News 01 Apr 2021 Back to All News

Back to School for Teacher After Successful Removal of Three-Quarters of His Liver in Rare Cancer Surgery

66-year-old Cleveland Clinic Abu Dhabi patient’s itchy skin signaled gallbladder cancer

​Abu Dhabi schoolteacher Dale Yost didn’t suspect even for a minute that a sudden itch all over his body could be anything more than a simple dermatological issue. The 66-year-old resident thought that the pills and creams prescribed by a dermatologist would solve the problem. But when the itching persisted, he began worrying. 

Additional bloodwork and scans done at the first hospital that he visited when the symptoms began revealed that he was suffering from gallbladder and bile duct cancer. 

“It sounds so strange that an itch can be a sign of cancer,” says Dale. “They could tell by the scans that my bile ducts were plugged and so all the bile was building in my body and causing jaundice and the itchiness. The doctors twice tried to put stents in so that the bile could flow into the small bowel again, with no luck.”

He says they then tried a biliary drain, a procedure where bile is collected in a bag outside of the body. “I had that pouch on me for a couple of weeks before the hospital recommended that I transfer to Cleveland Clinic Abu Dhabi for the complex surgery to remove the cancer.”

Dr Naveed Ahmed, the Hepato-Pancreatico-Biliary surgeon (liver, pancreas, and bile duct) in the Digestive Disease Institute at Cleveland Clinic Abu Dhabi – an integral part of Mubadala Health – who treated Dale with a multidisciplinary team of physicians, dieticians, and wound care nurses in November 2020, says their attempt to clear the blocked bile ducts and relieve the symptoms of jaundice with stents was a success. This approach was necessary to continue his treatment to remove the cancer. 

The team had to carry out a central hepatectomy, where they had to not only remove the bile duct and gallbladder completely, but also had to resect three-quarters of Dale’s liver to cure him.

“About 90 percent of gallbladder cancers are unresectable, so treating Dale with this procedure is quite uncommon. The surgery required a lot of technical capability and a team with expertise in interventional radiology, advanced endoscopy, gastroenterology and wound care.”

Dr. Ahmed explains that the decision to remove such a significant portion of the liver is only done in rare cases. 

“If the tumor is on the periphery, you only need to remove the diseased portion, but for central tumors, we have to remove the healthy part of the liver as well to prevent it from spreading.”

The liver is the only organ in the human body that can regenerate. But Dr. Ahmed says that depends on how much of the liver can be saved. 

“If the remnant is small for the size of the patient, it can be fatal. In Dale’s case, where the cancer had spread outside the liver, a transplant was not an option either. We were lucky that we could preserve a healthy portion, making it possible to save his liver.”

Dale’s liver-related tests show that his liver has grown to a normal size and is functioning at an optimum level. He is now undergoing chemotherapy to treat the cancer in his lymph nodes. 

Dale, who is a father of three and grandfather to 10, plans to retire at the end of the year. He says that his family wanted him to return to his home in Canada earlier for treatment. 

“If this had happened back home, I would have avoided seeing a doctor because of the wait times to get an appointment. The healthcare in Abu Dhabi, and Cleveland Clinic Abu Dhabi in particular, is superior. You just walk in and an integrated team of physicians, surgeons, dieticians and wound care nurses are by your side to aid your recovery.”

For more information or to book an appointment at Cleveland Clinic Abu Dhabi, call 800 222 33, visit www.clevelandclinicabudhabi.ae or download the Cleveland Clinic Abu Dhabi app.

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