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Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system is a network of glands, nodes, and channels producing lymph fluid. The lymphatic system helps the body fight infection by removing bacteria and other foreign substances from the blood. It also helps fight cancers and tumors by making special proteins called antibodies.

It affects the lymph nodes and other parts of the immune system. It usually progresses slowly but can be life-threatening if it spreads to other organs like the lungs or bone marrow.

Hodgkin lymphoma is named for description by Thomas Hodgkin and his colleagues at Guy’s Hospital in London in 1832.

Types of Hodgkin Lymphoma

There are four main types: 

Nodular Sclerosing Hodgkin Lymphoma (NSHL) is a rare form of Hodgkin lymphoma with a distinctive appearance. It is characterized by large, solid tumors that are sessile and have no capsule. These nodules are surrounded by a thin rim of reactive cells, which can appear as a pale halo surrounding the nodule on CT scans. The lesions may be solitary or multiple and can occur anywhere in the body.

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) is a rare, aggressive form of non-Hodgkin lymphoma. A distinctive pattern of histology and molecular alterations characterizes it. Affected individuals are typically younger than those who have other types, and the disease tends to be more aggressive in its early stages.

Lymphocyte Rich Classical Hodgkin Lymphoma (LRCH) is a type of Hodgkin lymphoma that is characterized by an abundance of lymphocytes (white blood cells), which are the main component of the immune system. It is also known as “nodular sclerosis classical Hodgkin lymphoma” or “nodular lymphocyte predominant Hodgkin lymphoma.” The term “nodular” refers to the characteristic tumor nodules appearing in Hodgkin lymphoma. In contrast, there are fewer or no nodules in most other forms. Two types of LRCH exist type 1, which has a more favorable prognosis than type 2 and type 2, which has a worse prognosis than type 1.

Mixed Cellularity Classical Hodgkin Lymphoma (MCCL) is a form that has cells with both Reed-Sternberg and non-Reed-Sternberg features. It is more common in older adults than other types.

Symptoms of Hodgkin Lymphoma

The most common symptoms are:

• Painless swelling of the neck, underarms, or groin
• A fever that lasts for more than 3 days
• Night sweats
• Weight loss for no known reason

Causes of Hodgkin Lymphoma

The cause of this disease is unknown, but research has shown that it could be linked to genetics and lifestyle factors. In particular, a person’s risk of developing the condition increases if they have a family history of the illness or if they have been exposed to certain environmental factors like radiation or chemicals.

Risk Factors of Hodgkin Lymphoma

The risk factors include,

Age. Hodgkin lymphoma is most common in people between the ages of 15 and 30, with the highest rates occurring among those between 20 and 24 years old. While it can occur at any age, it is rare in children younger than 10.

Gender. Males are more likely to develop the condition than females. However, it is important to note that this difference may be due in part to the fact that men are more likely to seek medical care when they experience symptoms.

Ethnicity. Caucasians are more likely to develop the condition than Asians or African Americans.

Family History. People who have a parent or sibling with Hodgkin lymphoma have an increased risk of developing it themselves. In addition, there is evidence that suggests having multiple family members with the condition can increase your risk by two times compared with someone who does not have this family history.

Diagnosis

Tests and procedures used to diagnose the condition include the following: 

Physical Exam: The doctor will examine you, checking for swollen lymph nodes in your neck, underarm area, or groin. They’ll also check your skin for signs of infection and look at your body for any other abnormalities.

Blood Tests: A blood test can confirm the presence of Hodgkin’s lymphoma by looking for increased levels of a protein called LDH (lactate dehydrogenase). Chest X-ray: An X-ray can help determine whether you have any enlarged lymph nodes in your lungs or chest wall. It may also show signs of lung damage from cancer treatment.

CT Scan: A computed tomography (CT) scan uses X-rays to make detailed pictures of areas inside the body, including the lymph nodes. This test can determine if there are enlarged lymph nodes and whether they contain cancer cells. 

MRI: Magnetic resonance imaging (MRI) uses a strong magnetic field and radio waves to make detailed pictures of areas inside the body without using X-rays. It can help doctors see tumors that are difficult for CT scans to detect. 

Lymph Node Biopsy: The doctor will use a needle to remove several small tissue samples from your lymph nodes for testing in the lab. In some cases, this may be done under sedation or general anesthesia so the procedure doesn’t cause pain or discomfort.

Treatment

Treatment involves chemotherapy, radiation therapy, and stem cell transplantation.

Chemotherapy is used to treat both stages 1 and 2 of Hodgkin lymphoma. The goal is to destroy cancer cells with drugs against fast-growing cells. Chemotherapy may be combined with radiation therapy or surgery to treat the condition.

Radiation therapy uses high-energy rays or particles to kill cancer cells. Radiation therapy may be used alone or in combination with chemotherapy to treat the condition.

Stem cell transplantation is used if your doctor thinks your disease has come back after treatment (recalled) or if you have advanced stage 3 or 4 Hodgkin lymphoma. Stem cells are immature blood cells that can become any blood cell in your body when they mature. Stem cell transplants replace your unhealthy bone marrow with healthy donor bone marrow.

Hematologists and Bone Marrow Transplanation experts at Burjeel Medical City, Abu Dhabi, treat Hodgkin lymphoma and other blood disorders.

Myelodysplastic syndromes (MDS) are a group of conditions that affect the blood and bone marrow. They are characterized by abnormal production of blood cells (myeloid cells), which can decrease the number or function of red blood cells, white blood cells, and platelets. MDS usually develops slowly over time and may progress to acute myeloid leukemia (AML).

What are the Symptoms of Myelodysplastic Syndromes?

The symptoms of MDS can vary from person to person and may not be present in all patients with this condition. Some of the most common symptoms include:

• Feeling tired or short of breath
• Feeling weak or dizzy
• Bleeding or bruising more easily than normal
• Pain in your bones or joints
• Feeling itchy or tingling sensations in your arms or legs
• Feeling like you have a fever

What are the Types of Myelodysplastic Syndromes?

• Acute Myeloid Leukemia, or AML, is the most common type of myelodysplastic syndrome. It occurs when the bone marrow produces too many immature white blood cells, which can cause infections, anemia, and bleeding disorders. The leukemia cells can also spread to other parts of your body.
• Chronic Myelogenous Leukemia (CML)—This type of leukemia affects older adults but is not as common as AML. CML causes abnormal growth of white blood cells in the bone marrow. If untreated for a long time, it can progress into acute leukemia or another form of cancer called acute promyelocytic leukemia (APL).
• Juvenile Myelomonocytic Leukemia (JMML)—This form affects children under age 20. It is less likely than other types of myelodysplastic syndrome to be inherited from your parents’ genes because it usually appears without warning during childhood or adolescence without any family history of JMML or other medical conditions.

What is the Cause of Myelodysplastic Syndromes?

The cause of MDS is unknown. It can develop in people who have had previous radiation or chemotherapy treatment. Other risk factors include aging, having a family history of MDS, being exposed to certain chemicals or drugs, and having certain genetic conditions.

How is it Diagnosed?

Myelodysplastic Syndromes can be diagnosed by a number of different methods, including:

Blood tests: These are used to measure red blood cell counts and the number of platelets in the body. They may also check for white blood cells and other markers that can signal disease.

Bone marrow biopsy: A small amount of bone marrow is extracted from your hip bone, which is then examined under a microscope. If your bone marrow is unhealthy, it will show signs of myelodysplastic syndrome.

Lumbar puncture: This test involves inserting a needle into your spine to collect cerebrospinal fluid, which surrounds the brain and spinal cord. The fluid can be tested for signs of leukemia or other cancers in addition to myelodysplastic syndromes.

How is it Treated?

Myelodysplastic syndromes are treated with a combination of chemotherapy, radiation therapy, and bone marrow transplantation. The goal is to slow down or stop the progression of this disease.

Chemotherapy is often used to treat myelodysplastic syndromes. This type of treatment involves using certain drugs to kill cancer cells and shrink tumors. These drugs are typically taken by mouth or injected into a vein (IV). Some chemotherapy drugs can be given through an IV in your arm or hand before you go home from the hospital or doctor’s office after surgery to remove your spleen. Radiation therapy may also be used to treat this condition.

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to destroy cancer cells and keep them from growing back (recurring).

If these treatments don’t work, you may need a bone marrow transplantation. A bone marrow transplantation replaces damaged bone marrow with healthy bone marrow that contains normal blood cells.

Hematologists and Bone Marrow Transplantation experts at Burjeel Medical City, Abu Dhabi, treat Myelodysplastic Syndromes with the latest medical advancements

Multiple myeloma is a type of cancer that develops in the bone marrow or the soft tissue inside your bones. It’s a malignant (cancerous) condition that occurs when abnormal plasma cells grow and invade other tissues, including the bone marrow. The abnormal cells produce large amounts of immunoglobulin, which can lead to various symptoms.

What are the Symptoms of Multiple Myeloma?

The most common signs and symptoms of multiple myeloma are:

• Bone pain
• Fatigue or weakness
• Shortness of breath
• Fever and chills
• Loss of appetite (not related to nausea)

What are the Causes & Risk Factors of Multiple Myeloma?

There is no known cause of multiple myeloma. It is thought to be caused by a combination of factors, such as genetic predisposition, environmental exposure, and hormones, but several factors may increase your risk. These include:

• Age – Multiple myeloma is most common in people over age 50.
• Infection with Human T-cell Lymphotropic Virus Type 1 (HTLV-1) – A virus that can cause leukemia and other blood disorders; it’s found mostly in tropical areas.
• Family History – People who have a family history of multiple myeloma are more likely to develop it themselves.
• Exposure to radiation or certain chemicals

How is Multiple Myeloma Diagnosed?

A blood test, such as a complete blood count (CBC), can determine if your body has increased monoclonal immunoglobulin (Ig) G protein-specific antibodies. These antibodies are produced by the plasma cells that have been transformed into malignant plasma cells in multiple myeloma.

If the CBC determines that you have an increase in these proteins, your doctor will likely perform other tests. You may have a bone marrow aspiration and biopsy, which involves inserting a needle into your hip bone to remove some bone marrow for testing. This can help confirm the presence of cancerous plasma cells and determine whether they are located in areas where they shouldn’t be—such as the liver or kidneys.

Another common test for multiple myeloma is magnetic resonance imaging (MRI). This test creates images of your bones and soft tissues by sending radio waves through them so that they can be seen on a computer screen. An MRI can help detect tumors throughout your body and determine their size and location so that doctors can provide treatment plans accordingly.

How is it Treated?

Multiple myeloma can be treated with chemotherapy, targeted therapy, radiation therapy, and stem cell transplantation. Doctors will choose from these treatment options based on the patient’s medical history and type of multiple myeloma.

Chemotherapy is used to destroy cancer cells before they spread or return after treatment has ended. It does this by damaging or killing rapidly dividing cells that grow into tumors.

Targeted therapy uses drugs that target specific molecules involved in cancer growth or spread. These drugs may help stop cancer cells from growing or spreading so that they become less harmful to patients. Radiation therapy uses high-energy rays to destroy cancer cells.

Radiation may be used alone or combined with other treatments like chemotherapy or targeted therapy as part of your overall treatment plan for multiple myeloma.

Stem cell transplantation involves replacing some of your immune system’s stem cells with those from another person who has healthy stem cells but no history of cancer. Stem cell transplants are generally performed only when other treatments have not worked well enough.

Hematologists and Bone Marrow Transplantation experts at Burjeel Medical City, Abu Dhabi, treat multiple myeloma and other malignant blood diseases. They are also experts in bone marrow transplantation, stem cell transplantation, immunotherapy, and finding the best treatment for your condition.

Lymphoma is a cancer of the lymphatic system, which consists of a network of vessels, organs, and glands throughout your body. Lymphomas are classified by the type of cell from which they develop.

The lymphatic system helps to protect humans from disease by carrying away waste products and foreign substances from the body. The lymphatic system includes the bone marrow, spleen, thymus gland, tonsils, adenoids, mucous membranes in the nose and throat, lymph nodes, and other tissues.

Lymphocytes (white blood cells) are produced in the bone marrow and travel through the bloodstream to reach other parts of the body. Lymphomas are cancers that begin in B-cells (white blood cells) or T-cells (a type of white blood cell). In general terms, lymphomas involve abnormal growths called tumors that start in one part of the body but spread to other parts through the lymphatic system or blood stream.

What are the Types of Lymphoma?

There are two main types of lymphoma: Hodgkin’s and non-Hodgkin’s.

Hodgkin’s lymphoma is cancer that starts in white blood cells called lymphocytes. It can occur anywhere in the body, but it most commonly appears in the lymph nodes located throughout the body.

Non-Hodgkin’s lymphoma (NHL) is another form of cancer that starts in lymphocytes. However, non-Hodgkin’s lymphoma does not usually start in the lymph nodes like Hodgkin’s does and can affect any part of the body.

Other types of lymphomas include chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and small-cell carcinoma of the lung.

What are the Symptoms of Lymphoma?

Symptoms of lymphoma can develop slowly over time or they can appear suddenly. The most common symptoms are:

• coughing up blood
• pain in the abdomen or chest
• loss of appetite and weight loss
• feeling very tired all the time (feeling like you have the flu)
• night sweats (waking up sweating at night)

What are the Causes of Lymphoma?

The causes of lymphoma are not well understood. Some lymphomas have an inherited genetic component, but most do not. Most cases of lymphoma occur in people who don’t have any known risk factors.

What are the Risk Factors of Lymphoma?

Some people are at higher risk for lymphoma than others. Risk factors include

Age: The risk of developing lymphoma increases as you get older.

Gender: Men are more likely to develop lymphoma than women.

Genetics: Certain genes can increase your risk of developing certain types of lymphoma (such as chronic lymphocytic leukemia).

Exposure to certain chemicals or radiation: People exposed to certain chemicals or radiation may be at higher risk for developing certain types of lymphoma (such as hairy cell leukemia).

How is it Diagnosed?

Tests and procedures used to diagnose the condition include:

Lymph node biopsy. A pathologist examines a sample of tissue from a lymph node for signs of cancerous cells.

Blood tests. These tests can detect abnormal white blood cell counts, which are often high in people with lymphoma.

CT scans or MRI scans. These imaging tests can help doctors see if there’s any tumor tissue in the spleen or other organs outside the lymph nodes or bone marrow.

Bone marrow aspiration/biopsy (called a marrow test). This test involves removing a small amount of bone marrow through a needle and examining it under a microscope for signs of cancerous cells.

How is it Treated?

Chemotherapy: This is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body to reach cancer cells that have spread to other parts of the body. These drugs are not selective, meaning they will affect normal cells as well as cancer cells, which can cause side effects such as nausea, hair loss, and fatigue.

Stem cell Transplantation: This procedure replaces diseased bone marrow with healthy cells from a donor who has been matched for tissue type (e.g., blood type) and gender. Transplants are usually done when the patient has exhausted other treatment options, or their disease progresses rapidly.

Targeted Therapy: Targeted therapies take a more personalized approach to treating cancer by targeting specific areas within a tumor or oncogene (a genetic mutation that triggers uncontrolled cell growth). These therapies are used in combination with traditional chemotherapy drugs to increase effectiveness for some cancers such as lymphoma, leukemia, or multiple myeloma.

Hematologists and Bone Marrow Transplanation experts at Burjeel Medical City, Abu Dhabi, treat lymphoma and other blood disorders.

Leukemia is a type of cancer that affects the blood. It can be either acute or chronic, and it starts when the bone marrow makes abnormal white blood cells. These abnormal cells crowd out normal blood cells, creating anemia, which causes tiredness and weakness.

What are the Symptoms of Leukemia?

The symptoms vary depending on the type. The most common symptoms are:

• Fatigue and weakness
• Bleeding or bruising easily
• Fever and night sweats
• Loss of appetite and weight loss
• Shortness of breath
• Recurring infections

What are the Causes of Leukemia?

The causes are not well understood, but it is thought that the disease develops when a person’s bone marrow produces abnormal white blood cells. The abnormal white blood cells grow in the spinal cord or central nervous system, causing symptoms such as headaches, seizures, and paralysis. In other cases, these cancers can cause no signs or symptoms until they spread throughout the body.

How is Leukemia Classified?

Leukemia is classified by the type of white blood cells that are affected. The most common types of leukemia are lymphoblastic leukemia and acute myeloid leukemia.

Lymphoblastic leukemia occurs when the body produces abnormal lymphocytes or white blood cells.

Acute myeloid leukemia occurs when a person’s bone marrow makes too many immature white blood cells.

How is Leukemia Classified?

According to the American Cancer Society, there are several different types of leukemia. They include:

• Acute lymphoblastic leukemia (ALL) is children’s most common type of leukemia. Cancer begins in your bone marrow, where blood cells are made.

• Acute myelogenous leukemia (AML)is fast-growing cancer that starts in your bone marrow and affects your white blood cells. It causes anemia, which is when you have too few red blood cells to carry enough oxygen throughout your body.

• Chronic lymphocytic leukemia (CLL) is slow-growing cancer that starts in your bone marrow and affects your white blood cells.

• Chronic myelogenous leukemia (CML) is slow-growing cancer that starts in your bone marrow and affects your white blood cells. It causes anemia, which is when you have too few red blood cells to carry enough oxygen throughout your body.

What are the Risk Factors?

Risk factors include:

• Being a male
• Having a family history of leukemia
• Being exposed to radiation or certain chemicals
• Having been diagnosed with another type of cancer or an infection that affected your immune system

How is Leukemia Diagnosed?

It is a cancer of the blood or bone marrow. It can affect all age groups and races but most commonly affects children, adolescents, and young adults.

A diagnosis begins with a physical examination and medical history by a hematologist or blood cancer specialist. The doctor may order other tests to rule out other conditions that may cause symptoms similar to those of leukemia. These tests may include blood tests, imaging tests (such as X-rays or CT scans), or tissue biopsies.

The hematologist will examine your skin, nails, and eyes by looking for any signs of unusual coloration or growths. Your lymph nodes will also be checked for swelling or tenderness. Your bodily fluids may be tested for increased white blood cells, which are an indication of infection; decreased red blood cells, which indicate anemia; or decreased platelets, which indicate bleeding problems.

A bone marrow biopsy may be performed to determine if there are abnormal cells present in the bone marrow, which is another way to diagnose the condition. Suppose your doctor suspects that you have it based on your symptoms and initial test results. In that case, he or she will likely order additional tests to confirm the diagnosis and determine how far the disease has progressed in your body.

What Does the Treatment Involve?

Leukemia is treated in a number of ways. There are three main types of treatments: chemotherapy, radiation therapy, and bone marrow transplantation. 

Chemotherapy: Chemotherapy is the use of a drug to treat cancer by killing cancer cells. It does this by attacking the rapidly dividing cells that makeup tumors. Because healthy cells also divide quickly, chemotherapy can also kill some healthy, normal cells in your body. Chemotherapy can be given through an IV (intravenously), or it can be taken by mouth. 

Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells and shrink tumors. Radiation may be given as one large dose or several small doses over time.

Targeted Therapy: Targeted therapies help stop cancer cells from growing or spreading by blocking them from receiving signals to grow and divide. Targeted therapies are often used after chemotherapy has been ineffective at controlling your symptoms.

Bone Marrow Transplantation: Bone marrow transplants are used most often when there is no chance that your leukemia will go into remission without one. A person with leukemia who receives a transplanted bone marrow stem cell has a better chance of remission than someone who doesn’t receive the transplant.

Hematologists and Bone Marrow Transplantation experts at Burjeel Medical City, Abu Dhabi, treat leukemia and other blood disorders in both adults and children. The Hematology department of Burjeel Medical City provides advanced care for patients with blood diseases. The department offers a wide range of services, including hematology, oncology, and bone marrow transplantation.

Bladder cancer is a disease that affects the bladder, which is located in the lower part of your pelvis. The bladder is a hollow, muscular organ that stores urine. Urine flows from the kidneys to the bladder through tubes called ureters. When you urinate, urine flows out of the body through another tube called the urethra. Bladder cancer is a disease that begins in cells in your bladder and spreads beyond it. It can affect other organs, such as the lymph nodes or prostate gland (in men).

Symptoms of Bladder Cancer

Symptoms of bladder cancer include,

• Urinary symptoms such as pain, blood in your urine, or frequent urination
• Back pain or pain in the lower abdomen
• Blood in your stool or vomit (may be caused by bleeding from the anus)
• Weight loss without trying to lose weight
• Trouble breathing or swallowing

Causes of Bladder Cancer

Bladder cancer is caused by the uncontrolled growth of abnormal cells in the bladder. It is also referred to as transitional cell carcinoma, squamous cell carcinoma, or adenocarcinoma. Normally, bladder cells are able to grow and divide in a controlled manner. However, when a mutation in certain genes controls cell division, the cells can continue to divide and grow without stopping, causing them to become cancerous. There are two main types of mutations: chromosomal and molecular. Chromosomal mutations are changes in DNA that occur when chromosomes break apart and then rejoin incorrectly. This can cause a change in how proteins are formed or stop them from being produced altogether. Molecular mutations occur when proteins don’t function properly or aren’t produced at all because they’re defective or missing altogether.

Types of Bladder Cancer

There are several types of bladder cancer, including urothelial carcinoma, squamous cell carcinoma, and adenocarcinoma.

Urothelial carcinoma is the most common type of bladder cancer in adults and accounts for 90% of all cases. It usually occurs in the bladder’s inner lining and can be treated successfully with surgery, chemotherapy, or radiation therapy.

Squamous cell carcinoma is another common form of bladder cancer that develops in the outer layer of cells lining the bladder’s surface. This type of cancer is typically treated by removing the tumor with surgery and chemotherapy to kill remaining cancer cells.

Adenocarcinoma is a rare form of bladder cancer that develops from mucus-producing glandular tissue inside the bladder. It tends to grow slowly but may spread rapidly if not detected soon enough.

Risk Factors of Bladder Cancer

The risk factors for bladder cancer include:

• Tobacco smoking
• Alcohol consumption
• Occupational exposure to strong chemicals, including aniline dyes and rubber chemicals
• Exposure to radiation, like uranium or radon gas
• Genetic conditions such as hereditary nonpolyposis colorectal cancer (HNPCC), familial adenomatous polyposis (FAP), Lynch syndrome, and multiple endocrine neoplasia type 1 (MEN1)
• Age: The risk increases with age. All people over 50 should have an annual test called a cystoscopy to check for early signs of bladder cancer
• Gender: Men are more likely than women to develop it

Diagnosis

Bladder cancer is usually diagnosed by cystoscopy, biopsy, and imaging tests.

Cystoscopy is a procedure in which a thin, lighted tube (cystoscope) is inserted through the urethra to examine the inside of the bladder. The doctor can look for abnormal areas that may be cancerous or pre-cancerous. A sample of tissue from any suspicious areas can be taken during cystoscopy for further evaluation.

Biopsy is the removal and examination of tissue to look for signs of cancer. The doctor performs a biopsy by inserting a thin needle into an area of concern through the skin and taking a sample of tissue for examination under a microscope.

Urine Cytology involves examining cells in urine under a microscope to detect abnormal cells that may indicate bladder cancer.

Treatment

The treatment depends on the type of cancer cells and how advanced they are.

Targeted therapy is a form of immunotherapy that uses drugs to block specific molecules in cancer cells, which can help slow down or stop the growth of tumor cells.

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells.

Radiation therapy is a treatment that uses high-energy radiation to kill cancer cells and shrink tumors. Immunotherapy is a type of treatment that helps your body fight off disease by boosting your immune system’s ability to fight cancer cells.

Bladder Cancer Surgery

Bladder cancer surgery involves removing the tumor, preserving the ureter, and reconnecting it with the bladder to prevent urinary incontinence.

Transurethral resection of bladder tumor (TURBT): This procedure is performed through a small incision in the perineum using a laser to cut out a portion of the tumor. The remaining part of the tumor is removed by shaving it off.

Cystectomy: This procedure removes all tumors in one operation. In some cases, it may be performed via laparoscopy, and in others, via open surgery. It can also be done using robotic technology for less invasive procedures.

Neobladder Reconstruction: A neobladder is a tube that connects an ileal conduit to a continent urinary reservoir (CUR). The CUR collects urine from your kidneys and passes it into your bladder when you are urinating.

Ileal conduit is a type of urinary diversion. It involves inserting a catheter into the small intestine and then connecting the catheter to a bag of fluid that can be drained. The ileal conduit is used when there is no bladder left after bladder cancer surgery.

Continent Urinary Reservoir is a type of urinary diversion in which two tubes are inserted into the bladder. One tube connects to the ureters and drains urine from the kidney; another tube connects to the urethra, and urine can flow through it directly into the bag of fluid. Continent reservoirs are used when there is no bladder left after bladder cancer surgery.

Our Uro-Oncologists at Burjeel Medical City have experience treating bladder cancer. They will work closely with you to create an individualized treatment plan that will meet your needs and goals.

Carpal tunnel syndrome is a common medical condition affecting the hands and wrists. Pressure on the median nerve, which runs from the forearm through the carpal tunnel in the wrist, causes it. Carpal tunnel syndrome symptoms include tingling, numbness, and pain in the hand and fingers.

What Causes Carpal Tunnel Syndrome?

The carpal tunnel is a small passageway in the wrist bounded by the carpal bones and ligaments. The median nerve, as well as the tendons that control the fingers, pass through this tunnel. When the tunnel narrows due to swelling tendons, it can pressure the median nerve, causing pain, tingling, and numbness in the hand and fingers.

Several factors, including repetitive motions, wrist injuries, and medical conditions such as diabetes, arthritis, and thyroid disorders, can cause the condition. It is also more common in women than in men.

Rest, wrist splinting, anti-inflammatory medications, and corticosteroid injections can all be used to treat the condition. In some cases, surgery may be required.

How Can You Prevent it?

It can be avoided by limiting repetitive motions, taking frequent breaks, and performing activities involving the hands and wrists with proper ergonomics. A wrist splint worn at night can also help relieve symptoms.

If you have symptoms of carpal tunnel syndrome, you should see a doctor for a proper diagnosis and treatment plan. Early treatment can help prevent further median nerve damage and long-term complications.

Expert Neurologist in Abu Dhabi

Dr. Halprashanth D.S

Consultant Neurology

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Years of Experience: 11

Nationality: India

Languages Known: English, Urdu, Hindi, Kannada, Tamil

In the UAE in 2021, about 1 million people had diabetes, and the predicted figure in 2040 is expected to be 2.2 million. There are two main types of diabetes mellitus, type1 and type2, type1 presents about 10% of diabetes mellitus, and type2 diabetes mellitus presents around 90%. Therefore, can we reduce the burden of type 2 diabetes mellitus on society and individuals? Do you believe we can reduce the estimated number of diabetes cases by 2040?

Does Type 2 Diabetes Occurs Solely as a Result of Genetics and Family History

Genetics and family history account for 15% of your risk of developing type 2 diabetes mellitus; however, lifestyle, diet, and exercise account for 85% of your risk. This indicates that 15% is considered a non-modifiable risk, while on the other hand, 85% is considered modifiable. So, let us look at how we can address the modifiable 85% risk:

First, for early detection, a blood checkup should be done every 6 months, including the diagnostic test HBA1C, which checks your mean blood glucose for the last 3 months and fasting and post-prandial blood sugar. Early detection will be achieved even in the pre-diabetes stage.

Second, exercise can work on increasing the sensation of insulin in your body, which helps improve the glucose absorption in your body cells, reduces the work burden on the pancreas, and can help you lose extra body weight if the person is obese.

Thirdly, weight loss is one of the most important key elements in reducing the risk of developing type 2 diabetes mellitus, as it helps improve insulin sensation at the cell level. The American Diabetes Association recommends that people with prediabetes lose at least 7% to 10% of their body weight to prevent disease progression. More weight loss will increase the health benefits even more.

Fourth, lifestyle and behavioral changes are the most difficult challenges in the journey. Therefore, a multidisciplinary team of a doctor, dietitian, psychologist, and diabetic educator is needed to empower you to achieve the ultimate goal.

Diet plays the most important role in managing blood glucose readings; having a realistic goal and meal plans will help you maintain the result of adequate blood glucose control.

In conclusion, prevention is better than cure. By working on all the mentioned elements, the burden of diabetes mellitus can be reduced in society and improve your quality of life.

Diabetes Expert at Burjeel Day Surgery Center in Abu Dhabi

Ms. May Abu Galala

Diabetes Educator

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Years of Experience: 11

Nationality: Palestine

Languages Known: Arabic, English

Cervical cancer is a disease in which malignant (cancer) cells form in the cervix, the lower part of the uterus. The cervix is the passageway that connects the vagina, uterus, and fallopian tubes. The uterus is where a baby grows before birth. Cervical cancer can lead to death if not treated, but it’s most often treatable when found early.

What Causes Cervical Cancer?

Cervical cancer is a disease that develops when cells become abnormal and multiply uncontrollably. These abnormal cells begin to crowd out healthy cells in the cervix responsible for protecting the uterus and fallopian tubes. Cervical cancer is most often caused by human papillomavirus (HPV), although other factors can also cause it.

What are the Symptoms of Cervical Cancer?

Cervical cancer symptoms include,

• Bleeding after sexual intercourse or between menstrual periods
• Difficulty urinating or pain in the lower abdomen or pelvis
• Pain during sex, especially deep penetration
• Prolonged menstrual bleeding or bleeding between periods
• A lump or mass in the vagina

What are the Stages of Cervical Cancer?

There are three stages of cervical cancer: stage 0, stage 1, and stage 2.

Stage 1: In this stage, the cancer is confined to the cervix, the lower part of the uterus. Stage 1 is further divided into two sub-stages:

• Stage 1A: The cancer is microscopic and can only be detected with a microscope.
• Stage 1B: The cancer is visible to the naked eye or can be detected through imaging tests but remains confined to the cervix.

Stage 2: At this stage, the cancer begins to spread beyond the cervix but still remains within the pelvic area. Stage 2 is further divided into two sub-stages:

• Stage 2A: The cancer has spread to nearby tissues, such as the upper part of the vagina.
• Stage 2B: The cancer has reached the tissues next to the cervix, such as the parametrium (connective tissue surrounding the cervix) or the lower part of the vagina.

Stage 3: In this stage, the cancer extends further beyond the pelvis. Stage 3 is divided into three sub-stages:

• Stage 3A: The cancer has reached the lower part of the vagina.
• Stage 3B: The cancer has invaded the pelvic wall or caused hydronephrosis (buildup of urine in the kidney due to a blocked ureter).
• Stage 3C: The cancer has spread to nearby lymph nodes.

Stage 4: This is the most advanced stage of cervical cancer, indicating that the cancer has spread to distant organs or tissues. Stage 4 is further divided into two sub-stages:

• Stage 4A: The cancer has spread to nearby organs, such as the bladder or rectum.
• Stage 4B: The cancer has metastasized to distant sites, such as the lungs, liver, or bones.

How is Cervical Cancer Diagnosed?

Cervical cancer is diagnosed through physical exams, tests, and procedures. The first step in the process is a pelvic exam. During this exam, your doctor will perform an internal examination to look for abnormalities in your cervix. If abnormalities occur, your doctor may order additional tests such as a pap smear or HPV test. If you have symptoms of cervical cancer, your doctor may recommend other tests such as an endocervical swab for cytology (a sample of cells) or imaging tests like an MRI or CT scan. It may also be diagnosed with colposcopy and biopsy. This procedure involves inserting a small magnifying instrument called a colposcope into the vagina to examine the cervical area. The doctor will then use a tiny tool to scrape cells from your cervix for testing.

What is Colposcopy?

A colposcopy is an examination of your cervix using a magnifying instrument called a colposcope. A biopsy removes tissue samples from your cervix to be examined under a microscope.

What are the First Steps in Treating Cervical Cancer?

You should first make an appointment with your primary care physician or gynecologist to discuss your diagnosis and treatment options.

Your doctor will likely order blood tests and a Pap smear to evaluate the stage of your cancer and determine if chemotherapy or radiation therapy is needed.

He or she may also recommend an MRI scan of your pelvis to check for any tumor spread into nearby lymph nodes. Once you have more information about the extent of your cancer, you may choose one of three treatment options: surgery, radiation therapy, or chemotherapy.

Surgery involves removing the tumor and some surrounding tissue; radiation therapy uses high-energy beams to destroy cancer cells; chemotherapy uses drugs that kill cancer cells by stopping them from dividing or growing.

Importance of Serial Cervical Smears for Early Detection of Cancer Cervix 

Cervical cancer is the second leading cause of death in women. Most women diagnosed with advanced stages of cancer have either not done screening or have not followed up on their abnormal smears. 

Here are some interesting facts about cancer cervix: 

1. Unlike most other cancers, the cervix is slow-growing, and it has a pre-malignant/pre-invasive stage where it can be captured through smears and treated completely. The diagnoses of these pre-malignant lesions are made through serial pap smears in short paps smears.  
2. Majority of these cancers, the etiological factor is found to be a virus called the Human Papillomavirus ( HPV). The high-risk HPV strains, predominantly 16 and 18, and a few other strains are responsible for causing the disease. One has to understand that the mere presence of HPV does not mean that the woman will develop cancer; subsequently, in the majority of cases, the virus dies a natural death and disappears when tested in a couple of years. Only in a small percentage do they persist and cause the disease.
3. Vaccines are developed that protect against HPV 16, 18, and a few other high-risk HPV strains. Vaccination is ideally given before the girls get sexually active and young women up to 26 years of age.

 According to the UAE National Guidelines

• All women should begin screening with cervical smears  at 21 years of age 

• Women aged 21-30 should have pap smears every 3 years.  

• After 30 years, the frequency of screening is again once in 3 years, but if HPV testing is also combined, the frequency could be once every 5 years. 

Since Abu Dhabi has a rapid population turnover, we, as general gynecologists, perform opportunistic testing; we take cervical smears when women present to us with unrelated complaints.  Few precautions, however, need to be exercised to get satisfactory reports with opportunistic testing. Avoid taking smears when women present with symptoms of vulvovaginitis. It is a good practice to schedule the women for smears after the infection is treated. Performed during an ongoing infection can result in the finding of abnormal cells, which will confuse the patient and the physician. It is important to understand that the presence of abnormal cells does not mean the presence of cancer but needs to be evaluated by an expert who has experience treating abnormal cervical smears and correctly interpreting them in the context in question.   

Thyroid disorders are a group of conditions that affect the thyroid gland. Thyroid disorders can cause a wide range of symptoms and can affect children, adults, and seniors. They also may be temporary or permanent, depending on your disease type.

What Does the Thyroid Gland Do?

The thyroid gland is a butterfly-shaped organ in the neck that produces hormones that help regulate metabolism. It’s located just below Adam’s apple and above the collarbone. It consists of two lobes, each with its thyroid tissue. A part of the brain controls the thyroid called the pituitary gland, which sends out hormones that tell your thyroid to make more or less of certain protein-based hormones. The thyroid can be affected by infections, physical injury, or radiation exposure. If it becomes overactive (hyperthyroidism) or underactive (hypothyroidism), it can cause problems with metabolism and lead to other health issues.

What is the Function of Thyroid Hormone?

Thyroid hormones are essential for the body’s proper growth, development, and function. They influence nearly every cell in the body, affecting growth, metabolism, and other complex processes. A feedback mechanism controls the production of thyroid hormones. The pituitary gland secretes a hormone called thyrotropin (TSH).

TSH signals the thyroid gland to produce more thyroid hormone when levels fall too low or less when they are too high. The thyroid gland produces two types of thyroid hormone: triiodothyronine (T3) and thyroxine (T4). T3 is the active form of the hormone; it stimulates cellular activity in almost every organ system in the body. In contrast, T4 is inactive until it is converted into T3 in target tissues such as muscle, bone marrow, and fat cells.

What are the Symptoms of Thyroid Hormone?

Signs and symptoms of a thyroid problem can include weight gain, especially around the midsection.

• Fatigue or lack of energy
• Muscle weakness or cramps
• Hair loss or thinning hair
• Cold intolerance (feeling cold even when others are warm) and unexplained chills
• Constipation or diarrhea, especially after eating, sometimes alternating between constipation and diarrhea.
• Dry skin that may feel coarse to the touch

What are the Causes of Thyroid Disorders?

Thyroid disorders are caused by the thyroid gland not producing enough hormones or by an overactive thyroid gland. The most common causes include the following:

• Iodine deficiency
• Autoimmune thyroid diseases
• Radiation exposure
• Congenital hypothyroidism

What are the Types of Thyroid Disorders?

Graves’ Disease

Graves’ disease is a condition that causes hyperthyroidism or an overactive thyroid gland. The thyroid gland is in the front of your neck, beneath your Adam’s apple. When someone has Graves’ disease, the immune system mistakenly produces antibodies that attack the thyroid gland and cause it to produce too much thyroid hormone. This can lead to several symptoms, including:

• Feeling overly energetic
• Weight loss despite increased appetite
• Hoarse voice (due to swelling in the throat)
• Increased sweating
• Irregular heartbeat (palpitations)

Hyperthyroidism

Hyperthyroidism is when the thyroid gland produces too much of the hormone thyroxine. The main treatment for hyperthyroidism is a medication that suppresses the production of thyroxine by the thyroid gland. Surgery may also remove part or all of the thyroid gland if the medication does not work well enough to control symptoms. The symptoms may include:

• Weight loss
• Heat intolerance
• Increased appetite

Hypothyroidism

Hypothyroidism is an underactive thyroid gland, which means the thyroid doesn’t produce enough hormones. It’s a condition that occurs when the body fails to secrete enough thyroid hormones. The symptoms of hypothyroidism include:

• Fatigue
• Weakness
• Constipation
• Dry skin and hair
• Weight gain and depression

Thyroid Cancer

Thyroid cancer is when abnormal cells form in the thyroid gland. The cause of thyroid cancer is not known. However, risk factors include exposure to radiation and certain chemicals, a family history of thyroid cancer, and being female and over 60 years old. Symptoms of thyroid cancer may include:

• A lump or swelling in your neck
• A sore throat that doesn’t go away with antibiotics
• Painless swelling in your neck or underarm
• Difficulty swallowing or breathing
• A cough or hoarseness that doesn’t go away

Thyroid Nodules

Thyroid nodules are small lumps that develop on the thyroid gland. Thyroid nodules are common and can develop due to an enlarged thyroid gland (goiter), inflammation, or irritation, or they may be caused by other conditions that affect your thyroid. If you have a thyroid nodule, it’s important to see your doctor for an evaluation to determine whether it is cancerous. The symptoms include:

• Difficulty swallowing
• Enlarged neck (goiter)
• Hoarseness or voice changes
• Difficulty breathing
• Pain in your neck or throat that feels like pressure or pain when you swallow

Hashimoto Thyroiditis

Hashimoto thyroiditis is when the immune system attacks the thyroid gland, causing thyroid inflammation. Hashimoto thyroiditis occurs when antibodies attack the cells in the thyroid gland, causing it to become inflamed. The antibodies are produced by a type of white blood cell called a T-lymphocyte. The body normally produces these antibodies to protect itself against viruses and bacteria, but in people with Hashimoto’s disease, these antibodies mistakenly attack healthy tissue. Hashimoto’s disease often appears gradually over time, with symptoms including:

• A hoarse voice
• Weight gain or difficulty losing weight
• Fatigue Sensitivity to cold temperatures

Silent Lymphocytic Thyroiditis (SLT)

Silent Lymphocytic Thyroiditis (SLT) is an autoimmune disease that causes a gradual deterioration of the thyroid gland. It’s known colloquially as “silent” because it doesn’t present with any symptoms, and it’s only discovered when a doctor orders a blood test for another reason. SLT is most common in women aged 15-35 with no other health problems. It can also affect men, but at a lower rate than women. Symptoms include:

• Low-grade fever
• Weight gain/loss
• Fatigue
• Tenderness or pain in the neck

Goiter

Goiter is a condition that causes the thyroid gland to enlarge beyond its normal size. Goiter usually occurs when there’s an iodine deficiency in the diet or water supply. Other causes include:

• The thyroid gland not producing enough thyroid hormone
• Excess iodine in the diet
• Excessive consumption of foods high in goitrogens (e.g., soy, cabbage, broccoli)

The most common symptom of goiter is swelling in the neck. The patient may also experience Difficulty Swallowing, Shortness of breath, and heart palpitations.

How are Thyroid Disorders Diagnosed?

Physical Examination

The doctor will work with several tests and procedures to determine whether or not you have a thyroid disorder. They will also look at factors like your family history, symptoms, and age to make a diagnosis. A physical exam is often the first step in diagnosing a thyroid disorder. Your doctor will look at your neck for signs of nodules or swollen lymph nodes and examine your throat and mouth for any unusual lumps or bumps. They may also listen to your heart and lungs and check your temperature, blood pressure, and weight.

Blood Tests

Diagnosis can be made through a blood test measuring thyroid-stimulating hormone (TSH), which is released by the pituitary gland in response to low levels of thyroid hormones. If the TSH level is greater than 4 mIU/L but less than 10 mIU/L, you may have hypothyroidism, which means your body isn’t producing enough thyroid hormone. If your TSH level is greater than 10 mIU/L but less than 50 mIU/L, you may have hyperthyroidism or too much thyroid hormone. If your TSH level is greater than 50 mIU/L and you also have symptoms such as weight loss or heart palpitations, then you may have Grave’s disease (hyperthyroidism). Suppose the symptoms don’t match any of these conditions. In that case, your doctor may order lab tests for thyroid antibodies—TSH receptor antibody (TRAb), thyroglobulin antibody (TgAb), anti microsomal antibody (AMA), thyroperoxidase antibody (TPOAb), and thyroid antimycobacterial peptide antibody (MAB).

Imaging Studies

Imaging tests can look at the thyroid gland’s size and shape, while thyroid ultrasound uses sound waves to create an image of the gland. They may also order imaging studies such as magnetic resonance imaging (MRI), or computed tomography (CT) scans if they suspect there’s something wrong with your pituitary gland or hypothalamus—the areas of the brain that control hormone production.

How are Thyroid Disorders Treated?

The treatment for thyroid disorders depends on the type of disorder, its severity, and the patient’s age. In most cases, treatment for thyroid disorders will involve taking a combination of medications and lifestyle changes to help manage symptoms. Medications used to treat thyroid disorders include

• Levothyroxine – a synthetic T4 hormone that replaces what you don’t have enough of in your body; it’s often used to treat hypothyroidism.
• Liothyronine – synthetic T3 hormone that replaces what you don’t have enough in your body; it’s often used to treat hypothyroidism.
• Thyroid hormone replacement therapy (THRT) replaces T3 and T4 hormones; this is often used when someone has had their thyroid removed surgically or accidentally damaged by radiation treatment.
• Antithyroid drugs – block the production or actions of thyroid hormones; they are prescribed as a last resort when hyperthyroidism is severe or uncontrolled by other treatments.

Thyroid Surgery

A thyroidectomy is a surgical procedure to remove the thyroid gland. Thyroidectomy is one of the most common surgeries performed on adults, and it’s often used to treat benign (non-cancerous) tumors and nodules in the thyroid gland. During a thyroidectomy, your doctor will remove all or part of your thyroid gland. Your surgeon may also remove lymph nodes from around your neck and any enlarged lymph nodes found near your vocal cords during surgery. This procedure can be done through a traditional “open” approach or a minimally invasive technique called robotic-assisted surgery (RAS), which uses computer-controlled surgical tools instead of traditional metal instruments. After surgery, you’ll stay overnight at the hospital for observation and then go home when you’re ready to resume normal activities. Most people can return to work within two weeks after having this surgery—but it depends on how many lymph nodes were removed during surgery and how quickly your body heals afterward.

At Burjeel Hospital in the United Arab Emirates, our endocrinologists are experts in diagnosing and treating all thyroid diseases, including hyperthyroidism (including Graves disease), adrenal disorders, hypothyroidism, hypopituitarism, and thyroid cancer. Our team of experts uses state-of-the-art techniques in their diagnosis, including ultrasound imaging and blood tests. We also provide comprehensive management for the treatment and surgical procedures for various thyroid conditions.