Check if you doubt you really have cancer

Check if you doubt you really have cancer 

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Under Hong Kong's health care system, what should you do if you or a loved one suspect you have cancer?

Initially, an X-ray revealed a shadow on my lung, but the government doctor wouldn't explain what was wrong.

First, when you or a loved one suspects cancer, you must find out what stage it is and what type of cancer it is.

For example, I was hospitalized coughing up blood, but the government doctor wouldn't say anything but suggested I see a private doctor and have a PET-CT scan.

At that time, don't delay; immediately ask the doctor to write two letters:

1. A referral letter from the private doctor

2. A referral letter for the PET-CT scan

Do not wait for the government!! Do not wait for the government!! Do not wait for the government!!! Immediately book a PET-CT scan at a clinic. Don't see a private doctor first, as they need to review the PET-CT report before performing any procedures. Most insurance policies don't cover PET-CT scans, so don't delay; get it done as soon as possible. A government referral letter usually offers a discount. For example, I had mine done at Anmei Clinic in Sheung Wan for HK$8300, and the report was available in as little as two days.

Once you receive the PET-CT report, see a specialist as soon as possible.

For example, a quick Google search reveals it's likely lung cancer. So, see a cardiothoracic surgeon immediately—whoever is fastest will do so first. Even top-tier surgeons need to perform tissue tests first.

Once you see the cardiothoracic surgeon, they will review the report and tell you the stage of cancer. In my case, it was stage four lung cancer that had spread.

A cardiothoracic specialist outpatient visit costs HK$550.

Afterward, request the doctor to arrange for a radiologist to perform tissue tests and DNA comparison as soon as possible.

Why the rush? Because DNA matching takes 7-8 days to get a report. How much will the cancer cells have increased in your body in another 7-8 days? These 7-8 days are indeed the most agonizing wait!!!

My private doctor wants me to have the tissue sample taken at the Hong Kong Sanatorium & Hospital. The bill, including the lab fees, is HK$26,000, and I can leave immediately without needing to stay in the hospital.

Once you've taken care of the essentials, take your PET/CT report to the government emergency room. Explain your initial symptoms upon admission, and they'll arrange for hospitalization. Of course, the government doctor won't discuss your condition further after reviewing the report, but you should have already heard from your specialist. When you see the government doctor, ask for two referral letters:

1. Government oncology referral letter

2. Private oncology referral letter

3. Arrange discharge (because you've completed the necessary steps).

The first thing to do after discharge is to take the PET/CT report and the government oncology referral letter to the hospital's oncology department to register and file for treatment.

The later you file, the later you'll receive treatment.

If you have insurance or are financially well-off, book your appointment with the oncologist on the day your DNA report is available.

Even renowned oncologists can't be booked for tomorrow, and top doctors need to see DNA reports. The Hong Kong Sanatorium & Hospital says the report will be available in 7-8 days, so book accordingly. A private oncology clinic 8-9 days later:

If you're in a hurry, you can see an oncologist first, but the oncologist will tell you to use the terminology of a cardiologist, but there will be a $1300 consultation fee.

On the day you get your DNA report, give the report to the oncologist, who will then develop a treatment plan.

For example, I have end-stage lung cancer, and surgery is not an option; only palliative care can prolong my life. The DNA report can match me with which targeted therapy to use. If you are financially well-off, you can pay for the targeted therapy immediately.

I'm taking Tagrisso, a third-generation targeted therapy for lung cancer, which costs $48,000 per 28 days.

My insurance covers the targeted therapy, but it takes 2-3 days to apply and receive it.

Once I start taking the targeted therapy, I can slow down and wait for a response from the government oncology department.

If I'm lucky, I can see a government oncology doctor in about two weeks. I'll then show them my PET-CT report and DNA report. However, the government oncology doctor will say, "I know what medication to use, but procedurally, I can't prescribe it on the first meeting, so I have to wait for a second meeting."

The government oncology doctor will also prescribe the same medication, which I have to pay out of pocket: $33,800 per 29 days.