Flying with a brain tumour

In Germany, around 7,000 people a year fall ill when a problem occurs when there is a failure in the regulation of the proliferation of new cells as new tissue is forming in the brain. This is commonly referred to as a brain tumour. 

Doctor looks at image of brain

What exactly is a brain tumour?

The simplest way to describe a brain tumour is to look at it as an uncontrolled proliferation of cells. In medical terms, only tumours of the neuroectodermal tissue are brain tumours. But there can also be intracranial tumours that enter the brain as metastases of other malignant tumours, such as breast cancer. The biggest problem with a brain tumour is where it originates. The brain is very well protected by the human skull, the bones of which are about 7 mm thick. At the same time, however, there is no space for accommodation if a swelling occurs. Incidentally, tumor is the Latin word for swelling. This is why both benign and malignant brain tumours are dangerous.

The tumour, even if it is only small, can affect particular areas of the brain, depending on where it originated. This makes surgical removal difficult, as there is always a risk that the healthy tissue surrounding the tumour could be damaged. Usually, the medical team will attempt to treat a brain tumour with radiotherapy or chemotherapy and try to induce the tumour to reverse the cell proliferation process of its own accord. These treatments can sometimes take months and there is often a risk that the brain tumour could return.

If a holidaymaker abroad complains of any severe or unusual headaches and their doctor diagnoses a developing brain tumour, the patient will naturally want to return to their home country as soon as possible, but it may well be that the doctor does not recommend flying for the homeward journey, and for good reason.

Why flying can be problematic for brain tumour patients

The human body is accustomed to carrying a fairly heavy load on its shoulders and this is constant, even during sleep. But, depending on whether we are standing at the top of a mountain or on a beach at sea level, there are differences in the actual air pressure, that is, the atmosphere that is pressing down on us. After all, the atmosphere extends to an altitude of around 10,000 metres, resulting in air pressure of a good few kilograms.

However, this atmospheric pressure exists not only above us, but also within and around us. For example, human blood transports oxygen molecules. Oxygen is a gas that expands or contracts as air pressure increases or decreases. This affects every organ in the body and, of course, also affects the cells of a brain tumour. On board an aircraft in flight, the air pressure decreases so that the cells of the brain tumour expand, which increases the pressure on the surrounding brain regions and can have life-threatening effects.

Doctors can prescribe a Sea Level Flight

Sea level pressure

Of course, the medical professional abroad who diagnoses a brain tumour in a tourist or a business traveller will be aware of these issues. On the one hand, the treatment of a brain tumour often takes many weeks and months. On the other hand, the patient cannot be expected to remain abroad for such a long time just because the risk of taking a flight home is too high. The way out of this dilemma is to obtain a doctor's order for the patient to return home on a Sea Level Flight in an ambulance jet.

How does a Sea Level Flight work?

Typically, a scheduled airliner that flies the Frankfurt-New York route every day, for example, reaches a cruising altitude of around 10,000 metres. However, in the passenger cabin, the air pressure corresponds to an altitude of only 2,500 metres. This is due to the artificial atmosphere generated in the aircraft by the pressurised cabin. For healthy people, an altitude of 2,500 metres is not an issue, but it is a serious problem for people with brain tumours, as described above.

A Sea Level Flight takes place in an air ambulance that has a reinforced cabin, allowing the air pressure to be further increased, so that it corresponds to approximately 800 to 900 metres above ground level. In addition, the pilot does not fly at the maximum possible flight altitude but remains slightly lower. For example, instead of flying at 10,000 metres the pilot flies at only 7,000 metres. The artificial air pressure that is generated in this way keeps the expanding tumour cells in the brain at a level that does not normally present a danger.

Who covers the cost of a Sea Level Flight?

Neither private nor statutory health insurers will normally cover the cost of transporting patients by air ambulance. The only way to cover the risk without having to pay for everything yourself is to take out a travel insurance policy that includes adequate medical cover, with the option of medical repatriation included in the policy.

However, despite the written assurance of medical repatriation cover there may be a snag to be found in the policy’s Terms and Conditions. It is a question of the definition of ‘medical necessity’. Repatriation may not be ‘medically necessary’ if the same medical treatment is available in the country the patient is staying in. The insurers then sometimes argue that medical repatriation is not necessary. The situation is different if instead the phrase in question is ‘medically reasonable’ repatriation. A brief look at the policy should help to clarify this. In the case of a medically reasonable repatriation, the insurance company will usually cover the costs. These are legal subtleties that can save a lot of money.

How much does an ambulance flight cost?

The occurrence of a brain tumour is not related to hereditary health conditions, nor to the country or region the patient is staying in. It can happen at any time, anywhere in the world, so a cost calculation would firstly depend on where in the world the diagnosis has been made. Only when this has been determined can the additional costs be calculated.

An ambulance flight has almost nothing in common with scheduled flights or charter flights, which is why it is no use comparing it with the flight prices of low-cost airlines. The sole purpose of an ambulance flight is to fly a sick patient home safely. Basically, this necessitates a corresponding level of effort and expenditure and the costs for such flights have to be calculated for each individual case. However, experience helps, and the Medical Air Service has plenty of that. 

Medical repatriation with Medical Air Service

The diagnosis of a brain tumour is a complex medical matter and organising a medical repatriation via a Sea Level Flight will be essential to fly the patient back safely home. As professionals with many years of experience in the repatriation of patients from all parts of the world, our team at the Medical Air Service knows how a flight home for a sick patient can be carried out quickly, cost-effectively and with the greatest possible care.

Any further questions?

If you would like to know more about ambulance flights, we recommend that you take a look at our FAQ.

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