Oncology in Cambodia

Oncology is the branch of medicine that focuses on the research, prevention, diagnosis, and treatment of cancer. A medical professional who specializes in diagnosing and treating people with cancer is called an oncologist.

An oncologist can design a treatment plan based on detailed pathology reports that shows the type of cancer the patient has, how much cancer has developed, how fast the cancer is likely to spread, and what parts of the patient's body are involved.

The field of oncology has three main areas, which include:

• Medical oncologists use chemotherapy, hormonal therapies, and other types of targeted treatments to treat cancer. Most people think of medical oncologist as their primary cancer doctor. Medical oncologists help monitor and maintain patients' well-being, as well as helping patients manage side effects. Often patients follow up with their medical oncologist once their treatment is complete.
• Surgical oncologists perform the surgical removal of the tumor and surrounding tissue. They will help patients prepare for and recover from any surgical procedure they undergo during their cancer treatment. If your primary doctor suspects that you have cancer, a surgical oncologist is likely one of the first doctors you see. Surgical oncologists can perform biopsies, which involves removing a small tissue sample to be checked for cancer cells.
• Radiation oncologists treat cancer using radiation therapy. They use high-energy photon beams to target and destroy cancer cells. Approximately one-half of all cancer patients will undergo radiation treatment during their cancer care.

Because most cancers are treated with a combination of therapies, you could see two or all three different oncologists during the course of your treatment.

Besides the three main areas, there are also several other areas of oncology. These include:

• Pediatric oncologists diagnose and treat cancer in children. Some types of cancer appear more often in children and teenagers, such as leukemia, brain tumors, osteosarcoma, and Ewing’s sarcoma. Some pediatric oncologists focus on conducting research on childhood cancers, while others specialize in certain types of cancer.
• Gynecologic oncologists treat cancers that affect women, such as cancer of the ovary, cervix, uterus, vagina, and vulva. Additionally, they also treat complicated gynecological conditions that are not cancerous, such as fibroid tumors and endometriosis.
• Hematologist-oncologists diagnoses and treats blood cancers, such as lymphoma, leukemia, and myeloma. They may also specialize in the management of solid tumors.

Oncologists usually work with a variety of other medical professionals, including pathologists, diagnostic radiologists, oncology nurses, and oncology social workers. They may also work with doctors from other areas of medicine, such as neurologists, dermatologists, or urologists.

What does Oncology Involve?

There are many types of procedures to treat cancer. The types of procedures that you receive will depend on the type of cancer you have and how advanced it is. Some people who have cancer will only have one treatment. However, most people have a combination of treatments, such as surgery with radiation therapy and/or chemotherapy. Below are the types of procedures to treat cancer:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to kill cancer cells in the body and prevent them from growing. The drugs can prevent cell division, target the food source of the cancer cells’ (the hormones and enzymes the cells need to grow), and trigger apoptosis (a process in which cancer cells kill themselves).

• Chemotherapy drugs can be given in several different ways, including.
• Oral – taken in a pill or capsule form.
• Intravenously – through an infusion into a vein.
• Shots – injected with a needle.
• Topical – applying creams or gels into the skin. This type is used to treat certain types of skin cancer.

Chemotherapy drugs can also be given directly to cancer or directly to an area of the body, such as the abdomen or central nervous system.

Immunotherapy

Immunotherapy, or biologic therapy, boosts your body’s natural defenses to fight cancer. It uses substances made by your own body, or in a laboratory, to improve or restore your immune system function. It can stop cancer from spreading to other parts of the body, stop or slow the growth of cancer cells, and help your immune system work better at destroying cancer cells.

There are several types of immunotherapy to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators. Different types of immunotherapy may be given in different ways, such as intravenous (IV), oral, intravesical (directly into the bladder), or topical.

Targeted therapy

Targeted therapy uses drugs that are designed to specifically “target” cancer cells without affecting normal cells. It targets the cancer’s specific proteins, genes, or other tissue environment contributing to cancer survival and growth. These proteins and genes are found in cancer cells or in cells related to cancer growth.

The targeted drugs can block or turn off chemical signals that tell cancer cells when to divide and grow, stop making new blood vessels that feed cancer cells, change proteins within the cancer cells so the cells die, trigger the immune system to kill cancer cells, and carry toxins in the cancer cells to kill them.

• There are two types of targeted therapy:
• Small-molecule drugs, which is given through pills or capsules that you swallow
• Monoclonal antibodies, which are given through a needle in a blood vein.

Radiation Therapy

Radiation therapy uses intense energy beams to kill cancer cells and shrink tumors. It most often uses X-rays, but other types of energy, such as protons may also be used.

Radiation therapy can be done in two ways:

• External-beam radiation therapy – this type of radiation therapy delivers radiation from a machine outside the body. You will lie on a table, and the machine (called a linear accelerator) moves around you to deliver radiation from several different angles. It is a quick and painless procedure.
• Internal radiation therapy – also called brachytherapy, involves both temporary and permanent placement of radioactive sources in the body. During the placement of the radioactive sources, you will be given anesthesia.

Hormone therapy

Hormone therapy stops or slows the growth of cancer that uses hormones to grow. It works by blocking your body’s ability to produce hormones or interfere with how hormones behave in your body. It can reduce the chance that cancer will return by stopping or slowing its growth, as well as preventing or reducing symptoms in men with prostate cancer.

Hormone therapy is usually used to treat breast and prostate cancer. It can be taken in many ways, including orally, through an injection, and surgery.

Stem Cell Transplant

People whose blood-forming stem cells are damaged by the very high doses of radiation therapy or chemotherapy can undergo stem cell transplant to restore the cells. Blood-forming stem cells are vital since they grow into different types of blood cells that you need to be healthy. The stem cells will be given to you through an IV catheter. The process is very much like receiving a blood transfusion.

Surgical treatment

Surgical treatment for cancer is a procedure to remove cancer from your body. There are many types of surgeries to treat cancer, which differ based on the part of the body that requires surgery, the purpose of the surgery, the amount of tissue to be removed, and your preference. In general, the surgery can be open or minimally invasive.

• During open surgery, one large incision is made to remove the tumor, some healthy tissue, and some nearby lymph nodes.
• During minimally invasive surgery, a few tiny incisions are made instead of a large one. These incisions are made to insert a laparoscope (a long, thin tube with a camera on its end) and special surgical tools. The laparoscope allows your surgeon to see the inside of the body, and the surgical tools are used to remove the tumor and some healthy tissue.

How Long Should I Stay in Cambodia?

For chemotherapy, radiation therapy, immunotherapy, hormone therapy, and targeted therapy, the treatment schedule may vary. You may have treatment every day, week, or month. It may also be given in a cycle, which is a period of treatment followed by a period of rest to give your body a chance to recover. For surgical treatment, you may need to stay in the hospital for a few days, and you need to stay in Cambodia for at least 10 to 14 days. Your oncologist and/or medical tourism team will advise you on the length of stay in Cambodia.

What's the Recovery Time?

The type of procedure you undergo determines the recovery period. While you may be able to get back to your normal routine within 10 days after laparoscopic surgery, you may need to wait around 6 weeks to fully recover from open surgery. Your oncologist will give you a detailed recovery timeline.

What About Aftercare?

You will be given instructions on how to take care of yourself. Your surgeon or nurse will explain how to control your pain, how to take care of your wound, activities you can and cannot do, and how to spot signs of infections. You may also need to talk to a dietitian to help with eating problems caused by the treatment. You will need to attend follow-up checkups to monitor your condition.

What's the Success Rate?

Cancer survival has improved significantly due to constant advancement and improvements in the field of oncology, including improvement in treatments and screening (allowing for earlier diagnosis). Still, you need to be aware of the risks, such as infection, bleeding, nerve damage, fatigue, nausea, vomiting, and hair loss.

Are there Alternatives to Oncology?

There is no other alternative than to see an oncologist when it comes to cancer treatments. Some people may choose to undergo meditation, hypnosis, and acupuncture as well, usually to relieve the stress, anxiety, and pain that cancer can bring.

Oncology in and around Cambodia

Introduction

Perched in the heart of Southeast Asia, nestled between Thailand and Vietnam, lies Cambodia — a dynamic blend of ancient and contemporary worlds that makes for an intriguing adventure. Dominating its list of attractions is the globally-renowned Angkor Wat, embroidered by lush jungles. 

It is the soul of Cambodia — its vibrant culture, warm inhabitants, profound historical heritage, stunning coastlines, delightful cuisine, and spirited nightlife — that gives this nation its unique charm. Each element, individually fascinating and collectively harmonious, weaves a magical tapestry that is Cambodia.

Over recent years, Cambodia has strategically bolstered its healthcare infrastructure, aiming to appeal to a global patient community. In this endeavor, the country has witnessed several of its hospitals forging partnerships with institutions from close-by countries, with Thailand being a significant partner.

These strategic alliances have been key in establishing state-of-the-art healthcare facilities across Cambodia. These healthcare establishments strive to cater to a diverse array of medical needs, ensuring the delivery of world-class, professional care that meets, if not surpasses, internationally accepted standards.

Cambodia is relentlessly driving efforts to enhance its healthcare sector, with one main goal - to give patients access to top-notch medical care at costs significantly lower than those in other Southeast Asian nations, Singapore being a prime example.

This strategic approach is geared towards attracting patients from regions like Laos, Taiwan, and China. The essence of this approach is to establish Cambodia as a major healthcare destination that offers high-quality medical services, all within a budget-friendly framework that doesn’t strain patients' finances.

Popular Cities and Regions in Cambodia

Phnom Penh is the capital of Cambodia, as well as the main medical tourism destination in the country. Once the ‘Pearl of Asia,’ this bustling city is now filled with bustling bars, historical architecture, vibrant café culture, a world-class food scene, and a glimmering Royal Palace.

Tourists venturing into Cambodia are invited to traverse the myriad attractions this enchanting nation has to offer. A must-visit is the National Museum of Cambodia which houses the country's extensive cultural history and art. For those who seek a deeper insight into Cambodia's past, the Tuol Sleng Genocide Museum provides a poignant yet important glimpse into the darker chapters of its history. In addition, the Royal Palace stands as a testament to Cambodia's architectural grandeur, drawing admiration from visitors across the globe. Another gem to explore in Phnom Penh is the Silver Pagoda, a unique blend of tranquility and exquisite craftsmanship, making for an unforgettable experience.

Moving beyond the capital city of Phnom Penh, Siem Reap emerges as another popular destination in the Cambodian travel circuit. This city, bustling with energy and soaked in history, captures the diverse ethos of Cambodia in its vibrant art, architecture, and local life. Inclusion of Siem Reap in any Cambodian itinerary lends an additional layer of cultural depth, making the exploration of this intriguing nation an even more enticing proposition. As such, whether it's diving into the past or experiencing the dynamic present, Cambodia offers a varied palette of experiences to delve into.

It’s where the fascinating, UNESCO-listed Angkor Wat is located. Aside from Angkor Wat, Siem Reap also offers other attractions, such as the Angkor Silk Farm, Wat Bo, War Museum, and Senteurs d’Angkor Botanic Garden. Those who want to relax on a beach should visit Sihanoukville. It was once a quiet beach town, but now it has become a modern up-and-coming holiday destination. 

Transport in Cambodia

Phnom Penh International Airport stands as the largest and most bustling airport in Cambodia. Acting as a critical transportation nexus, it facilitates both domestic and international air travel. The airport offers numerous flight connections to various cities across Asia, making it a convenient choice for international tourists. Besides being a gateway into Cambodia, it also serves as a starting point for internal travel.

For tourists looking to cover various parts within the country swiftly, opting for domestic flights is a time-efficient choice. These flights are well-linked, providing easy access to different parts of this captivating country. Despite being the fastest mode of travel, they maintain reasonable fares, ensuring that the journey is equally enjoyable as the destination.

As one navigates within the cities, there is a disparity between the modes of transportation used for intra-city and inter-city travel. While trains and buses are the preferred options for traveling between different cities due to their affordability, city-based transportation adopts a different palette altogether. For daily city commutes and quick visits to local sights, taxis, tuk-tuks, and motorbikes are the most viable options. They're not only readily available but also allow for an intimate view of Cambodian city life. This dynamic and efficient transportation network significantly enhances the convenience of exploring Cambodia's stunning expanse.

Visas in Cambodia

• Citizens of 9 countries, including Laos and Singapore, can visit and stay in Cambodia for up to 30 days without a visa.
• Citizens of most other countries can apply for a visa on arrival or eVisa.
• All visitors must have a passport valid for at least six months beyond their intended date of departure from Cambodia.

Visa on arrival

• A visa on arrival can be obtained at any of the following Cambodian airports: Phnom Penh International Airport (PNH), Siem Reap International Airport (REP), and Sihanoukville International Airport (KOS).
• The visa on arrival fee is USD 30.
• Visitors who obtain a visa on arrival must have a valid passport and two passport-size photos.

eVisa

• An eVisa can be obtained online at the website of the Cambodian government.
• The eVisa fee is USD 35.
• Visitors who obtain an eVisa must have a valid passport and a digital photo.

Weather in Cambodia

Cambodia is blessed with a warm climate throughout the year, making it a destination for all seasons with temperatures seldom falling below 20°C. Cambodian weather is generally categorized into two primary seasons: wet and dry. The wet season, spanning from May to October, is marked by episodic showers during daytime hours, adding to the country's tropical charm.

The dry season, commencing from November and extending up to April, is typified by agreeable and sunny weather conditions, making it an ideal time for travel and exploration. However, it is worth noting that during the peak of the dry season, specifically in March, temperatures can climb up to a sweltering 35°C. Despite the somewhat extreme conditions, the resplendent beauty of the country remains undeterred, with Cambodia promising a riveting experience regardless of the season.

Additional Info

1. Local Currency: Cambodian riel (KHR) is the official currency and 1 USD converts to approx. 4,161.63 KHR. However, USD is widely accepted.
2. Money & Payments: ATMs are widely available and sometimes dispense US dollars. Credit cards are accepted in major cities. Tipping is expected and appreciated.
3. Local Language: The official and mainly spoken language is Khmer. Some people also speak Vietnamese and Chinese. English is mostly used in tourist areas and major cities. 
4. Local Culture and Religion: About 97% of the population follows Theravada Buddhism. Islam, Christianity, and tribal animism make up the remaining 3%.
5. Public Holidays:  Victory over Genocide Day, Khmer New Year, King’s Birthday, Day of Remembrance, and Independence Day are some of the public holidays celebrated in Cambodia.