The Need for Improved Access to Treatment for Liver Cancer Patients in Thailand

Key Point :

• WHO states that in 2020, the number 1 most common cancer in Thailand is liver cancer 14.4% of 27,384 cases, and Thailand is ranked 4th in the world with a high death rate from liver cancer.
• However, the treatment of liver cancer still have space because even though Other cancer patients will have access to treatment fairly, but ‘liver cancer’ is still limited
• grouping, creating a networkcancer patientsstrong liver would be another approach in pushing for access to treatment rights can be more concrete, as well as the Friends of the Kidney Disease Association of Thailand that have successfully moved forward

data incidencecancer According to the World Health Organization in 2020, it was found that the number 1 most common cancer in Thailand was liver cancer, 14.4% of 27,384 cases (of which 18,268 cases were found in males, 9,126 times more than females, and It was the fourth most common cancer in females), followed by lung cancer 12.4%, breast cancer 11.6%, colon cancer 11.1% and cervical cancer 4.8%.

At the same time, Thailand is still ranked 4th in the world with a high mortality rate from liver cancer. And is number 1 in the country compared to other types of cancer, with every 1 hour there will be 3 patients who die. If not treated, it will die quickly. Even though liver cancer treatment technology has progressed greatly in terms of chemotherapy, targeted drugs and immunotherapy drugs. But patients’ access to treatment rights is still limited.

related news

On April 29, 2023, National Cancer Institute Department of Medical Services organized a seminar. to develop knowledge Empowerment cancer patientsLiver No. 1 of the year 2023 sponsored by Roche Thailand Company Limited To open a forum to jointly find solutions, guidelines for the treatment of liver cancer with the goal of improving the quality of life ofcancer patientseveryone

Dr. Sakarn Bunnag, Director of the National Cancer Institute, Department of Medical Services, revealed that liver cancer There are many issues that are still gaps that need to be developed. Whether it is about educating, screening, treatment and terminal care. Nowadays, to drive these matters, if using the same old model The policy side thinks People exercise their rights is like standing on the other side, so being able to have an organization It doesn’t even have to be official. But gathering groups to drive together, especially the people who come to vote on their own issues and there are policy sectors to listen and academic departments that come to guide policy will make the drive reasonable find solutions together will make the drive go far and worthwhile to meet the needs of all parties

People still do not have access to treatment rights.

Prof. Dr. Pisit Tangkitvanit Gastrointestinal and liver pathologist Chulalongkorn Hospital explains that because liver cancer is rarely present, according to internationally published data, it is found that The incidence of liver cancer by disease stage in 2017 was 38.0% found in the middle stage 26.0% in the final stage 16.0%, early stage 11.0% and metastatic stage only 9.0% found in the early stage

Current information, 2023, found that drugs that are used in benefits are still limited. Some medicines are available on civil servant rights. and some drugs have to be paid for Although universal health coverage in Thailand provides patients with adequate access to various cancer treatments, liver cancer is still very limited.

“So there should be a campaign to raise awareness that this disease is an important disease in the long run. How to make people have access to more comprehensive benefits? Many parties are trying to push cancer drugs into the national list of essential medicines. joint disbursement Or select groups that are appropriate to have more access to drug use. Finally, is to increase public health capacity. infrastructure to improve.”

Advances in liver cancer treatment

Prof. Dr. Suebpong Thanasarnwimol, M.D. Oncology Chulalongkorn Hospital Discussed an overview of the current innovations and advancements in liver cancer treatment that during the past 4-5 years, liver cancer treatment drugs The most difficult to access are targeted drugs, immunosuppressive drugs. and chemotherapy, respectively, although chemotherapy drugs seem more accessible, but are not used as much because their efficacy may not be as good as other drugs.

current treatment results ‘Chemotherapy drugs’ It found that the patient’s survival time was about 6 months, the hope for a response was less than 10%, while a single “immunotherapy drug” might have a survival time of up to 16 months, the hope for a 16% response, and finally. The “targeted drug” survival time was about 15.5 months and the chance of response was about 18.8%.

At the same time, there is currently evidence that targeted drug administration in combination with immunotherapy drugs can provide better treatment results than targeted therapy alone The survival time was 19.2 months. Patients are expected to live longer than 2 years and the chance of a response is about 27%. Currently, if patients have access to the best drugs, it is said that 1 in 3 cancers will disappear. and will save the lives of patients.

Aiming to build a sustainable network

Surachai Lertamonsin, a former liver cancer patient The administrator of the liver story group for liver cancer patients said that the reason the liver cancer group could not form a group Because liver cancer before knowing the symptoms is already stage 3, stage 4, causing the patient to have a long life of 6 months or 2 years, so it is difficult to form a group. How to take care of your body? Encouragement via Facebook group. “Stories from the liver” statistics for 3 months found that there were more than 169 posts, 3,547 comments, and 6,408 likes.

“Nowadays, in the volunteer team, there is a summary of what they want to do, namely raising awareness. Whether it’s a risk group, they need to have a physical examination and educate them to prevent risk groups from developing liver cancer. If found early, it can be treated more easily and at a lower cost. Building a Network During COVID-19 Therefore, there are social media channels, Facebook, and in the future there must be a more sustainable grouping,” Surachai said.

Patient Network Success Examples

Thanapon Dokkaew, President of the Kidney Disease Friends Association of Thailand And Chairman of the Chronic Disease Network, which is one of the four founders of the association. consume There is a communication process to create knowledge for the people. Including Facebook channels, the Friends of the Kidney Disease Association of Thailand Including online channels and websites www.kfat.or.th”

On the other hand, Ekkawat Suwantharoj, vice president of the Hemophilia Patients Club of Thailand, the club is a group between Patients and doctors in 1999 at Ramathibodi Hospital Collaboration with patients. The advantage is to prevent fake news. Medical personnel help find new evolutions for treatment. Patients’ duty is to screen each other with physicians as consultants, communicate, develop knowledge among patients.

“Next is to help in matters of policy. There are discussions between patients and there is academic support from physicians. Another area that can help is research. There are representatives to vote when the government opens up to listen. Must try to create these things. The result is helping with treatment, taking care of yourself, creating a body of knowledge and sharing follow-up results. Whether it is the quality of life of patients and caregivers. Because when one person gets sick, the whole family gets sick, so the dimension of care must be spread out,” said Ekkawat.

What should I do when I get side effects from cancer drugs?

Tanchanok Rattanajarusiri, M.D., Oncology M.D. The National Cancer Institute, Department of Medicine, explains that liver cancer drugs are divided into three groups: chemotherapy drugs, targeted drugs and immunotherapy drugs. for therapy “Chemotherapy” side effects that are found are nausea, vomiting, loss of appetite, diarrhea, side effects from nerve endings, so the patient must eat in small amounts, but often, chew food thoroughly, eat soft food, should sit up high after eating or sit for at least 2 hours

If anorexia Eat a diet high in protein. and increase appetite by eating sour foods If you have diarrhea, avoid drinking milk, vegetables and fruits for side effects on the nerve endings. It is advisable to avoid eating and handling cold things for 3-5 days after taking the medication. Be careful of sharp objects, hot objects, going up and down the stairs. And can take vitamins to nourish the nerve endings, such as vitamin B complex, to help reduce numbness.

for ‘Targeted drug’ There will be side effects on the skin on the palms and feet, numbness, tingling on the palms, soles or red peeling, itching, diarrhea, fatigue, fatigue, high blood pressure. Therefore, when having skin symptoms, red, peeling, should wear gloves and soft socks to apply. moisturizing cream If the rash follows The cream should be applied immediately after taking a shower or before going to bed. Choose one without perfume or preservatives. Avoid hot showers, sunlight and apply sunscreen SPF30 or higher. Wear comfortable clothing. and if there is exhaustion after receiving the drug should get enough rest light exercise Avoid caffeinated beverages after noon. Eat nutritious food from all 5 food groups

in part ‘Immune therapy drugs’ Side effects are fever, pneumonia, inflammatory bowel disease, causing diarrhea. including hepatitis a rash abnormal endocrine function Pancreas malfunction, etc. If the patient has the following symptoms, seek medical attention early: jaundice, jaundiced eyes, shortness of breath, chest tightness, which are symptoms of pneumonia. Severe abdominal pain and high fever