Need some advice regarding possible skin cancer/melanoma treatment in Thailand

[TSF]

I'm 71 yo, retired in Thailand, currently on holiday with my Thai wife in Perth, Australia. While I'm in Perth I've had some routine health check-ups and all is good. 

However I have a couple small sunspots on my left arm that require a closer look. This morning I saw a skin specialist and he wants to do a biopsy on these spots as there's a possibility they could be early cancerous and require removing or other treatment. 

I wanted a second opinion so an hour later I saw another doctor at a different clinic (I didn't tell him anything about already seeing the skin specialist) and this second doctor also said these spots need closer inspection and may require a biopsy and removal. So something needs to be done.

Now, we have flights booked back to Thailand in just under 3 weeks, and Xmas/NY is almost here. So not much, if anything, will get done before we depart.

Should I go see skin specialists at a hospital in Thailand (we live in Korat) and do what needs to be done there? Or should I return to Perth after a few weeks and continue with the skin specialist I saw this morning?

Cost is also a factor. In Australia I hold the Medicare card, but don't have any private health insurance and don't have any pension card. So I have to pay myself for any tests & treatment. I can get free treatment at gov' hospitals but I believe the waiting list is long.

In Thailand I don't have health cover, but I know from past experience that medical treatment is very much cheaper than Western countries, particularly in the Thai gov hospitals.

I'm interested in hearing from anyone who has had this type of treatment done in Thailand and how it went and what the charges were.

[Sheryl]

Thai doctors -- even highly experienced dermatologists -- have little to no experience with skin cancers because they are very, very rare in Thais. (Australia is at the other end of the spectrum, the skin cancer/melanoma capital of the world and thus the place with by far the most medical expertise in it).  Many, many cases of skin cancers being missed/misdiagnosed here.

 

The only doctor I can recommend for this is Dr. Anna Jaruwan in Pattaya and she is at one of the (arguably the) most expensive hospitals in the country. Biopsy there will run you at least 15,000 baht per spot, more or less depending on depth of the lesion.

 

If you can afford this amount and a trip to Pattaya fine, otherwise go back to Oz.  I do nto recommend treatment in Issan for this.

 

 

[TSF]

Thanks Sheryl, what you say makes sense so I guess I'd better return after a couple weeks and sort it out here in Perth.

[livram]

You may just want to spend a day to just have them removed Small scar on arm and you will have peace of mind after test results.

 

have had several skin cancers removed from my chest and back. Removed quickly via scalpel. Tested with results a week later. BCC but clear around the edges so all removed.

 

Bangkok Hospital wanted 60K-70K and night in hospital.

Had 2 different lesions removed from St Mary's - 12K each operation. Satisfied.

But the best was Saranaree University Hospital outside Korat. Two operations months apart to remove 2 lesions from chest and also 2 lesions from back. SUT Hospital is very modern and latest equipment. 33450 Baht total including biopsy to see if really cancer and if all removed, followup for stitches removed. Total cost 3450 Baht.

 

Outside of Korat and plan on taking Thai speaker. Can be done without but Thai speaker helps speed process.

[TSF]

livram: Thanks for your reply. We live in Pak Thong Chai, so Saranaree University Hospital is actually closer to me than Korat hospitals. It'll probably be a good idea to drop in and see them when I'm back in Thailand in a couple of weeks.

[arjunadawn]

My wife is a dermatologist in Thailand. She sees this, but as Cheryl notes, not so much. I offer no medical advice but it occurs to me that the biopsy, if recommended, is both therapeutic and diagnostic. You should take images now, with a coin or scale, or measurements, and plan on doing that in the future from time to time. This way, no matter who you see and when, you have an established baseline to comment on any changes in size. Have loved one ensure there are no others, and do not postpone this. I would suggest my wife, but that is simply mercenary. I pray you good health but strongly urge you not to dither. Godspeed.

[Sheryl]

In Thailand you need to be concerned about the limited experience not just of the dermatologist but also the pathologist who does the biopsy.

 

If it is a BCC or even an SCC, any errors will likely not be catastrophic  but do not take any chances if there is any suspicion of possible melanoma - go back to Oz. I've seen some people lose thir lives by failing to do that in a timely manner.

 

[TSF]

Thank you arjunadawn & Sheryl for your kind words and concern. I can't see a dermatologist here right at the moment as they are mostly shut down for the Xmas period and not taking appointments until mid Jan. While these spots are cause for concern, I'm not going into panic mode right at the moment. My Thai wife frequently applies body lotion to my arms & legs after I shower and she tells me I've had these spots for ages and they haven't changes in size or appearance...but yes I will be having them seen to and dealt with in the very very near future.

 

I'm returning to Thailand first week in Jan and will be flying back to Perth a couple weeks later to see another skin specialist. While in Thailand I will drop by the Suranee University Hospital in Pak Thong Chai and see what they say too. But regardless of what the Suranee docs say I'll still fly back to Perth around 3rd week in Jan. 

[TSF]

On 12/21/2018 at 8:16 PM, arjunadawn said:

My wife is a dermatologist in Thailand. She sees this, but as Cheryl notes, not so much. I offer no medical advice but it occurs to me that the biopsy, if recommended, is both therapeutic and diagnostic. You should take images now, with a coin or scale, or measurements, and plan on doing that in the future from time to time. This way, no matter who you see and when, you have an established baseline to comment on any changes in size. Have loved one ensure there are no others, and do not postpone this. I would suggest my wife, but that is simply mercenary. I pray you good health but strongly urge you not to dither. Godspeed.

 

On 12/21/2018 at 10:44 PM, Sheryl said:

In Thailand you need to be concerned about the limited experience not just of the dermatologist but also the pathologist who does the biopsy.

 

If it is a BCC or even an SCC, any errors will likely not be catastrophic  but do not take any chances if there is any suspicion of possible melanoma - go back to Oz. I've seen some people lose thir lives by failing to do that in a timely manner.

 

arjunadawn & Sheryl: Here's the update on my situation: I went to Thailand early Jan' and saw a doctor at Saranaree University Hospital, Korat. A very nice lady, she had a quick look at me and asked if I used a moisturiser and then prescribed two creams for me to use. A week later I flew back to Perth and saw a skin cancer specialist, she went over my body with a big magnifying glass instrument the size of a tennis racquet and ordered 3 biopsies. I got the results last week, nothing too serious, no melanomia, one is early skin cancer and the doc will cut that out this Monday, the others can be treated with freezing. Then I'll need a course of fluorouracil 5% cream. The specialist told me I'm lucky that I got the check up when I did, my skin condition is not so serious and can be treated, but if I left it for a longer time then I could have some big problems. I need to remain in Perth for approx two months until everything is completed, then I'll return to Thailand. But now I've made a lifestyle change...no more lying on beaches and riding motorcycles wearing singlets & shorts. 

[BAYBOY]

Last year a small " wart" on my right leg,which I have had for years, started to grow out wards.
Saw a cancer doctor friend in Siriraj Hospital Bangkok, who got me into the Skin Clinic (4th floor OPD building) for specialists to look at.Two doctors checked my growth, followed by six doctors in training, then the head of the department, and finally a Professor from the Mahidol University.
The interest was because they do not have many skin cancer cases in Thailand, but told me it is increasing more these days. Ozone layer, climate change??

Up shot the next week a biopsy, skin cancer confirmed...week later 2 growths cut out, under local, next week checked, next week stiches removed, and a full check of arms, hands, and both legs.....several bumps treated with nitrogen spray and 2 more cut from my right arm. See them every 3 months for checks nothing further.

Excellent service, staff as usual friendly and helpful.

Can remember that the cost of the leg growth was 3500 b, and the other visits in the low hundreds.

Have lived in Thailand for 20 years, always wear trousers when working outside, plus long sleeved shirtsnd hat. Would never sit sun bathing, just suffering rhe sins of a youth spent at the beach 60 years ago.
Cheers,
BAYBOY.

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[downunder66]

I had a mole on my back inspected in Singapore a few years ago and they tested it and told me not to worry. Less than 6mths after returning to Australia it was re-tested and I was told it was melonoma. It was removed but less than a year later I was found to have stage 4 melonoma (inoperable). I had to get immunotherapy infusions for 12mths and if the government didn’t pay I was up for about AUD400,000 (that’s how expensive it was). The government did pay through Medicare and the only fees I ever had were at my Specialist visits at about $130 a pop. My recommendation is great this seriously and get it solved only in Australia, and quickly - they have the know how and you won’t have to pay out a lot of money.


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[TSF]

@downunder66: agree, in Oz they have the experience and expertise. That's why I flew back to Perth and getting my treatment there and not in Thailand (where I'd rather be right now) there's also the added plus that the cost of all my treatment is covered by Medicare. 

[davidst01]

On 12/20/2018 at 1:55 PM, Sheryl said:

Thai doctors -- even highly experienced dermatologists -- have little to no experience with skin cancers because they are very, very rare in Thais. (Australia is at the other end of the spectrum, the skin cancer/melanoma capital of the world and thus the place with by far the most medical expertise in it).  Many, many cases of skin cancers being missed/misdiagnosed here.

 

The only doctor I can recommend for this is Dr. Anna Jaruwan in Pattaya and she is at one of the (arguably the) most expensive hospitals in the country. Biopsy there will run you at least 15,000 baht per spot, more or less depending on depth of the lesion.

 

If you can afford this amount and a trip to Pattaya fine, otherwise go back to Oz.  I do nto recommend treatment in Issan for this.

 

 

If your talking about dr anna at bkk hospital then I agree its the most expensive in LOS. 

 

She diagnosed a suspicious spot on my leg last yr. I declined her offer to do biopsy at the hospital and did it at the local govt hospital. Turned out it was not a problem. 

 

At the time I asked her for advice on another skin issue. When paying the bill she added on a drug for me to take which was rediculously expensive. I told the cashier I didnt want it. 10min later it was taken off the bill and I bought it 1/5 of the price in town. 

[TSF]

On 2/18/2019 at 8:43 PM, davidst01 said:

If your talking about dr anna at bkk hospital then I agree its the most expensive in LOS. 

 

She diagnosed a suspicious spot on my leg last yr. I declined her offer to do biopsy at the hospital and did it at the local govt hospital. Turned out it was not a problem. 

 

At the time I asked her for advice on another skin issue. When paying the bill she added on a drug for me to take which was rediculously expensive. I told the cashier I didnt want it. 10min later it was taken off the bill and I bought it 1/5 of the price in town. 

I had a similar thing at a hospital in Udon some years ago, saw a doc there, she gave me a perscription, when I went to pay the cashier it was outrageous, from memory about 3,000Bt, I asked the cashier why so much, the med was some expensive import from Europe, so I said don't you have the same med from Thailand...yes they did, the bill then went down to about 500Bt.