Amid the COVID-19 pandemic, Thailand is also faced with the problem of increasing cancer-related threats, which is the number one killer among Thais. To bring light to this issue, recently, Roche Thailand, a leader in innovative treatments and diagnostics, has organised a hybrid discussion event on the topic “Mission to Fight Liver Cancer: The No.1 Silent Killer Among Thais,” in order to reinforce its 50th year of commitment to the Thai society, and its 125th year global anniversary. The event was joined by an honourary oncologist, a government representative, as well as a liver cancer caretaker and a celebrity with behavioral risk to liver cancer. Discussions revolved around pressing topics such as the current liver cancer situation in Thailand, causes of liver cancer in patients, treatment guidelines, advancements in medicine, as well as relevant government project and reimbursement schemes that will help increase treatment access for Thais in the future.
Farid Bidgoli, General Manager of Roche Thailand, Myanmar, Cambodia and Laos, revealed Roche's role and commitment in its liver cancer fight, in line with the current liver cancer situation in Thailand: “Over 30,000 Thai people die from liver cancer every year, which equates to 3 deaths per hour – as the threat outweighs the deaths caused by COVID-19, which accounts for 18,799 Thai lives in the past 22 months. In the past 12 months alone, liver cancer accounted for 26,704 deaths, from an incidence rate of 27,394 people. Therefore, Roche is committed to the research and development of innovative liver cancer treatments, in order to provide better treatment options and access for liver cancer patients. We sincerely hope that patients will be able to accelerate access to the appropriate liver cancer treatment, with support from the government and all related stakeholders whom will be a helping hand to help reduce the premature mortality rate for Thais; similar to the success with breast cancer, as Thailand was able to reduce the mortality rate to half of all incidences in the country.”
In addition, Passakorn Wanchaijiraboon, MD. Assistant Director, Cancer Excellence Center, Prapokklao Hospital, Chantaburi, has provided interesting information about liver cancer that: “Most liver cancers are caused by cirrhosis, which is associated with regular alcohol consumption behaviour, fatty liver, obesity, Hepatitis B or C virus, as well as people who like to eat food with parasites that causes sclerosing cholangitis, chronic hepatitis, cirrhosis and liver cancer. These are all silent threats that does not display symptoms in the early stages. When detected in the later stages, the disease can only be treated according to the symptoms, as the good liver is depleted, and the patient will only be able to live on for approximately 3 months. Therefore, it is recommended that everyone, especially high risk groups go through a thorough physical examination, receive Hepatitis vaccine and immunisation booster to stay clear of liver cancer and related threats.”
In terms of progress and support from the government, Dr. Rattaphol Triamwichanon, National Health Security Office (NHSO) revealed that: “Since January 2021, NHSO has launched the Cancer Anywhere program to help cancer patients with treatment cost, time, and treatment technology. From the latest statistical data, the number of cancer patients in Thailand remain prevalent amid COVID-19, which poses a serious threat to the livelihood of Thais. The Cancer Anywhere program is a joint collaboration between government agencies, hospitals and related organisations, who join to support in terms of appointments for radiation, surgery, radiation, and chemotherapy, to allow timely access to essential treatments. We have a special referral network between hospitals through the NHSO which acts as an intermediary. Therefore, patients do not have to wait long and can access to treatment faster.”
As an oncologist, Dr. Passakorn said that in Thailand, there is already an innovative treatment for liver cancer patients at different stages of treatment. According to a study in 2012*, patients that are able to receive the correct treatment for their different stages will experience prolonged life expectancy, with the following significant implications:
Stage A: Small lumps are present. If the patient is treated with surgery, liver transplant, or high-frequency sound waves to dissolve the small lumps, it helps prolong their lives up to 120 months, from 30 months in the event of no treatment.
Stage B: Mid stage when the lump is getting bigger. If the patient received a catheterisation, it helps prolong their lives up to 26 months from 15 months.
Stage C: The metastatic stage with treatable liver. If utilising new innovative medicines, such as the combination of multiple drug regimens, from targeted drug combined with immunotherapy drugs which is targeted directly at the blood vessels, patients will have a chance of prolonging their life by more than 19 months from 7 months.1
Stage D: The liver function has been greatly depleted. Treatment is palliative care according to symptoms. This includes radiation, morphine to relieve pain, or use of medication in combination to other treatments. This can help to prolong the patient's life by approximately 3 months, from 1 month.
“According to the statistics of Thai people*, liver cancer is most prevalent in men, at the age of 30 years and over, which is an important workforce for the country. This is especially true for patients in the working age of 31 to 60 years, as their sickness will have a direct effect on the workforce and economic output of the country. Therefore, if patients are able to receive treatment that allow them to live longer, it will have a positive impact to Thailand as a whole,” Dr. Passakorn added.
Hatthaya Wongkrachang, spoke out about her experience as a caretaker for her late husband, the beloved actor and director, Sarunyoo Wongkrachang, saying “My husband was already infected with Hepatitis B, but has never shown any signs of illness in the past. However, after his fall injury, he had an opportunity to go for a thorough body examination, and found out that he developed Stage IV liver cancer – which can only be treated according to symptoms, such as treating the liver lumps that are still good, keeping the cancer from spreading by injection, as well as following doctor instructions, with plenty of rest. From the initial diagnosis, he was able to receive treatment for only six months before he passed. Therefore, regular check-ups, stress management and self-care is extremely important for all of us.”
Right after the actress Mayurin Pongpudpunth, as a person with risk behaviors, realised that she could have been in danger of getting liver cancer, she immediately reduced behaviors that would cause cirrhosis, such as quitting alcohol, avoiding inhalation of cigarette smoke, getting enough rest and reducing the consumption of high-fat foods to prevent fatty liver disease, as well as not sharing personal items to reduce the chances of spreading Hepatitis B and C.
“At present, the National Health Security Office (NHSO) is cooperating with the private sector to determine cost-effectiveness of treatment access and innovative technologies, which will help to increase access to innovative treatment and medication approved by the FDA. That said, prevention, self-care and proper vaccination are best, in order to help reduce the risks of liver cancer. The voice of the people is an important aspect to drive treatment access, which in turns will support for a better quality of life for Thais in the future,” Dr. Rattaphol concluded.
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