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The outsider: Charlie Teo

Sunday, May 27, 2007
Charlie Teo
60 Minutes present a Live Interview with Neurosurgeon, Charlie Teo.

Interviewer: Dr Teo, thank you for joining us tonight in our live online chat

Dr Teo: It is a great honour to be here tonight and talking with you.

MsMoli asks: Hi Charlie, why is it that other doctors seem reluctant to use your techniques? Dr Teo: Quite honestly, I don't know. I think it is a combination of having to admit that they may have been wrong with their initial criticism of the techniques, and probably some professional jealousies. It boils down to basic human failure of fear of the unknown. If they came to watch some of the surgery, they would see that ti's not anything too difficult then they may be converted to use some of the techniques.

ellen asks: How do you think you can someday cure brain tumours, from research you are doing or from what you are learning in the operating theatre? Dr Teo: Good question. It's a combination of both. Probably more questions will be answered in the lab, rather than the operating theatre.

chris asks: What percentage is your success rate?

Dr Teo: It depends on how you define success. In terms of successful surgery, the rate is very high, higher than 90 percent. If you quantify success by survival and cure, it is very low, because 70 percent of all brain tumours that we see are malignant and it doesn't matter how good your technique, these patients will succumb to the disease.

benadette asks: Many people have been told they have an inoperable brain tumour, would you agree with the term inoperable or just get in and have a go?

Dr Teo: Good question. No brain tumour is inoperable. We can operate on all tumours, the bit question is whether it is worthwhile.

Question: Even before tonight's show, I have always told my family to get me to Dr Charlie Teo if need be, hopefully that will never be the case. Well done Dr. Many people have been told they have an inoperable brain tumour, would you agree with the term inoperable or just get in and have a go?

Dr Teo: Good question. No brain tumour is inoperable. All tumours can be taken out. The big question is whether it is worthwhile taking out the tumour, sometimes risk is greater than benefit. The ratio can change by decreasing the risk. So if I can decrease the risks, then I can call some of the inoperable tumours operable, because it changes the risk benefit ratio. Please explain how your technique is different to other doctors. The reasons are multi-factorial.

Firstly, I have had very good training both in Australia and overseas. Secondly, I have the latest technology available to me. Thirdly, I have gathered a world class team. Fourthly, I have had a vast experience. Finally, I think you naturally get better at something if you specialise in that field. I only do brain tumours, so naturally I should be better at it.

Question: What do you consider to be your greatest challenge professionally?

Dr Teo: The greatest challenge is to provide a cure for brain cancer.

The second greatest challenge is to provide the same quality of care, the same excellent quality of care to people all over the world, not only in our country, but also in developing countries.

Question: Did you always want to be a brain surgeon?

Dr Teo: Absolutely not. I initially wanted to be a garbage collector, I wanted to be a movie star, a karate instructor, prime minister, and then a doctor.

Even when I was a doctor I wanted to be a paediatric surgeon first, it wasn't until I got a taste of neurosurgery that I wanted to be a neurosurgeon. I never thought I would be good enough to be a neurosurgeon, some people say that I am still not good enough.

Question: My name is Lynne I suffer from chronic migraine which I have had for 5 years. You have seen me as a patient and I had a nerve removed from my spinal cord but it was not successful can you tell me if you have any other treatments available?

Dr Teo: If you have migraines and your treatment hasn't worked, unfortunately I can't help as I specialise in tumours. I would suggest that you see a neurologist.

Question: Could you please tell me the name of your charity. You have inspired me with your interview. Thanks.

Dr Teo: The name of the charity is the Cure for Life Foundation. The website is http://www.cureforlife.org.au The charity is a registered charity.

It was established four years ago by myself. We have raised over $1.5 million in 4 years. All the money goes towards the treatment and research of brain tumours. There are very few overheads, we employ only 1.5 people. The board of trustees mostly comprise of friends of mine or patients of mine. If you would like to make a donation you can call on 02 9697 0078.

Question: Have you ever hesitated or denied surgery to a patient. Believing that you cannot do it ?

Dr Teo: No. I am extremely confident with most tumours that I see, but I have refused to operate when I believe that the risk is so great that the quality of life after the surgery would be so badly impacted that it wouldn't be in the best interest of the patient. It's my job to be the patient's advocate. Sometimes I see patients with little quality of life, but their loved ones want me to operate. It can sometimes not be in the patient's best interest to prolong life. This happens rarely.

Question: Dr Teo, It was a great story tonight. Just wondering which Hospital you operate from and how I can contact you if my Grade 3 Gemistocytic Astrocytoma ever returns.

Dr Teo: POW private, Prince of Wales hospital and Sydney Children's hospital. My office number is 02 9650 4940.

Question: Charlie do you think you have an extraordinary level of hand eye co-ordination to operate using your particular technique?

Dr Teo: I think it helps to have excellent hand/eye coordination, but it is not essential for neurosurgery. You can train someone to be a good neurosurgeon technically, but it is more than this. It's also about perseverance, compassion, balancing intellectual and emotional input.

Question: Who inspires you?

Dr Teo: There is no one single person. If there is anything that inspires me it is their patients and their courage. They give me the inspiration to keep moving and to try and find a cure for brain cancer. There are some patients that stand out, but in general all patients show an amazing amount of faith in me so I try to respond to that faith in me.

Question: I can imagine your job is very demanding. How do you unwind and take time out?

Dr Teo: My children. I spend time with my children and my wife.

Question: What advice would you give someone who wanted to pursue a career in neurosurgery?

Dr Teo: Very simple. Perserverance. You have to work and work. If it's your passion and you want to do it, you can. I had so many hurdles, I failed exams, I was fired from residency, my colleagues have tried to have me deregistered, but I have kept at it.

Question: Charlie, are you 'IT' or are there other surgeons who are willing to go the extra yard as you do?

Dr Teo: Yes, there are. There are a lot of neurosurgeons who will. I know part of tonight's story highlighted the hurdles, but there are a number of colleagues out there who are excellent neurosurgeons and who are willing to go the extra yard like me. Hopefully with time, it will be the majority of neurosurgeons.

Question: How do you respond to those colleagues who want to see you deregistered or who have tried to block your success?

Dr Teo: I used to respond with anger, and now I try to ignore them. There are two sayings by which I now live. The first is - that which doesn't kill you will make you stronger. The second is - the cream will always rise to the top. If you are good and kind to your patients, there's really not much they can do to you.

Question: Do you think we will see a day where we have a cure for brain tumours?

Dr Teo: Yes. I wouldn't have said that two years ago, but I believe that if we put enough time and money into research like we have done with the cure for life foundation, I believe we will. There is a template - leukaemia used to have a mortality rate of 90 percent, and with research and money and time and effort, the cure rate is now 90 percent, so it has completely changed. About 40 years ago, 90 percent of people with leukaemia would die, today 90 percent survive.

Question: Can you tell us a little about the research you are undertaking at present.

Dr Teo: In layman's terms, we believe that the answer to cancer is identifying the abnormal genes that allow cancer cells to grow rapidly. We are taking all the brain tumours that we take out, placing it in a tumour bank, and using the tissue to try and identify genes or abnormal genes that are unique to those tumours.

Once we identify these genes, and we have identified 2 in the last year, we can hopefully modify them, or at least modify the proteins that are produced by those genes.

Question: Do you get much lab time, or is the majority of your time in the theatre?

Dr Teo: I don't spend any time in the laboratory. I provide the tumours for my colleagues to analyse. I have provided scientists with a lab, and I provide the tumour cells that they can use to carry out their study. I have gathered good people together to do this research. They are in Sydney, Melbourne and Brisbane.

Question: I saw you packing a mean punch on the TV tonight, running up stairs and looking active. Do you agree that a healthy mind equals a healthy body? Dr Teo: Absolutely. I have lived by that philosophy all my life. I believe that a mind has to have a healthy body to work at an optimal pace.

Question: Our daughter had a ganglioglioma removed in Dec 2006 and it was diagnosed initially by an optometrist which led to CT scans and MRIs. Is this difficult to diagnose?

Dr Teo: Yes. Most are difficult to diagnose because they present as a headache which is a very non-specific symptom. It is not unusual for patient to have a delay in diagnosis, sometimes even years. I think anyone who is willing to go out on a limb when others seem to back away should be congratulated. I hope that other neurosurgeons will embrace the keyhole surgery and give some of these people some chance rather than offering a time frame for life expectancy.

Most patients would rather die trying I'm sure!!

I did ask before if you thought that their reluctance to train in this procedure was a time factor away from their hectic schedules and how long it would take a neurosurgeon to train up in the keyhole approach??

Most skilled and experienced neurosurgeons could learn keyhole techniques with simply a course, a hands on practical course, followed by two or three weeks of observation. I know this is hard to understand, but it's not so much the techniques, it's more about mindset, it's about a mind shift in the way that one approaches brain tumours.

It's frustrating for me, because neurosurgeons in Australia have the skills, knowledge and abilities, but they have a barrier in the way that they think. They could very easily see from a course and observation the benefits of the technique.

It's about a change in mindset, with a bit of training on top.

Question: What are your future hopes for your profession?

Dr Teo: I would like to see the general neurosurgery community embrace non-invasive techniques. I would like to do more teaching - I spend about three months a year in developing countries.

I would like to spend more time away teaching them neurosurgery.

Question: Dr Teo, How do people get referred to you. Is it very expensive and what is the waiting list like.

Dr Teo: It's very simple. Just go to my website and it gives you all the instructions. You can get an opinion from me and it won't cost you a thing. If I do operate it will cost.

My website is http://www.neuroendoscopy.info Interviewer: Unfortunately we are out of time, do you have any final words for those who have joined us tonight?

Dr Teo: It has been a great privilege to share this time with you. Thank you for watching the show and thank you for all the positive comments. If you would like more information, please visit my website. Thank you.

Interviewer: This concludes our Live Chat with Charlie Teo, 27 May 2007

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