tissue and the prostate capsule. This procedure allows complete resection of all adenomatous tissue, minimizing the need for future re-treatment.

    •    Mayo Clinic researchers are testing the use of HoLEP for men with hypocontractile or acontractile bladders and BPH.

Original article: http://www.mayoclinic.org/medical-professionals/clinical-updates/general-medical/minimally-invasive-holmium-laser-enucleation-prostate-offers-advantages Regards 

 

 

 

 

[Sheryl]

I am not clear whether the tissue that will be removed via  HOLEPs  will be suitable for biopsy - however if the doctors know that biopsy is desired they can perhaps ensure a sufficient size sample of un-pulverized tissue. Suggest you discuss with them.

 

Good luck and let us know how it goes. Cost aside, I think you are definitely wise nit to let a doctor inexperienced with this technique rent the equipment and do it!

[al007]

As always Sheryl your input is both reassuring and helpful

 

I am in discussion with the hospital, in India at the moment, they are checking, on doing a biopsy from the Holep tissue

 

But even if this is difficult when I am out under anaesthetic, the traditional biopsy can be done prior to commencing the holep procedure The Mayo clinic talk about a biopsy being done from the Holep , Maybe I contact them direct and ask?

 

When the Holep is complete another biopsy could be done on the remaining tissue, just in case

 

I have gone through the stress of making the decision and just want to get the procedure done

 

If at the end some cancer were left, hopefully the slow growing one and a decision can then be made

 

I am having this done, not because of my cancer worries but my inability to get more than two hours sleep in one go at night, I am an individual who needs more than the average amount of sleep

 

I am aware very few die from lack of sleep

[Jingthing]

That does sound like a severe case of frequent night urination. Has your doctor ruled out even trying going on Finasteride for four months to see if symptoms improve? Do you know the size of your prostate in centimeters? That would be determined on a scan. 

http://men.emedtv.com/finasteride/what-is-finasteride-used-for.html

Quote

 

Enlarged Prostate Treatment

An enlarged prostate (known medically as benign prostatic hyperplasia, benign prostatic hypertrophy, or BPH) is very common among older men. The prostate begins growing during puberty and continues to grow throughout most of adulthood. Usually, this is not a problem until men reach their fifties or sixties. When the prostate becomes too large, it can press against the urethra, causing problems with urination. Specific BPH symptoms may include frequent urination (which is especially noticeable at night), difficulty fully emptying the bladder when urinating, and other problems.

 

 

[Sheryl]

Yes, they can certainly do a biopsy first and while you are under.

 

The issue with biopsy on the tissue removed would be damage to the cells in the process of grinding up the tissue - but it may depend on how thorough the morcellation is.

 

You should be aware that there have been a few reports of morcellation aggravating the spread of cancer when applied to tissue that was actually malignant - this is from its use in treatment of uterine fibroids which is where the largest amount of experience with morcellation has been.  Doing a biopsy before hand with a quick "frozen section" (i.e. rapid path exam while the patient is still on the table) may be wise since you have not had a biopsy and your PSA has been climbing, I suggest you discuss this with your doctor.

[al007]

In reply to Jingthing, thanks, yes my Urologist had me on Avodart to see if reduction occurred but it did not and he told me to stop taking

 

As regards prostrate size a year ago when MRI done was 5.1cm by 4.8cm  by 3cm, I am also around 6ft 2ins and 140 kilos so a very large man, everything else functions OK I am on no medication and my blood pressure around 135/80, I have some colon polyps, I am 71

 

I have and still do live a very full life, by the time I die I do not expect to be in mint condition, and instead of running through the Pearly Gates, if that is where I am sent, would be happy to be crawling there only just still alive, the car that is kept in the showroom all its life sees no life

 

I also understand living itself is terminal

 

I remain a very happy grateful man

[TerryLH]

Which government hospital did you go to?

 

Terry

[al007]

In response to TerryLH question .The main hospital that is used mainly by Thais next to the prison, for the record the problem was not fully the hospital, but a very large proportion the consultant, who probable should not have tried with the shortfall of equipment

 

The hospital was quick friendly and helpful, I was requiring something outside the norm, and in no way would I, or do any of us foreigners have any right to criticise the hospital.

 

I chose to go there

 

As i stated earlier, in the end the bill when presented was only 50Batt, Thank you KhonKaen hospital

[TerryLH]

KK Hospital is good, but you might want to try Srinagarind.  That's the teaching hospital for KKU, and the regional hospital for the upper  NE.  Excellent reputation.

 

As far as criticising  a hospital, any hospital, I think if they deserve criticism why should a foreigner not be allowed to do so?  Or are you just talking about this hospital in this specific instance?

 

Good luck .  I hope you get the problem resolved soon rather then later.

 

If you've never had a prostate biopsy - you're in for a treat.

 

Terry

 

 

 

[joealx]

"Northern Thailand neither non invasive treatments available

 

Bangkok yes but expensive" (OP-ID:1).

 

What provider does the HoLEP in Bangkok?

[mikedee]

How different was my biopsy story at the Government Hospital in Udon Thanni.

History

I was diagnosed as having BPH 3 years ago when I had to attend the hospital as I was unable to urinate following a birthday binge the night before. I was fitted with a catheter and bag, put on Avodart. I went back a month later and the catheter was removed. In the afternoon I had to return as I was unable to urinate again. The process was repeated and I went back one month later and the catheter was removed . Happily I was able to urinate as normal and kept up the Advodart medication and had my PSA checked every year. Knowing my prostate was alcohol intolerant I cut out the alcohol except for the occasional beer shandy.

This year the PSA test went from 5.5 to 10.2 and the doctor recommended a prostate biopsy.

Not wishing to endure the biblical size crowds to see the Urologist on his Wednesday surgery at  the hospital I visited his private clinic. He checked his commitments and made a date for August 2nd 2017. Some 2 months ahead.

The Biopsy

I arrived at  the hospital at 7pm The initial paperwork was done. Weight and blood pressure recorded and then onto the X-Ray department for a chest X-ray. Up to the ward and an ECG was carried out. A blood sample was given for a PSA test and I was issued with a ID band, a bottle of antiseptic mouth wash and shower gel and a DIY enema kit.

After a  change into hospital garments and a visit to the bathroom I was ready for bed.

A line was hooked up and I slept soundly.

Next morning about 10 o'clock I was collected and taken to the operating theatre. Several verbal checks were made outside to ensure I was the correct patient for the correct procedure and I was wheeled in.

Once on the table the Anesthetist introduced herself and a mask was put over my nose and mouth and the last I remember was my hospital bottoms being removed and my legs being maneuvered into position.

I woke up in the recovery room and my first instinct was that the  biopsy had not taken place. No pain and no blood.

Back at the ward I was hooked up to a line again and this was alternated with a second anti-biotic bottle.

My first urination and I was almost relieved to see some blood in the urine meaning the biopsy had taken place! Still no pain or discomfort.

A boring day in bed and the next day the Urologist come to see me. He confirmed he had taken 12 samples and I was free to return home.

An appointment was made one week later at his clinic for the biopsy report.

The discharge protocol was carried out,  the medication collected and the bill paid. 6600 Baht.

My wife had ridden my motorbike down and I drove us the 25 Kilometers home.

Happily the results were all clear. The only problem being when the 7 day antibiotic tablets were finished I had some pain and difficulty urinating. Fortunately this coincided with my appointment and the Urologist gave me a further course.

However the Urologist could only offer TURP as a procedure for BPH but with cancer out of the picture I have time to see what other options are available. Incidentally I am 74 years old

 

 

[teddog]

18 hours ago, mikedee said:

How different was my biopsy story at the Government Hospital in Udon Thanni.

History

I was diagnosed as having BPH 3 years ago when I had to attend the hospital as I was unable to urinate following a birthday binge the night before. I was fitted with a catheter and bag, put on Avodart. I went back a month later and the catheter was removed. In the afternoon I had to return as I was unable to urinate again. The process was repeated and I went back one month later and the catheter was removed . Happily I was able to urinate as normal and kept up the Advodart medication and had my PSA checked every year. Knowing my prostate was alcohol intolerant I cut out the alcohol except for the occasional beer shandy.

This year the PSA test went from 5.5 to 10.2 and the doctor recommended a prostate biopsy.

Not wishing to endure the biblical size crowds to see the Urologist on his Wednesday surgery at  the hospital I visited his private clinic. He checked his commitments and made a date for August 2nd 2017. Some 2 months ahead.

The Biopsy

I arrived at  the hospital at 7pm The initial paperwork was done. Weight and blood pressure recorded and then onto the X-Ray department for a chest X-ray. Up to the ward and an ECG was carried out. A blood sample was given for a PSA test and I was issued with a ID band, a bottle of antiseptic mouth wash and shower gel and a DIY enema kit.

After a  change into hospital garments and a visit to the bathroom I was ready for bed.

A line was hooked up and I slept soundly.

Next morning about 10 o'clock I was collected and taken to the operating theatre. Several verbal checks were made outside to ensure I was the correct patient for the correct procedure and I was wheeled in.

Once on the table the Anesthetist introduced herself and a mask was put over my nose and mouth and the last I remember was my hospital bottoms being removed and my legs being maneuvered into position.

I woke up in the recovery room and my first instinct was that the  biopsy had not taken place. No pain and no blood.

Back at the ward I was hooked up to a line again and this was alternated with a second anti-biotic bottle.

My first urination and I was almost relieved to see some blood in the urine meaning the biopsy had taken place! Still no pain or discomfort.

A boring day in bed and the next day the Urologist come to see me. He confirmed he had taken 12 samples and I was free to return home.

An appointment was made one week later at his clinic for the biopsy report.

The discharge protocol was carried out,  the medication collected and the bill paid. 6600 Baht.

My wife had ridden my motorbike down and I drove us the 25 Kilometers home.

Happily the results were all clear. The only problem being when the 7 day antibiotic tablets were finished I had some pain and difficulty urinating. Fortunately this coincided with my appointment and the Urologist gave me a further course.

However the Urologist could only offer TURP as a procedure for BPH but with cancer out of the picture I have time to see what other options are available. Incidentally I am 74 years old

 

 

22

TURP can be equally as bloodletting as HOLEP, depends on how much needs chopping away. Last quote govt hospital (prob TURP) was 265,000 baht,(not my provided figures), private hospital ,where HOLEP might exist many times more than that, depends which way the wind is blowing for quote, even then it's not fixed...Id say spend just over 5000 baht plus visa fee  and save 230,000 baht on govt, estimate and God knows what on private hospital quote and have far better experience, yes in india

[Sheryl]

There must be some mistake there. A TURP in a government hospital would not cost anything near that, in fact no surgery in a government hospital costs anything like that unless expensive imported equipement/supplies are involved (e.g; stents, titanium screws etc). Was this perhaps  for robotic surgery?

 

A simple (non-laparoscopic) TURP in a government hospital would usually be closer to 20,000 baht. Lapasoscopic, at least double that. Still nowhere near 100k let alone 200+.

 

But for robotic, possible it is as high as 250K.

[teddog]

7 hours ago, Sheryl said:

There must be some mistake there. A TURP in a government hospital would not cost anything near that, in fact no surgery in a government hospital costs anything like that unless expensive imported equipement/supplies are involved (e.g; stents, titanium screws etc). Was this perhaps  for robotic surgery?

 

A simple (non-laparoscopic) TURP in a government hospital would usually be closer to 20,000 baht. Lapasoscopic, at least double that. Still nowhere near 100k let alone 200+.

 

But for robotic, possible it is as high as 250K.

4

Sheryl, there have been many threads on this particular subject as you well know, it would be magnificent if surgery was as low as you state, but another thread few months ago,the poster must have trawled govt. hospitals for answers and that was the figure he stated,anyway up to whoever,  I intended India regardless         If the poster (above) is still experiencing pain after catheter removal I would ask the doc about sub meatal whatever, end of the cock collects scar tissue needs unblocking (now that hurts)  530 baht (click and its all over)

[Sheryl]

The cost is that low.  You will not find a government hospital charging mega bucks for a simple TURP.  Laparoscopic of course is more, and if you want robotics then indeed, big money. But not conventional TURP.

 

There would, of course, be a wait list for the procedure and other inconveniences at a government hospital.

 

Most of the TV members doing price searches aren't looking for a simple TURP.

 

It would not make much economic sense to go to India for a simple TURP. It would for a robotic procedure for for HOLEPs.

[lopburi3]

Price one year ago at government hospital here in Bangkok for radical cystectomy with ileal conduit was 80,000 baht and that is one of the most expensive procedures.  At private hospital was about 14 times that.

Edited August 16, 2017 by lopburi3

[giddyup]

Did the OP go to India for treatment?

[al007]

1 hour ago, giddyup said:

Did the OP go to India for treatment?

Yes and it was cost effective, very professional and very good

 

I will willingly discuss on the phone, a couple of people since have also been and happy

[zlodnick]

My prostate was really causing me a lot of grief and seriously affecting my quality of life. Medication wasn't working and it looked like it wouldn't be long before I would be unable to urinate at all. 

 

 After reading Al007's, (the OP), posts about surgery in India, I sent him a PM to get more information. I really wasn't sure if I could go through with the laser surgery. Just the thought of having anything inserted in my urethra gives me the creeps. He explained the process and said it wasn't a big deal. They give you a spinal block and you don't feel a thing. It was starting to sound better. By the end of our conversation, I was convinced.

 

He gave his surgeon in India my contact details and after a few emails back and forth, I headed out to New Delhi.

 

The surgery was nothing really. I spent a week in India, one day in the hospital, three days with a catheter then back home. I didn't enjoy it, but well, I wasn't there on holiday.

 

 That was back in March. Today, I'm a new man. I'm pissing like a kid again. Having the surgery was the best thing I could have done. I went through 20 years of urinary problems and to be free of that seems too good to be true.

 

 The cost was US$ 4,000. It would be about double that in Bangkok and 3-4 times that in a western country. The money wasn't really a concern. To me, the most important thing is the surgeon. The Dr. that the OP and I went to has had a lot of experience in the US and India. He was very confident and even guaranteed I would be satisfied with the results. I am VERY satisfied.

[giddyup]

4 minutes ago, zlodnick said:

My prostate was really causing me a lot of grief and seriously affecting my quality of life. Medication wasn't working and it looked like it wouldn't be long before I would be unable to urinate at all. 

 

 After reading Al007's, (the OP), posts about surgery in India, I sent him a PM to get more information. I really wasn't sure if I could go through with the laser surgery. Just the thought of having anything inserted in my urethra gives me the creeps. He explained the process and said it wasn't a big deal. They give you a spinal block and you don't feel a thing. It was starting to sound better. By the end of our conversation, I was convinced.

 

He gave his surgeon in India my contact details and after a few emails back and forth, I headed out to New Delhi.

 

The surgery was nothing really. I spent a week in India, one day in the hospital, three days with a catheter then back home. I didn't enjoy it, but well, I wasn't there on holiday.

 

 That was back in March. Today, I'm a new man. I'm pissing like a kid again. Having the surgery was the best thing I could have done. I went through 20 years of urinary problems and to be free of that seems too good to be true.

 

 The cost was US$ 4,000. It would be about double that in Bangkok and 3-4 times that in a western country. The money wasn't really a concern. To me, the most important thing is the surgeon. The Dr. that the OP and I went to has had a lot of experience in the US and India. He was very confident and even guaranteed I would be satisfied with the results. I am VERY satisfied.

Good to know. Was there any pain/discomfort after the surgery? Have the nightly visits to the loo ceased? Is the same procedure available in Bangkok?

Edited August 17, 2017 by giddyup

[zlodnick]

giddyup,

 

 The catheter wasn't painful, but uncomfortable.

 

 I was getting up to urinate 7-8 times a night before. Now 1-2 times. 

 

 As I understand it, laser surgery is available in Bangkok and Pattaya. I believe it's fairly new and the surgeons are not as experienced as in other countries.

[giddyup]

Just now, zlodnick said:

giddyup,

 

 The catheter wasn't painful, but uncomfortable.

 

 I was getting up to urinate 7-8 times a night before. Now 1-2 times. 

 

 As I understand it, laser surgery is available in Bangkok and Pattaya. I believe it's fairly new and the surgeons are not as experienced as in other countries.

Did you have to stay in a hotel after your one day in hospital?  What was the cost of a return trip to Delhi?

[zlodnick]

Nice hotel, $35, across the street from the hospital.

 

bkk-delhi  about $300  expedia

[giddyup]

3 minutes ago, zlodnick said:

Nice hotel, $35, across the street from the hospital.

 

bkk-delhi  about $300  expedia

All sounds like money well spent. Good to hear a success story.

[teddog]

Hell, I must be a Cheap Charlie...35 000  baht, yes I had Holep too,but my prostate was huge, estimate 170 grammes ,was140 7 years before , giving grief  but the bigger the more problems apparently and recovery delayed too. 5 days I spent in the hospital and the catheter was painful, asked for morphine,offered strips, but was withdrawn just after asking, total focus on the bag of piss hanging from bed   dark red ,light red then orange,thank God

  Almost want to be ill with those prices,64 slice MRI 150 baht?.  Anyway I'm over there soon enough  5500 baht return Calcutta,all my cancer scans... I asked Gavin about prices here in Thailand  40,000 baht for a FNA exercise, pinned the same procedure to 179 baht there

[al007]

5 hours ago, zlodnick said:

My prostate was really causing me a lot of grief and seriously affecting my quality of life. Medication wasn't working and it looked like it wouldn't be long before I would be unable to urinate at all. 

 

 After reading Al007's, (the OP), posts about surgery in India, I sent him a PM to get more information. I really wasn't sure if I could go through with the laser surgery. Just the thought of having anything inserted in my urethra gives me the creeps. He explained the process and said it wasn't a big deal. They give you a spinal block and you don't feel a thing. It was starting to sound better. By the end of our conversation, I was convinced.

 

He gave his surgeon in India my contact details and after a few emails back and forth, I headed out to New Delhi.

 

The surgery was nothing really. I spent a week in India, one day in the hospital, three days with a catheter then back home. I didn't enjoy it, but well, I wasn't there on holiday.

 

 That was back in March. Today, I'm a new man. I'm pissing like a kid again. Having the surgery was the best thing I could have done. I went through 20 years of urinary problems and to be free of that seems too good to be true.

 

 The cost was US$ 4,000. It would be about double that in Bangkok and 3-4 times that in a western country. The money wasn't really a concern. To me, the most important thing is the surgeon. The Dr. that the OP and I went to has had a lot of experience in the US and India. He was very confident and even guaranteed I would be satisfied with the results. I am VERY satisfied.

Thank you for your positive feed back, these days I prefer to correspond mainly by PM so I thus avoid the negative brigade and comments that disturb my simple head and mind

 

I will very willingly share anything I can on prostate, holep, prostate cancer and colorectal cancer, preferably on the phone

 

An observation my prostate surgeon in India USA trained stated that he finds cancer when doing the biopsy from the holep surgery in 60% of cases where prostate biopsy says no cancer, so a 12 sample biopsy is not necessarily so safe, a 24 section one maybe better but still not safe

 

I have assisted another member on penile implants with the same urologist

[giddyup]

2 hours ago, teddog said:

Hell, I must be a Cheap Charlie...35 000  baht, yes I had Holep too,but my prostate was huge, estimate 170 grammes ,was140 7 years before , giving grief  but the bigger the more problems apparently and recovery delayed too. 5 days I spent in the hospital and the catheter was painful, asked for morphine,offered strips, but was withdrawn just after asking, total focus on the bag of piss hanging from bed   dark red ,light red then orange,thank God

  Almost want to be ill with those prices,64 slice MRI 150 baht?.  Anyway I'm over there soon enough  5500 baht return Calcutta,all my cancer scans... I asked Gavin about prices here in Thailand  40,000 baht for a FNA exercise, pinned the same procedure to 179 baht there

Did you have Holep in India or Thailand? 35,000 baht seems pretty cheap anywhere.

[teddog]

1 hour ago, giddyup said:

Did you have Holep in India or Thailand? 35,000 baht seems pretty cheap anywhere.

India actually, used to live there , have more confidence in the place, standard rate throughout, looked at another hospital afterwards, doing it for 23 000. West coast, major cities will be more, Chennai,and Bangalore probably less

[al007]

When I started this thread just under a year ago, I only thought I had prostate problems, in the previous six months I had had, MRI scan;  CAT scan, Ultrasounds, and  colonoscopy, and recived reports in all cases no cancer around, with hindsight and on review of the results all incorrect, and 4/5 different doctors and technicians all involved

 

Fortunately I decided to go to India for Holep surgery, despite being told in various places getting up to pee three times in the night should not be complained about, I stuck to my decision to try and improve matters

 

In india I also decided to get second opinions on colonoscopy and blood loss from the bowels on a regular basis

 

After the Holep, the tissue removed was sent for biopsy

 

Both of these tests revealed separate and unrelated cancers, prostate cancer and colorectal cancer, the second being the worst

 

I was being faced with two lots of major surgery chemotherapy, and radiation treatment 

 

I was lucky and wound up at Chulalongkorn, probably the best equipped cancer hospital in Thailand

 

So far I have avoided the surgery, and am on watch , wait and see, after successful chemo and radiation treatment, but from reading below, I know those cancer cells are still there, but again from below surgery could spread the cancer

 

I consider myself lucky and fortunate, today i am still here and happy, I was fortunate to discover through my own persistence the cancers at relatively early stages a year ago

 

I continue to do my own research and learn, and attach what I consider some very relevant information from the John Hopkins Cancer hospital in the States

 

 

Subject:   From John Hopkins--Cancer Update 

AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY
('TRY', BEING THE KEY WORD) TO ELIMINATE CANCER, JOHNS HOPKINS IS
FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY .

Cancer Update from Johns Hopkins:

1. Every person has cancer cells in the body. These cancer
  cells do not show up in the standard tests until they have
  multiplied to a few billion. When doctors tell cancer patients
  that there are no more cancer cells in their bodies after
  treatment, it just means the tests are unable to detect the
  cancer cells because they have not reached the detectable
  size.

2. Cancer cells occur between 6 to more than 10 times in a
  person's lifetime..

3. When the person's immune system is strong the cancer
  cells will be destroyed and prevented from multiplying and
  forming tumors.

4. When a person has cancer it indicates the person has
  nutritional deficiencies. These could be due to genetic,
  but also to environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing
  diet to eat more adequately and healthy, 4-5 times/day
    and by including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing
  cancer cells and also destroys rapidly-growing healthy cells
  in the bone marrow, gastrointestinal tract etc, 

  and can cause organ damage, like liver, kidneys, heart, lungs etc.

7.. Radiation while destroying cancer cells also burns, scars
  and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often
  reduce tumor size. However prolonged use of chemotherapy

   and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from
  chemotherapy and radiation the immune system is either
  compromised or destroyed, hence the person can succumb
  to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to
    mutate and become resistant and difficult to destroy.
    Surgery can also cause cancer cells to spread to other sites.

11. An effective way to
    battle cancer is to starve the cancer
    cells by not feeding it with the foods it needs to multiply.

*CANCER CELLS FEED ON:

a. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made
  with Aspartame and it is harmful. A better natural substitute
   would be Manuka honey or molasses, but only in very small
   amounts. Table salt has a chemical added to make it white in
  color. Better alternative is Bragg's aminos or sea salt.

b. Milk causes the body to produce mucus, especially in the
  gastro-intestinal tract. Cancer feeds on mucus. By cutting
  off milk and substituting with unsweetened soy milk cancer
  cells are being starved.

c. Cancer cells thrive in an acid environment. A meat-based
   diet is acidic and it is best to eat fish, and a little other meat,
   like chicken. Meat also contains livestock
   antibiotics, growth hormones and parasites, which are all
   harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole
  grains, seeds, nuts and a little fruits help put the body into
  an alkaline environment. About 20% can be from cooked
  food including beans. Fresh vegetable juices provide live
  enzymes that are easily absorbed and reach down to
  cellular levels within 15 minutes to nourish and enhance
  growth of healthy cells. To obtain live enzymes for building
  healthy cells try and drink fresh vegetable juice (most
  vegetables including bean sprouts) and eat some raw
  vegetables 2 or 3 times a day. Enzymes are destroyed at
  temperatures of 104 degrees F (40 degrees C)..

e. Avoid coffee, tea, and chocolate, which have high
  caffeine Green tea is a better alternative and has cancer
  fighting properties. Water-best to drink purified water, or
  filtered, to avoid known toxins and heavy metals in tap
  water. Distilled water is acidic, avoid it.

12. Meat protein is difficult to digest and requires a lot of
    digestive enzymes. Undigested meat remaining in the
    intestines becomes putrefied and leads to more toxic
    buildup.

13. Cancer cell walls have a tough protein covering. By
    refraining from or eating less meat it frees more enzymes
    to attack the protein walls of cancer cells and allows the
    body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system
    (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals,
    EFAs etc.) to enable the bodies own killer cells to destroy
    cancer cells.. Other supplements like vitamin E are known
    to cause apoptosis, or programmed cell death, the body's
    normal method of disposing of damaged, unwanted, or
    unneeded cells.

15. Cancer is a disease of the mind, body, and spirit.
    A proactive and positive spirit will help the cancer warrior
     be a survivor. Anger, un-forgiveness and bitterness put
     the body into a stressful and acidic environment. Learn to
     have a loving and forgiving spirit. Learn to relax and enjoy life.

16. Cancer cells cannot thrive in an oxygenated
    environment. Exercising daily, and deep breathing help to
    get more oxygen down to the cellular level. Oxygen
    therapy is another means employed to destroy cancer cells.

1. No plastic containers in micro.

2. No water bottles in freezer.

3. No plastic wrap in microwave..

Johns Hopkins has recently sent this out in its newsletters. This
information is being circulated at Walter Reed Army Medical Center as
well. Dioxin chemicals cause cancer, especially breast cancer. Dioxins
are highly poisonous to the cells of our bodies. Don't freeze your
plastic bottles with water in them as this releases dioxins from the
 plastic. Recently, Dr Edward Fujimoto, Wellness Program Manager at
Castle Hospital , was on a TV program to explain this health hazard.
He talked about dioxins and how bad they are for us. He said that we
should not be heating our food in the microwave using plastic
containers. This especially applies to foods that contain fat. He said
that the combination of fat, high heat, and plastics releases dioxin
into the food and ultimately into the cells of the body. Instead, he
recommends using glass, such as Corning Ware, Pyrex or ceramic
containers for heating food. You get the same results, only without
the dioxin. So such things as TV dinners, instant ramen and soups,
etc., should be removed from the container and heated in something
else. Paper isn't bad but you don't know what is in the paper. It's
just safer to use tempered glass, Corning Ware, etc. He reminded us
that a while ago some of the fast food restaurants moved away from the
foam containers to paper The dioxin problem is one of the reasons.
Please share this with your whole email list.........................
Also, he pointed out that plastic wrap, such as Saran, is just as
dangerous when placed over foods to be cooked in the microwave. As the
food is nuked, the high heat causes poisonous toxins to actually melt
out of the plastic wrap and drip into the food. Cover food with a
paper towel instead.



 

 

 

 

 

 

[Sheryl]

This did NOT come from Johns Hopkins and it contains dangerous quackery.

 

And no one, anywhere, has ever said that "chemotherapy is the only way to try"