Abu Dhabi: A third of patients presenting with breast cancer to a pioneering Abu Dhabi hospital are below 40 years of age, a pattern that bucks international trends for the disease.
In addition, about a third of breast cancer patients visiting the Cleveland Clinic Abu Dhabi (CCAD) present with advanced stages of the disease, said Stephen Grobmyer, chair of the Oncology Institute at the Cleveland Clinic Abu Dhabi.
“We have recently done some work which shows that we are seeing an unusually young population [with breast cancer] here, which is completely different from the population of patients we would see in the United States. The patients are also presenting with more advanced stage disease, which means they are not coming in [as] early [as anticipated],” Dr Grobmyer said.
“We are [therefore] using our teams of experts to begin to unravel these issues. For instance, we are now involved in a study to look at the germline genetics of patients in the UAE. We know that early onset breast cancer can be caused by gene mutations in your parents. But nobody has ever studied gene mutations in Emirati patients, and we are doing that now. The solutions to the breast cancer problems in the Unties States will be different to the situation here. There, breast cancer screening starts at age 40. So now, we are working beyond the walls of this hospital to find high-risk patients, and to screen for breast cancer earlier than we normally would,” the doctor explained.
He was speaking during a media tour of the hospital’s new cancer centre. Named the Fatima bint Mubarak Centre, it pays tribute to Her Highness Sheikh Fatima bint Mubarak, Mother of the Nation, for her unique role and many contributions towards advancing healthcare and wellbeing in the UAE.
The 19,000 square metre outpatient centre, which received its first patient in November 2022, was formally inaugurated in March. It is housed in a standalone building connected to the main hospital, and is equipped to deal with complex cases of cancer in adults. The centre is staffed by 150 clinical and non-clinical personnel, and collaborates directly with the Ohio-based Cleveland Clinic and its Taussig Cancer Centre.
The facility includes 32 exam rooms, 24 private infusion rooms, and two procedure rooms. Doctors said the building has been designed to help lighten the burden of cancer care on patients and their families, with the infusion and exam rooms bathed in ample light.
“Historically, we have seen patients in the UAE [travel abroad] for cancer care. We believe that a patient treated in an environment with their own family, food and home will fare better. That is why it is important that we have brought [specialist] care here,” Dr Grobmyer said.
The facility has thus far seen patients with many types of cancers, including the illnesses that are most common in the UAE and the Gulf region, such as breast cancer, prostate cancer, colorectal cancer, and haematological cancers. Doctors said during the tour that they can also treat one-off, rare cases.
Apart from differing patters of breast cancer incidence, the Cancer Centre has also detected difference in prostate cancer and acute leukaemia presentation, with patients presenting at more advanced stages than expected.
So far, about 10 per cent of the patients at the facility have come in from outside the UAE, including from Egypt, Lebanon, Bahrain, Kuwait, Pakistan, and India. Dr Grobmyer said patient numbers are growing rapidly as awareness increases, and as people come to know through word-of-mouth about the advanced technologies on offer.
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Chief among these is the is the Ethos adaptive radiotherapy. Using artificial intelligence (AI) and machine learning, Ethos allows the radiotherapy medical team to adapt a patient’s treatment plan in real-time, based on daily changes in the patient’s anatomy. Previously considered impossible, the AI-aided process significantly reduces treatment time, with sessions lasting just 25 to 30 minutes.
The technology also reduces exposure to radiation when compared to more traditional treatments, and even uses motion sensing to suspend treatment in case the patient shifts to a position that makes the targeted treatment area inaccessible, said Dr Fadi Geara, department chair for radiation oncology at the CCAD’s Oncology Institute. While the machine is suitable for all cancer types, it is currently being primarily used for pelvic, abdominal, bladder and prostate cancers.
The Centre also offers radioembolisation, TARE-Y90 therapy, a minimally invasive targeted therapy that uses radioactive particles to destroy cancer cells in the liver. The procedure involves injecting tiny beads, known as microspheres, into the blood vessels that supply the tumour in the liver with blood. These microspheres emit radiation that targets the tumour cells while sparing healthy liver tissue. The treatment is particularly useful for patients with liver cancer that has spread to other parts of the body, as it can help shrink tumours that may be otherwise inoperable and alleviate symptoms such as pain and fatigue.
Safety and wellbeing
A chemotherapy robot at the infusion pharmacy also reduces risks of radiation exposure for caregivers. The robot uses an automated compounding process to compound patient-specific hazardous medication doses.
In a bid to enhance patient wellbeing and outcomes, the Cancer Centre earlier this year also launched a 4th Angel programme, which matches patients undergoing treatment with survivors. The programme thus provides personal peer support for patients in order to empower them.
In addition, the Cancer Centre, which offers multidisciplinary care to patients, currently also conducts clinal research studies, such as the study on breast cancer health awareness and genetic among Emirati women. An offshoot of this is the clinical trials that the hospital will soon offer clinical trials to patients, supported by its research pharmacy team and research professionals, including a research infrastructure that will have its own institutional review board.