BANGKOK BREAST CANCER SUPPORT GROUP

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• BANGKOK BREAST CANCER SUPPORT GROUP

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THAILAND

• Population
• 60 Million

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BANGKOK
Population 10 Million
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SLUM PROJECT AND OUTREACH

• Itinerant workers come to Bangkok from rural
  areas seeking supplementary work.
• Wages are usually sent back to family in the
  provinces.
• They often stay in the slum areas.

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• Other residents may be locals to Bangkok and have
  social issues which have forced them to live in
  these cicumstances.

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• Life in the slums is complex, it has its own
  leadership and social network.
• We contacted well established non-government
  organisations, in some cases established for over
  30 years to liaise with the women and to invite
  them to meet us and attend informal talks on
  breast cancer awareness.The talks were in Thai
  and led by Thai volunteers.
• We were advised that the presence of too many
  foreign volunteers would lead to high
  expectations of financial support.
• Meetings take place on Sundays and Friday
  evenings when the women are available and can
  bring their children. Help is at hand for child
  care.

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BBCs Slum Outreach
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Outreach seminar
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Volunteer Oncology Nurse
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Slum Project Phase 2

• A team of doctors from the Breast Cancer Centre
  at Chulalongkorn Hospital Bangkok, a government
  hospital and medical school, will link up with
  the BBCs and assess a large group of women in the
  slums.They will be selected by the non-government
  organisation with whom we are closely
  associated.This will ensure the women who really
  need asssistance will be taken care of and our
  funds used wisely.
• Histories and examinations will be carried out.
• Women of the appropriate age and women with
  suspicious lesions will be taken to the Breast
  Centre,for mammography and ultrasound and any
  required follow up assessment and treatment.

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FUNDING

• Donations from
• BBCsactivities
• appeals to outside organisations.
• The THAI Government operates a fixed price of 30
  BAHT 1 U.S.dollar for the care of all ailments
  in a government hospital.
• BUT
• The patient has to be in his or her own official
  home - often this is upcountry and in many cases
  the patient cannot afford to go home.

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The Breast Cancer Centre,Chulalongkorn Hospital
Bangkok.

• ADDITIONAL AID
• BBCs funding is allocated to the research
  nurse at the Breast Centre.
• Screening of women who may need additional help
  with their diagnostic/assessment fees, is
  carried out.
• Records and receipts are given to BBCs for
  financial accounting.

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ALLIANCE OF BBCs WITH THE BREAST CENTRE AT
CHULALONGKORN HOSPITAL

• A CENTRE OF EXCELLENCE IN BREAST CANCER IN THE
  REGION
• A MODEL OF EXCELLENCE IN CARE
• PROMOTES AND HAS PIONEERED BREAST PRESERVATION
  WHEREVER POSSIBLE.
• COHESIVE AND CLOSE TEAM APPROACH TO PATIENT CARE.
• STATE OF THE ART EQUIPMENT AND TRAINING.

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Team members

• Three surgeons
• Three radiologists.
• Two radiotherapists.
• Two pathologists.
• Two nurse counselors.
• One research nurse.
• BBCs VOLUNTEERS

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Equipment

• Mammography GE Unit 1
• Full-field whole breast digital
• mammography Unit 2
• first to be installed in Asia.
• Mammotome for breast biopsy, mammogram guided
  Unit 3
• Two high resolution ultrasound units.

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Therapeutic Equipment

• Linear Accelerator
• 3 Cobalt Units
• Top quality control for diagnostic film
  development is ensured by being kept separate
  from all other specialty development eg. Limb
  x-rays.

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9 month projection for equipment

• 3 Dimensional Linear Accelerator.
• Additional Linear Accelerator purely for breast
  cases, ensuring the best possible cosmetic
  result.
• 2 extra high resolution ultrasound units.One for
  the operating theatre,for ultrasound guided
  mammotomes
• Operating theatre for breast cancer work only.
• Interoperative radiation to be introduced.
• Rooms for pain control and complementary therapy

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9 Month Projection

• Lecture theatre
• Teaching Rooms
• Prayer Room

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• The response was excellent and audiences ranged
  from 30 for the leadership groups up to 200 for
  larger groups.Information covered, basic breast
  awareness,practical advice on self-examination.
  The aim of all the talks is to help overcome the
  fear and shame associated with cancer.It some
  instances it is considered a transmittable
  disease from close contact.Many women hide breast
  lumps out of shame or shyness.Often an unmarried
  woman would not think herself a relevant
  candidate for assessment.A Thai Buddhist belief
  is that the present life experiences ,including
  health are dependent on previous behaviour in
  former lives.Many women believe they deserve an
  illness to 'pay for these bad actions'.One
  example is PI May, a very wealthy,sophisticated
  woman with 4 children and a caring husband. She
  felt she had poisoned people in her previous life
  in the 17 century, her under 1 cm lesion which
  was highly treatable was left to fungate.We try
  to encourage women to see that they deserve the
  best possible care , as it is available, then
  perhaps they do afterall, deserve to take
  advantage of it.We are sensitive and respectful
  to any of the religious beliefs we encounter and
  are far from dismissive.We are very aware that
  the psychological well-being and the spiritual
  side of the woman is vital, but we have to retain
  the fact that our role is to help with emotional
  support and education.
• By taking breast cancer survivors along to
  discuss issues openly has proved a very effective
  method of decreasing fear levels.
• It also gives us the opportunity to discuss
  modern treatment methods and to encourage women
  not to pursue
• an unproven method of treatment, but to stick
  with conventional methods alongside complementary
  treatment if they so chose.
• OR, TO BE PROACTIVE ABOUT THEIR BREAST CARE

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• Thank you for the invitation and the chance to
  share what the Bangkok Breast Cancer Support
  Group ,the BBCs, is achieving in Thailand.
• We are a very young group and the first in
  Thailand.We established ourselves formally in
  2002, when we came under the umbrella of the Thai
  Red Cross, which offers us credibility and the
  chance to do fund raising with tax exemption.It
  has allowed us to establish ourselves without
  having to form a foundation at this stage, which
  is expensive and complicated.
• We have also associated ourselves with a centre
  of excellence in breast cancer care,The Breast
  Centre at Chulalongkorn Hospital, Bangkok, which
  follows a model of care that we advocate and of
  which we are also a part.
• However we are an independent group open to any
  woman in Thailand.
• Crystal Cuddyre our co-chair is representing the
  expatriot community and I am representing the
  Thai community as a long term resident.Together
  we represent all women in Thailand.