Cha cha your way to health

Latin dancing has taken Thailand by storm over the last few years, and although the trend has slowed, there is now an entrenched dancing scene in town. Before you dust off your dancing shoes and join in, however, you might like to find out about what the style of dancing is, where some of the dances come from, and what your options are when it comes to taking classes.

What is Latin dancing?

The Dance Centre’s artistic director Vararom Pachimsawat says that many Latin dances were originally created to appease the gods, while others were created for martial purposes – that is, to prepare the mind and body for action. Still others were more romantic in nature and used for courtship. "Latin dances have their own history that reflect the people of the country of origin," she says.

General manager of the Pathumwan Princess (home to the Salsa Club) Stanley Pao says that ballroom dancing has long been on the scene in Thailand, and that it’s always been popular as a form of exercise. "Now with Latin music here, it’s even more energetic. The real Latin dances like the salsa and the merengue keep you moving all the time. It’s a very good form of exercise."

Vararom adds that dance is good for both the mind and body. "It can stimulate the nervous system and can also be relaxing after a strenuous work out."

Besides Ricky Martin, Latin dancing’s popular appeal can be attributed to how simple it is to learn. El Nino’s dancing teacher Nicky ("everybody knows me by my first name") says that it’s not as strict and constraining as ballroom dancing. "You just need to know the basic steps, and then the pattern is up to you. It’s fun, but it’s also hard work."

Furthermore, the strong rhythms in Latin music are generally easy for even poor natural dancers to follow. Latin line dancing, used to teach basic steps at El Nino, has become popular among many people who otherwise may not have thought of stepping onto a dance floor.

The dances

There are several basic Latin dances, of which there are many variations, with some occasionally borrowing heavily from others. Some of the dances include the mambo, from Cuba, with the music being a fusion of swing and Cuban beats influenced by African and Caribbean styles. In parts of Cuba the dance is known as "the devil’s dance" due to its suggestive nature. Popularised in the 1950s, it led to the development of the easier cha cha. Arthur Murray, the famed American dance studio king, then popularised it in America.

Mambo also contributed to the development of salsa, both of which feature six steps taken over eight beats of music and share some similar moves. Salsa, however, features more turning, is more energetic, and most movement is from left to right, while mambo steps tend to go forwards and backwards.

The Dominican Republic can claim responsibility for the merengue, (in Haiti, it’s called the meringue), an energetic march which became popular there in the mid-nineteenth century, while Brazil is known for creating the samba.

Those who think Latin dancing is sexy have something upon which to base their opinion: the original native African rumba was supposed to represent sex. Another type of rumba developed in Spain, but as with other Latin dances, it became truly popular in Cuba. Today the dance still features a healthy amount of flirting between the dancing partners.

Where to find the beat in Bangkok

"Latin is fun, it’s lively, and these facts appeal to the Thai sense of how life should be lived," says the Dance Centre’s Vararom. Indeed there are plenty of places to learn how to do more than just tap your feet to the tune. Here are a few to get you started.

Pedicures for punished feet

They’re easy to forget about, but your feet deserve some special attention occasionally: the average person walks more than six kilometres per day, or an astounding 184,000 kilometres in a lifetime. And bearing the brunt of this are those two complex but compact anatomical networks at the end of your legs, containing 26 small bones and more than 150 ligaments.

One way to treat your feet is to give yourself a home pedicure. You’ll save the cash you’d otherwise spend on a salon pedicure, and the time you’d have to spend getting there as well.

They’re not just a luxury

Arline Finch, a beauty consultant with Spa of Siam, advises that pedicures can do much more than soothe tired feet. "They can help reduce fluid retention, and help the lymphatic system get toxins out of your body. And they improve the visual appearance of your feet, which can be important in places like Thailand, where open-toed shoes are popular and perfectly pedicured toes are really noticed."

She recommends the following:

· Take either a foot spa if you have one, or a bowl of warm water and add some essential oils. Lavender is good choice for its relaxing and rebalancing properties, while lemon and lime are uplifting.

· Soak your feet for five to 10 minutes to soften up hardened skin and cuticles.

· Use an almond-kernel based body scrub to sweep away the dead cells from the surface of your feet’s skin. Rinse off.

· Dry your feet with a towel, and clip your nails back using clippers. Make the shape slightly rounded: keep some support in the sides of your nails to prevent weakening.

· Use an emery board to smooth the nails.

· Apply cuticle cream remover around the cuticle area, and massage.

· Take an orange stick, protect the end with a piece of cotton wool, and gently push back your cuticles.

· Using cuticle clippers, trim hangnails.

· Use a shoal scrubbing pad to remove dead skin cells still left on the bottoms of your feet.

· Massage an edible oil such as almond, avocado or sesame, or a naturally-based cream into your feet.

· Weave a folded tissue between your toes to separate them.

· Use a nail polish remover to clean off the toes, then add a base coat, two coats of colour and a top coat.

If you’re in a hurry

Nirin Saiseang, a manicurist/pedicurist at The Oriental Hotel, recommends the following no-frills procedure be done fortnightly by those who are in a hurry but are still want good-looking feet:

· Soak your feet in warm water with a dash of Dettol – good for its antiseptic qualities – for about five minutes.

· Rub a quality body lotion around your nails to help further soften your cuticles.

· Moving your fingers in a circular motion, massage your nails and push your cuticles back.

· Take a wooden toothpick, snap it in half, and cover one broken end with cotton wool. Use it to push back the cuticles a little further.

· Use the sharp end of a nail file to clean the nails if necessary.

· Take a soft brush and shower gel or soap, and wash your feet.

· Change the water, add some more Dettol and soak your feet for a further five minutes.

· Men should cleanse the foot with an alcohol before adding a massage or cream lotion, while women should add a massage lotion prior to painting their nails if desired. (Nirin advises that you should use a cream on your feet every second day. Apply to your feet before bed.)

"Nurture yourself," are Finch’s final words. "If you’re busy and successful, it’s important to take time out to look after yourself and recharge your batteries."

Protein makes perfect

With lifestyles changing and hair colouring being more popular than ever before, your hair could benefit from adding a regular salon protein treatment to your hair care routine.

"It depends on what you expect from a treatment," says stylist Schai from Schai Coiffeur. "Nowadays nearly everyone has a colour, perm or some kind of chemical treatment. Plus there’s pollution, and even if you go swimming, your hair’s natural condition changes."

Panipa Pavanarit, president of the Hairdressers’ Club of Thailand and manager of Panipa Hair and Beauty, explains that a protein treatment will bring the hair back to its natural condition. "The difference between a normal conditioner and a treatment is that the conditioner stays on the outer layer of the hair, making it shiny, soft and easy to comb. Protein, on the other hand, actually penetrates right into the hair shaft."

The protein gets right into your hair

Each strand of human hair features seven to twelve layers of cuticle scales, which protect the inner structure of the hair. In healthy hair, these scales stay flat and give the hair its sheen. However, if you have your hair chemically treated, swim in chlorine or salt water, expose your hair to the sun, or use heating products, the hair will be damaged and the scales will break or fan out. This results in weak, dry hair that loses its lustre.

Hair is basically protein. When proteins such as collagen, keratin or silk are "hydrolysed" or chemically broken down, they can be applied to the hair and will actually fill in the gaps in the scales.

"There are so many good treatments around," says Panipa. "Each brand develops its own combination of ingredients or proteins. Speak to your stylist – we work with the products all day long, year by year, so we know which brands are effective on different types of hair."

But not everyone will benefit to the same degree by using a treatment. "If you have ‘virgin’ hair, and you use a good shampoo and conditioner, you might not need a treatment. But they have to be good!" warns Schai.

"The effect is not the same if you apply it to hair that doesn’t need it," agrees Salon de Bangkok’s branch manager Aek Vibulsiriwongse. "It is also possible to apply treatments too frequently."

So how often is appropriate?

Most stylists agree that the average person, whose hair is simply stressed from Bangkok’s humidity, pollution and the sun, can benefit from treatments at least once or twice a month. But if your hair is severely damaged, once a week can be optimal. "After a month of weekly treatments, the condition of your hair should be better, so you could then drop back to once every two weeks, and once it’s back to normal condition, once a month," says Schai.

In the salon, the treatment will be applied to your hair before it’s trimmed. After a shampoo featuring a head massage to help stimulate the hair follicles, the head will be wrapped in a special plastic and then placed under a steamer for around ten to fifteen minutes to help the protein penetrate into the hair shaft.

If you can’t make it to a salon, there are still take home treatments, but they’re not as concentrated as those used in salons. "Apply the protein to towel-dried hair, leaving it on for up to twenty minutes underneath a shower cap," suggests Panipa.

But there’s no point getting a treatment if you’re not going to back it up the rest of the time. "Use a good shampoo and conditioner from a salon," says Schai. "It won’t wash away the nutrition the treatment gives. And choose from the same brand – the ingredients will support each other."

No more squinting

Whether you wear glasses and put off going to get your script checked, or you’ve never worn glasses before in your life, it’s worth considering whether a trip to an optician or opthamologist might be beneficial.

What’s the difference?

Opticians or technicians usually work in shops selling glasses and contact lenses, while opthamologists are qualified doctors. Opticians are able to give you a prescription to correct your vision, and will refer you to an opthamologist should they suspect you have more than just refractive problems.

"We check people’s distance and up-close vision, and will correct it," says Rachanee Leicester, optician and manager of Boonteng Optical. "We can also check for cataracts, plus if we are unable to correct a patient’s vision to 20/20, we’ll refer them to an opthamologist."

Opticians may only see patients within a certain age bracket, depending on their own expertise. Wichai Manonom, an optician at Smile Optic, sees patients aged only 15 to 60. "These patients can be more complicated, so it’s better if they see a doctor."

Opticians may not be qualified

Rachanee notes that regulation in the optical industry is lax. "There are not many qualified opticians in Thailand – there is no law that people cannot practise without a licence." But this is improving, with the introduction two years ago of a short course approved by the Thai Optometric Association.

Therefore it makes sense to ensure that your optician is properly qualified. "Qualified opticians will test using more than just a computer," says Rachanee. "For instance, a retinalscope [a torch-like instrument] should be used to check the eyes." If there are too few machines in the testing area, and your test is very quick, consider going elsewhere for a second opinion.

Who should be checked and when?

It is crucial that children have their eyes tested, says Dr Sorot Wutthiphan, an opthamologist at Samitivej Hospital. Soon after birth, babies should be checked by their paediatrician for infections and structural defects, cataracts, and glaucoma. Eyes should be checked again by an opthamologist when aged six months, three or four, and then five or when the child starts school. "Opthamologists will have testing boards with pictures, so it’s easy for children to look at them and tell us what they can see," says Dr Sorot.

One condition that is vital to pick upearly is "lazy eye", or amblyopia, which is the loss or lack of development of central vision in one eye. It usually develops before age six. "If treatment is left until after age eight, it is usually ineffective," says Dr Sorot. ‘The younger the child is, the more effective treatment is."

If children have no problems when tested at age five, or they have myopia (shortsightedness), they should still be tested every year. If they have hyperopia (farsightedness), testing should be done every six months.

Adults, whether they have problems or not, should aim to be tested every two years, although those with hyperopia should consider an annual checkup. A normal consultation with an opthamologist can detect glaucoma, cataracts, diabetic retinopathy, macular degeneration and retinal problems. "People who are diabetic, have other eye conditions, or have a close relative with glaucoma should be seen more regularly," says Dr Sorot.

When symptoms strike, get help

If you have the following symptoms, you should see an opthamologist:

· decreased vision;

· flashing;

· red eyes with pain or blurred vision;

· double vision; or

· floaters.

But even without symptoms, regular checkups are important. "There are many people in Thailand – usually poor people in rural areas – who are blind from treatable diseases, such as glaucoma," says Dr Sorot. Chronic glaucoma sufferers show no symptoms until the late stages of the disease – when it’s too late for medical intervention.

Throw away your glasses

More and more Thais are gleefully throwing away their glasses, thanks to developments in the refractive surgery industry. Technology is improving, and prices are falling as competition among centres increases.

What does refractive correction surgery involve?

"Lasik" (laser in-situ keratomileusis), the latest development in refractive surgery, can correct myopia (short sightedness), hyperopia (far-sightedness) and astigmatism – but not yet presbyopia, which all people over 40 will develop.

While the patient is under a topical anaesthesia, the ten-minute (per eye) procedure involves creating a flap in the top one-third of the cornea, prior to exposing the underlying cornea to an excimer laser. This effectively changes the shape of the cornea. The flap is then repositioned closed, where it is left to adhere without sutures. Due to the lack of disturbance on the corneal surface, recovery time is quick – it takes about six hours for the wound to heal.

Lasik has largely replaced PRK (photorefractive keratectomy), where an excimer laser directly reshapes the cornea. "The procedure results in an open wound, which takes around four days to grow back," explains Dr Chate Kietrsunthorn from Bumrungrad Hospital. This makes Lasik more optimal in the majority of cases.

The risks

Lasik surgery is reputed to be the safest in the history of eye surgery – but low risk does not mean no risk. The presentation shown to prospective patients at the Refractive Surgery Centre (TRSC) is sobering. "No one has ever gone blind from Lasik, but you can always be the first," warns Dr Ekktet Chansue, the centre’s director.

Anoma Rutnin Sethpornpong, executive director of the Rutin-Gimbel Excimer Laser Eye Centre, says that it’s a very personal decision. "If you are happy with glasses or contact lenses, stay with them. But your lifestyle can change a lot as a result of surgery."

There is a 1 in 5000 risk of developing a serious infection, and a one in 100 chance of developing serious complications – both of which could lead to a loss of vision.

Other risks include:

· developing a permanent "dirty windshield" type problem (more common with PRK);

· a reduction in night vision;

· developing night glare, where starbursts or halo patterns can be seen around lights;

· a complication in creating the corneal flap; and

· several minor side effects such as tearing, burning and dry eyes, which usually go away within a few days.

There are also no guarantees when it comes to achieving perfect vision. "Your eyesight will not be any better than what it is with your current glasses," says Dr Ekktet.

Mr Amatzia Sadan, 61, is one of Bumrungrad’s happy customers. He considered the risks, but the thought of life without three different pairs of glasses – for reading, long distance, and the sun – was too good. "Within two minutes of stepping outside after the first consultation, I said, ‘I’m going to do it!’ Now I still need my glasses for reading, but not all the time, and I wear sunglasses but without any number. I would recommend the operation one hundred per cent."

Not suitable for all

To be a suitable candidate, you need to be over 18, have had stable vision for at least one year, and not be pregnant. Up to ten per cent of prospective patients may be turned away due to other existing eye problems or characteristics.

Choosing a centre

"Find a friend who can recommend a good doctor," advises Rutnin-Gimbel’s Anoma. "Check how many eyes your doctor has done, how many complications there were, and ask what the worst complication was. Check that they are up to standard."

Rates of success in achieving certain levels of vision varies, so do check this as well.

The TRSC’s Dr Ekktet also encourages patients to ask as many questions as they like. "There is a lot of information available – possibly more than you can digest quickly. Find out as much as possible and ask questions – no questions are too dumb."

Tended talons

It can be a marvellous spectacle to watch a woman with very long painted nails at work, using a telephone, taking notes. But for the ordinary woman, it can be troublesome enough just trying to keep her nails healthy and respectable looking. The key?

Regular basic manicures, according to Pimonrat Trirattanakittikul, owner and general manager of nail salon Nail Intensive Care (NIC). "Nails complete a person’s total look, and a basic manicure is the foundation for all other nail services," she says. "Every nail salon needs to be good at a basic manicure."

But getting a manicure isn’t just about beautiful nails. Yupin Macleod, manager of The Best salons, points out that more than just beauty is at stake. "Over time, cuticles can become hard, and nails can start to become ingrown. This can lead to a lot of bacteria getting caught in the nails, or to fungi developing – remember, we use our hands for everything, all day. A manicure can help prevent this build up."

The relaxation aspect is important too, says Pimonrat. "Having a manicure allows you to enjoy some personal attention by a professional." And if you tend to bite your nails, having such a treatment can also encourage you to stop.

According to Pimonrat, the typical salon manicure will involve these steps:
· Removal of old polish;
· Nail cleaning with a soft brush and soap;
· Soaking hands in warm water for around ten minutes;
· Pushing back cuticles with an orangewood stick;
· Filing nails into shape. Filing should happen in one direction only, from the edge to the centre;
· Trimming of excess skin from the cuticles and getting rid of hangnails; and
· Cleaning with alcohol again.

If no nail polish is being applied, the next-to-final step is to massage cuticle oil into the fingertips, followed by an application of hand lotion. But if colour is being added, a base coat should first be applied, and after being left properly to dry, two coats of nail polish should be added, followed by a top coat. Next up comes a cuticle oil massage around the cuticle area, and finally, a massage with hand lotion.

A one-hour manicure at NIC costs Bt250; the Best also charged Bt250 and their manicures are usually done in conjunction with other salon services, such as a shampoo and blowdry.

As for the latest in nail fashion, Pimonrat says that gold has been the most popular colour over the past year, while bright purple and pink is hot this month. "And in America, filing nails into an oval shape is most popular, while Thai people love square nails," she adds.

If you can’t get to a salon, Pimonrat recommends treating yourself at home. It’s a good opportunity to relax a little; play some music, grab some magazines to browse through while waiting for your nails to dry.

These are Pimonrat’s recommended steps for a home manicure:
· Wash your nails using a soft brush and soap;
· Soak your hands in plain warm water for ten minutes;
· Use a cotton bud to gently push back your nail base;
· Use a cuticle cutter to trim away excess skin from your cuticles and hangnails, but don’t cut too much off or they will grow out hard;
· Massage cuticle oil around the cuticles and over the nail’s surface;
· To strengthen the nails, add a top coat.

"Don’t use a nail buffer, as this can dehydrate and weaken nails," Pimonrat warns. "Professionals can use a buffer in the salon, but you shouldn’t use one yourself at home."

Heading to a salon or pulling out your own equipment to give yourself a manicure once every two weeks should be enough to keep your nails looking healthy. "I sometimes do my nails myself," says Pimonrat, waving her elegant talons around. "But it’s more difficult. Plus it’s more relaxing when a nail technician does them."

Getting a good cut from your stylist

It’s happened to nearly everyone: a haircut that’s failed to live up to your expectations or even had you in tears by the time you’ve arrived home.

But there are steps you can take to ensure you get the cut you want. "Talk to your hairdresser before you get your hair wet. That way your hairdresser can see your hair’s texture, condition, the way it falls," says Panipa Pavanarit, manager of Panipa Hair and Beauty, and president of the Hairdressers’ Club of Thailand.

Stephane, owner of the French salon that bears his name, advises that you should speak openly with your stylist during this initial consultation. "Dialogue is the most important thing. You need to make sure the stylist understands what you want. I can’t do a good job if I don’t know what I’m supposed to be doing. "

Bringing a photograph can sometimes help. "But it must be clear. If you cannot see the style, it’s no use. And don’t bring me a picture of Jennifer Aniston if you look like Whitney Houston."

[Stephane says Jennifer Aniston and Meg Ryan are the two most popular stars whose cuts people want themselves. As for men: "Men never bring in photos," he says. "They don’t want to look like another good-looking man. They want to be the best looking man themselves!"]

Pattanapong Yanasit, a stylist with The Best, agrees that a photograph can be useful because it allows him to see what the client really wants. "But in another way, it’s not good, because sometimes it might not be possible to do that style for the client – because of the texture of the client’s hair, or their features. What I can do is take that concept and adapt it to suit them."

Panipa emphasises that the language you use when talking to your stylist is important. "Talk in inches or centimetres when you’re saying how much you want cut off. A ‘little bit’ in your mind might not be a ‘little bit’ in your stylist’s mind. If you want your hair cut to a certain length, try to say where: to the shoulders, chin, ear, half way down the ear. These are the terms hairdressers understand."

Once the stylist starts work, you can help by paying attention. "With your first cut, don’t read a book," says Panipa. "The stylist wants to talk to you as she styles your hair, so she can adapt what she’s doing as she works. If you don’t like what she’s doing she can change it as she goes."

On the other hand, Stephane points out that hairdressers can be moody. "Don’t say: ‘Don’t cut there!’ after they have started. Try to be diplomatic. Try not to affect the mood of the hairdresser. Also, try to relax. Your hairdresser will know you’re tense because your shoulders will be tight and higher – and they might think you’re doubting their capacity to do the style. As a stylist, if you feel like you’re in a cage, you will not do a good job."

But what if, despite following all of the above, you’re unhappy with the result? "Be friendly to your stylist and tell them," advises Pattanapong. "Maybe we talked but our understanding was different. I might think the cut is beautiful and trendy, but the client might cry – this has happened before. We can change it, make sure it’s something that suits the client."

"You have to tell the stylist," Panipa agrees. "If you think it doesn’t suit you, say so, don’t just go home. All stylists want a good result – if your client is happy, you’re happy too. Don’t think that you’re taking up too much of your stylist’s time."

If the cut is too heavy, the stylist can texturise it; if it’s too long, it can be cut shorter, she says. And if it’s too short? "Well, I would tell the client that hair grows at half an inch per month," Panipa says. "And sometimes it can take a week to grow to like a new look. Styling products can also make hair appear longer."

Support for breast cancer sufferers

"It was like the end of my world," says twenty-eight year old Penkhra Jitjamnong, of being told two years ago that she had breast cancer. "I had so many questions, like why me? There were no right answers. I didn’t know what to do, and I didn’t know what to say when people would ask me ‘Are you going to die?’ "

As her illness progressed, she asked nurses about whether there were any support groups for breast cancer patients, and eventually a nurse gave her a brochure about the Bangkok Breast Cancer Support Group (BBC). "I’m so happy I found out about them. I’ve connected to a big family," she says. "The BBC will tell you about what to do if you lose your hair, how to feel good about yourself and stop thinking about being sick."

Dr Narongsak Kiatkikajornthada, an oncologist at Samitivej hospital, says that it can help cancer patients to talk to other people who have had a similar experience. "So you know that you will be okay later on. But in Thai culture, I’m not sure how it would work… At the moment, [a support group] would have to be gradually developed."

The BBC was launched more than a year ago by American Connie Larkin and two other women. When several of Larkin’s friends were diagnosed with breast cancer, she decided to do something to help them by getting the group going. "In America, support groups are very, very prevalent," Larkin says. "Even in a couple of other places in Asia, but not Bangkok."

The group consists of volunteer women from diverse backgrounds – there are currently nine women on the committee, who speak five languages between them – who are able to provide emotional support to people who have been diagnosed with breast cancer. "What we are trying to do with this group is provide alternatives to people, both Thais and expatriates. When people are diagnosed, they can call us and ask ‘Where do I go in Bangkok? What’s here for me? What services exist?’ "

As well as promoting community awareness of breast cancer, another of the group’s objectives is to create a resource centre with literature and current information. "We have tried to gather information from various cancer societies. We’ve also purchased books, and we research what’s coming out of the major cancer institutes. If people go to a doctor’s office here, there is little to sometimes no information."

Larkin hopes that doctors will let their patients know about the group. "Part of our success will be based on getting the support of physicians and their referrals. This is our main obstacle at the moment."

One of the main activities of the group are the monthly emotional support group meetings, held at a different hospital each time, which Penkhra found so useful. "I think we’re going to increase the number of meetings because the people who are sick and are coming to these meetings say they want more," says Larkin. "What we’re trying to do is encourage them to support each other, so after every meeting we send a list to everyone who participated and they can call each other."

Pensri Wanrakakit, an oncology nurse, says that she has often been asked by patients about whether it is possible to contact a support group anonymously. "Some patients want help over the phone, or Internet instead," she says.

Culturally, then, perhaps the group will take some time to be sought out by Thai women. Penkhra, however, remains baffled by this lack of enthusiasm to meet and talk about problems. "I don’t understand why Thais don’t talk. If you talk about something, it makes you feel better. When I was going to hospital, I wanted to talk to the other patients there, ask them how they were feeling. I thought maybe we should share our experience together," she says. "I really needed someone to talk to."

Penkhra has now recovered and is returning the favour to other patients by remaining active in the BBC. "If there’s someone new, I want to help her. I want to hug her, tell her that she will be fine. I understand what she’s feeling. I lost my hair – if someone is going to lose their hair, I’ll tell them to look at me," she says, indicating her now very healthy-looking locks.

Breast cancer in Thailand

Worldwide, it affects millions of women: It killed 385,000 women globally in 1997 and one in nine American women will have it by the age of 85. But there is some good news on breast cancer: with an increasing awareness of the disease, and more sophisticated technology, the early detection and treatment of breast cancer is becoming easier and is improving women’s chances of survival.

In Thailand, the statistics on the number of women diagnosed are difficult to pin down. For Bangkok, it’s estimated that just over 20 women in every 100,000 will be diagnosed with breast cancer – a rate higher than the rest of the country, but similar to rates in developed countries.

Dr Narongsak Kiatikajornthada, an oncologist at Samitivej Hospital, says that people are more aware of breast cancer than ever before. "And the incidence of breast cancer is now higher partly because we can detect it more easily. [At Samitivej] we see more breast cancer than cervical – but if you look at the national figures, cancer of the cervix is number one."

This, he says, is probably because the hospital’s patients tend to come from a higher socio-economic group among whom there’s a higher awareness – and fear – of the disease. There’s also a possible link between the diet of this group compared to others.

"There are now facilities all over the country, and we have the technology to detect breast cancer in its early stages. The problem is getting people to go and be examined," says Dr Sankiat Vayakornvichit, a gynaecologist at the same hospital.

Regular breast examinations and mammograms (breast x-rays) have a vital role to play in the early detection of breast cancer, when treatment has a much higher rate of success. At Samitivej, doctors recommend that women start to regularly self-examine with the onset of puberty, but they note that there are some cultural barriers to overcome for Thai women to do this. "The culture of Thai women means they are usually not keen on doing breast examinations," says Dr Pornthep Pramyothin, a surgeon on the Samitivej team.

But self-examinations alone are not enough – they are a necessary complement to regular mammograms. "If you can feel a lump in your breast, there’s a fifty per cent chance that it may spread through your system," says Dr Pornthep. Mammograms, on the other hand, can detect lumps that you can’t yet feel yourself.

"Guidelines for when to start screening for breast cancer vary between different national cancer bodies around the world, and between hospitals," says Connie Larkin, founder and co-ordinator of the Bangkok Breast Cancer Support Group. "We tend to promote the American Cancer Society’s guidelines because they are the most conservative."

These guidelines recommend that self-examinations should be done monthly from the age of 20, a clinical breast exam should be done every three years for women aged 20 to 39, and women aged over 40 should have a mammogram and a clinical exam every year.

When a lump is found a biopsy is required to find out whether it is cancerous. If cancer is detected, the course and combination of treatments followed will depend on the individual woman’s risk factors, her genetic disposition and the characteristics of the cancer."There is some choice," says Dr Pornthep. "The main objective is to control the disease. We need to consider the pros and cons of different treatments, explain the options to the patient and make a recommendation."

Dr Sankiat strongly encourages women to see their gynaecologist annually. "Please have a physical exam once a year – not just for a pap smear, but for a breast exam. It’s an integral part of a woman’s check up. And see a gynaecologist directly – we have more expertise in this area, it’s what we do. We want to see patients before they have a lump, rather than at a late stage, because with early detection, patients have a better prognosis."

The median age for women with breast cancer is 50 years old – that is, in a group of 100 women with breast cancer, around half will be aged close to 50. "If you are young and you find a lump, it’s probably fibrocystic disease, which is benign," adds Dr Narongsak. "I’ve seen many young women who have not been able to sleep because they have found a lump. They need to know that they are not in a high risk group, but they should still seek medical advice."

Where to do yoga in Bangkok

Although the history of yoga stretches back some 5,000 years, in Bangkok yoga has been taught formally for only around 40 years – rather surprising if you consider that some scholars assert that yoga practice is central to Buddhism. There are many different styles of yoga, with the main differences stemming from what component is emphasised. This can include the alignment of the body, the coordination of breath and movement, or maintaining a smooth flow from one posture to the next. What’s important is finding a style and a teacher that you like.

There are now more and more classes being offered around Bangkok, so options are on the increase. Here’s a rundown of a few teachers and places to start:

Teacher’s name: Chomchuen Sidthivech

Style taught: The Sivananda school of yoga, developed by Swami Vishnu-devananda and named after his teacher,is one of the world’s most popular. It follows a set structure of asanas, pranayama and relaxation. Chomchuen emphasises that this form of yoga is very graceful, with no jerking, a trait that can sometimes be observed in other schools. "Srivananda is smooth, gentle, slow," she says.

Background: Chomchuen learned the Sivananda form of yoga from possibly the first teacher to open a school in Bangkok. "My guru studied at the Sivananda Ashram in Rishikesh in north India," she says. After several years there, he returned to Bangkok to open a yoga school on Soi Wattanayothin – that was around 40 years ago. Chomchuen studied with him for three years before she too began teaching at his school. Eventually they moved the school to her current home, where they taught together for around eight years. Since her guru died she has taught alone, although she is now training her youngest sister to assist her. One group of around ten women have been coming to her for more than ten years. "A lot of my students are like my sisters or my cousins," she says.

Contact details: 310/1 Ekamai Soi 16. Phone 392 9869.

Class times: Daily except Wed and Sun, 7.30-10am, 2-5pm. Students work individually, and can thus start and finish at their chosen time. Beginners should arrive early in the sessions.

Cost: Bt150 per class.

Teacher’s name: Justin Herold

Style taught: The Iyengar style of yoga is another of the world’s most popular. Created by BKS Iyengar – who taught the Queen of Belgium to do a headstand when she was 83 years old – this style is noted for its great attention to detail and the precise alignment of its postures, as well as the use of props such as blocks, belts, ropes, bolsters and blankets to help students get into poses. Iyengar teachers must complete a rigorous two- to five-year training program before being awarded certification. "I tried other schools of yoga," says Justin. "But I found that the Iyengar system was the one that best suited me."

Background: Justin started practising yoga in 1979. He eventually took a teacher training course in Los Angeles, taught at the Los Angeles Iyengar school for three years and has visited Pune, India, to study with BKS Iyengar on several occasions. He arrived in Bangkok nine years ago, where he has since taught at the Sukhothai, Phillip Wain, the Sheraton and the JW Marriott Hotel, among other places. He opened his own studio in October 1999.

Justin points out that one of the main things with yoga is finding both a school and a teacher you like. "The end results are pretty much the same. Some people like Ashtanga yoga, where you go through a series of postures, and it gets really rigorous. It’s subjective, and that’s why I get people here – because some people like the way I teach."

Contact details: 55th Plaza Building, 90 Sukhumvit Soi 55. Phone 714 9924.

Class times: Sessions are 1.5 hours, daily except Friday. See http://www.iyengar-yoga-bangkok.com/ for details.

Cost: Bt330 for drop-in, Bt2,700 for ten lessons to be used within two months, Bt2,700 for unlimited classes for one month or 27,000 for a yearly membership.

Teacher’s name: Hilary Fedderson

Style taught: Hilary teaches her own version of yoga which she describes as being mostly Iyengar and Sivananda based.

Background: Indian-born Hilary Feddersen learned yoga on and off while she was in her twenties. She started practising more seriously when she developed some lower back problems, and found the yoga helped strengthen her back and eventually eliminated the problems.

After learning yoga with eleven teachers of various disciplines she began teaching her own combination of yoga. Besides the basic yoga asanas, Hilary believes the breathing and the meditative aspects of yoga are very important components to be included in each practice in order to receive the full benefits of yoga. "To treat yoga merely as a form of physical exercise is a mistake many people make, because well-being results from harmonising both mind and body," she says.

She gave her first yoga classes in Bangkok over 20 years ago where she and her family have been residents for about 30 years.

Contact details: Apt 6A2 Royal Mansion, 304 Sukhumvit 55 (between sub sois 8 and 10). Phone 390 2310 or 01 692 0081.

Class times: Tuesday and Thursday mornings between 9.30 and 11.00 a.m.

Cost: Bt 1,000 for 4 sessions.