A second opinion in Singapore however, painted a drastically different picture.

Being told you have less than a year to live is never an easy pill to swallow. On 12 June 2008, in a clinic in the Russian port city of Vladivostok, businessman Galkin Vladimir was given such a pill.

The 48-year old relates, “My wife was very worried and concerned. For me, it was a big blow too and I was not too sure what was wrong with me or what to do next.

Vladimir had gone to see a doctor several days earlier after breaking out with a high fever. For a man who had seldom fallen ill or even been hospitalised before, that understandably struck him as strange.

He had sought answers from several doctors but to no avail. However a specialist who later carried out some blood tests and a CT scan had found a lump in his liver which he felt to be malignant. Yet, he could not be sure.

All he could say was if it was advanced liver cancer, Vladimir had no more than eight months to live. The news had rocked his family and sent him spiralling into depression. Fortunately, a business partner suggested he get another opinion. With nothing to lose, he agreed.

 

East due east

By the end of June, arrangements were made for Vladimir to fly east - from his home in Eastern Russia to Singapore in the heart of Southeast Asia where he was to meet with a specialist. He was not exactly in high spirits but was somewhat encouraged by what his business partner had told him about the island-state.

“He informed me that there was a better chance of getting a more accurate diagnosis in Singapore because the equipment there was more advanced. Russian doctors are good but without state-of-the-art equipment, they are limited in what they can do,” opines Vladimir, who had never been to Singapore prior to this.

On 29 June 2008, the Russian met with Dr Denis Nyam, Consultant Surgeon of Nyam Colon, Rectal & General Surgery at the renowned Mount Elizabeth Medical Centre in Singapore. Vladimir’s business partner knew Dr Nyam personally and thus made the recommendation.

Dr Nyam is also one of the medical consultants from Sourcelink Group, an integrated healthcare company that develops, operates and manages general medical services and specialist care services. It runs a small group of general practice clinics and a cancer clinic in Singapore. It also distributes medical products such as masks and gloves.

 

Eliminating uncertainty

On looking through the reports and scans Vladimir had brought with him, Dr Nyam decided to repeat the scans. This time however, he would use a 64-slice CT scanner unlike the old-fashioned 8-slice scanners used in Vladivostok.

Dr Nyam explains, “It makes a huge difference, four generations to be exact. While the 8-slice showed a lesion in the liver, it did not show conclusively if it was cancerous or not. Also, they did not have the facilities to do a needle aspiration or biopsy. The only option was an open biopsy but they decided against it.”

Besides the CT scan, to get a definitive diagnosis, a CT-guided biopsy was done percutaneously (needle puncture through the skin) on Vladimir at Mount Elizabeth.

“In Singapore, we are lucky to have radiologists well-trained in interventional radiology. They can get for us samples or tissues without the need for us opening up the patient. Our pathologists too are highly-trained. It was through them that we discovered from a rather difficult biopsy, that the tumour was unlikely to be malignant,” reveals Dr Nyam.

He adds, “It just didn’t fit – the diagnosis he had been given. We did some blood tests and they too did not fit into the category of liver cancer. The cancer markers had all indicated negative for cancer.”

A new lease of life

The news was met with much relief. Vladimir was ecstatic and could not wait to call home to inform his wife of the latest development. He felt a huge load lift from him and almost immediately went shopping to buy some gifts for his family. It was as if he had been given a new lease of life. However, Dr Nyam was cautiously optimistic.

“I didn’t want to tell him he was 100 per cent out of danger. I explained to him that there always was the possibility of a sampling error. Sometimes when you sample an area which is deep in the middle of the tissue, you may miss it altogether. So to be absolutely sure, I told him to come back in three months to repeat the scan. No one is perfect,” Dr Nyam maintains.

Nonetheless, Dr Nyam admits, “He was certainly one of the happiest patients I have ever encountered. To be honest, I felt extremely happy for him too because he is still young with very young children and now he was returning to them without the thought of impending death hanging over him.”

“It has been a wonderful experience. I only stayed in hospital for two days and the staff made me feel at home. Dr Nyam especially was very professional and patient – taking time to explain everything clearly to me,” declares Vladimir.

He adds, “I felt very confident and seeing the technology they have here, I was really impressed. I will definitely recommend my friends and family to come to Singapore if they have a complicated medical problem. From having not long to live to being able to carry on my life as before – it’s a world of a difference.”

Contact

Nyam Colon, Rectal & General Surgery #14-02 Mount Elizabeth Medical Centre Singapore 228510 Tel: (65) 6836 9909; (65) 6535 8833 (After office hours) Email: nyamcrgs@pacific.net.sg

Why Singapore appeals to the Russian patient

Like Vladimir Galkin, an increasing number of Russians are flying to Singapore for medical treatment. According to Dr Denis Nyam, many of them are recommendations from patients.

He insists, “Word of mouth is very powerful. They get high quality treatment, a sterile operating environment and benefit from our use of advance technology. But truth be told, there are other deciding factors.”

“We are a clean and green city with a good transportation infrastructure and moreover, our lifts work. To a Russian, that is a big thing,” he quips.

What also appeals to many international patients, not only those from Russia, is the fact that Singapore’s cosmopolitan and multi-religious society allows for seamless assimilation whether it be food concerns or religious practises. The availability of interpreters is also helpful. Not many other countries can boast of these.

Patients from Vladivostok often chose to come to Singapore over Moscow for the simple reason that it’s further and more expensive. To travel to the Russian capital, they have to fly through seven time zones. Singapore is only two time-zones away.

Sourcelink’s presence in Vladivostok

Singapore-grown Sourcelink Group, in partnership with a private Russian consortium is awaiting the completion (fourth quarter 2009) of a US$100 million, full-fledged diagnostic centre with hospital facilities in Vladivostok.

The International Medical Centre, Vladivostok, will be a 14-storey, 132-bed private medical centre, the first of its kind in the Russian Federation. It aims to serve the city’s 700,000 residents, especially the top 15 per cent income earners. Some 600,000 residents in the neighbouring Khabarovsk region will also stand to benefit from the centre’s development.

With medical staff largely Russian, training will be provided by the Singapore side. Managers from both countries will be involved. State-of-the art medical equipment such as the latest CT scans and MRI machines will also be installed at the hospital.

Initially, the focus will be general surgery, cardiology and oncology. Nonetheless, patients with complex medical conditions will still have to travel to Singapore for treatment until a time when such expertise becomes available at the centre in about 10 to 15 years.