For the attachment of life, a part of the rich cancer patients have chosen the way of overseas medical treatment.
The 61 year old Deng He (a pseudonym), two years ago in consecutive days of cough, chest tightness, go to the hospital with pneumonia, one month after treatment, not good, voice hoarse, the doctor's time to consider suspicious lung cancer, advised him to do pathological examination.
After several biopsies, there was no puncture to the tumor cells, and the doctor could not complete the diagnosis. In the process of waiting for &ldquo and &rdquo, Deng and his anxiety were very painful. Finally, the pathological diagnosis: lung adenocarcinoma, with lymph node metastasis, adrenal metastasis, is four stage lung cancer, the prognosis is very bad.
The painful experience of a subsequent chemotherapy and a variety of misery in the course of the treatment made Deng and his wife move to the United States for medical treatment.
The vast majority of overseas medical treatment are cancer patients. The common features of this group are the strong desire for survival, the pursuit of better medical care, and the rich family that can afford expensive medical expenses.
Through an agency, Deng and he went to the MD Anderson cancer center in the United States, one of the best cancer research and treatment institutions in the United States.
At the MD Anderson cancer center, he received a detailed examination and reassessed the pathology and gene test. His chief physician judged that hoarseness was caused by tumor invasion of recurrent laryngeal nerve, which may affect drinking and eating, and easily cause cough. It is strongly recommended that ENT specialists enter the treatment team.
The results of Deng's CT reexamination showed that the lesion was slightly smaller, indicating that the domestic treatment had been effective. The doctor decided to continue the same chemotherapy regimen. But unlike in China, doctors recommend oral folic acid during chemotherapy to relieve side effects and guide him to drink and eat in detail, so as to avoid choking cough.
The clinical level of cancer treatment in some famous Three A hospitals in China is not inferior to that of foreign countries, and even in some areas beyond the foreign counterparts, such as tumor resection.
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This kind of qualification is not more intimate than the details of the American medical staff. This is also the direct impression that many patients come to China for medical treatment. The accuracy degree of domestic doctors in diagnosis and treatment is not enough, and light patients lead to bad medical experience, which may affect the treatment plan and therapeutic effect.
Wang Xian has also treated lung cancer in both China and the United States. At home, he and his family with thick cases and images in the hospital internal medicine, surgery, Radiology, pathology, radiotherapy, back and forth, each doctor left his lack of communication time for 5 minutes, even for medical explanation, just a few minutes, which makes him very practical.
In the end, Wang Xian chose to go to the United States to see a doctor. The time for outpatient visits was 1.5 hours. In the half time, the doctors elaborated the disease treatment plan, and the other half asked Wang Xian to ask questions freely.
Cancer such as a major disease endangers life, China's medical and patient communication time is poor. From the case of the medical record, the diagnosis, the diagnosis, the provision of treatment programs, a few minutes.
Wu Han, who suffered from pancreatic cancer, had a deep fear of chemotherapy. When chemotherapy drugs destroy cancer cells, a large number of normal cells will also be eliminated together. The normal functioning of patients will be disturbed. There will be nausea and vomiting, loss of appetite, numbness in hands and feet, and hair loss.
However, in the General Hospital of Massachusetts Medical School Affiliated to Harvard University, Wu Han's chief physician told her that she would appropriately adjust the dosage according to her age and physical condition, and at the same time, patiently introduced to her the effects and adverse reactions of various drugs in the chemotherapy plan. In the course of treatment, she returned to the application of a variety of drugs to reduce the occurrence of adverse reactions, such as &ldquo are domestic patients die; ” chemotherapy was not nearly to the normal life of Wu Han much.
Chemotherapy can be done in the US clinic, and patients who receive chemotherapy often do not have too much adverse reactions. Many American patients drive directly to work after chemotherapy.
Deng and his doctor also asked him in detail to make the process comfortable and to maximize his quality of life. After four cycles of chemotherapy in the United States, Deng's findings showed that the lung tumor was greatly reduced and the tumor on the adrenal gland did not change. The chief physician had doubts about the diagnosis of adrenal metastasis in China, and let Deng and he take the adrenal biopsy again. Biopsy proved benign nodules, not adrenal metastasis.
According to this, the doctor adjusts the follow-up treatment plan, uses the single drug chemotherapy, and synchronizes the lung radiotherapy. This means that Deng's tumor stage is actually earlier and, accordingly, the prognosis will be better.
The most anxious of the patient is that the domestic doctor generally simply explains the treatment plan, and then is waiting for the patient to make a decision. Doctors and cancer patients make decisions on the treatment program, which is the norm in Europe and the United States.
Doctors will give details about the efficacy, benefits and risks of cancer treatment plan, and patients can talk to their doctors about their views and doubts about illness and related risks, even personal values, economic conditions, family occupations and other social backgrounds. Finally, under the guidance of the doctor, doctors and patients jointly solve the problem of diagnosis and treatment in the medical process. Obviously, this treatment is more reasonable.
In the medical decision-making of cancer, there is a system in the United States hospital, which is a multidisciplinary assessment. The core is the treatment of cancer, which is entirely centered on patients. A multidisciplinary expert is based on the condition of each patient to make personalized comprehensive treatment plan.
Deng he feels the benefits of multidisciplinary consultation. He is surrounded by a medical team composed of tumor doctors, surgeons, radiation doctors, geneticists and nutritionists. According to his condition, diagnosis is made and treatment plan is put forward. With the progress of treatment, multidisciplinary experts will evaluate the therapeutic effect and decide whether to continue or adjust the plan.
There are hospitals in China trying the multidisciplinary consultation of cancer patients. But in Lin Yanglin's view, the number of cancer patients is too large, and they are gathered at the top three hospitals. The quality medical resources are too intense, making the multidisciplinary consultation of some domestic hospitals more than enough.
Reduce the overseas medical threshold
Not every economically capable patient can get the opportunity to see a doctor in the United States. Sometimes it is rejected when making an appointment. When an American doctor sees a patient's case and agrees with the domestic treatment plan and medication, he will advise them not to go to the US.
This is because American hospitals follow the principle of patient benefit, after all, the 13 - hour flight between China and the United States does not necessarily bring more benefits to the patients.
A patient like Deng and such a patient in the United States will experience two processes, evaluation stages and treatment stages. In the evaluation stage, we have to communicate and check with a multidisciplinary team of experts, including pathological examination and gene detection. Then the expert team develops an exact diagnosis and personalized treatment plan.
“ this is the most valuable stage for the patient. ” Cai Qiang says it usually takes two weeks for this stage to spend about 100 thousand yuan, and many patients are acceptable.
According to the statistics, from 2012 to 2015, the patients with severe treatment in the United States were increased from less than 1000 to about 3000, and 5000 were estimated in 2016. The average cost of treatment for cancer patients is 1 million - 1 million 500 thousand yuan.
It is very difficult to excavate customers through the Internet or by the earth. It is necessary to find the target customers accurately and make the customer trust. After all, it's not only expensive for customers, but also a matter of life and death.
In Lin Yanglin's view, in addition to let patients go out, it is the development of the remote video consultation in a good way, not only reduce costs, but also eliminates were fatigued by a long journey. However, the global doctors' tele consultation is not carried out by the intermediary agencies. The intermediary can only provide consulting services, unable to have a remote diagnosis with diagnostic significance, and want to do this thing, and also rely on domestic hospitals to take an active part in it.
And enjoy the United States MORE HEALTH medicine, has signed 400 of America's 1% top experts, has a medical case professional team and advanced technology, to provide professional and accurate joint medical opinions; and obtained FDA certification, and compliance with the HIPAA regulations, the platform has a number of patents; a doctor-patient relationship can be established through the platform and the doctor, provision of drugs issuing and distribution of medical institutions, to solve customer visits in the course of pain problems.
New drugs determine the distance between life and death
The new anticancer drug is lagging, and it is also the driving force for some cancer patients to choose overseas medical treatment.
Most of the new anticancer drugs are developed by European and American pharmaceutical companies. Due to regulatory and other factors, these new drugs are often lagging behind in the Chinese market for several years.
Before the entry of new anticancer drugs into the mainland of China, the State Food and Drug Administration will have to approve the clinical trials, so that the time for new cancer drugs to enter the mainland is four or five years later than that of Hongkong and Macao.
This lag time is the distance between life and death. The third generation of targeted drugs such as lung cancer in Europe has been listed for more than a year, the mainland is the first generation of targeted drugs in the market.
In most cases, when a target drug is used for a period of time, the cancer cells in the body will produce drug resistance, so that the curative effect will obviously decrease. At this time, it is necessary to consider dressing change. If there is only one generation of drugs in the market, it means that the patients with drug resistance will have no medicine.
Some drugs are expensive in Europe and America. The immunotherapy drugs are even more expensive, and the annual drug cost is over 150 thousand dollars. So some Chinese patients have another way to go to India to buy cheap generic drugs to continue their lives.
CAR-T, a cancer immunotherapy that is favored by the medical community, will be more expensive in the future, and most of the families are hard to reach.
It is a difficult problem to bring effective therapy to the Chinese patients in a way that the ordinary family can take.
(the first publication of the Journal of Finance and economics, published in April 10, 2017)
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