Neurology · diagnostics and second opinion
Multiple sclerosis treatment in China, on Hainan
Relapses keep coming through your therapy, or the diagnosis itself is in doubt — and at home every scan and every test means another month of waiting. In the Hainan cluster, contrast MRI, spinal fluid, antibody testing and a neurologist's examination run back to back over a few days, and you fly home with a written report and a translation. You can start for free and from your own sofa: Dr Yang reads the records himself and tells you whether there is any point in coming. There is no cell therapy programme for multiple sclerosis here — we say so before you buy tickets.
About the condition
What has to be settled first with this diagnosis
Two questions decide almost everything, and both are urgent. First, is the diagnosis correct: on review, some cases turn out to be neuromyelitis optica spectrum disorder or MOG antibody disease — and that determines whether your current regimen is helping you or harming you. Second, is the therapy working: lost nerve fibres do not come back, so the question is not "what else could we try" but what your follow-up MRI shows. You can start the review from home.
And the situations in which you must not fly. A relapse happening right now is treated at home, and the trip is moved to a stable period. See a doctor the same day if you have a fever while on immunosuppressive therapy, sudden loss of vision in one eye, trouble swallowing or breathing, urinary retention, or new confusion. On natalizumab, add anything that has been building over weeks — changes in speech, behaviour, thinking or visual fields.
Why people come
The situations we see most often
If one of these is yours, it is worth establishing the stage and the options.
- Disease activity is breaking through therapy
You are on a high-efficacy drug, yet relapses keep returning or the follow-up MRI shows new lesions again.
- The diagnosis is in doubt
The picture is atypical and you want your scans and spinal fluid reviewed by a neurologist who has never managed your case before.
- You have been offered "stem cells"
A review will show what is actually on the table: a haematopoietic stem cell transplant and mesenchymal cell injections are different things. And whether you have the signs of activity that make a transplant a genuine discussion.
- Walking is getting worse without relapses
No relapses, but your legs are obeying you less and less. Here you will be told plainly what works in that pattern and what, of the things unavailable at home, is worth checking in the zone.
Standard care first
What is normally done before anything else
We do not propose replacing proven treatment. On the contrary: without it, any next step loses its meaning.
Everything starts with standard care — in most cases the question is settled at that level. What should already be in place at home:
- Disease-modifying therapy is the foundation: DMTs reduce relapse rates and the accumulation of lesions. In most countries the core drugs are funded by the health system or insurance — there is nothing to fly for
- Escalation to the high-efficacy line if the platform therapy has not held the disease. At home this is a committee or insurer decision, and how easily it comes varies enormously from place to place
- Follow-up MRI on schedule — success is not measured by how you feel today, but by the absence of relapses and new lesions
- Relapse treatment — a short course of steroids, but infection is ruled out first: with an infection old symptoms return without any new inflammation, and steroids will only do harm
- Symptomatic treatment and rehabilitation — spasticity, bladder, pain, fatigue, walking. Stopping smoking genuinely affects prognosis
This is your treating neurologist's work; a trip does not replace it, and your therapy must not be interrupted for it. If standard care has been done and the disease is still active — send us your documents.
Where a programme begins
No programme starts without a work-up
Diagnostics come first: they decide whether the method is indicated in your case and to what extent. From here there are two possible next steps.
The regenerative approach
What the cluster additionally considers
On medical grounds — as an addition to standard care, never instead of it.
- The diagnosis first: it decides whether your therapy is harming you
The cost of getting it wrong is concrete. In neuromyelitis optica, several multiple sclerosis drugs can make the disease worse; in MOG antibody disease they usually just do not work, and time is lost. So when the picture is atypical, aquaporin-4 and MOG antibodies are checked before therapy starts. In the cluster the scans, spinal fluid and records are reviewed and whatever is missing is added; turnaround times at the reference laboratory are quoted to you before the trip.
- What you get from doing it all in one block
The reason to fly is not a method but density: MRI of the brain and spinal cord with contrast, spinal fluid, laboratory work and a neurologist's examination run back to back over a few days. We ask the neurologist to record your baseline scores — EDSS, the Timed 25-Foot Walk and the Nine-Hole Peg Test: without them there will be nothing to compare against in a year. What the report must contain is agreed before you travel.
- There is no cell therapy programme for this diagnosis here
"Stem cells for multiple sclerosis" is two separate conversations. A haematopoietic stem cell transplant comes with high-dose chemotherapy: that is the work of a transplant centre, and the cluster does not do it. Mesenchymal cell injections are something else: in MESEMS, the largest trial, the primary endpoint was not met. What the documents can show, though, is the thing people are really looking for when they ask about cells — whether you have the signs of activity that make a transplant a genuine discussion.
- If the decline is happening without relapses
When progression comes without inflammatory activity, the options are thin everywhere in the world: nearly every drug that works, works on inflammation. In the cluster they check whether the decline has another cause, record your scores and put together a rehabilitation plan. Separately, we ask the hospital whether the zone has the medicine approved in the EU in the summer of 2026 for secondary progressive disease without relapses; it is unavailable in many countries. We name the other side of it straight away: the US regulator refused it over the risk of severe liver injury — six severe cases in roughly 2,700 patients treated, one of them fatal. Weekly ALT monitoring is required for the first 12 weeks, so we discuss from the outset how you would obtain the drug and have your bloods done at home. Without that plan there is no point starting.
- If things get worse while you are here
You are not at a beach resort away from medicine — you are inside a medical cluster: the hospitals are minutes away, your coordinator interprets, and your history is already with the doctor who examined you. If symptoms are new and last more than 24 hours, we will help arrange a neurologist's review — and the decision is his.
Methods
Which directions may be considered
What suits your case is determined by a physician after diagnostics.
Second opinion on your records
A cluster neurologist reviews the MRI, spinal fluid and discharge summaries: is it the right diagnosis, the right disease course, and are there grounds to change the regimen.
Diagnostics before any decision
What is specific to multiple sclerosis: MRI of the brain and spinal cord with contrast, spinal fluid and aquaporin-4 and MOG antibodies are extra to the programme, at the hospital's own price list. You get a written estimate for your list before you buy tickets.
Rehabilitation
Spasticity, walking, balance, fatigue — the things that change an ordinary day. Traditional Chinese medicine is used for sleep and fatigue; it does not replace DMTs, and there is no evidence that it affects the course of the disease. We record any herbal prescription in writing and check it against your therapy: some formulas are hard on the liver.
Plainly about the limits
When the regenerative route is not for you
This matters more than any marketing: knowing in advance when the method is not considered.
Sometimes, after reading the records, our answer is: do not come. The main cases:
- The disease is stable on therapy — no relapses, follow-up MRI done on time, no new lesions. A trip would add nothing but expense, and you will hear that before you book flights
- All you need is a review of the scans — that is work with documents, and it can genuinely be done remotely, including by specialists in your own country
- You are coming for stem cells — they are not used for multiple sclerosis in the cluster, and selection for transplant is made by a transplant centre's own panel
- The only outcome of the trip would be a recommendation for a drug you cannot reliably obtain at home — a gap in treatment is more dangerous than the absence of a recommendation
If you have been told there is no treatment, we will not promise that we have one: sometimes the documents make it clear there is no reason to travel, and we will say so plainly. We do not sell a method — we arrange access to a physician's decision.
How it works
From your records to coming home
- 11. You send your documents
Your neurologist's summary, the discs or phone photos of brain and spinal cord MRI, the spinal fluid result if you have had one, and your drugs with start dates. If something is missing, send what you have — photographs of scans taken off a screen will do.
- 22. Dr Yang's written reply
He reads the records himself; Russian and Chinese without a translator, anything else we translate before it reaches him. The reply covers what the scans show, what data are missing, whether there is any point in coming and what the additional tests would cost. No diagnosis is made online: this is an assessment of documents, not a consultation.
- 33. Flying in and being met
For most travellers no visa is needed, and this is not small print: Hainan runs its own visa-free entry for up to 30 days, and medical treatment is expressly named among the permitted purposes — which the China-wide scheme does not do. One condition: you must arrive on the island directly, with no transfer in mainland China; the regime does not let you travel on into the country, and programmes longer than 30 days need a visa obtained at home before departure. We check your passport against the list in writing before you book. Most arrivals come through Sanya, but the cluster is not in Sanya: it is about 180 km up the east coast, roughly two and a half hours by car with your coordinator. Arrange travel insurance at home — on immunosuppressive therapy in the tropics that is not a formality. And tell us when your next infusion is due: the trip is planned between doses, and you must never move natalizumab yourself.
- 44. The work-up and going home
MRI, spinal fluid, laboratory tests and the examination run back to back, and the neurologist gives a written report with a translation. Take the images away in DICOM and ask for the standard MS protocol — otherwise your neurologist at home will not be able to compare them with his own. Any complications after you return are managed by doctors where you live.
Why here
What the Boao Lecheng cluster offers
- Dr Yang reads the records himself
A partner physician of the cluster who took his medical degree in Russia. He works through your documents in the original language rather than from a summary. He is the person you are writing to.
- We check your specific request before you book a flight
Whether the zone has the test or the medicine you need — we ask the hospital and answer in writing, before tickets. We never promise availability sight unseen.
- You pay the hospital directly
No mark-up on the medicine: we earn from organising the trip — interpreting, accompanying you and logistics.
- What the Boao Lecheng cluster is
A pilot zone on the east coast of Hainan, in Qionghai: things not registered in the rest of China are legally available here. We are not a clinic and we do not treat — the cluster's hospitals do.
Common questions
The essentials
Send your scans — and get a straight answer
A specialist physician in the cluster will look at your stage and say whether the regenerative route is worth considering. The review is free; we do not diagnose online.