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Cleveland Clinic Performs First-In-World Full Multi-Organ Transplant to Treat Rare Appendix Cancer

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#USA, August 13, 2022 – Cleveland Clinic has successfully performed a first-in-the-world full multi-organ transplant to treat a patient with a rare form of appendix cancer called pseudomyxoma peritonei (PMP). Upon completion of the lifesaving transplant surgery, the patient received five digestive organs: liver, stomach, pancreas, duodenum, and small intestine.

Anil Vaidya, M.D., Cleveland Clinic’s Intestinal Transplant Program co-director, led the seven-surgeon team that completed the pioneering operation on a 32-year-old man in September 2021.

“The patient had one of the more advanced cases of PMP I have seen,” said Dr. Vaidya. “While about 80% of patients with the condition can be treated with traditional therapies, what do you do with the 20% for whom the traditional therapy isn’t successful? In some cases, the answer may be a multi-organ transplant.”

During the 17-hour operation, surgeons removed the patient’s diseased organs. He then received the following deceased donor’s organs all together and at the same time: liver, stomach, pancreas and duodenum (pancreaticoduodenal complex), spleen, small intestine, and right colon. The donor spleen was initially transplanted to boost the immune protection of the newly transplanted organs and improve blood flow to the pancreas until fully transplanted. The donor right colon was initially transplanted to help protect the new intestine from infection and improve its ability to absorb nutrients.  Both the donor spleen and donor right colon were removed prior to the completion of the transplant after they successfully served to protect the other organs during the operation.

“As far as we know, it is the first time in the world that a full multi-organ transplant, including the liver and four other digestive organs, is performed to treat PMP,” said Dr. Vaidya.

Prior to joining Cleveland Clinic in 2020, Dr. Vaidya performed in England the world’s first modified multi-organ transplant (excluding the liver) to treat a patient with PMP who had exhausted all other management strategies.

PMP is a rare cancer that typically originates as a tumor in the appendix. When the slow-growing tumor ruptures, its jelly-like content spreads to other digestive organs, with additional tumors developing that impair gastrointestinal function. Malnutrition and life-threatening complications ultimately occur.

Following the diagnosis in 2019, the patient began a long odyssey of treatments. He was one of the 20% of patients with PMP for whom the traditional treatments were ineffective. Often, this population of patients is left with few to no treatment options.

The patient was referred to Cleveland Clinic in 2021 in the end stage of his disease. He was receiving hospice care at that time. The patient had stopped working and could no longer eat solid foods. He was receiving nutrients intravenously through total parenteral nutrition (TPN).

“We needed to perform an evaluation to determine if transplantation in his case was safe, feasible and could provide long-term benefits,” said Dr. Vaidya.

Dr. Vaidya completed a thorough assessment of the patient’s case and received approval from Cleveland Clinic’s Intestinal Transplant Selection Committee to proceed. The patient was placed on the national transplant waiting list in July 2021.

“The patient – who needed a liver and four other digestive organs – had started to deteriorate quite rapidly,” said Dr. Vaidya. “It was touch-and-go that he would make it.”

In September 2021, a donor was found, and less than 24 hours later, the patient was undergoing the groundbreaking

surgery. The first three hours were preparatory, in essence removing the diseased abdominal organs. Next, the donor organs were inserted into the abdominal cavity, all the necessary vascular connections were completed and a left-sided ileostomy was created to handle bodily waste and let the body recover from the surgery.

“The operation was well planned and went like clockwork,” said Dr. Vaidya. “The team members knew exactly what they were going to do, and the timing was perfect. It went really well.”

Following the transplant, the patient remained in the hospital for 51 days.  Soon after he was discharged, he returned because he was suffering from a case of graft-versus-host disease, a common occurrence following intestinal or bone marrow transplants where the donated organs’ immune cells recognize the recipient’s tissues as foreign and attack the recipient.

The patient underwent a procedure perfected and performed by Amy Lightner, M.D., colorectal surgeon and director of Cleveland Clinic’s Center for Regenerative Medicine and Surgery. Dr. Lightner administered three doses of mesenchymal stromal cell (MSC)-derived exosomes, a first ever, novel treatment in solid organ transplants — another first for a patient who received a full multi-organ transplant to treat PMP.

According to Dr. Vaidya, “The patient’s recovery was absolutely amazing. His symptoms abated within two hours of the first dose.”

Nine months post-transplant, the patient, now 33, can eat and digest solid foods again and has energy to do what he loves, including walking and biking outdoors.

“There is currently no evidence of cancer recurrence,” said Dr. Vaidya.

 

Photo Captions: 

Header: Masato Fujiki, MD, (center) and the Cleveland Clinic surgical team, led by Anil Vaidya, MD, performing the first-in-world multi-organ transplant to treat a rare type of appendix cancer. (Photo courtesy of Cleveland Clinic)

1st insert: Anil Vaidya, M.D.

2nd insert: From left: Anil Vaidya, M.D., Shannon Jarancik, physician assistant, Amy Lightner, M.D., Andy Voge, patient, Rachel Voge, Andy’s wife, and Anita Barnoski, transplant coordinator.

Release: Cleveland Clinic / DPA media

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Know the Possible Warning Signs of Prostate Cancer

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September is Prostate Cancer Awareness Month – which means it is time to watch out for the warning signs. Possible signs include slow urine flow and loss of bladder control — but if this common cancer is caught before it spreads, the prognosis is good.

Your prostate is only about the size of a walnut. But this small gland can cause big problems if left unchecked.

Warning signs of prostate cancer

“Most men with prostate cancer don’t have symptoms at first,” says urologist Christopher Weight, MD. But if you notice certain warning signs, like changes in your pee routine or pain, it’s a good idea to visit a urologist.

Prostate cancer is one of the most common cancers in men. But when it’s found early, it’s also one of the most treatable. Knowing the signs and talking with a healthcare provider about screening could save your life.

So, what should you look out for?

Slow or weak urine flow

Trouble starting to pee — called urinary hesitancy — is common as men get older. You may also notice slow flow or dribbling. Or your flow may stop altogether. The most common cause is benign prostatic hyperplasia. Still, if you experience these symptoms, it’s important to get your prostate checked.

Frequent need to urinate

A frequent and sometimes urgent need to urinate, especially at night, may be a sign of nerve damage or an infection. Or it could indicate that a tumor is putting pressure on your bladder and urethra.

Painful or burning urination

Pain or burning when you pee — called dysuria — is usually linked to a urinary tract infection (UTI). But in some cases, it can signal prostate cancer. This is especially true when it’s paired with other symptoms.

Blood in your urine

Another possible warning sign of prostate cancer is hematuria, or blood in your pee. Though this can be associated with other health issues, including a UTI, it’s worth checking out.

Prostate pain

Unexplained prostate pain — especially when sitting — can be an early sign of trouble. “It might also mean an infection, but only your urologist can say for certain,” Dr. Weight says.

Loss of bladder or bowel control

Bladder or bowel incontinence can happen with age or other medical conditions. But if you’re leaking urine or can’t control bowel movements, talk to a doctor to rule out prostate cancer.

Changes in sexual function

These symptoms can stem from many causes, but they may also signal prostate cancer. Talk to a urologist if you notice:

  • Painful ejaculation
  • Decreased volume of ejaculation
  • Inability to keep an erection
  • Blood in your semen (hematospermia)

Sexual health is a vital part of your overall well-being. So, if something feels off, it’s not just OK to speak up — it’s vital.

Later-stage signs

These symptoms often only appear when prostate cancer has spread:

  • Ongoing pain in your lower back, hips or chest
  • Numbness in your legs or feet

“Of course, there are endless other reasons that your back may hurt or that you have tingling in your toes that are entirely separate from any prostate troubles. But they can also be signs of later stages of prostate cancer,” Dr. Weight clarifies.

Importance of prostate cancer screening

“Since early-stage prostate cancer doesn’t cause symptoms, many men don’t know they have it,” Dr. Weight notes. “That’s why regular screening is so important — it helps catch prostate cancer early, when treatment is most effective.”

A healthcare provider may recommend screening if you’re between the ages of 55 and 69, or earlier if you have a family history or other risk factors.

Screening might feel uncomfortable to think about, but skipping it could mean missing a chance to catch prostate cancer early, when it’s easier to treat.

“A simple blood test, often followed by a physical exam if needed, gives your doctor important information about your prostate health,” Dr Weight says.
Early detection doesn’t just improve treatment options — it can also give you peace of mind.

Lower your risk of prostate cancer

“You can’t do anything about some of the risk factors for prostate cancer, like age or family history,” Dr. Weight recognizes. “But you can make lifestyle choices that support a healthier prostate.”

These small steps may make a difference:

  • Get regular prostate screenings.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Eat a nutritious diet.
  • Quit smoking.

“When prostate cancer is diagnosed before it spreads to other parts of the body, about 99% of people live at least five years after diagnosis,” he continues. “But the survival rate is much lower if the cancer has spread.”

That’s why it’s so important to stay proactive. Regular screenings, healthy habits and paying attention to changes in your body can make all the difference. Talk to a provider about the right plan for you.

CREDIT: CLEVELAND CLINIC

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Is It Bad To Sleep in a Bra?

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Head to bed in a bra to reduce breast pain, nipple irritation and stretch marks

 

When you think about sleeping in a bra, “comfort” probably isn’t the first word that comes to mind — it may not even make the Top 10. But is it bad to sleep with a bra on?

Breast surgical oncologist Margaret Thompson, MD, explains the upsides and downsides of wearing a bra while you snooze.

Should you sleep in a bra?

Several factors may affect your decision to wear a bra to bed, but Dr. Thompson emphasizes that the risk of breast cancer should not be one of them.

“There’s no evidence that wearing a bra while sleeping increases your risk for breast cancer,” she states. “It really comes down to comfort and personal preference.”

But there are also other health issues to consider. Dr. Thompson lays out the pros and cons of sleeping in a bra.

Pros: Why sleeping in a bra might be good for you

Should you wear a bra to bed? There are some benefits, especially if you’re recovering from surgery or breastfeeding.

Lessens breast pain

Having the support of a bra day and night may help relieve breast pain (mastalgia). That’s good news, because up to 70% of women in the United States deal with it at some point in their lives.

Common causes include:

  • Hormonal changes, which often occur as part of your menstrual cycle
  • Locally advanced breast cancer, including inflammatory breast cancer
  • Lactation (producing milk), which may cause your breasts to ache
  • Large breasts, which may strain breast ligaments and tissue
  • Recent surgery related to your heart or breasts
  • Underwires, especially if your bras are too tight

“When somebody reports breast pain, one of the first things we ask is whether they wear an underwire bra,” shares Dr. Thompson. “It can dig into your skin or breast tissue, leaving you sore and tender.”

A soft sleep bra can keep your breasts from shifting and causing discomfort while you snooze.

Protects lactating breasts

If you’re breastfeeding, you know all too well that your mammary glands don’t care if you’re trying to rest. Swollen or full breasts can be painful, especially as you move during sleep or change positions. Wearing a clean and supportive bra while sleeping:

  • Holds nursing pads in place
  • Keeps nipples dry and free from bacteria
  • Reduces nipple chafing
  • Supports the structure of your breasts

Make sure your sleep bra is supportive, but not too tight. Wearing a bra that’s too tight while breastfeeding can lower your milk production and possibly lead to clogged milk ducts and mastitis — inflammation of the breast tissue.

Prevents fungal infections

Everyone loves to be warm and cozy in bed. But do you know what else loves a warm environment? Fungus.

“There’s a lot of skin-on-skin contact underneath your breasts, especially if you have larger breasts,” notes Dr. Thompson. “If you’re also covered in blankets and sweating, it becomes a perfect environment for fungal or yeast infections.”

Wearing a bra to bed helps absorb moisture beneath your breasts and reduce friction. A camisole with a built-in shelf bra can also help.

Reduces nipple irritation

Friction is a common reason for nipple pain — ask any avid runner. You may not be running a marathon in your sleep, but your nipples can still get sore from rubbing against:

  • Tight shirts, especially if they’re textured or have a graphic design that can be felt inside the shirt
  • The fabric of your pajama top or sheets
  • A sleep bra that’s too loose

Wearing a sleep bra can limit movement, easing nipple irritation.

Helps with recovery after surgery

It’s important to keep your breasts compressed after certain surgeries involving your chest. Restricting breast movement helps protect stitches and incisions. The added compression can also:

  • Decrease fluid collection
  • Minimize pain
  • Hold gauze and drains in place

“Most cardiac and breast surgeons want you to wear a bra for some time after surgery, even while sleeping,” emphasizes Dr. Thompson. “Always follow their advice.”

Diminishes stretch marks

Stretch marks on breasts are common, especially if your breasts change size during pregnancy. Bras support your skin’s structure, which helps prevent stretch marks.

“There’s no proof that wearing a bra at any time of day will decrease breast sagginess,” Dr. Thompson clarifies. “But it may help decrease stretch marks.”

Cons: Why it’s bad to sleep with a bra on

Looking for a reason to sleep without strapping on a bra? Dr. Thompson points out a few potential disadvantages of sleeping in a bra.

Causes skin irritation and infection

A sleep bra can protect your skin from irritation and infection. But it can also cause those issues if it has an underwire or it’s:

  • Dirty
  • Too tight
  • Too loose

Restricts circulation

“Bras that are too tight or contain underwires may cause you to wake up with some discomfort,” reiterates Dr. Thompson. “They can restrict your circulation while you sleep.”

Nobody wants to wake up to find that their bra left angry red indents in its wake. That’s why selection is key.

Tips for wearing a bra to bed

If you decide to sleep in a bra, choose one that’s comfortable and fits well — not too tight, not too loose. And be sure to replace your bras every six to 12 months, or whenever your breast size changes. Measure yourself or ask the fitter at your lingerie store or undergarments department for help finding the right size.

For the best experience with your sleep bra, Dr. Thompson recommends that you:

  • Choose a gentle fabric. Avoid lace or scratchy fabrics that may be rough on your nipples. Choose a natural material like cotton or something silky and soft.
  • Consider a shelf bra. Some camisoles and tank tops have a built-in shelf bra that may help you feel supported while sleeping.
  • Skip the underwire. Underwire can restrict circulation and cause pain while you sleep.
  • Wear a clean bra. Don’t wear a bra you’ve worn all day, and wash your sleep bras regularly — after every two or three wears.

Bottom line? If you choose to sleep in a bra, you want one that’s supportive and comfortable. If it interferes with your sleep, it’s not the right fit.

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Turks and Caicos Islands Hospital Celebrates Successful Completion of 2026 Summer READY Programme

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Providenciales, Turks and Caicos Islands – August 18, 2026 – Turks and Caicos Islands Hospital is pleased to announce the successful completion of its Summer READY Programme, a two-week internship initiative designed to provide high school students in Forms 3-5 with hands-on exposure to the healthcare environment and an opportunity to explore careers within the sector.

The programme, organised and hosted by the Training and Education Department, welcomed students into various clinical departments, where they gained first-hand insight into the day-to-day operations of a healthcare facility and learned directly from healthcare professionals.

Throughout the two-week internship, students were exposed to different aspects of patient care and clinical operations while developing important workplace competencies, including communication, teamwork, professionalism, punctuality and responsibility. The experience was designed to complement classroom learning while helping students make more informed decisions about their future education and career pathways.

Vernessa Forbes, Training and Education Manager, said the Summer READY Programme reflects the hospital’s commitment to developing young people and creating meaningful opportunities for them to explore the healthcare profession.

“Summer READY is about giving our young people an opportunity to experience healthcare beyond what they may have seen or learned in the classroom. Over the two weeks, our students were able to interact with healthcare professionals, observe different clinical environments and gain a better understanding of the dedication and teamwork required to care for our patients. We were impressed by their enthusiasm, curiosity and willingness to learn, and we hope this experience has inspired them to consider the many rewarding careers available in healthcare.”

By rotating through and gaining exposure to various clinical departments, students were also able to see that healthcare extends beyond the roles most commonly associated with a hospital. The programme introduced them to the range of skills, disciplines and professionals that work together to deliver safe, compassionate and high-quality patient care.

Dr. Denise Braithwaite-Tennant, Chief Executive Officer, said the hospital has an important role to play in building the human capacity needed to support the future development and sustainability of healthcare in the Turks and Caicos Islands.

“As a hospital, our responsibility extends beyond providing healthcare services today; we also have an important role in helping to develop the people who will deliver and lead healthcare tomorrow. Human capacity building is essential to the long-term sustainability of our health system, and programmes such as Summer READY allow us to introduce young people to healthcare careers early, nurture their interests and help them understand the educational and professional pathways available to them.

By opening our clinical environment to students and providing mentorship and practical exposure, we are helping to build a pipeline of future nurses, physicians, allied health professionals and other healthcare workers. We want our young people to see that there is a place for their talents within the health sector and, importantly, that they can build rewarding careers while contributing to the health and development of the Turks and Caicos Islands. We are proud to play our part in investing in the next generation and strengthening our country’s future healthcare workforce.”

The programme concluded with the presentation of certificates of completion to the students, recognizing their successful participation and commitment throughout the two-week internship.

Turks and Caicos Islands Hospital congratulates all of the students who successfully completed the Summer Ready Programme and extends its appreciation to the clinical teams, supervisors and staff members who provided mentorship, guidance and practical learning opportunities throughout the programme.

Through the Summer READY Programme and its wider education, training, internship and professional development initiatives, Turks and Caicos Islands Hospital remains committed to supporting national human capacity development. By partnering with educational institutions, government agencies and other stakeholders, and by providing mentorship and practical learning opportunities within the healthcare environment, the Hospital aims to strengthen the pipeline of skilled healthcare professionals needed to meet the evolving health needs of the Turks and Caicos Islands.

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