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NNI Patient Went Through Brain Surgery Awake
NNI doctor carried out the operation while the patient was awake so that the team could monitor the patient's vital functions during the procedure.



Original title: Brain Surgery When He is Awake

He lies in the operating theatre, still and seemingly asleep.

Part of his head is behind a transparent curtain. From behind, his skull has been sawn open and neurosurgeon Ng Wai Hoe begins the delicate process of removing a walnutsize tumour from the deep recesses of his brain.

Photojournalist Wang Hui Fen, who is documenting the operation, zooms in for a close-up. The patient opens his eyes a fraction, looks straight at the camera, raises his right arm and gives that universal sign of approval, a thumbs up.

Meet KPMG auditor Oh Zhi Long, the world's most upbeat brain surgery patient.

He is awake, so Associate Professor Ng and anaesthetist See Jee Jian can talk to him to assess the effects of the surgery.

The job is a delicate balancing act: Remove too little tissue and the tumour will most certainly come back. Take out too much, from the wrong spot, and Mr Oh could be rendered unable to speak, or paralysed for the rest of his life.

Earlier that day – on the morning of March 28 – the atmosphere is relaxed as the operation is set to begin.

Multiple checks are done before the procedure, including marking the site of the growth and confirming for the umpteenth time that the tumour lies within the left frontal lobe – the seat of language for righthanded folk, and an important movement control centre as well.

"Finally," says Mr Oh with a smile as he is wheeled into an operating theatre at Tan Tock Seng Hospital about an hour later.

Prof Ng, medical director of the National Neuroscience Institute (NNI), is a veteran of such operations, having done them since the early 2000s, performing up to 15 a year and more than 200 in total.

He removes Mr Oh's glasses and, pointing to his hair, asks him how close a shave he wants. "I'm a jack of all trades," he quips, as he whips out his clippers. "Take it all off, it's only hair, it will grow back," Mr Oh replies. "I have no regrets."

Awake brain surgery is done in less than 10 per cent of brain tumour cases at the institute, when surgeons need to operate on an area of the brain that involves or is close to regions that control critical body functions, or sensory and language capabilities. In such cases, it is critical for the patient to be conscious so the surgeon can monitor vital functions during the procedure.

Senior manager of operating theatre service Lee Sow Fong, who oversees the procedure, is a model of efficiency. She reminds The Straits Times team – the first to document this operation here – not to disrupt the work of the medical professionals.

"Do not get in their way," she warns us sternly.

Mr Oh is sedated, but only mildly. Associate Professor See explains: "During certain periods, he needs deeper sedation, but sometimes we need his cooperation and we use different drugs to achieve that.

"Every patient is slightly different, so we have to find the level that is appropriate for him."

Throughout the procedure, he carefully monitors Mr Oh's vital signs including his heart rate, breathing and blood pressure, and talks to him to keep him calm.

Prof Ng and NNI's director of neurosurgery research Nicolas Kon begin by cutting through the skin on the head, before drilling through the skull.

"You will hear a drilling sound, just relax," Prof Ng tells Mr Oh, as the sound of metal crunching through bone fills the quiet of the operating theatre.

Once the piece of skull is lifted, he slices through the dura – the tough membrane which protects the brain – pulling it back and attaching it to the skull with neat surgeon's stitches to make sure it "remains tight" to minimise bleeding.

Then he cuts through the arachnoid or spider membrane, which cushions the central nervous system, and finally the delicate pia membrane on the brain's surface.

Pink, glistening and delicate, the body's most important organ is now exposed.

The brain, home to 80 to 100 billion neurons, does not have any pain receptors and cannot feel anything – luckily for Mr Oh. So it is the only major organ which can be operated on while the patient is awake.

Every effort is made to ensure he is comfortable. In fact, the transparent drape separating the part of his head being operated on from the rest of him is Dr Kon's innovation.

Previously, surgeons took the lead from their overseas counterparts, using the classic green opaque hospital drapes to do the job. But this could make a patient feel claustrophobic.

It was also difficult for the surgeon, from his position behind the drape, to monitor the patient's responses, explained Prof Ng.

So they rigged up the transparent sheet on a metal stand, much like a shower curtain.

Mr Oh's head is also not clamped – another NNI first.

Instead, it rests on a horseshoe cushion, making him much more comfortable.

With neuro-navigation technology, a tracker is stuck to Mr Oh's forehead, so that the MRI scanner can accurately track where the tumour is in real time, even with slight movements.

NNI doctors and scientists are currently studying the use of a fluorescent dye which lights the brain tumour up, while healthy tissue is unaffected. If successful, this will be a cheap and effective way of singling out the tumour so that it can be removed.

Once the brain is exposed, a little cerebrospinal fluid – the colourless liquid which surrounds the brain – is collected for research.

The tumour will also be deposited in the NNI's brain tumour bank, which has amassed over 130 samples in the last decade.

The idea is to study the genetic make-up of the tumour, so that doctors will one day be able to tailor specific treatments for different patients, based on the tumour's genetic signature.

"Zhi Long, are you awake now?" asks Prof See, head of anaesthesiology, intensive care and pain medicine at Tan Tock Seng Hospital. "We're going to start very soon, are you comfortable?" The patient nods slightly. Another hour has gone by.

As Prof Ng delves into the tumourous tissue, which is an unhealthy yellowish white compared with white healthy tissue, Prof See asks him to make a fist, and moves forward with an iPad.

"Can you see without your glasses?" asks Prof See. "I'll try," Mr Oh replies drowsily.

He is asked to name common images on the iPad, ranging from a car to a dolphin to roti prata.

"Can I see what's in my head also?" Mr Oh asks, to which Prof Ng responds: "Later we'll show you." Mr Oh has a few more questions – "Somehow my legs feel numb now, is it due to the brain?" ("No, it's probably just the local pressure."); "Is the tumour cutting into my vocal area?" ("No, the vocal area is behind it, so we'll have to ask you some more questions later.") "Okay, just cut more lah," Mr Oh responds.

The naming test goes on as Prof Ng delves deeper into the brain to excise the tumour, and about four hours after Mr Oh is first wheeled into the operating theatre, the growth is removed.

Then comes the process of sewing back the dura and screwing the skull shut with titanium plates, and finally stitching up the scalp which had earlier been peeled back like the skin of a fruit.

Prof Ng tells him: "You did very well," and his patient squeezes his hand one more time. Mr Oh is even able to move himself onto the hospital bed that will be wheeled into the recovery ward.

When he wakes up, he may remember very little of the entire procedure.

But he tells ST later: "I was joking but I felt a bit terrified. For my first surgery, it was quite a major one." Primary brain cancers are rare, afflicting about 25 to 30 in every 100,000 people, said Prof Ng.

But if not treated, they can be extremely disabling and life-threatening because they grow rapidly and invade surrounding brain tissue.

In Mr Oh's case, it was in the left frontal lobe, the part of the brain which has a lot of "reserves", and is able to cope with significant damage with minimal or no deficit.

To make sure the cancer was eradicated, he also had to go through 30 sessions of radiotherapy, as well as eight months of chemotherapy.

After all that, his prognosis is good. Said Prof Ng: "As the tumour is largely benign, we hope that the aggressive treatment will lead to a cure."

Mr Oh, who stayed active even when undergoing treatment, went back to work in July with a new zest for life. He exercises regularly and is determined to keep himself even fitter than he was before the operation.

He also plays basketball and tries to eat healthily. "I'm lucky that everything came together," he said.

　

(article from https://www.healthxchange.sg/news/nni-patient-went-through-brain-surgery-awake)

NEW CANCER TREATMENTS - PROLONGING PATIENT'S LIFE



POSTED INHEALTHNEWS 2017,PUBLIC ACCESS



New treatments prolonging lives



Attendees at a cancer seminar in Singapore heard about the latest in cancer treatments available to people with breast, ovarian, endometrial, lung and blood cancers.

Even as cancer becomes more common in Singapore, researchers have discovered ways to prolong the lives of cancer patients.

That was the message given during a seminar titled Understanding Cancer and Beyond, which was organised by Channel NewAsia and Parkway Cancer Centre (PCC) at the Pan Pacific Singapore hotel on 29 July.

Dr Khoo Kei Siong, the Deputy Medical Director of PCC, noted that since the 1970s, cancer survival rates in general have gone up from 25 per cent to 50 per cent.

However, treatments for certain cancers have seen more progress than others. Patients with cancers such as testicular cancer, melanoma,prostate cancer, Hodgkin's lymphoma,breast cancerand uterine cancer are surviving much longer than before.

However, treatments forliver cancerandpancreatic cancerhave not progressed as much.

He said that improvements in treatment have been due to three reasons: earlier detection, effective treatment of micrometastases and better understanding of the biology of cancer.

Micrometastases is when the cancer has spread but it cannot be seen, even with sophisticated scans. With better chemotherapy drugs and new treatments like targeted therapy and immunotherapy, micrometastases can be more effectively treated and mortality reduced, he said.

A better understanding of the biology of cancer cells also allows doctors to attack cancer cells more accurately and effectively. Targeted therapy, for example, looks for specific biomarkers that identify a particular kind of cancer to find the drug most effective against it.

Targeted therapy and immunotherapy, have also given doctors more tools to fight cancer. Immunotherapy uses the body's immune system to recognise and fight cancer cells.

"Because of these trends," said Dr Khoo, "we suspect that cancer treatment will become increasingly tailored and individualised, based on genetic makeup and cancer characteristics."

Dr See Hui Ti, a senior consultant in medical oncology, spoke about advances in the treatment for cancers specific to women. On breast cancer, she noted that doctors now know who will not benefit from chemotherapy, who will benefit from chemotherapy before surgery and how to reduce the risk of getting cancer.

Through a genetic array test, oncologists now know which types of breast cancer are low risk and thus do not need chemotherapy.

Doctors can now also determine who will benefit from getting chemotherapy before surgery. Some types of breast cancer are very aggressive but respond well to chemotherapy. By doing chemotherapy before surgery, the operation can conserve the breast. It also means that we know how well the cancer responds to chemotherapy.

Some patients will also benefit from risk-reducing surgery. For example, patients who have a high risk of getting breast cancer, the cancer can be detected by testing them for a genetic mutation. Likewise, some women have a genetic mutation which puts them at a high risk of getting ovarian cancer. For these women, the only way to reduce the risk is to remove both ovaries and the fallopian tubes before the cancer develops.

On endometrial (womb) cancer, genetic array testing held a lot of promise, she said. In future, it may allow doctors to use a simple test to identify the kind of endometrial cancer that a patient has. As a result, some women might not even need surgery if they had a very slow growing cancer.

On his part,Dr Lim ZiYi, a senior consultant in haematology, spoke about a kind of immunotherapy called cell therapy. He talked about how T-cells, which the body uses to fight infection, can be armed with a Chimeric Antigen Receptor (CAR) so that it can find and kill cancer more effectively.

He recounted the 2015 case of a baby with very aggressive leukaemia who received 1ml of CAR T cells after all conventional treatments failed. "In the fourth or fifth week, the leukaemia cells started melting away,¡± he noted.

So far, there has been very good data on using cellular therapy for blood cancers such as acute lymphoblastic leukaemia, lymphoma and myeloma, he said. Researchers are now looking at using cell therapies on solid tumours.

"We believe that cell therapy is going to be very important going forward, for the field of treating cancer,¡± said Dr Lim. That is why PCC was looking to bring cellular therapy to the masses in the next few years, he said.

Dr Lim Hong Liang, a senior consultant in medical oncology, talked about how the treatment of lung cancer had improved, thanks to targeted treatment and immunotherapy.

He noted that for mutation-positive lung cancer, targeted therapy and chemotherapy treatment improved the median survival time to 2.5 to three years, compared to 12 months from just chemotherapy alone.

In addition, newer forms of immunotherapy such as anti-PD-1 checkpoint inhibitors had shown to be able to further improve the survival of advanced lung cancer patients.

He said he was very excited because it was an additional mode of treatment that was well tolerated and had longer response durations compared to chemotherapy and targeted therapy. With immunotherapy, the five-year survival rate for lung cancer was 16 per cent, compared to five per cent without immunotherapy.

Following the presentations, there were panel discussions that covered a wide range of issues. Among the questions raised were whether stress caused cancer. In response, Dr See said efforts to prove a direct link between stress and cancer had failed. However, she noted, stress could lead to activities and lifestyles that could cause cancer such as smoking and overeating.

Dr Lim ZiYi added that cancer is multifactorial, it could be genetic or due to the environment, or to diet or smoking. His advice In all things, moderation.

Another question asked was whether there were diets that could prevent cancer.Senior Dietitian Fahma Sunarjasaid that the best way to lower cancer risk was to avoid being overweight, to be active, to eat more plant-based foods, and to limit the consumption of energy-dense foods, processed meat and salted and preserved foods.

Cancer treatment: The good news

Cancer survival rates have risen from 25 per cent to 50 per cent over the past 40 or so years. Recent breakthroughs spell even better news for some common cancers.

Breast cancer:Genetic array tests can help reveal low-risk types of breast cancer that may not require chemotherapy.

Blood cancer:The use of cellular therapy to treat blood cancers such as acute lymphoblastic leukaemia, lymphoma and myeloma looks promising.

Lung cancer:Immunotherapy has improved the five-year survival rate for lung cancer, from five per cent to 16 per cent.

What you can do

Avoid activities and lifestyles that can cause cancer, such as smoking and overeating.

Keep your weight down.

Stay active.

Eat more plant-based foods.

Limit the consumption of energy-dense foods, processed meat, and salted and preserved foods.


Written byJimmy Yap

Reference extracted from Parkway Cancer Centre/ Health News2017 / Public Access.
Reproduced from...
Tags: blood cancer, cancer latest breakthrough, cancer mutation, chemotherapy, immunotherapy, metastatic cancer, new ways to treat cancer, stress and cancer, targeted therapy, women (gynaecological) cancer


Note: This article is reproduced from www.parkwaycancercentre.com

COMMON MYTHS: CHEMOTHERAPY, IMMUNOTHERAPY & TARGETED THERAPY


POSTED IN-HEALTHNEWS 2018,-PUBLIC ACCESS

Beyond chemo: Myths & facts

Parkway Cancer Centre's-Dr Tan Wu Meng-looks at two common myths about immunotherapy and targeted therapy.



Myth: Chemotherapy is the only treatment for cancer

Fact: Cancer can be treated with a combination of treatments

Some people believe that chemotherapy is the only way to treat cancer. - But in a number of cases, a multimodal approach - that is, combining treatments - can produce better treatment outcomes. These include surgery, chemotherapy, immunotherapy, targeted therapy and hormonal therapy. Doctors now have an increasing number of options and effective treatment combinations to choose from in the battle against cancer. - The recommended choice and combination depends on the type of cancer cell and the stage of the cancer.

One of the most exciting new treatment methods is immunotherapy which harnesses the human body's own immune system to fight cancer cells by giving it a boost. The immune system fights disease by detecting abnormalities in the body and destroying them. But cancer cells can camouflage themselves to avoid detection.

Immunotherapy can use checkpoint inhibitors to lift the "brakes" off the immune system, allowing it to detect the camouflaged cancer cells and destroy them. One involves stimulating the immune system to attack cancer at a cellular level.

Immunotherapy has been found to be effective in certain types of cancer. For example, it has been approved by the United States' Food and Drug Administration for certain malignant lymphomas, metastatic melanoma, metastatic non-small cell lung cancer, bladder cancer and recurrent head and neck cancer - and this list continues to evolve.

However, like other forms of treatment, immunotherapy also has side effects. You should discuss with your doctor on what side effects to look out for, and how best to monitor yourself.

Myth: Targeted therapy (oral tablets) has no side effects

Fact: Targeted therapy has some side effects

Targeted therapy homes in on specific cancer cells to stop them from growing.

Some of the drugs used in targeted therapy home in on cancer-related genes and their ensuing proteins which are related to the growth and spread of cancer, and attempt to restore normal cell behaviour or act as an antibody against the cancer cells. Others target the blood vessels that supply nutrients to the tumour, preventing the cancer from growing and spreading.

Unlike chemotherapy, these mechanisms do not cause as much harm to healthy cells in general. However, there can still be side effects, depending on how the individual targeted therapy works.- These are generally well tolerated and better controlled than those caused by traditional chemotherapy. Some of the common ones include:

- Diarrhoea

- Skin, hair, nail or eye problems

- Slower healing of wounds

- Hypertension

- Abnormal liver function

The exact side effects depend on individual targeted therapies, and you should discuss them with your doctor.

However, it has its limitations. If the targeted treatment is aimed at a gene mutation that stimulates the cancer's growth, then the treatment can only work if the tumour has that particular mutation.

In some cases, the tumour may not respond to the drugs used, or the cancer cells may mutate and become resistant to them. The tumour may also find a new way to grow by mutating so that it no longer depends on the target.

No magic bullet

While immunotherapy and targeted therapy are important advances in cancer treatment, we need to remember, however, that they are not magic bullets. The optimal choice of treatment, and in which sequence or combination, will depend very much on the type of cancer and the stage of the cancer.

With researchers developing more targeted drugs as they learn more about cancer cells, and clinical trials showing successful treatment therapies, we can look forward to an ever-widening range of treatments and better outcomes for cancer patients.





Tags:-cancer drugs,-cancer mutation,-chemotherapy,-common side effects of cancer treatment,-immune checkpoint inhibitors,-immunotherapy,-misconceptions,targeted therapy


Note: This article is reproduced from www.parkwaycancercentre.com

CANCER FIGHTING FRUITS: MYTH OR FACT?



Several types of fruit and their extracts are believed to help?in the treatment of cancer. Myth or fact??Senior Dietitian Gerard Wong?from Parkway Cancer Centre takes a look at some of them.

Mangosteen



This tropical plant that is native to Southeast Asia is used in traditional medicine to treat skin infections, wounds and diarrhoea. This has led some to promote the use of mangosteen juice for cancer treatment. Products containing the fruit are now widely sold as "liquid botanical supplements".

There is some truth to the healing properties of the mangosteen: The skin of the fruit is a rich source of a class of polyphenols - micro-nutrients found in plant-based foods - known as xanthones. Xanthones from the mangosteen have some anti-bacterial, anti-fungal, anti-inflammatory and anti-cancer properties. However, only specific xanthones have some of these properties, and they may apply only to certain types of cancer.

The efficacy of the mangosteen as a cancer-curing resource, however, is unknown. There has not been enough human trials to prove such properties. There is also insufficient evidence for the health benefits of "liquid botanical supplements" containing mangosteen.

Soursop



Soursop, or graviola, has long been used in many countries as a traditional cure for common ailments. In Africa, it is used to treat coughs, pain and skin diseases. In India, the fruit and flower are used as remedies against mucous. And in Malaysia, a mixture of crushed soursop leaves and hibiscus is believed to prevent fainting.

Soursop extracts have been said to kill some types of liver and breast cancer cells. And indeed, extracts from graviola leaves have shown anti-inflammatory, fungicidal and anti-microbial properties - in animals. However, no studies have been done on human beings.

There may also be some side effects from eating too much soursop: Certain chemicals in graviola can cause nerve changes and movement disorders when the fruit is consumed in large amounts.

Laetrile

Laetrile, or amygdalin/vitamin B17, is a naturally-occurring chemical compound that is found in the seeds and pits of apricots, apples, peaches and raw almonds.

Laetrile is broken down by enzymes in the intestine to produce cyanide, which is cytotoxic - that is, toxic to living cells. This has prompted claims that apricot seeds and other fruits containing laetrile can cure cancer by killing cancer cells but leaving normal tissue cells unharmed.

Animal studies, however, have not supported such claims. A clinical trial conducted in the late 1970s, supported by the National Cancer Institute in the United States did not find amygdalin to be beneficial. In fact, some patients in the study were affected by the toxicity of the cyanide.

A systematic review has since also concluded that amygdalin is ineffective against cancer. Laetrile has been banned in the United States by the Food and Drug Administration (FDA) and is also not allowed in the European Union. However, it has been surfacing again, under the label of "Vitamin B17".

Pomegranate

Pomegranate juice has been touted to lower cholesterol and blood pressure, a claim supported by several studies. Recent research has also lent strength to the belief that the pomegranate can help to prevent or cure cancer.

Some results have shown that pomegranate extracts selectively inhibit the growth of breast, prostate, colon and lung cancer cells in culture.

In a recent study, a blend of green tea, pomegranate, broccoli and curcumin that was taken as a supplement appeared to reduce the rate of increase of prostate-specific antigen (PSA) in men with prostate cancer. The effects, however, cannot be solely attributed to the juice, and data was also conflicting.

Indeed, many of these studies are not conclusive, as limited studies have been conducted on humans.

For example, studies have suggested that pomegranate extracts can help reduce the production of estrogen, but the implications on breast cancer and humans are unknown.

And while no significant adverse effects were seen in men who drank 240ml of pomegranate juice every day for over two years, those with diabetes should take note of the sugar content in the fruit.

Noni juice

Derived from the fruit of a tropical tree called morinda citrifolia (popularly known as the Indian mulberry), noni juice is used in many Polynesian cultures as a traditional medicine for infections as well as a general tonic.

Lab and animal studies suggest that the juice has anti-bacterial, anti-fungal, anti-inflammatory and anti-oxidant properties, and possibly anti-cancer effects in animals. However, clinical trials have not shown the same effect in humans.

And while noni juice has been shown to be effective in reducing the incidence of early post-operative nausea in humans, it has also been reported to cause acute hepatitis, at least in one case of a 62-year-old woman who drank two litres of the juice every day over three months.

Noni juice also contains high levels of sugar and potassium, which can affect patients with diabetes and kidney problems, respectively.

Jamu juice

Jamu juice is a traditional herbal medicine from Indonesia that is made from roots, barks, flowers, seeds and fruits. There are many variations of the medicine; the root-based versions include turmeric, tamarind and palm sugar.

Jamu juice has long been touted as a health tonic and a cure-all for many diseases, including cancer.

To be sure, turmeric has been shown to contain anti-inflammation and anti-oxidant properties. In one trial involving patients taking curcumin (a substance of turmeric) orally before going for surgery, it was shown to counter the loss of weight and appetite. In another trial, turmeric appeared to reduce the side effects of treatment.

When a turmeric-based cream was used by patients with head and neck cancer undergoing?radiotherapy, it showed some efficacy in reducing the radiotherapy-induced dermatitis. Several animal studies also suggest that turmeric has anti-cancer properties in rats that have been exposed to carcinogens.

Human studies, however, remain limited, so there is not enough evidence to support the anti-cancer claims regarding turmeric.

There are also side effects to consuming turmeric. Because of its anti-platelet properties, turmeric can increase the risk of bleeding. It can also interfere with the activity of some chemotherapy drugs in the treatment of?breast cancer.

Bottom line... eat with care

Cancer is a complex disease that affects different people differently, and claims that one type of food or fruit has the power to eradicate or prevent cancer entirely are a gross oversimplification.

While all these fruits and their extracts may well contain some cancer-fighting properties, there is no conclusive evidence that they can prevent cancer or kill cancer cells during treatment.

Ultimately, a well-balanced diet and healthy lifestyle are still the main key to reducing the risk of getting cancer, coping with cancer treatment, and recovering well after cancer treatment.



Tags: anti-cancer herbs,cancer diet & nutrition,head & neck (ENT) cancer,healthy food & cooking,misconceptions,prevent cancer


Note: This article is reproduced from www.parkwaycancercentre.com

Asia's leading destination for advanced medical care.


International patients come to Singapore each year for a whole range of medical care from health screenings to high-end surgical procedures in specialties such as cardiology, neurology, oncology, ophthalmology, organ transplants, orthopaedics, and paediatrics. In 2013, medical expenditure generated from travellers was S$832 million.

With well-respected doctors trained in the best centres around the world, internationally-accredited hospitals and speciality centres, medical travellers to Singapore can be assured of quality treatment.

As a multi-faceted medical hub, Singapore attracts a growing number of medical professionals and multi-national healthcare-related companies from various parts of the world to share and exchange their expertise, conduct healthcare-related research and training as well as host international conferences and events.

With Singapore's well-developed infrastructure and robust medical ecosystem, healthcare providers in Singapore are constantly strengthening their medical capabilities through professional exchanges and access to innovation in medical technology.

In Singapore, medical travellers can receive quality medical care in an environment that is safe and welcoming, with no uncertainties from political instability, social unrest, or worries about poor health safety. This is on top of an efficient transportation system, wide range of accommodation options, and a wide variety of leisure offerings to enhance the experience in Singapore.

Over the years, the Singapore Tourism Board (STB) has worked closely with private healthcare providers to expand their reach in key target markets and profile Singapore as an advanced medical care destination. With the experience and networks built over time, the private healthcare providers now take the lead to drive the growth of the medical travel industry in Singapore.


SINGAPORE HEALTHCARE – BRIEF F​ACTS

Singapore's quality healthcare, as one of the best in the world, is internationally recognised.

  • Ranked first for most efficient healthcare system, out of 51 countries, in 2014 by Bloomberg.

  • Ranked second in the world for health-care outcomes according to The Economist Intelligence Unit (EIU) in 2014.

  • Ranked first as a global favourite medical tourism destination in PHD Chamber Medical and Wellness Tourism Report 2013.

  • 21 hospitals and medical centres and medical organisations in Singapore have obtained the Joint Commission International (JCI) accreditation.

  • Singapore's blood supply ranks among the safest in the world. Blood Services Group HSA (previously known as Singapore's Centre for Transfusion) was appointed a World Health Organization (WHO) Collaborating Blood Centre for Transfusion Medicine for the Western Pacific Region in1992.



Note: This article is reproduced from www.stb.gov.sg

Comfort and Convenience

One Stop Personalised Concierge Services (PMC)

PMC was set up to provide a one-stop service for international patients looking for specialists' expertise, personalised patient care and cutting-edge technology at Mount Elizabeth Hospitals.

Our dedicated and experienced PMC staff are professionally trained to provide genuine care and comfort, and to attend to the special needs of patients before, during, and, if necessary, after their visit. They are also able to provide advice on the estimated cost of treatments and procedures at our hospitals.

Medical Specialist Arrangement

• Mount Elizabeth offers a wide range of specialist medical services, both outpatient and inpatient. In accordance with your medical condition needs, we will recommend and schedule medical appointments for you with the appropriate specialists and make all the necessary arrangements for your visit.

• Doctor Referrals & Appointments

• Whether you have a preferred primary care physician or need specialty care for a specific medical problem, we're here to help.

Transport arrangement

• As a visitor to Singapore, you may not be familiar with how to get around. PMC staff will be happy to make your transport arrangements for you to ensure you get to all your appointments on time.

• Flight Arrangements & Extensions

• Should your treatment take longer than expected, we will assist you in altering your flight arrangements and extending your visa, if required.

• Airport Transfer Services by Ambulance/Limousine

• Upon request, PMC staff can arrange for transport from the airport to the hospital or your hotel via ambulance or limousine.

Accomodation arrangement

• PMC staff will gladly assist you in locating and reserving a hotel or serviced apartment to keep you in the style you are accustomed to.

• For your convenience, we will arrange for hotel properties that are located near the respective hospitals. The hotels listed are suggestions based only on their proximity to the hospital and not recommendations. The hospital is not connected to the hotels in any way.

Special Arrangements

• We also offer a range of non-medical services to make your stay in Singapore a pleasant one.

• Language Interpretation Assistance

• PMC can arrange for interpreters and translation services for a number of languages to ensure communication barriers are eliminated.

• Special Food & Beverage / Religious Arrangements

• If you are on a special diet or would like a spiritual care provider of your own religion, do inform us and we can make the necessary arrangements.

• Local Sightseeing Tours

• If you are up to some sightseeing while you are in Singapore, consider taking the time to explore what the city has to offer. PMC staff will be glad to arrange local sightseeing tours and suggest places of interest to visit during your stay.

Visa Assistance, application and extension

• You will be required to obtain a valid visa prior to your visit to Singapore. For more details on the list of countries that require a visa, please visit the Immigration & Checkpoint Authority (ICA) website.
• Short-term Visit Pass Extension
• PMC will assist you in extending your short-term visit pass if your treatment takes longer than had been anticipated.
• We will require the passports of the patient and accompanying visitors in addition to the following:
• Application form for a visit pass (Form IMM 14)
• Application for extension of stay on medical grounds (Form V75)
• Doctor's letter
• Please submit the completed documents to us in person at least one week before the expiration date stated on your visit pass.
• The visit pass extension is subject to ICA approval and administrative charges from ICA may apply.