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Brain Cancer: Is Medical Tourism Open to 'Keyhole' Surgery?

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Her hormones were apparently fine even though she was 42 years old and premenopausal. Scott Baio, the actor on See Dad Run and Happy Days past, knows now that a tumor in the lining of her brain has caused his wife, Renee, to suffer for two years from migraines and cluster headaches.

“Renee has a meningioma brain tumor,” said Baio earlier this month on Facebook. “Although 90 percent of these types of tumors are benign, they can cause serious problems depending on the size of the tumor and the location.”

Scott Baio says Renee has yet to shed a tear as the family patiently waits to learn the tumor's exact location and the potential for surgery. In the meantime, some solace for Renee Baio and the more than 6,500 patients like her mostly women who develop meningioma, can be found in a new era of neurosurgery in which advances have resulted in better outcomes and faster recoveries.

Dr. Daniel Kelly, M.D., director of the Brain Tumor Center and Pituitary Disorders Program at Providence Saint John's Health Center in Santa Monica, Calif., said skilled neurosurgeons can now remove tumors and those of the skull base through smaller, more precise openings while minimizing the risk of damage to the normal brain, nerves and critical blood vessels.

The concept of ‘keyhole’ surgery is really about sneaking in and out, said Kelly, a speaker at the 8th World Medical Tourism & Global Healthcare Congress, Sept. 27-30, 2015, in Orlando, Fla. We want to effectively remove the tumor with absolute minimum disruption to surrounding normal structures, promoting a more rapid and less painful recovery.

Depending on the location of the tumor, Kelly said, keyhole surgery can be done through the nose or through a small bony opening in the eyebrow, behind the ear or through other scalp positions. A long, thin surgical telescope equipped with a high-definition camera dubbed an endoscope provides surgeons with an enhanced, panoramic, up-close and highly detailed view inside the head.

Pitching Procedures

Dr. Kelly, who has performed more than 4,000 brain procedures both conventional and keyhole said he is anxious to share his experiences at the World Medical Tourism & Global Healthcare Congress with colleagues from the international medical community who have patient populations in need of advanced neurosurgical services and comprehensive approaches to brain, skull base and pituitary tumors.

The Brain Tumor Center already has ongoing clinical fellowships for U.S. and Canadian neurosurgeons as well as observational fellowships and visiting scholar programs for surgeons from outside North America, said Kelly. In the last few years, we have had fellows from Brazil, China, Chile, Egypt, Ghana, Italy, Japan, Mexico, Nigeria, Turkey and Germany.

By no means do brain tumors adhere to boundaries, nor do they discriminate. About 14.1 million cancer cases were estimated worldwide in 2012, of these 7.4 million cases were in men and 6.7 million in women, according to World Cancer Research Fund International. That figure, expected to increase to 24 million by 2035, has already influenced hospitals and physicians seeking to attract medical tourism patients who are anxious to obtain the most effective cancer treatments.

In that sense, Renée-Marie Stephano, President of the Medical Tourism Association, said more patients are traveling beyond their local doctors to get a second opinion or for innovative cancer therapies. And more hospitals worldwide are stepping up medical tourism strategies or international patient programs to meet their demands.

Patients with cancer need to make many important decisions, she said. Among the most important considerations is where to receive treatment. Competition to provide the best care among hospitals can be brisk. Name recognition, innovative technology and access to new drugs and therapy treatments and individualized care all play an important role in choosing from among the many cancer centers that have opened worldwide.

See Life

Today nearly 700,000 people in the United States are living with a primary brain tumor, and more than 69,000 others will be diagnosed this year. And although brain tumors are often deadly, impact quality of life, and change everything for patients and their loved ones, innovative procedures and technology are confronting some of the more common forms including meningioma and neuroma.

Benign, skull base tumors like meningioma are likely to be found in middle-aged women like Renee Baio and Josephine Edu, a registered nurse, mother of an autistic teen and survivor.

Edu developed a tumor that lacked the malignant properties of cancer, but was rapidly diminishing her vision. Plus, she was six months pregnant with twins who were at risk to the tumor's effect on her pituitary hormonal function.

A decade has passed since Edu underwent an eyebrow craniotomy, a unique, minimally invasive approach in which Dr. Kelly removed her tumor through an incision in her eyebrow and a small half-moon shaped bony opening in the skull above the orbit. In that time, she has delivered healthy fraternal twin boys, her vision is back to normal and she has been tumor-free.

My life is full, said Edu. We're waiting to see what the future what the future will bring.

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