MedStar Health Blog

Patients with Advanced Liver Cancer Among Those Benefitting

Dr. Moin is one of the few specialists in the region performing Y-90 radioembolization.

Advances in medicine have created a wide range of new treatment options for a variety of conditions in recent years. Leading the way in the development of many of these groundbreaking tools, technologies, and techniques have been interventional radiologists.

“Interventional radiology (IR) is a specialty that gives us the ability to treat nearly every organ in the body with minimally invasive, targeted approaches,” explains Adnaan Moin, MD, a vascular and interventional radiologist at MedStar Harbor Hospital. “By harnessing the power of advanced imaging, we can see inside the body and treat complex conditions less invasively and with unprecedented precision. As a result, IR can reduce the length of hospital stays, minimize potential complications and save lives.”

At MedStar Harbor, Dr. Moin is now collaborating with medical and surgical oncologists throughout MedStar Health in the use of image-guided technology to treat cancer. “Interventional oncology is a growing field offering new minimally invasive treatment options for a variety of primary and metastatic solid tumors,” Dr. Moin says.

Today, the Interventional Oncology program at MedStar Harbor is one of the few in the region to offer patients with liver cancer a treatment option called Y-90 radioembolization, an alternative to surgery.

“The surgical removal of liver tumors offers the best chance for a cure but they are often inoperable because they are too large or have grown into major blood vessels or other vital structures,” Dr. Moin explains. “Sometimes, many small tumors are spread throughout the liver, making surgery too risky or impractical.”

Y-90 radioembolization, an outpatient procedure, combines the use of radiation therapy with a process called embolization in which blood vessels are blocked off to prevent blood flow. A catheter is inserted through a tiny incision in the femoral or radial artery until it reaches the hepatic artery, one of two blood vessels feeding the liver.

When the catheter is in place, millions of microscopic beads containing the radioactive isotope Yttrium-90 are released. The microspheres lodge in the smaller vessels that directly feed the tumor, stopping blood flow and emitting radiation to kill the tumor cells. The painless procedure is usually completed within an hour and the side effects are mostly limited to fatigue and loss of appetite.

“The liver is an ideal organ for this type of treatment since the hepatic artery is the one that most commonly supplies blood to the cancerous tumors,” says Dr. Moin. “While the procedure doesn’t cure the cancer, it can help extend the lives of patients with inoperable tumors and improve their quality of life.” He also points out that in some cases it may reduce the size of the tumor enough for it to be resected or for the patient to be evaluated for a liver transplant.

“A big benefit of this procedure and other interventional oncology treatments, such as chemoembolization and radiofrequency ablation, is that we can target the cancer tumor from inside the body,” Dr. Moin adds. “Interventional oncology gives clinicians another focused area of cancer care in which to collaborate.”

Millions of people get a flu vaccine in the fall as recommended by the Centers for Disease Control and Prevention (CDC), the American Medical Association and other professional medical groups. But many people don’t, believing it doesn’t work or will make them sick.

If you’re thinking about skipping a flu shot this season, MedStar Harbor Primary Care Nurse Practitioner Anta Kah, MSN, CRNP, encourages you to reconsider. Below are five reasons to get the flu shot.

1. Not only can the flu vaccine keep you from getting the flu, it may make your illness milder if you do get sick.

2. Getting vaccinated benefits everyone around you. “The flu virus spreads easily— you can contract it when an infected person coughs, talks, or sneezes. You can also get the flu by touching something that has the virus germs on it, then touching your eyes, nose, or mouth,” notes Kah.

3. Some people are at greater risk of getting seriously ill from the flu, like pregnant women, older adults, and people with chronic health conditions. If you fall into one of these categories, the vaccine can help protect you. “Flu symptoms can lead to dehydration, the worsening of chronic illnesses, bacterial pneumonia, ear or sinus infections, and in severe cases, death,” says Kah. “Every year, about 200,000 people are hospitalized because of the flu.”

4. The flu shot is safe and it can’t give you the flu. The flu vaccine is formulated from dead or inactive viruses, so it can’t make you sick. If you do get sick, chances are you were exposed to the virus before getting the shot or you picked up a virus not included in the vaccine.

5. Last year’s vaccination won’t protect you this year. “The flu is a virus that changes from year to year,” Kah explains. “The vaccine is reformulated annually to protect against strains of the virus predicted by the CDC to be most widespread.”

Children 6 months or older and most adults should get vaccinated against the flu annually. Flu season usually starts in October and can last until May, so it is important to get vaccinated early. “Getting the shot is the single best way for nearly everyone to prevent the flu,” says Kah.

Dr. Kankam chats with a patient during a consultation.

It’s normal - even expected - to experience days where you feel down, unmotivated, and just not exactly like yourself. When this happens, sometimes a quick walk around the park, giving yourself a 15-minute “time out” to regroup and reset, or connecting with a friend for coffee or tea, is all it takes to get back on track.

But what do you do when the “quick fixes” that typically help don’t seem to be working? What happens when a few “down days” here and there become more of the norm and you struggle to get through the day, feeling unmotivated, insecure, and indifferent? You start to wonder if what you are experiencing is how people with depression feel. And then it hits you. It’s possible that you are one of those people. Maybe you might actually be depressed.

Fall is a time of year that impacts many people emotionally. Some struggle with the end of summertime and the shorter periods of daylight that come with the season. These changes can alter your mood, slow your thoughts down, and impact your ability to concentrate or focus. Throw in the fact that the holiday season is quickly approaching, and it’s easy to see why so many people need treatment for seasonal depression this time of year.

“Seasonal affective disorder, more commonly called seasonal depression, is a type of clinical depression—a medical illness that causes persistent changes in the way we feel and think, and can negatively impact our ability to function,” says Jemima Kankam, MD, FAPA, a board-certified psychiatrist at MedStar Harbor Hospital. “A person who is depressed feels like they have been painted over by a dark cloud. Often, this person lacks hope, energy, and focus, and feels like they are to blame for everything negative that happens around them.”

Research indicates that across the U.S., nearly 10 million people suffer from some level of seasonal depression. Those with a family history of the illness are at a higher risk. Professionals like Dr. Kankam are trained to provide care and treatment for patients of all ages who seek help and are ultimately diagnosed with clinical depression.

“There is so much we can do to help people who are facing these types of challenges,” says Dr. Kankam. “Sometimes we prescribe medication and usually counseling. Other times we consider lifestyle adjustments that can be made. Good nutrition, living an active lifestyle, getting proper sleep, and keeping stress minimized can make a big difference.”

Especially during times of seasonal change, Dr. Kankam encourages people to educate themselves on the signs and symptoms associated with depression, and contact a physician for help if mood changes become persistent or begin impacting relationships or activities of normal, daily living.

“A lot of people delay seeking treatment because they misinterpret what they are feeling and assume it’s stress-related and that it will eventually subside,” adds Dr. Kankam. “When the negative feelings and thoughts don’t seem to go away, it could be a sign that there is a bigger problem present. Don’t ignore the signs. You don’t have to suffer with this illness. There are proven treatments available that can offer the relief you need and deserve.”

MedStar Harbor has earned a reputation as a premier provider of behavioral health services, with a team of psychiatrists, psychologists, nurse practitioners, psychiatric nurses, case managers, social workers, and clinical counselors on staff to help patients who face clinical depression, emotional challenges, and other behavioral health conditions. The hospital also has several new, state-of-the-art clinical spaces for patients seeking care on an outpatient basis, as well as a dedicated inpatient Behavioral Health Unit.

Dr. Bitar, medical director of MedStar Harbor Women's Care, and Dr. Ghadisha, OB hospitalist and chairman of the Department of Obstetrics and Gynecology at MedStar Harbor, discuss a recent delivery.

Nearly every pregnant woman hopes that the obstetrician she saw during her pregnancy will be the one to deliver her baby when the big day comes. And in some cases, that’s exactly what happens. Mom-to-be goes to the hospital when the time is right, and her physician is there to bring her new bundle of joy into the world.

Sometimes, however, the obstetrician that mom-to-be selected, and saw for care throughout her pregnancy, simply cannot be there. Maybe the physician is out of town. Perhaps he or she is seeing patients in an office, or is at the hospital but has three other patients delivering babies at the exact same time. Or it might be that the mom goes into labor in the middle of the night, and progresses so quickly that the baby is born before the physician can even get to the hospital.

The good news is that MedStar Harbor Hospital has taken steps to ensure that every new mom receives the expert care she needs when delivery time comes, even when one of these unpredictable situations occurs.

Five full-time OB hospitalists— board-certified Ob/Gyns who are dedicated to the hospital and the patients who arrive to deliver their babies— are on staff. Scheduled on rotations around-the-clock, these hospitalists work with the woman’s personal obstetrician, stepping in to provide the skills, care and support a new mom needs when her regular physician is unavailable.

According to David Ghadisha, MD, OB hospitalist and chairman of the Department of Obstetrics and Gynecology at MedStar Harbor, it’s a model that promises each woman continuum of care, regardless of when her baby is born.

“When a woman is in labor and preparing for the birth of her baby, every minute counts. Delivery is not a riskfree event,” says Dr. Ghadisha. “It’s important that a hospital have physicians and nurses on board with the right skills ready to respond immediately for deliveries that are routine in nature as well as the more complicated ones. MedStar Harbor has that. It creates a safer process and a better patient experience.”

Having a team of OB hospitalists on board carries great benefits for patients and physicians alike. Obstetricians who are part of MedStar Harbor’s medical staff collaborate with the hospitalists and highly skilled nurses to remain “in the loop” during and after their patients are in delivery without disrupting their daily office schedules. They can remain focused on patient appointments that are scheduled, knowing that patients who have been admitted to the hospital are in good hands.

“I always tell my patients that I will make every effort to be at the hospital for the delivery, but if I can’t be there, physicians and nurses that I know and have a strong relationship with will be ready to take care of them,” says Wael Bitar, MD, medical director of MedStar Harbor Women’s Care. “I trust the team that works day in and day out on the unit and because of that, I can stay focused each day on my tasks at hand, and give every single patient the time and attention she deserves throughout her pregnancy.”

Additionally, the OB hospitalists are a resource for pregnant women who are seen in the MedStar Harbor Emergency department (ED), or admitted to the hospital for treatment of other medical issues not related to their pregnancy. Dr. Ghadisha explains that it is ideal for a trained obstetrician to be involved whenever a pregnant patient presents in the hospital in need of treatment.

“Our goal is always to provide a safe and comfortable environment of care for our patients,” says Dr. Ghadisha. “If a pregnant woman comes into the ED with a broken bone or has cut her hand and can’t get the bleeding under control, for example, the OB hospitalist is there to help make decisions about the treatment plan. Again, it all goes back to safety and doing everything we can to give each patient a great experience and outcome.”

When you get a cold or the flu, you want to get better as soon as possible. Many people, at the first sign of illness, call their primary care physician looking for an antibiotic. But antibiotics don’t work for every illness and may do more harm than good.

“A lot of people think that no matter what their symptoms are, antibiotics will speed up the recovery process,” explains Primary Care Physician Robert Dart Jr., MD. “Antibiotics truly are wonder drugs, but they are only helpful if you have an infection caused by bacteria. Common health problems, such as colds and the flu, are caused by viruses. Antibiotics don’t work against viruses. While taking an antibiotic may make you feel like you’re doing something to get better, it’s not helping at all.”

In fact, taking antibiotics may make you feel worse. Like every other drug, antibiotics can have bad side effects, including severe diarrhea and serious allergic reactions.

Up to one-half of antibiotic use in humans is inappropriate, according to the Centers for Disease Control and Prevention (CDC). Each year in the United States, 47 million unnecessary antibiotic prescriptions are written, which has led to another serious problem: drug-resistant bacteria.

“About 23,000 children and adults in the U.S. die each year from drug-resistant infections,” Dr. Dart notes. “Because of excessive exposure to antibiotics, some bacteria have changed enough that antibiotics no longer work against them. So, as part of a nationwide effort to reduce the number of serious infections due to drug-resistant bacteria, many healthcare providers are prescribing antibiotics less frequently.”

If you feel miserable, it’s still wise to see your primary care physician. Just because your healthcare professional doesn’t give you an antibiotic doesn’t mean you aren’t sick. “We have other ways to help you feel better,” says Dr. Dart. “My job is to help patients understand when to allow the body to heal itself and when an antibiotic is truly needed. I always tell my patients, ‘it takes seven days to cure a cold without antibiotics. With antibiotics, it takes a week.’”

Reena Ardeshna, MD

The newest physician to join the Behavioral Health team, Dr. Ardeshna has a wide range of experience in treating various anxiety disorders, bipolar disorder, depression, schizophrenia, and other psychotic and substance use disorders. Dr. Ardeshna received her training in psychiatry at Johns Hopkins University School of Medicine in Baltimore and earned her medical degree at Drexel University College of Medicine in Philadelphia, Pennsylvania. She holds a bachelor’s degree in psychology from New York University, New York, and a master’s degree in biomedical science from the University of Medicine and Dentistry of New Jersey, Newark.

Mohammed Jawed, MD

Dr. Jawed, a vascular and interventional radiologist, is certified by the American Board of Radiology with a specialty certification in vascular and interventional radiology. Dr. Jawed completed his residency in radiology and imaging at Liaquat National Hospital in Karachi, Pakistan. He continued his training with a fellowship in vascular and interventional radiology at Emory University Hospital in Atlanta, Georgia; a fellowship in pediatric vascular and interventional radiology at Emory University Hospital/Children’s Healthcare of Atlanta; as well as a fellowship in neuroradiology at SUNY Upstate Medical University Hospital in Syracuse, New York. Dr. Jawed has been an active member of the Society of Interventional Radiology for a decade. He has authored more than 25 scientific presentations and peerreviewed publications and holds academic appointments as associate professor of Radiology, Department of Vascular and Interventional Radiology, at SUNY Upstate Medical University Hospital and Golisano Children’s Hospital in New York as well as senior instructor, Department of Radiology and Imaging at Liaquat National Hospital in Karachi, Pakistan.