Cancer treatment in Thailand

[medic5678]

My mother in law just had a CT done and it shows a mass with mets to lymph nodes.  She is a poor Thai woman and I am wondering what our treatment options are and what they will cost if I pay for health care at a cancer treatment center.  Anyone with information and experience, your input is much appreciated.  I am sure this is a death sentence, but I would like to make her more comfortable and extend her life to give her quality time.   I am sending her daughter and granddaughter to Thailand so they can be with her through the summer.   

[ezzra]

Jut seen on Aussie Tv the other day how they are doing miracles with terminal stricken cancer people whereby the re rejuvenate and re energize the white blood cells in a laboratory setting and re inject it back to patient and many, astonishingly, has gone to remission and are now cancer free, of course, thees things are light away from happening in Thailand as i'm gut wrenchingly witnessing the demise of a dear friend who is also in dire predicament owing to aggressive breast cancer that has now metastasize to all over her body...

[ChipButty]

I guess it depends where she lives and what facilities they have in the area, International hospitals is going to cost you a small fortune in Bangkok there is a superb cancer hospital sorry I would have to ask the wife the name of it, 

If the cancer operation is not bad enough then along comes Chemotherapy and Radio.

That Chemo is a killer I thought my wife was going to die on me one night I kept her awake allnight had the A/C on freezing walking her around sit on the computer for a while, I was worried, 

Strange feeling when in the morning the sun is coming up shinning through the windows and she survived the night you can breath a sigh of relieve, put the kettle on and make a cup of Tea,

I forget to add, I bought a few of them cold towels from 7/11  

[lopburi3]

Having cancer myself have come to the conclusion that life extension drug treatments are not cost effective for myself so prepared to meet end a few days earlier when alternative operative methods are no longer available.  Believe suffering/pain is more of a concern than the extra month(s) or so drugs may provide.  We all seem to die so making that as pain free as possible seems to be a better goal.

 

I did try targeted liver cancer medication for a month - not happy with it (or the medical used car sellers push to use it) but do understand some may not have as bad reactions as others when taking.   As for cost the special drugs can run very close to US prices in private treatment hospitals.  

[longball53098]

I went through having cancer here in LOS. 4 years ago had tongue cancer that metastasized to my lymph nodes in right neck. Had tongue surgery and neck surgery and then 6 weeks of chemo radiation treatments in early 2017. I survived all that in Bangkok. My surgeon was an ENT that works at BNH hospital and Bangkok med center also and other places too I assume. The surgery was hell on my body and mind and the radiation was terrible too. The effects of chemo for me were not bad as the treatment of chemo was a very mild chemo but the radiation on my mouth and neck was incredibly damaging to my mouth and neck. Rad was done at Chulalongkorn Hospital and chemo at BNH. We lived in BKK for 7 weeks during that time. 

I am still here today thanks to them but my life is not great. The follow-up rehab and any treatments have been extremely poor and all my questions regarding what I can do or who I can see went unanswered. Now 4 years later I have a PEG tube in my stomach for all my liquid food since July last year due to my tongue and throat not co-operating and I started choking on any food or liquid and I was aspirating too much.  The docs I inquire to about do not have any more of a help than too do swallowing exercises to improve my muscles in my throat that control the automatic swallow function. I have tried this and it doe not help. I don' know what my next move/option is. I do not live in BKK but in Rayong. So I am better off than a local Thai neighbor. She had a very similar cancer as me. Strictly treated at government expense. She last about 6 or 8 months.  So position in life and access to care means a lot it seems.

I was never made aware of any special cancer treatment centers even to this day. If there are any they would be in BKK. All of my follow-up MRIs and tests show I am still cancer free. The scar tissue in my throat area and my reconstructed tongue are the worst of this and the after effects of the radiation also and to date no one has recommended a way to improve this. I feel if I were in the US I would not be in the same condition. The docs and nurses here are good but I think they are still way behind.

[medic5678]

2 minutes ago, longball53098 said:

I went through having cancer here in LOS. 4 years ago had tongue cancer that metastasized to my lymph nodes in right neck. Had tongue surgery and neck surgery and then 6 weeks of chemo radiation treatments in early 2017. I survived all that in Bangkok. My surgeon was an ENT that works at BNH hospital and Bangkok med center also and other places too I assume. The surgery was hell on my body and mind and the radiation was terrible too. The effects of chemo for me were not bad as the treatment of chemo was a very mild chemo but the radiation on my mouth and neck was incredibly damaging to my mouth and neck. Rad was done at Chulalongkorn Hospital and chemo at BNH. We lived in BKK for 7 weeks during that time. 

I am still here today thanks to them but my life is not great. The follow-up rehab and any treatments have been extremely poor and all my questions regarding what I can do or who I can see went unanswered. Now 4 years later I have a PEG tube in my stomach for all my liquid food since July last year due to my tongue and throat not co-operating and I started choking on any food or liquid and I was aspirating too much.  The docs I inquire to about do not have any more of a help than too do swallowing exercises to improve my muscles in my throat that control the automatic swallow function. I have tried this and it doe not help. I don' know what my next move/option is. I do not live in BKK but in Rayong. So I am better off than a local Thai neighbor. She had a very similar cancer as me. Strictly treated at government expense. She last about 6 or 8 months.  So position in life and access to care means a lot it seems.

I was never made aware of any special cancer treatment centers even to this day. If there are any they would be in BKK. All of my follow-up MRIs and tests show I am still cancer free. The scar tissue in my throat area and my reconstructed tongue are the worst of this and the after effects of the radiation also and to date no one has recommended a way to improve this. I feel if I were in the US I would not be in the same condition. The docs and nurses here are good but I think they are still way behind.

What did all this cost you?  I wonder if there are treatments for Thai citizens a tier above government expense, which would be affordable and produce a better outcome.  

[longball53098]

The total from start to end is a guesstimate but the 16 day stay in hospital for the surgery and recovery was about 1 million THB but add in all the various testing and chemo/ radiation and such maybe another million. 

[ChipButty]

18 minutes ago, medic5678 said:

What did all this cost you?  I wonder if there are treatments for Thai citizens a tier above government expense, which would be affordable and produce a better outcome.  

I think most of the hospitals have a private section, for Thais 

[Sheryl]

She can receive treatment for free through the government hospital system. There are a number of regional cancer hospitals within the public health system and care is free with a letter of referral from the hospital where she is registered under the universal health care system (there is supposed to be a reform whereby the referral letter is nto longer required but I am nto sure how that is working. Should not be a problem to get the referral).

 

Certainly no reason to pay for private chemo or radiation, nor for surgery if indicated (yo udo nto indicate where the tumor is located). However, if the hospital which treats her is located far from home (often the case), there will be travel costs which the family has to bear and might need help with.

 

What she will probably not get from the public system is:

 

(1) an honest and detailed explanation of her options and prognosis, the norm is to tell the patients very little other than their appointment dates. And while patients have the right to refuse treatment, that right is seldom utilized both for cultural reasons and lack of understanding. If she and/or her family want to get a detailed, frank explanation and to make informed decisions they would do well to have a private consultation with an oncologist. A simple consultation will nto cost more than 1000 - 2000 baht max.

 

(2) optimal palliative care. For that, should be under the care of a palliative specialist and these rae available in only a few places. Also, need to specifically ask for it.

 

I could advise better if I knew where in Thailand she was and at what hospital she has so far been treated. And where the tumor is.

 

if it is breast cancer and the spread is only to adjacent lymph nodes, or even axillary lymph nodes on the same side, the prognosis is actually good with treatment.

 

 

 

 

[medic5678]

2 minutes ago, Sheryl said:

She can receive treatment for free through the government hospital system. There are a number of regional cancer hospitals within the public health system and care is free with a letter of referral from the hospital where she is registered under the universal health care system (there is supposed to be a reform whereby the referral letter is nto longer required but I am nto sure how that is working. Should not be a problem to get the referral).

 

Certainly no reason to pay for private chemo or radiation, nor for surgery if indicated (yo udo nto indicate where the tumor is located). However, if the hospital which treats her is located far from home (often the case), there will be travel costs which the family has to bear and might need help with.

 

What she will probably not get from the public system is:

 

(1) an honest and detailed explanation of her options and prognosis, the norm is to tell the patients very little other than their appointment dates. And while patients have the right to refuse treatment, that right is seldom utilized both for cultural reasons and lack of understanding. If she and/or her family want to get a detailed, frank explanation and to make informed decisions they would do well to have a private consultation with an oncologist. A simple consultation will nto cost more than 1000 - 2000 baht max.

 

(2) optimal palliative care. For that, should be under the care of a palliative specialist and these rae available in only a few places. Also, need to specifically ask for it.

 

I could advise better if I knew where in Thailand she was and at what hospital she has so far been treated. And where the tumor is.

 

if it is breast cancer and the spread is only to adjacent lymph nodes, or even axillary lymph nodes on the same side, the prognosis is actually good with treatment.

 

2 minutes ago, Sheryl said:

It is lung cancer, with mets to lymph nodes.  She is in Kamphaeng Phet.  Thus far, just a CT scan done, which I paid for.  They thought initially she had fluid on her lung and tried to do a thoracentesis, when they realized that there was no fluid, but instead a hard mass.  Thank you for your help here, it is much appreciated.  I can come up with $1000 a month for treatment, if it will make a real difference.  No biopsy yet, so I don't know exactly what we're dealing with.  They will begin testing on Wednesday.  From the CT, it appears to be at stage 3.

 

 

 

[ivor bigun]

Our sons girlfriends father was having stomach pains just over a week ago ,he was diagnosed with a stomach cancer ,taken into Chonburi hospital (they live in the area) had an operation next day ,he is in hospital now ,i know he is on the 30baht scheme ,sorry thats all i can tell you.

[Sheryl]

 

 

Lung cancer stage 2 or 3, prognosis is probably terminal but she could have a few more years. Treatment will likely involve surgery, radiation and chemo and can buy as much as a few years of life.

 

However first need to rule out stage 4 which cannot be done from lung CT, have to do additional scans to rule out metastasis to other organs e.g. bones,brain and liver.

 

Stage 4 is definitely terminal and unlike stage 3, not much gained by aggressive treatment - a few more months at best and this at the price of being constantly in the hospital. So determining whether or not there is metastasis to other organs is very important to making decisions about care. Personally I would seriously consider no treatment in favor of palliation only if stage 4. Whereas stage 3, might agree to treatment - so the distinction is important and can only be made after brain, liver and bone scans.

 

From Kamphaeng Phet I am not sure which hospital they will refer her to: might be Lampang Cancer Center or Lopburi Cancer Center. Depending on where in Kamphaeng Phet she is, that will be about 3 hour trip each way and one usually has to be at these places first thing in the morning so think in terms of say a 2 night hotel stay each trip unless they have family nearby.

 

Or possibly they would just send to Pitsanoluk  Hospital (Buddhachinaraj Hospital) , not an oncology specialty hospital but it is a regional level hospital. There is also a University hospital in Pitsanoluk (Naresuan University Hospital) though I don't know if it has capability for cancer treatment.  treatment in Pitsanoluk will involve probably about 1 - 12 hour trip each way.

 

Private hospitals in that region are small with limited capacities and not very good. 

 

Treatment should be free at the government hospital unless some new/experimental drugs are recommended. And as there is also often a long wait for scans at government facilities there might be reason to pay privately to do them at a private imaging center instead (hospital staff will advise).

 

In terms of palliative care, there is a team in the Lampang area see this website  https://peacefuldeath.co/pcnearhome/

Might be worth contacting some of the resource people listed. There is also a facebook page  https://www.facebook.com/groups/452080111507479/

When the time comes, would be important to transfer her from the care of oncologists to the primary care of a palliative specialist. This can be done but has to be assertively requested.

 

 

[Sheryl]

P.S. forgot to mention - free care under the government system includes only a ward room. Which is especially difficult for accompanying relatives. A private room, which will have some sort of sofa for a family member to sleep, will cost around 1,500 - 2,000 baht a night.

 

So I think in terms of what you might want to help with financially it would be:

 

travel costs

private room

maybe scans done privately to avoid long wait

[teacherclaire]

3 hours ago, lopburi3 said:

Having cancer myself have come to the conclusion that life extension drug treatments are not cost effective for myself so prepared to meet end a few days earlier when alternative operative methods are no longer available.  Believe suffering/pain is more of a concern than the extra month(s) or so drugs may provide.  We all seem to die so making that as pain free as possible seems to be a better goal.

 

I did try targeted liver cancer medication for a month - not happy with it (or the medical used car sellers push to use it) but do understand some may not have as bad reactions as others when taking.   As for cost the special drugs can run very close to US prices in private treatment hospitals.  

 

   Sorry to hear of your misfortune. A friend of mine, a psychologist at the local hospital, prescribes morphine to many people, including foreigners.

Why suffer if there's an easier way? 

I hope that you'll find the best possible solution. 

[lopburi3]

10 minutes ago, teacherclaire said:

 

   Sorry to hear of your misfortune. A friend of mine, a psychologist at the local hospital, prescribes morphine to many people, including foreigners.

Why suffer if there's an easier way? 

I hope that you'll find the best possible solution. 

Actually have no seen cancer at present and in fairly good health but can not expect that to last forever as the liver cancer has already recurred once.  RFA treatment has thus far been very effective for the primary liver cancers (which appeared a few years after primary bladder cancer which removal took care of but probably would not have been found as early if not under observation for any spread).  But this all in 70's so can not complain.  

 

 

[ChipButty]

1 hour ago, teacherclaire said:

 

   Sorry to hear of your misfortune. A friend of mine, a psychologist at the local hospital, prescribes morphine to many people, including foreigners.

Why suffer if there's an easier way? 

I hope that you'll find the best possible solution. 

Somebody said that to me years ago do what Thai's do get on the opium you could last another 3 to 4 years, how true I dont know

[Sheryl]

A post with dangerous misinformation and reply to it have been removed.

[Smelg]

There is a hospital that does that gene altering treatment on your blood and inject it back in your body ..its called immunotherapy ..the hospital is called Akesis Life ..21 Fl.253 Asoke building , Sukhumvit 21   Bangkok 10110

[sirocco]

Indeed, and there is a hospital that does it in Germany, but the price is very high.
More than 90,000 Euros, and it is not certain that this treatment will be effective for all patients.

[lopburi3]

20 minutes ago, sirocco said:

Indeed, and there is a hospital that does it in Germany, but the price is very high.
More than 90,000 Euros, and it is not certain that this treatment will be effective for all patients.

Indeed believe it is an option at many hospitals - cost is about double what targeted drugs cost (and they are very expensive). 

Edit:   LENVIMA was targeted drug what I took for a month and cost was about 3,000 baht per day/pill.

Edited February 13, 2021 by lopburi3

[medic5678]

6 hours ago, Sheryl said:

P.S. forgot to mention - free care under the government system includes only a ward room. Which is especially difficult for accompanying relatives. A private room, which will have some sort of sofa for a family member to sleep, will cost around 1,500 - 2,000 baht a night.

 

So I think in terms of what you might want to help with financially it would be:

 

travel costs

private room

maybe scans done privately to avoid long wait

Thank you so much for your advice.  First we'll have to find out exactly what we're dealing with.  If I could only get her in the U.S., I could get higher end treatment but that is just a pipe dream.   Now trying to send my wife and daughter back to Thailand for the summer.  It's a challenge to get into Thailand from the U.S.  Not sure if we'll get mired in red tape.

[Sheryl]

14 hours ago, medic5678 said:

Thank you so much for your advice.  First we'll have to find out exactly what we're dealing with.  If I could only get her in the U.S., I could get higher end treatment but that is just a pipe dream.   Now trying to send my wife and daughter back to Thailand for the summer.  It's a challenge to get into Thailand from the U.S.  Not sure if we'll get mired in red tape.

 

Getting into Thailand from US is same as getting into Thailand from anywhere else. They will have to quarantine for 14 days on arrival.

[ChipButty]

15 hours ago, medic5678 said:

Thank you so much for your advice.  First we'll have to find out exactly what we're dealing with.  If I could only get her in the U.S., I could get higher end treatment but that is just a pipe dream.   Now trying to send my wife and daughter back to Thailand for the summer.  It's a challenge to get into Thailand from the U.S.  Not sure if we'll get mired in red tape.

My friend had to do the Quarantine coming from the US 

[medic5678]

I can spend about $10 to $15k on this.  Not sure if that is enough to really make a difference vs. the traditional medical system.  Unfortunately, I have had a huge investment loss and that has severely affected my ability to afford treatment for her.  Again, this is stage 3 lung cancer, with mets to lymph nodes.    

[ChipButty]

1 hour ago, medic5678 said:

I can spend about $10 to $15k on this.  Not sure if that is enough to really make a difference vs. the traditional medical system.  Unfortunately, I have had a huge investment loss and that has severely affected my ability to afford treatment for her.  Again, this is stage 3 lung cancer, with mets to lymph nodes.    

Its no where near enough for the international hospitals my first bill was 300,000 baht let her go to the government hospitals

[medic5678]

3 minutes ago, ChipButty said:

Its no where near enough for the international hospitals my first bill was 300,000 baht let her go to the government hospitals

That's what I thought, but I can perhaps afford better medications for her.

[lopburi3]

19 minutes ago, medic5678 said:

That's what I thought, but I can perhaps afford better medications for her.

Actually for the most part government hospitals do have access to first class medications.  Perhaps a better use for funds would be for hire of nursing help (at least until family can provide)?  Most government hospitals have staff ready to work in a private capacity during off-time.  This may not be required now but perhaps home help is?  I know in the past mail order medications from India is sometimes advised for advanced items without high markups but that would be specific to a handful of items and doctors will sometimes recommend doing this.  But I am not medical so just providing experience and hearsay so the more you can tell Sheryl the more help she can be.

[Sheryl]

3 hours ago, medic5678 said:

That's what I thought, but I can perhaps afford better medications for her.

 

It is by no means a given that there are "better" medications that would make a difference compared to what she will receive in the government system.  Most likely not.

 

Private chemo and radiation would run to millions of baht, and likely nto give any better outcome than treatement through the government system.

 

As mentioned what you can help with that would matter - and will also fit within your budget - would be:

 

travel costs

private room

paying privately for scans if there owuld otherwise be a long wait (often the case)

 

[Sheryl]

4 hours ago, medic5678 said:

 Again, this is stage 3 lung cancer, with mets to lymph nodes.    

 

Actually this is not at all sure from what you say. All that is known is a mass present with lymph node involvement, and even that should be taken with a grain of salt unless/until a specialist has reviewed the scan (the radiology reports one with a scan here  aren't worth the paper they are printed on).  I have seen several cases where supposed lung masses turned out not to be present at all. And even if a mass is present, there are other potential causes besides cancer.

 

And if it is lung cancer, cannot stage it without getting liver, bone and brain scans done.

 

 

 

 

[medic5678]

5 hours ago, lopburi3 said:

Actually for the most part government hospitals do have access to first class medications.  Perhaps a better use for funds would be for hire of nursing help (at least until family can provide)?  Most government hospitals have staff ready to work in a private capacity during off-time.  This may not be required now but perhaps home help is?  I know in the past mail order medications from India is sometimes advised for advanced items without high markups but that would be specific to a handful of items and doctors will sometimes recommend doing this.  But I am not medical so just providing experience and hearsay so the more you can tell Sheryl the more help she can be.

Her daughter will quit working and stay with her around the clock.  We'll be sending her to Nakhon Sawan for oncology.  We have just finished building a house so she's got a great place to live.  There is more than enough family available so she will have excellent around the clock care (assuming she doesn't need skilled nursing).