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In a standard biopsy, doctors take 12 random tissue samples from throughout the prostate, guided by ultrasound. A newer, more targeted approach uses magnetic resonance imaging (MRI), fused with real-time ultrasound images, to precisely pinpoint areas of suspected cancer that can be biopsied and analyzed. This method increases the chances of identifying aggressive tumors that require immediate treatment and not overtreating slower-growing cancers that may never prove deadly.
"This has really revolutionized the confidence that we have in a diagnosis of prostate cancer, in understanding the true burden of disease that the patient has," says Dr. M. Minhaj Siddiqui, Associate Professor of Surgery at the University of Maryland School of Medicine and Director of Urologic Oncology and Robotic Surgery at the University of Maryland Greenebaum Comprehensive Cancer Center. "If we want to take a more conservative approach, one that is less likely to cause complications, we can do it.
Dr. Siddiqui has co-authored several studies about MRI-targeted prostate biopsy as a collaborating member of a National Cancer Institute (NCI) research team. The latest study, published in the New England Journal of Medicine in March, found that using this newer approach, combined with standard biopsy, is significantly more likely to detect the most aggressive prostate cancers than standard biopsy alone.
With increased confidence in the diagnosis, doctors are able "to offer a wider variety of treatments in a more personalized way to treat the tumor in a less aggressive way or a more aggressive way than we otherwise would have done," Dr. Siddiqui says.
Options include surgery to remove the prostate; focal therapies to treat only the cancer, such as cryoablation (freezing); hormone therapy to thwart cancer growth: and active surveillance to monitor for progression.
More than 200,000 American men are diagnosed with prostate cancer each year. September is National Prostate Cancer Awareness Month.
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Ophthalmologist, engineer team up to make eye exams safer
It is not lost on Roni Levin, MD, Assistant Professor of Ophthalmology & Visual Sciences and Pediatrics at the University of Maryland School of Medicine, that an ophthalmologist working in Wuhan was one of the first victims of SARS-CoV-2, the virus that causes COVID-19.
The coronavirus has not stopped the need for eye exams. As a practicing ophthalmologist at the University of Maryland Medical Center, Dr. Levin continues to see patients with eye emergencies, babies in the neonatal intensive care unit at the University of Maryland Children’s Hospital born prematurely and at risk of eye problems, and patients with retinal disease who need monthly injections to prevent blindness.
At the same time, Dr. Levin sees the need to reduce the risk of infection for both patient and doctor during a microscopic eye exam, as they face each other just inches apart.
Dr. Levin turned to a network of friends and colleagues on social media for ideas and one caught her eye. A college friend she had not seen in 20 years said her husband, an engineer at the Johns Hopkins Applied Physics Laboratory, could help. Blake Schreurs had access to the APL’s Maker Center, filled with a number of tools, including a laser cutter, freely available to employees to make what they want on their own time.
The video shows their solution.
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Swift Response Saves 22-Year-Old Suffering Massive Stroke
UMMC's Comprehensive Stroke Center is one of the nation’s top places to treat the most complex stroke patients and one of the few institutions in the region that offers a mechanical thrombectomy - placing a thin catheter through the groin and into the brain to remove a clot.
Once this procedure is performed, the blood flow through the treated vessel is restored.
This story shows stroke emergency response in action.
At just 22, Jamie was visiting Baltimore when she suffered a massive stroke. She was conscious the entire time, but could not move or talk. She was brought to the University of Maryland Medical Center, where a team led by neurologist Dr. Seemant Chaturvedi and interventional neuroradiologist Dr. Gaurav Jindal performed a thrombectomy.
Amazingly, Jamie regained all movement and speech, and now is back to living her life as though stroke never happened.
- University of Maryland Medical Center Once Again Awarded Advanced Certification for Comprehensive Stroke Center
- University of Maryland Medical Center Receives Stroke Honor Roll Elite Plus Gold Plus Quality Achievement Award
- Stroke Care at UMMC
- About the UMMC Comprehensive Stroke Center
CAR-T Cell Therapy
For some cancer patients who have failed to respond to other therapies, treatment with their own genetically modified immune cells can mean the difference between life and death.
Says Chip Baldwin, whose cancer is now in remission, “I don’t think I would be here today if it wasn’t for CAR T.”
Diagnosed with an aggressive blood cancer that was growing into a major blood vessel in his chest, Mr. Baldwin was running out of treatment options when he was referred to the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), a regional leader in CAR T-cell therapy.
In this video, he talks about his cancer journey and life after receiving this FDA-approved immunotherapy in April 2018.
His oncologist, Dr. Aaron Rapoport, director of UMGCCC’s Blood and Marrow Transplant Program, calls CAR T-cell therapy “one of the most exciting new developments in cancer therapy.” He talks about UMGCCC’s robust clinical and research program and the promise of using CAR T-cell therapy to treat more types of cancer.
- Package without CGs
- UMGCCC Expands CAR T-Cell Treatment Options | Press Release
Targeted radiation treatment is delivered in less treatments and spares radiation exposure to other organs including the heart and lungs.
The University of Maryland Medical Center Downtown Campus in Baltimore is the first place in the country to offer this innovative new treatment.
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MRI-Guided Focused Ultrasound
With the potential to transform the treatment of many medical disorders by using ultrasonic energy to target tissue deep in the body without incisions or radiation, focused ultrasound is an early-stage, non-invasive therapeutic technology offering new hope to patients.
University of Maryland Medical Center physician scientists are pioneering the use of MRI-guided focused ultrasound to become a new standard of care for treating many common and devastating brain diseases including Parkinson's, essential tremor, neuropathic pain and glioblastoma, an often deadly type of brain cancer.
- Focused Ultrasound to Treat Parkinson's Disease | Press Release
- Focused Ultrasound to Open Blood-Brain Barrier | Press Release
- Man Finds Golf Swing After Essential Tremor Treatment | Patient Story
- ExAblate Transcranial MR Guided Focused Ultrasound for the Treatment of Parkinson's Disease
- Second clinical trial to test the safety and efficacy of using MRI-guided focused ultrasound on the brain in order to treat Parkinson's disease
- Clinical trial for glioblastoma which uses MRI-guided focused ultrasound
The Spirit of Thanksgiving: When a transplant surgeon’s medicine becomes personal
As the 11-year-old girl entered the operating room to get a kidney transplant, she declared she’d be a transplant surgeon when she grew up.
The transplant was a success, the girl actualized her dream, and today UMMC transplant surgeon Silke V. Niederhaus, MD, assistant professor of surgery at the University of Maryland School of Medicine, shares her firsthand perspective to help patients navigate the organ transplant process.
Two themes describe her approach to patient care:
- Thankfulness for all those who have donated organs
- Advocacy for living organ donation
Those themes came together recently, when her transplanted kidney began to fail after lasting a long time, 30 years. In late 2018, she began looking for a living organ donor, doing what she tells her patients to do – ask family, friends, even strangers to become an organ donor.
In this video, Dr. Niederhaus describes the steps she went through to find a living donor and her thankfulness for the donor whose kidney she received through a paired kidney exchange. The experience has also given Dr. Niederhaus a new appreciation of the difficult challenges thousands of people endure as they wait for an organ transplant. What she learned could provide new hope for her patients.
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University of Maryland Medical Center and City partner to establish the future of healthcare in Baltimore by bringing healthcare to home
First year sees decrease in re-admissions to ED and EMS utilization, improved patient health
An innovative community-based program to support the health of individuals in Baltimore City launched last year and is making a big impact on patient health and the healthcare system. Through a comprehensive, free, multidisciplinary care model for patients which provides care outside the hospital setting, and which is designed to reduce health disparities, decrease emergency department visits, and prevent hospital re-admissions, Mobile Integrated Health – Community Paramedicine has resulted in reduced emergency department visits, reduced readmission to the hospital and improved community health.
The University of Maryland Medical Center, the City of Baltimore and Baltimore City Fire Department, and the University of Maryland, Baltimore partnered to launch the new healthcare delivery model for selected areas of Baltimore City in an effort to advance patient centered care in the community and to incorporate a holistic approach focused on the improvement of patient outcomes. The goal is to meet the health care needs of our community members and to improve health disparities. It is a community-based, cost-effective and designed to provide effective and efficient care to patients outside of the hospital. Social and economic factors, weaknesses in primary care infrastructure, and lack of access to treatment for chronic conditions contribute to a high rate of potentially avoidable health care utilization and emergency medical service (EMS) responses in West Baltimore led to the program’s implementation.
At the inception of the program, more than 80% of Baltimore City Fire Department (BCFD) 911 responses are for EMS incidents, presenting a significant strain to the system. And, it is estimated nationally that 15% of persons transported to emergency rooms could be treated safely in non-urgent settings. Today, readmission rates are down, ED visits are down, and the health of those enrolled in the program is improved.