Now available in Thailand, new laser technique has reduced side effects and shorter recovery period.

Benign Prostatic Hyperplasia (BPH) is the most common non-cancerous enlargement of the prostate gland in men, and the chance of suffering from this problem increases with age. It is now known that half of all men will have BPH by the age of 60 years, and by 85 years the prevalence is about 90%. In the USA alone surgical procedures to treat BPH makes this the second most common surgical procedure, second only to cataract surgery.

There are a number of treatment options most common of which is surgical removal of the prostate's inner portion by endoscopic approach through the urethra, called TURP, often requiring a lengthy hospital stay and unwanted side effects.

A new PVP Laser technique, also known as “Green Light,” involves using a laser with a long wavelength to penetrate the tissue deeply and vaporize and remove the prostrate with minimal side effects. It is recommended for smaller prostrates as an effective, time-saving alternative to TURP.

PVP Laser is now available at advanced urological centers including Bangkok’s main hospitals. The estimated length of stay in the hospital is 2-3 days but plan to stay in Bangkok for up to two weeks for consultations, investigations and follow-up care. The estimated cost of PVP Laser treatment in Bangkok is 180,000-230,000 Baht (5,000-6,500 USD) not including airfare or hotel.

On my recent visit to Bumrungrad Hospital in Bangkok I noticed that each of the various clinics had staff in the patient waiting areas doing face-to-face customer surveys. Turns out this is part of Bumrungrad's efforts to improve patient feedback and raise the bar on their already high international standards. About half of their estimed 3,200 patients daily are from foreign countries.

It's all part of a management effort to win yet another first for a Thai hospital: the Thailand Quality Award (TQA) a global standard for corporate management. Only one other Thai corporation, a gas separation plant, has ever qualified for this.

Bumrungrad has long set the standard for progressive hospitals in the region. It was the first hospital awarded Hospital Accreditation (HA) and the first in Asia to win JCI accreditation.

Whether or not they manage to achieve this new benchmark remains to be seen. But with over 1,000 physicians and 4,000 nurses on staff, just getting everyone on the same level of qualty patient-care is an achievement in itself. Clearly the patients -- Thai and internalional alike -- benefit the most.

There's no doubt that medical treatment in Thailand will save you money on most medical procedures compared with Europe, the US and the Middle East. But it's easy to forget that part of the cost of your treatment is the follow-up with your local doctor once you return home.

Before you travel coordinate with your local doctor on follow-up care and financing. Will you need post-operative care at home? Special drugs? These are all part of your total costs.

Best advice is to arrange for your Thailand doctor to discuss your treatment in advance with your home doctor. Your follow-up care should be equally important to both. Your hospital or medical coordinator can make the arrangements for you.

If you are an American thinking about traveling overseas for medical treatment, the American Medical Association has issued guidelines of things to consider before you travel or engage the services of a foreign hospital or doctor: http://www.ama-assn.org/ama1/pub/upload/mm/31/medicaltourism.pdf

Useful checklist to have if you need to convince your employer or insurance company to help foot the bill.

The Thai Medical Council's proposed new regulations on stem cell research may not be approved without opposition from the National Research Council of Thailand and other researchers. http://www.nationmultimedia.com/search/read.php?newsid=30103591&keyword=stem+cell+treatment+thailand

But looking back over the past few years it shouldn't come as any surprise that a move to regulate stem cell treatments is underway. There have been several causes, some not so obvious.

1.) Aggressive sales by private stem cell banks in Thailand. Seeking to target new families with the storage of cord blood stem cells these companies went over the top with their marketing efforts and brought a controversial issue into the public eye.

2.) Stem cell roller scandal. Last year several private beauty clinics were exposed for offering a stem cell based wrinkle removing technique called "roller" or "derma roller" neither technique approved by the Thai FDA. Ironically, the concern was not the efficiency of the stem cell use but the way in which it was applied, raising concerns about hygiene. More bad publicity.

3.) Lack of independent labs to test stem cell viability. The private hospitals that have used stem cells often have no way of verifying that the cells are the right type or from the right patient. They also don't know if enough of the cells are still viable, or alive. This has nothing to do with the larger question of does the stem cell treatment yield positive results, but it does give critics a scientifically based argument to call for more regulation.

4.) Academics vs. private hospitals. It's all about the money. Academic scientists with a vested interest in securing government funding for stem cell research are some of the strongest voices calling for the new regulations. Since the regulations would effectively bring any research and treatment under the control of universities they would gain not only scientifically but economically. Some of Thailand's leading universities receive funding in the hundreds of millions of baht for stem cell studies. These same universities are also in a bid to compete with leading private hospitals for affluent patients to earn more revenue. It's not as mercenary as it seems. The gains from this lucrative target market help to cover money-losing treatments for poor patients.

Healthcare, whether at home or abroad, is usually considered from the patient's point of view. What is the disease? What is the best treatment? How much will it cost? What if something goes wrong?

But what about your Doctor? Are you a risk to them? Dr. Pauline Chen, writing recently in the New York Times, offers an interesting commentary on the risks faced by healthcare workers from patients with serious diseases: http://www.nytimes.com/2009/05/21/health/21chen.html

As Dr. Chen notes, doctors are ordinary people willing to take risks because of their beliefs.

Human stem cell treatments to be banned in Thailand?

This according to an article in Thailand’s The Nation on May 25, 2009. The proposed ban is scheduled to take place in September 2009.

http://www.nationmultimedia.com/topstory/30103512/Treatments-using-human-stem-cells-to-be-banned

As the article points out, the study and research of stem cells will continue to be allowed and it’s not clear if some medical treatments will be allowed “with permission.”

Not every area of treatment will be banned, notable exceptions being bone marrow transplants and some blood disorders and there may be exceptions for some heart diseases due to Thailand’s on-going research into stem cell treatment in this area.

The decree to regulate stem cell tests seems primarily aimed at clamping down on the number of small, independent clinics that have multiplied recently promising anti-ageing and dermatological improvements.

The proposed oversight board may not be in place for 2-3 years, according to one stem cell specialist I spoke with. This same specialist is also slated to be on the regulating committee to oversee which stem cell treatments will be allowed.

Is this a setback for patients seeking stem cell treatments in Thailand?

Perhaps temporarily while the various health and legal representatives try to sort out the ethics and legalities of stem cell treatment. But look for more clarity on exactly what treatments will be allowed and under what circumstances. Hopefully, the new decree will force out the quick-profit clinics and dubious stem cell banks while allowing real research to go forward, leading eventually to medically sanctioned and legal stem cell treatments.