From Uncertainty to Clarity: El Ammous Ep Shili’s Cancer Care Journey in Turkey

For El Ammous Ep Shili, a 44-year-old woman from Tunisia, living with metastatic colon cancer and liver metastases meant facing complex treatment decisions. She was already receiving FOLFOX chemotherapy and was also considering pembrolizumab (Keytruda) immunotherapy as part of her ongoing cancer care.

After her consultation in Thailand, Eden went back to her home country, the USA, to continue her course of rehabilitation and medication. Her experience shows that international healthcare involves not just an operation but a broader treatment approach. People can travel for consultations and continue their treatment back at home afterwards.

Eden benefited from this choice because she could consult a specialist for advice without losing control over which treatment options she would choose next.

El Ammous had metastatic colon cancer with lesions in the liver. In patients with metastatic colorectal cancer, the liver can be an important site of disease involvement, and the possibility of treating liver metastases may depend on several factors, including their number, size, location, relationship to important blood vessels and bile ducts, and the overall extent of cancer. For El Ammous, this assessment was particularly important because she wanted to know whether her liver lesions could be approached with surgery or ablation.

Travelling to Turkey for Specialist Evaluation

On May 28, 2026, El Ammous contacted MediGence through the website. Vanshika was assigned as her case manager. During her visit, she travelled from Tunisia to Turkey to undergo tests and scans as part of a supportive assessment.

Dr Tonguc Utku Yilmaz and the radiologists performed the assessment in Acidabem. The main purpose of the assessment was to determine the nature of the liver lesions and whether a liver-directed intervention was needed.

Rather than relying solely on her previous diagnosis and treatment history, the medical team reviewed her condition with additional imaging and radiological assessments. This step was important in helping the specialists develop a clearer picture of her disease and evaluate the feasibility of potential local treatment.

Reassessing the Treatment Approach

Following the diagnostic tests, imaging, and specialist consultation, the medical team reassessed El Ammous's treatment options. Although liver surgery or ablation had been considered, the evaluation did not lead to a recommendation for either procedure in Turkey.

Instead, the doctors advised her to continue her ongoing oncology treatment in Tunisia. This meant that no liver surgery or ablation was performed during her visit to Turkey. While this may not have been the outcome El Ammous initially expected, the consultation provided something equally important: a clearer understanding of the appropriate next step based on specialist assessment.

Cancer treatment plans can evolve as new imaging, pathology, treatment response, and specialist assessments become available.

For metastatic colorectal cancer, decisions regarding liver metastases often require input from multiple specialists. Imaging plays an especially important role in determining whether lesions may be technically treatable and how a local intervention would fit into the patient's broader oncology plan.

Returning with a Clearer Direction

Having concluded her diagnostic evaluation and consultations with specialists, El Ammous was told to keep receiving her oncology treatment in Tunisia.

Her experience demonstrates that consultations with medical professionals around the world will not always result in a procedure being performed or a new treatment regimen being instituted. In some instances, the most valuable outcome is knowing what not to do.

For a patient undergoing cancer treatment, it can be crucial to steer clear of an unnecessary procedure. The encounter with specialists gave El Ammous useful information she can use when communicating with her oncology team at home. That means she continues her cancer treatment in Tunisia.

A Journey Toward Informed Cancer Care

El Ammous's story serves as an example of how every cancer journey is unique. When cancer spreads to another organ, the decisions that need to be made about treatment can be complicated, leading to multiple treatment options.

In her case, the purpose of travelling to Turkey was to investigate whether her liver lesions could be treated locally. After detailed evaluation, the specialists recommended continuing her existing oncology treatment in Tunisia. No liver surgery or ablation was performed. Instead, her medical journey provided specialist reassessment and greater clarity about her treatment options.

For El Ammous, seeking another expert perspective became an important step in navigating a difficult diagnosis. Her experience highlights the value of detailed evaluation, multidisciplinary consideration, and informed decision-making in complex cancer care, especially when the right treatment may sometimes be to continue the current approach rather than immediately pursue another procedure.