Mayo Clinic Health Matters (Mayo Clinic)

It’s being called the "Quarantine 15" online — people poking fun at gaining weight while staying at home during the COVID-19 pandemic. Is it really a problem? Or does eating help cope with stress? And what about for kids? Public health researchers warn that COVID-19 related school closures will double out-of-school time this year, raising concerns about weight gain associated with summer recess for children.

On the Mayo Clinic Q&A podcast, Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program, discusses tips for healthy eating and exercising while staying at home.

Precision medicine aims to customize health care by tailoring medications and treatments to each patient. An important step in being able to personalize treatments is diagnostic testing.

Mayo Clinic BioPharma Diagnostics collaborates with biopharmaceutical, diagnostic, and other biotech companies to enable precision medicine through advanced diagnostics. Diagnostic testing can help find the right answers for each individual patient.

"A laboratory test can either help in making a diagnosis for a disease, or it can help guide the clinician to the right diagnosis or to the right treatment," explains Dr. Alicia Algeciras-Schimnich, medical director of BioPharma Diagnostics.

Accurate and rapid diagnostic testing has many benefits, says Dr. Algeciras-Schimnich.

"The faster we reach the right diagnosis for a patient, the faster we get to the right treatment. It not only improves their outcome, but it has been shown that the overall cost of health care is also reduced by providing the right answers faster."

On the Mayo Clinic Q&A podcast, Dr. Algeciras-Schimnich discusses diagnostic testing, precision medicine and what it means for patients.

Colorectal cancer is a term that includes colon and rectal cancers, both of which originate in the lower portion of the large intestine and into the rectum.

"The vast majority of the time, we don't know exactly what causes any specific cancer," says Dr. Jeremy Jones, a Mayo Clinic oncologist. "But there are a number of factors that can increase the risk of developing colon or rectal cancer."

Dr. Jones says one risk factor is increasing age. However, he adds that over the last 30 years younger patients have seen a 50% increased risk of developing colon and rectal cancers.

In this Mayo Clinic Q&A podcast, Dr. Jones talks about risk factors, symptoms, treatment, health care disparities and the latest in colorectal cancer research.

Mayo Clinic performed its first bone marrow transplant in 1963 and today hundreds of people receive blood and marrow transplants every year at Mayo Clinic in Arizona, Florida and Minnesota. Recently, Mayo Clinic in Rochester, Minnesota celebrated its 10,000th blood and marrow transplant.

Bone marrow transplant is used to treat blood cancers and related disorders by infusing healthy blood-forming stem cells into your body to replace unhealthy bone marrow. A bone marrow transplant is also called a stem cell transplant. Bone marrow transplants may use cells from your own body, called autologous transplant, or from a donor, known as allogeneic transplant. 

Autologous stem cell transplants are typically used in people who are producing enough bone marrow but need to undergo high doses of chemotherapy and radiation to cure their disease. These treatments are likely to damage the bone marrow. Prior to treatment, healthy bone marrow cells are collected, frozen and stored for later use. After treatment, the stem cells are infused back into the patient to repopulate the bone marrow.

Allogeneic bone marrow transplant is used when there is underlying bone marrow failure syndrome or for certain types of bone cancers and blood cancers. In those cases, donor bone marrow is needed to replace the diseased bone marrow.

One common complication of allogenic transplant is developing graft versus host disease. This condition occurs when the donor stem cells see the body's tissues and organs as something foreign and attack them. Researchers have now discovered metabolic markers that can predict a person's risk for developing severe graft versus host disease, allowing for a more personalized treatment approach.

"Graft versus host disease occurs in patients that have had an allogeneic transplant from a donor," explains Dr. William Hogan, director of the Mayo Clinic Blood and Bone Marrow Transplant Program in Minnesota. "And this is where the donor immune system doesn't just recognize the leukemia that we're trying to treat — which is what we want — but it also attacks the patient's normal tissues. This can be anything from a relatively mild to a very devastating problem that can occur after transplant. And one of the challenges was that, by the time that has been fully developed, then it's harder to treat. So one of the goals of research in the last few years has been to develop markers that will tell us which patients are at risk of having the most severe graft versus host disease, and allowing us to target more effective treatment toward those patients."

Other recent advances in blood and bone marrow transplant include the use of mismatched donors and the ability to use bone marrow transplant in older, more frail patients thanks to improvements in antibiotics, antifungal drugs and other medications.

Another cellular therapy that is helping treat blood disorders and cancers is chimeric antigen receptor-T cell (CAR-T) therapy. CAR-T involves taking the T cells from a person and reengineering them to recognize and destroy cancer cells.

"CAR-T therapy is a very interesting therapy," says Dr. Hogan. "It's really come to fruition in the last five to 10 years. This is similar to bone marrow transplant, but not quite the same. It's a cellular-based therapy, so not a drug, but using cells that are modified in order to try and treat leukemias and other cancers. And basically, what it does is it takes our native immune system — and then the T cells specifically — and modifies them so that they are much more effective at recognizing targets that are on leukemia cells or other malignant cells. And that really kind of allows us to use the native immune system in a much more effective way of trying to kill leukemias." 

Dr. Hogan says CAR-T therapy also is being developed for noncancerous conditions, like aplastic anemia, and research is looking at CAR-T as a treatment for a particular form of inflammatory multiple sclerosis. 

"Things have really been transformed over the last five to 10 years with the advent of CAR-T therapy which has been groundbreaking," says Dr. Hogan. "The field of blood and bone marrow transplant continues to move forward, creating more effective treatments with less toxicity for many patients." 

On the Mayo Clinic Q&A podcast, Dr. Hogan discusses advances in bone marrow transplant and cellular therapy, including CAR-T.

The Somos Latinos Mayo Employee Resource Group (MERG) was created in 2016 to promote, educate and celebrate the cultural heritage of Hispanic and Latino staff members and improve the patient experience. 

While the Somos Latinos MERG is based at Mayo Clinic in Rochester, Minnesota, Hispanic and Latino MERGs also are active elsewhere across Mayo.

"Resource groups are the response to promoting inclusivity as well as championing a team-based approach for all staff," explains Carlos Rodriguez Jr., a senior strategist at Mayo Clinic and chair of the Somos Latinos MERG. "Essentially, our task is simple: to create a community that people feel a part of. And that's what we work to achieve every day."

The work of MERGs supports several initiatives underway at Mayo Clinic to improve the experience for Hispanic and Latino patients. For example, Mayo is using in-person interpreters when possible, as well as video and phone interpretation, and making patient education materials available in Spanish. Another support option for patients is the Spanish-speaking patient coordinator program. 

"The patient coordinator programs are meant to have an individual whose job it is to help the patient navigate the health care system," says Dr. Enid Rivera-Chiauzzi, a Mayo Clinic OB-GYN and physician chair of the Somos Latinos MERG. "It's really complicated to figure out where you're supposed to be for an appointment, where you're supposed to park, who you were supposed to call, and really understanding what happened during your visit. And even if you are proficient in English and Spanish, it's just the culture. Maybe where you grew up is different than here. So the person who is matched with you is a bilingual individual who can help you navigate the health care world." 

Mayo Clinic also offers support to patients from Latin America who seek care. Representative offices in several countries — Colombia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama and Peru — are staffed by people who speak the local language, and can answer questions, help request appointments and make travel arrangements. 

"If you think about a patient representative on the ground in a given country, it really affords the patient the opportunity to connect with Mayo Clinic and start the process before they get to us," explains Rodriguez. "One of the differentiating propositions of Mayo Clinic is the integrated approach. The overall health care system is difficult to navigate, particularly when you're not familiar with the environment. So starting that conversation and engagement early is key to making the long-term relationship with Mayo Clinic a positive one."

Closer to home, work is underway at Mayo Clinic to build a Latino mentorship program for clinical staff that will ultimately benefit patients.

"We want to create a community of physicians and health care professionals who have been supported along their journey by other Latino and Latina health care professionals, therefore increasing our numbers," explains Dr. Rivera-Chiauzzi. "Our aim is to have more of us in these positions, which will help our patients see more people who look like them, or at least be as equally represented as they are in the community in general. That doesn't mean, 'Oh, I can only see a doctor that looks exactly like me and is exactly like me.' But we want to be in an environment where we can see all kinds of people and then whatever excellent person takes care of me, I feel like 'Oh, this person welcomes me.' That's important." 

To celebrate Hispanic Heritage Month, which takes place Sept. 15-Oct. 15, Dr. Rivera-Chiauzzi and Rodriguez join the Mayo Clinic Q&A podcast to discuss Mayo Clinic's efforts to support Hispanic and Latino patients and staff.

The thyroid gland creates and produces hormones that play a role in many systems throughout the body. When your thyroid makes too much or too little of these important hormones, it’s called a thyroid disease.

And thyroid disease is common.

"We know that about 10% of people have some degree of thyroid dysfunction," says Dr. Juan Brito Campana, a Mayo Clinic endocrinologist.

There are several different types of thyroid disease, including hyperthyroidism, or overactive thyroid; hypothyroidism or under active thyroid; and Hashimoto’s disease, where the immune system attacks the thyroid gland. Hypothyroidism is the most common thyroid disease. Treatment for hypothyroidism involves daily use of levothyroxine, a synthetic thyroid hormone that restores adequate hormone levels.

Levothyroxine is one of the most common prescription drugs in the U.S., but a new study by Mayo Clinic researchers suggests it is significantly overused in people with mild hypothyroidism or no apparent thyroid dysfunction. These results were published in JAMA Internal Medicine.

On the Mayo Clinic Q&A podcast, Dr. Brito Campana discusses diagnosis and treatment for thyroid disease, and what the research on the overuse of levothyroxine means for patients.

With a goal of shortening the wait time for a solid organ transplant, Mayo Clinic is leading efforts to expand the donor pool by making more organs suitable for transplantation. 

Organs from deceased donors are screened thoroughly, and donated organs that tested positive for hepatitis C were previously discarded. But research at Mayo Clinic has changed that. 

A recent Mayo Clinic study found that livers from donors exposed to hepatitis C can be safely used for transplant, thanks to improved treatments for hepatitis C infection. New antiviral drugs are so effective that recipients are protected from the infection.

Now, Mayo Clinic Transplant Center has expanded the protocol to use in other organ transplants.

"We were able to expand to kidney transplant, heart transplant and lung transplant within the past few years, and we have been able to do close to 150 kidney transplants, and 25 heart and lung transplants, using organs from donors with hepatitis C," explains Dr. Bashar Aqel, medical director of the Liver Transplant Program at Mayo Clinic in Arizona. "We had in place a treatment protocol and we treat them for hepatitis C immediately after transplant. Treatment was well tolerated, and everybody was cured from the infection. So more than 200 lives saved with organ transplant from donors with hepatitis C, and everybody has achieved the outcome that we are looking for."

On the Mayo Clinic Q&A podcast, Dr. Aqel discusses progress in expanding the donor pool for lifesaving solid organ transplants.

Integrative medicine uses an approach to health care that includes practices not traditionally part of conventional medicine, such as herbs, acupuncture, massage, yoga and meditation. Integrative oncology incorporates these therapies into conventional cancer care.

Integrative oncology helps people with cancer feel better by reducing the fatigue, nausea, pain and anxiety and other symptoms that come with cancer and cancer treatment.

"Integrative oncology is a practice where we are using lifestyle medicine," explains Dr. Stacy D'Andre, a Mayo Clinic medical and integrative oncologist. "We combine all of these modalities to help our cancer patients, not only with the quality of life, but also to hopefully improve outcomes as well."

Focus on diet, exercise and sleep are important parts of integrative medicine, and can help patients during each stage of their journey. This includes managing symptoms and treatment side effects. 

"The great thing about this type of practice is that it really empowers the patient, and patients become very active in their care," says Dr. D'Andre. "And because they're the ones doing the work — they're working on their die and they're doing the exercise — we're just guiding them. These are things that they can do and they can control to improve their health and outcomes."

On the Mayo Clinic Q&A podcast, Dr. D'Andre explains how integrative oncology helps people with cancer and discusses integrative medicine research underway at Mayo Clinic.

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling pollen or catching a cold or other respiratory infection. Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, unmanaged asthma can cause dangerous asthma attacks.

Childhood asthma isn't a different disease from asthma in adults, but children face unique challenges. The condition is a leading cause of emergency department visits, hospitalizations and missed school days.

The right treatment can keep symptoms under control and prevent damage to growing lungs.

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke a Mayo Clinic pediatrician and host of "Ask the Mayo Mom" is joined by Dr. Manuel Arteta, a Mayo Clinic pediatric pulmonologist, to discuss managing asthma in children.

Health care workers across the country have been on the front lines fighting the coronavirus for more than six months. COVID-19 has presented extraordinary challenges in treating patients and helping families cope, and those challenges are taking a toll on the health care workers themselves.

On the Mayo Clinic Q&A podcast, Dr. Ayan Sen, chair of Critical Care Medicine at Mayo Clinic in Arizona, shares his experiences managing patients and supporting staff during the pandemic.

It has been a remarkable year of discoveries and medical advances at Mayo Clinic's Center for Individualized Medicine. Some innovations include personalized treatments for cancer and rare diseases, and the development of lifesaving artificial intelligence algorithms. All of the center’s efforts are driven by advanced genetic analysis and aimed at providing patients with answers, treatment options and optimism. On the Mayo Clinic Q&A podcast, Dr. John Kalantari discusses artificial general intelligence. Dr. Kalantari is an associate consultant in the Department of Surgery, and a faculty member in the Mayo Clinic Center for Individualized Medicine Microbiome Program. He has a joint appointment in the department of Health Sciences Research. His research focuses on artificial general intelligence and the development of AI algorithms for predictive analytics, clinical decision-making and causal inference for preventive medicine.

More Americans are now eligible for COVID-19 booster doses as the Centers for Disease Control and Prevention approved the Pfizer vaccine booster for 16- and 17-year-olds late last week. Previously, only those 18 and older were eligible.

Early research suggests that a booster dose of the Pfizer COVID-19 vaccine improves protection against severe disease caused by the omicron variant, according to Pfizer.

Mayo Clinic experts say, regardless of the variant, prevention of infection works. Getting a booster offers the highest protection possible against COVID-19.

"Omicron infection rates are picking up rapidly," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "If we do not take the proper precaution over the holiday, we are going to see a January omicron surge."

Dr. Poland explains that there are two threats — delta and omicron COVID-19 variants — but there is a solution. "Masking and boosting — those are key to protecting yourself and your family."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest on COVID-19 variants and shares advice on how to stay safe this holiday season.

Research disclosures for Dr. Gregory Poland.

Long-term care facilities are taking steps to prepare and respond to the COVID-19 (coronavirus) pandemic. With guidance from the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services, long-term care facilities are restricting visitors in most cases.

The Mayo Clinic Q&A podcast features Dr. Brandon Verdoorn, a Mayo Clinic geriatrician. Dr. Verdoorn is also medical director of Charter House, a continuing care retirement community in Rochester, Minnesota, that is affiliated with Mayo Clinic. Dr. Verdoorn explains how staff are taking steps to keep residents safe and prevent the spread of the coronavirus.

The COVID-19 pandemic has revealed how quickly life can change. That's evident in people's personal lives and across the scientific community. Remarkable advances have been made in science over the past year, guided by international research collaborations.

"When you look at nine months from when we first identified this pathogen to having a vaccine, that's as close to a human miracle, if I could use that term, as as one could expect," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.

But he says there have been some frustrations. "As soon as we make some progress, everybody wants to open up and relax restrictions," says Dr. Poland. "Opening up and getting back to normal is not a light switch."

In this Mayo Clinic Q&A podcast, Dr. Poland talks about lessons learned during the COVID-19 pandemic, and that vaccinations aren't enough to beat the COVID-19 virus and variants. He also says that communicating science and public health messaging needs to improve in the future.
Research disclosures for Dr. Gregory Poland.

Arthroplasty is a surgical procedure to restore the function of a joint by replacing disease and damaged parts. However, everyone is not made the same way. When it comes to complex shoulder and elbow surgeries, 3D anatomical modeling can be used to help a surgeon plan the surgery for better outcomes.

On the Mayo Clinic Q&A podcast, Dr. Mark Morrey, an orthopedic surgeon at Mayo Clinic, discusses common elbow and shoulder problems, and treatment options, including surgery.

Three respiratory viruses — COVID-19, influenza and respiratory syncytial virus, or RSV — are currently circulating in the U.S., and experts worry that holiday travel and gatherings could fuel their spread and further increase the number of cases.

Recently, the Centers for Disease Control and Prevention (CDC) issued a health alert about the fall season increase in cases of influenza and RSV infection, primarily affecting young children.

To help protect against severe disease and hospitalization, the CDC recommends vaccinations against influenza and COVID-19 for all eligible people 6 months or older. 

While not yet available, there is good news on the vaccine front for fighting RSV, too.

"A number of vaccine manufacturers have developed vaccines, including a couple of them through phase three trials," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "Very likely, certainly before this time next year, I think we'll have a licensed RSV vaccine for adults, and then they'll move clinical trials down to kids. So we're definitely making progress there."

In addition to available vaccines, the toolkit for stopping the spread of viruses is familiar now after two years of battling COVID-19. The most basic protection measure, masking, is still effective, but many have grown tired of using it.

"Most people now are not wearing a mask, they're embarrassed to wear a mask, they're fatigued of it," explains Dr. Poland. "Over these holiday wintertime periods, it's very likely we'll have a surge of influenza and COVID-19 related to this kind of behavior. Don't let fatigue and letting your guard down be the reason that you get infected and suffer a complication."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest news on RSV, COVID-19 and this year's flu season.

Related articles:

• "Early increase of flu, RSV viruses affecting children — when to seek help"
• "Care tips for upper respiratory infections in children"
• "RSV season: What parents need to know"

Distraction runs rampant in our society — we can all relate. But when you have ADHD, navigating a chaotic world can be especially challenging. And adult ADHD is on the rise. During the pandemic, diagnoses and prescriptions for ADHD in adults increased significantly. So what’s driving this increase in diagnoses? And how do you tell if you yourself have ADHD, or are experiencing a typical level of distraction?

On this episode of Health Matters, family physician Dr. Robert Wilfahrt joins us to talk about all things ADHD.

Find us online at Mayo Clinic Press for more health and wellness articles, podcasts and books.

Do you have feedback, questions or topic suggestions? Email us at mcppodcasts@mayo.edu.

As the COVID-19 pandemic continues, efforts are underway to find a new normal and begin to reopen the country and the economy. While people are eager for strict social distancing rules to end, public health measures, including testing and tracing for the virus, will be important tools needed to control the spread of the virus and prevent an uptick in new infections.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic’s Vaccine Research Group, discusses the steps needed to reopen businesses, schools and other activities as the fight to control COVID-19 continues.
Research disclosures for Dr. Gregory Poland.

Hypoplastic left heart syndrome (HLHS) is a birth defect that affects normal blood flow through the heart. As a baby develops during pregnancy, the left side of the heart does not form correctly. Ava Weitl, now a first grader, was born with HLHS. She had her first heart surgery the day she was born. Now she is part of pioneering research at Mayo Clinic.

On this episode of Mayo Clinic Q&A, Ava and Dr. Timothy Nelson, director of the Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome at Mayo Clinic, will share her story.

A recent survey conducted on behalf of the American Psychological Association found that nearly 80% of adults say that the coronavirus pandemic is a significant source of stress in their lives. In addition, 60% say that they are overwhelmed by the number of issues America faces, including health care, the economy, racism and political tensions. Now, the holidays are looming, a time of year that often brings heightened family and relationship stress. How can we better cope in these unsettling times?

On the Mayo Clinic Q&A podcast, Dr. Craig Sawchuk, the division chair of Integrated Behavioral Health at Mayo Clinic, discusses how to handle relationships and stress during the holidays and beyond.

While the rate of cervical cancer has been declining for decades in the U.S., health disparities persist. Hispanic women have the highest incidence rate of cervical cancer, followed by non-Hispanic Black women, according to the American Cancer Society. And Black women are more likely to die from the disease than women of any other race or ethnicity. 

"Race is a social construct. There really isn't a genetic difference that is causing Black women to, unfortunately, die at higher rates of cervical cancer," explains Dr. Olivia Cardenas-Trowers, a Mayo Clinic urogynecologic surgeon and women's health provider. "It really has to do more with the historical background of racism and systemic racism. These disparities have infiltrated the health care system and have affected these women's access to resources, and therefore some of the health care that they need. And this trickles down into poor outcomes, essentially."

Disparities that affect a women's access to health care can include transportation, health literacy and trust in their health care provider. 

Dr. Cardenas-Trowers says addressing barriers to health care is key, so that all women, including Black women, receive regular routine screening. Screening helps identify cancer early, which leads to better outcomes. 

"It's important to address the factors that lead to poor outcomes for Black women — making sure that they have support and access to screening, access to the results, and resources if any follow up or intervention is needed," says Dr. Cardenas-Trowers.

On the Mayo Clinic Q&A podcast, Dr. Cardenas-Trowers discusses why disparities exist and what Black women can do to reduce their risk of cervical cancer.

Mayo Clinic has been a leader in developing and deploying testing for COVID-19, but understanding the different types of tests and what they measure can be confusing. Terms like viral, molecular, serology and antibodies aren’t clear for everyone. What are the different COVID-19 tests, and what do they do?

On the Mayo Clinic Q&A podcast, Dr. Bobbi Pritt, chair of the Division of Clinical Microbiology at Mayo Clinic, explains testing options for COVID-19.

Across the world, one of the biggest changes forced by the COVID-19 pandemic is in the field of education. Programs from kindergarten through postsecondary have rapidly moved to a distance learning model. Online and remote instruction has its own unique challenges, and has required students and educators to be creative to stay connected.

On the Mayo Clinic Q&A podcast, Dr. Alexandra Wolanskyj-Spinner, senior associate dean for student affairs at the Mayo Clinic Alix School of Medicine in Minnesota, discusses medical education during the COVID-19 pandemic.

Thanks to research and treatment advances over the past few decades, most children diagnosed with cancer now live on to pursue full adult lives. To ensure that those children will one day have the option to become parents, families must consider the risk of infertility when deciding about cancer treatment.

Researchers and health care providers have made progress in minimizing the side effects of cancer treatment without reducing its effectiveness, allowing many cancer survivors to have children after spontaneous recovery of fertility. However, some cancers require rigorous treatment that almost always leads to permanent infertility. But there is hope for those families through fertility preservation.

Mayo Clinic's Fertility Preservation Program offers several options for fertility preservation, depending on the child's age, stage of puberty, diagnosis and proposed treatment plan. Both ovarian and testicular tissue cryopreservation is possible.

"We hope the pediatric Fertility Preservation Program brings a lot of optimism for the future for these children," says Dr. Asma Chattha, chair of Pediatric Gynecology at Mayo Clinic. "They're obviously fighting an uphill battle. It's a very difficult time in their lives. But barring none, I've always found the conversation surrounding fertility preservation to be a source of hope for families." 

In recognition of International Childhood Cancer Day on Tuesday, Feb. 15, Dr. Chattha joins the Mayo Clinic Q&A Podcast to discuss what patients and their families should consider when making decisions related to fertility preservation, and the steps involved in the process.

As the new year kicks off, many people renew or begin a commitment to improving their health. Often, that starts with healthy eating, and this year it might include kicking bad habits developed during the COVID-19 pandemic.

On the Mayo Clinic Q&A podcast, Katherine Zeratsky, a registered dietitian nutritionist at Mayo Clinic, offers nutrition tips and suggests small changes that can lead to better eating habits and help you shift to healthier eating in 2021.

2020 has been a year consumed by COVID-19, from first news of the virus in the U.S. January to vaccines rolling out in December. Scientists, health care providers and the public have gained new knowledge and understanding of infectious diseases and virus transmission, and COVID-19 vaccines were developed in record time.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, looks back at what has been learned in 2020, and forward to the possibility of controlling COVID-19 in 2021.
Research disclosures for Dr. Gregory Poland.

According to the Centers for Disease Control and Prevention, the most common mode of transmission for COVID-19 is through close contact from person to person. While it is possible that someone can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes, this isn’t thought to be the main way the virus spreads.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic’s Vaccine Research Group, discusses virus transmission and steps to take to keep yourself safe.

With the COVID-19 pandemic entering a tenth month, experts says adherence to public health measures appears to be waning in some parts of the country. "COVID fatigue," meaning failing to comply with masking, hand hygiene and physical distancing guidelines, has fueled a resurgence in COVID-19 cases in more than half of the U.S. states.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, discusses the rising number of COVID-19 cases and how vaccine experts in science and industry are working together in unprecedented ways.
Research disclosures for Dr. Gregory Poland.

If you're fully vaccinated for COVID-19 you can travel domestically and where travel is allowed internationally, according to new interim travel guidelines from the Centers for Disease Control and Prevention (CDC). Even with those recommendations the CDC continues to recommend not traveling unless it is essential. Regardless, the CDC strongly recommends people continue to wear a face mask, practice social distancing and sanitize their hands.

Meanwhile, COVID-19 vaccine research is continuing in teenagers. "The early data show equal safety in young people age 12 to 16," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "I think this is going to imply that, somewhere between this fall and Christmas, we're going to be able to offer the (COVID-19) vaccine to every age group."

In this Mayo Clinic Q&A podcast, Dr. Poland answers a number of listener questions, including how long the COVID-19 vaccines are predicted to last and if the current transmission research still supports wiping down household items. Dr. Poland also explains why someone who has had COVID-19 should still get a COVID-19 vaccine.
Research disclosures for Dr. Gregory Poland.

Esophageal cancer occurs in the esophagus — a long, hollow tube that runs from the throat to the stomach — and can occur anywhere along the esophagus. Men are more likely to develop esophageal cancer than women. While treatable, esophageal cancer is rarely curable.

"It's an uncommon cancer," says Dr. Shanda Blackmon, a Mayo Clinic general thoracic surgeon. "But it's one of the deadliest cancers we know."

Dr. Blackmon says survival rates are improving, but many people don't realize they have esophageal cancer until it's in the advanced stages.

In this Mayo Clinic Q&A podcast, Dr. Blackmon discusses the risks, causes, symptoms and advances in treatments for esophageal cancer. She also explains what patients can expect with a diagnostic endoscopy and describes a new technique at Mayo Clinic that involves dropping a sponge down the patient's esophagus.

Colorectal cancer is the third most common cancer worldwide, accounting for almost 2 million new cancer cases each year, according to the World Health Organization. 

Colorectal cancer, also known as bowel cancer, typically affects older adults, although it can happen at any age.

Screening for colorectal cancer is important to identify precancerous polyps that could develop into cancer, and several screening options are available to patients. 

But which screening tool is right for you?

"The best screening tool is the one you're willing to get," says Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London. "There's no point in being set up for a colonoscopy if you're not willing to come for it. And there are a wide range of options now for bowel cancer screening — all of which provide substantial protection against bowel cancer."

Screening test options for colorectal cancer include:

• Colonoscopy.
• Stool DNA test.
• Fecal immunochemical test. 
• Virtual colonoscopy, or CT colonography.

While effective screening tools exist, research using artificial intelligence (AI) to develop better techniques to detect polyps is hoping to improve screening even further.

"I think the role of AI in endoscopy is huge. And it's it's coming to clinical care," says Dr. East. "This is really translating facial recognition technology, but instead of recognizing faces, the AI recognizes polyps at an astonishing rate during a live colonoscopy. This is really a game changer for us." 

On the Mayo Clinic Q&A podcast, Dr. East discusses advances in colorectal cancer screening.

Child health experts condemn the use of violence in any form, but some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment can leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.

The American Academy of Pediatrics recommends healthy forms of discipline, such as positive reinforcement of appropriate behaviors, limit setting, redirecting, and setting future expectations. The American Academy of Pediatrics recommends that parents not span, hit, slap, threaten, insult, humiliate, or shame children.

On the Mayo Clinic Q&A podcast, pediatrician and #AsktheMayoMom host Dr. Angela Mattke discusses positive ways to discipline your child with Dr. Chris Derauf, a Mayo Clinic pediatrician, and Dr. Arne Graff, a Mayo Clinic family medicine physician, who both specialize in child abuse at the Mayo Center for Safe and Healthy Children and Adolescents.

Back pain is one of the most common reasons people go to their health care provider or miss work, and it is a leading cause of disability worldwide. Most back pain gradually improves with home treatment and over-the-counter pain relievers. But for some people, back pain can be a debilitating problem that requires more advanced treatment. One option for persistent back pain is an implanted spinal cord stimulator that uses low levels of electricity to intercept or block pain signals.

On the Mayo Clinic Q&A podcast, Dr. Tim Lamer, an anesthesiologist and pain medicine specialist at Mayo Clinic, explains how spinal cord stimulation devices are implanted and used to relieve persistent back pain.

Fatigue and what's being called "brain fog" are turning out to be some of the most common issues for long-hauler patients recovering from COVID-19. The National Institutes of Health calls these and other symptoms, which can last for several months, post-acute sequelae of SARS-CoV-2, or PASC.

Those suffering from brain fog may experience short-term memory loss, confusion, difficulty concentrating, or just feeling different than they did before they had COVID-19, even if it was a mild case of the infection.

And Dr. Billie Schultz, a Mayo Clinic physical medicine and rehabilitation expert, says, though older patients more often to have these symptoms more often, younger people are also showing up with brain fog.

In this Mayo Clinic Q&A podcast, Dr. Schultz says brain fog seems to be more inflammatory than infection, but there are more questions than answers about this neurological concern. Meanwhile, efforts are underway to develop rehabilitation programs to help patients recover.

During the COVID-19 pandemic, women have reportedly skipped or delayed their regular breast cancer screenings. This may lead to a surge in breast cancer diagnoses in the months ahead. That's according to a study in JAMA.

October is Breast Cancer Awareness Month and Dr. Katie Hunt, a Mayo Clinic radiologist, says it's the perfect time to make sure women are up to date on their breast cancer screenings.

In this Mayo Clinic Q&A podcast, Dr. Hunt discusses a variety of recommendations for screening and encourages women not to miss the window of opportunity to catch breast cancer early.

Smaller incisions, less pain and faster recovery are just a few reasons minimally invasive heart surgery can be a good option for patients with heart disease.

"I would define minimally invasive heart surgery, or robotic-assisted surgery as essentially performing a standard surgical operation through smaller incisions, without going through the breastbone," says Dr. Phillip Rowse, a Mayo Clinic cardiovascular surgeon.

Treating mitral valve disease is one example of how often robotic-assisted heart surgery is performed at Mayo Clinic. "Mayo treats about 120 cases, or more, robotically each year," Dr. Rowse says. "We have dedicated cardiologists who are in the room performing the echo tests at the time of surgery and right afterwards."

In this Mayo Clinic Q&A podcast, Dr. Rowse discusses who's eligible for this surgery and what's involved with minimally invasive heart surgery.

The best way to keep your children safe in the car is to secure them in a properly installed car seat. But more than half of all car seats may be improperly installed, according to the Centers for Disease Control and Prevention.

So many car seat options are on the market, and many parents find this overwhelming. It's important to buy the right type of car seat, properly install it, and ensure the seat and straps fit your child. The type of seat your child needs depends on several things, including your child’s age, size and developmental needs.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on summer and car seat safety. Dr. Angela Mattke a Mayo Clinic pediatrician and host of "Ask the Mayo Mom" is joined by Dr. Meghan Cain, a pediatric emergency medicine physician at Mayo Clinic Children’s Center, and Nicole Guerton, a trauma center injury prevention coordinator at Mayo Clinic Children's Center and a certified child passenger safety technician.

A new serology test from Mayo Clinic Laboratories  is being used to identify the presence of immune response to SARS-CoV-2, the virus that causes COVID-19. The serology test is intended only to detect antibodies to the virus. It does not diagnose recent or active infection. Mayo Clinic Laboratories also offers a molecular test to diagnose very recent or active infection. Both tests are important tools in the pandemic response.

On the Mayo Clinic Q&A podcast, Dr. Elitza Theel, director of Mayo Clinic’s Infectious Diseases Serology Laboratory, explains why serology testing is initially focused on identifying people in areas where potential immunity is key, including front-line health care workers.

Having a baby born with a cleft can be upsetting, but cleft lip and cleft palate are among the most common birth defects, and both can be corrected.

Cleft lip and cleft palate are openings or splits in the upper lip; the roof of the mouth, or palate; or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don't close completely.

Treatment involves surgery or a series of surgeries to repair the defect and therapies to improve any related conditions. Treatment seeks to improve the child's ability to eat, speak and hear normally, and achieve a normal facial appearance.

On this edition of the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of "Ask the Mayo Mom", discusses cleft lip and cleft palate with three Mayo Clinic Children’s Center experts: Dr. Samir Mardini, chair of the Division of Plastic and Reconstructive Surgery; Dr. Shelagh Cofer, a pediatric otolaryngologist and head and neck surgeon; and Dr. Waleed Gibreel, a craniofacial and pediatric plastic surgeon. 

The first COVID-19 vaccines to reach the market are likely to be messenger RNA vaccines, or mRNA. According to the Centers for Disease Control and Prevention, mRNA vaccines work by teaching cells in the body how to make a protein that triggers an immune response. Unlike many vaccines that use a weakened or inactivated form of a virus, mRNA vaccines do not use the live virus that causes COVID-19.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, explains how mRNA vaccines work, gives a status update on the pandemic and answers listener questions.
Research disclosures for Dr. Gregory Poland.

Vaccines are at the forefront of daily news about COVID-19. Vaccines help prevent diseases that can be dangerous or even deadly by working with the body’s immune system. But how exactly do vaccines work?

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, gives an overview of vaccines, including the different types of vaccines and how you can make sure you are up to date with all recommended vaccinations.
Research disclosures for Dr. Gregory Poland.

While most people who contract COVID-19 will be able to manage symptoms and recover at home, there are some who have a more severe course of the disease and need to be hospitalized. Physicians and scientists have learned a lot about COVID-19 in the first nine months of the pandemic, and that new knowledge is improving treatments for patients hospitalized with COVID-19.

On the Mayo Clinic Q&A podcast, Dr. Raymund Razonable, a Mayo Clinic infectious diseases specialist, discusses management of hospitalized patients with COVID-19, including therapeutics available to treat COVID-19.

The information about the COVID-19 pandemic changes rapidly, and it's hard to stay up to date with the latest information. On today's Mayo Clinic Q&A podcast, Dr. Gregory Poland, a Mayo Clinic infectious diseases expert and head of Mayo Clinic’s Vaccine Research Group, answers COVID-19 questions.

Dr. Poland discusses preventive measures to stop the spread of the virus, what to do if you do get sick, and the potential for effective treatments and a vaccine.

Research disclosures for Dr. Gregory Poland.

A fourth COVID-19 surge is blanketing the U.S., and the delta variant is the culprit.

"Where did this delta variant come from? It came from unvaccinated people getting infected in large numbers allowing the virus to continue mutating," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.

In the past, a person with COVID-19 might infect two to four people. But with the delta variant, one person can infect nine people, according to Dr. Poland. He says if you want to protect yourself and your family, wear a mask, especially indoors, and get vaccinated with an appropriate series of one of the COVID-19 vaccines.

"These are the most studied vaccines in the history of the world," Dr. Poland emphasizes. "There have never been this many people who have received this many doses of vaccines during this amount of time with as much scrutiny as these COVID-19 vaccines have had."

In this Mayo Clinic Q&A podcast, Dr. Poland answers questions about a person's waning immunity and the likelihood of COVID-19 booster shots. He also explains the two phases of immunity and goes into detail about the extensive Federal Drug Administration license approval process for COVID-19 vaccines.

Research disclosures for Dr. Gregory Poland.

Last week, the Food and Drug Administration paved the way for commercial developers to create at-home COVID-19 tests. While no test is yet approved for home use, a fast and cheap test could encourage people to test themselves routinely before going to work or school. Real-time results would enable infected people to self-quarantine right away, keeping asymptomatic people from infecting others. "It fits with the modeling that’s been done where if you can test frequently enough that you could actually start to dampen down, if people would quarantine, you could dampen down cases. And that, as you know, would be huge," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic’s Vaccine Research Group.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the science behind at-home testing for COVID-19. Dr. Poland also shares the status of vaccine research trials, including how healthy adults can enroll in the COVID-19 vaccine clinical trial.
Research disclosures for Dr. Gregory Poland.

Melanoma is the most serious type of skin cancer. It develops in the cells that produce melanin, the pigment that gives skin its color. Melanoma is one of the most common cancer types in the U. S. Roughly 2% of people will be diagnosed with melanoma of the skin at some point during their lifetime, according to the National Cancer Institute. 

Treatment for early stage melanomas usually includes surgery to remove the melanoma. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. 

"Mohs surgery is essentially skin cancer removal," explains Dr. Nahid Vidal, a dermatologic surgeon at Mayo Clinic. "It's a surgical removal process that's highly specialized, where we're removing the skin cancer with a goal of not only removing all of it, but also leaving behind as much healthy tissue as possible."

Mohs surgery allows surgeons to verify in real time through pathology that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.

On the Mayo Clinic Q&A podcast, Dr. Vidal discusses skin cancer and the use of Mohs surgery to treat early stage melanoma.

On today's Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, shares the latest information on the COVID-19 pandemic.

Dr. Poland discusses the importance of testing for SARS-CoV-2, the virus that causes COVID-19; work being done on antiviral medications; and how long social distancing might need to last.
Research disclosures for Dr. Gregory Poland.

When a person is infected with a virus, the virus multiplies in the body and can be released into the environment through sneezing, coughing or even speaking. This release is called "shedding" and viral shedding is how COVID-19 is spread from person to person. How long a person who has COVID-19 will shed virus is still unknown.

On the Mayo Clinic Q&A podcast, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic’s Vaccine Research Group, discusses viral shedding and why asymptomatic carriers of COVID-19 are a big concern.

The Department of Medicine, which is the largest department at Mayo Clinic, is helping lead the transformation of health care. Important innovations include moving to digital and virtual care to meet patients where they are, and addressing health equity, all while keeping patients front and center.

"Patients are our North Star," says Dr. Vijay Shah, chair of the Department of Medicine at Mayo Clinic. "We're all about patients all day, every day. So, all of our strategies cascade out of that."

Dr. Shah explains those strategies include practice innovations, digital transformation and internal and external partnerships. Internal partnerships include working alongside the Mayo Clinic Cancer Center, the Center for Digital Health, Mayo Clinic Platformand others focused on improving patient care and developing cures.

These partnerships are leading to innovations in teleheath and at-home care models, as well as new ways to use health data to improve treatments. 

And at the core of it all?

"The most important pillar is our people and our culture," explains Dr. Shah. "Because our people are our greatest asset, and we're nowhere without them."  

On the Mayo Clinic Q&A podcast, Dr. Shah and Natalie Caine, associate administrator, discuss the innovations happening in the Department of Medicine at Mayo Clinic.

Cardiac amyloidosis is irreversible thickening of the heart muscle that typically presents as a form of congestive heart failure. It is overlooked often because the symptoms can masquerade as other conditions. Unfortunately, there aren't any preventive strategies for cardiac amyloidosis, says Dr. Melissa Lyle, a Mayo Clinic cardiologist.

"So the key, really, is early detection," says Dr. Lyle. "We want to make sure that we can detect these patients earlier, to get them on the right treatments."

She says it's important that patients bring any concerning symptoms to their health care provide, as soon as possible.

In this Mayo Clinic Q&A podcast, Dr. Lyle explains what those symptoms might be and talks about new therapies for treating cardiac amyloidosis.

While we know that health affects longevity and quality of life, it can be difficult to change bad habits. People often try to make sweeping New Year's resolutions, only to fail.

In fact, Jan. 17 is the date that the average America breaks their New Year's resolution.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small, sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Healthy eating

Eating lots of fruits and vegetables provides antioxidants and anti-inflammatory nutrients that help the immune system fight infections. Dr. Kopecky recommends fruits, vegetables and healthy fats from olive oil and nuts, all found in the Mediterranean diet. 

Exercising

Regular moderate exercise increases the activity of virus-killing immune cells.

“Exercise has been shown to give the immune system a boost by maximizing the body's ability to take in and efficiently use oxygen, among other things,” says Dr. Kopecky. “Moderate exercise, where you can talk but not sing while exercising, is enough to increase the activity of virus-killing cells both in the short term and long term. Even 20 minutes daily can help quell inflammation and boost immunity, and exercise can be divided up during the day. The best part about exercise is that it can be done anywhere. Leg lunges, sit-ups, squats and stair-climbing are all easy exercises you can do at home."

Managing stress 

Calming activities and supportive relationships minimize stress, reduce cortisol production and enhance the immune system's function. "Concern about the health of our loved ones, our jobs, children's schooling and other stressors will cause an increased production of the hormone cortisol in the body, which in turn can suppress the immune system," says Dr. Kopecky. "Practicing mindfulness and stepping away from what's causing anxiety can help us stay grounded. Exercises that have calming or meditative qualities, such as qi gong and yoga, also are beneficial."

Getting enough sleep

Adequate sleep boosts the number of immune cells circulating in the body and improves infection outcomes. The interaction between the immune system and sleep is a two-way street. "When your immune system response kicks in, it changes your sleep,” explains Dr. Kopecky. “You may find yourself sleeping longer, for example, as your immune system stages an attack against a virus. When you're not sleeping well, you may notice that you get sick more easily. Getting adequate sleep can help support the way your immune system functions by increasing the number of immune cells circulating in your body." 

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging. We can slow aging," says Dr. Kopecky. "But we can prevent disease. It's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.

Peripheral artery disease, or PAD, affects almost 10 million people in the U.S. Approximately one-third of patients will die within five years of a peripheral artery disease diagnosis, and 20% will experience a heart attack or stroke. 

Peripheral artery disease usually involves pain in the lower limbs caused by reduced blood flow due to narrowing of the arteries. Its symptoms, like reduced ability to walk due to leg pain, often are brushed off as signs of aging. While age is a factor, younger people with diabetes or who smoke also should be checked for the disease. 

"If you have risk factors for lower-extremity PAD — diabetes, tobacco use, high cholesterol, high blood pressure, as well as age — it's really important to have those conversations with your provider about your ability to exercise or walk if you are having any limitation," explains  Dr. Amy Pollak, a Mayo Clinic cardiologist. 

Peripheral artery disease is detectable and treatable, but it's often not diagnosed early enough. This means patients are often not treated with the most aggressive therapies. Health disparities play a big role, with the highest rates of peripheral artery disease occurring in Black men and women.

"There is an amputation epidemic," says Dr. Pollak. "And I don't use that word epidemic lightly. In today's climate, I use it intentionally. Depending upon where you live in our country, you may be at a higher risk of having an amputation for lower-extremity PAD, and not always be offered a revascularization procedure. So there is a lot of work that needs to be done to raise awareness of PAD, both for patients and health care providers."

A new PAD Action Plan spearheaded by the American Heart Association is hoping to do just that. 

The plan serves as a roadmap for reducing the burden of peripheral artery disease by improving the awareness, diagnosis and treatment of PAD. The plan also highlights the many gaps and opportunities in PAD research to further reduce preventable complications and deaths for future generations.

"The incidence of PAD is set to triple in the United States in the coming years," says Dr. Pollak, who is a co-chair of the PAD Action Plan. "So we have an important opportunity to not only prevent that from happening, but to prevent heart attacks and strokes to help people live longer lives with a greater degree of functional ability by diagnosing and treating PAD. When it comes to the health disparities, we need to be doing even more outreach to populations that have been historically not focused on with that important information about what PAD is, how it can present, and what treatment options there are."

On the Mayo Clinic Q&A podcast, Dr. Pollak discusses the importance of early diagnosis of PAD to reduce the risk of amputation, heart attack and stroke.

Related posts:

• "Mayo Clinic Minute: How is peripheral artery disease diagnosed?"
• "Peripheral artery disease can signal cardiovascular trouble for heart, brain and legs." 

Dr. Cheryl Willman was named executive director of Mayo Clinic Cancer Programs, and director of the Mayo Clinic Cancer Center in May. In this role, Dr. Willman is leading the expansion and strategic development of Mayo Clinic Cancer Center locations in Arizona, Florida and Minnesota, as well as newly developing Mayo Clinic global cancer programs in London and Abu Dhabi, United Arab Emirates.

Mayo Clinic Cancer Center is designated by the National Cancer Institute (NCI) as a comprehensive cancer center. At comprehensive cancer centers, staff coordinate innovative cancer care delivery for patients; conduct team-based cancer research to develop better means to prevent, detect and treat cancer; involve communities and patients in research; and train the next generation of cancer health professionals. Mayo Clinic Cancer Center offers its patients access to hundreds of clinical trials in all phases that test new and improved cancer treatments. 

"We have a menu of over 300 cancer clinical trials every year that are testing new drugs and bringing treatments to patients," says Dr. Willman. "Cancer clinical trials are essential to advancing our knowledge in cancer care."

Work is underway at Mayo Clinic Cancer Center to grow the Cancer Care at Home program and engage local communities, which can help address disparities in health care. Other initiatives include making advances in radiation therapy techniques and using genomics to develop individualized care for patients.

Mayo Clinic Cancer Center also is expanding the use of patient navigators, allowing cancer patients to have one point of contact to help them navigate the complexities of cancer care that often involves many specialists. 

"For a breast cancer patient, for example, that would include breast cancer surgeons, medical oncologists who give chemotherapy, radiation oncologists who give radiation, but also physical medicine and rehabilitation, nutrition, psychosocial support, and access to clinical trials," says Dr. Willman. "A patient navigator becomes the primary contact person for a patient we're caring for and truly navigates them through all of their providers."

On the Mayo Clinic Q&A podcast, Dr. Willman discusses the innovations taking place at Mayo Clinic to improve cancer care for patients.

The World Health Organization reports that the number of people with diabetes has risen from 108 million in 1980 to 422 million by 2014. And that number is estimated to reach 552 million by 2030.

One big concern for people with diabetes is the connection between diabetes and cardiovascular disease. People with diabetes are more likely to develop heart disease and are at higher risk of premature death.

"In people with diabetes, the risk of death due to heart diseases is approximately four or five times higher than in general population," explains Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And this, obviously, is a major concern. There is now a strong research and scientific evidence about this link and association between cardiovascular disease and metabolic diseases, especially diabetes." 

So what can be done to help patients?

Dr. Wamil explains that research has shown positive lifestyle changes such as quitting smoking, losing weight, exercising more, developing a healthy diet and controlling blood pressure, can all contribute to better heart health.

"We try to develop personalized management plans, we listen to our patients and try to understand what are the steps that they can take to improve their quality of life and to improve their future life and their health, " says Dr. Wamil.

On the Mayo Clinic Q&A podcast, Dr. Wamil discusses the diabetes and heart disease connection.

Endoscopy is a nonsurgical procedure used to visually examine the digestive system with a tiny camera on the end of a long, flexible tube. An upper endoscopy examines the stomach, esophagus and small intestines. A colonoscopy, which is another type of endoscopy, is used to examine the rectum, large intestine and colon.

In children, endoscopy can be used to look for causes of unexplained abdominal pain, to diagnose swallowing disorders or to identify conditions including Crohn's disease, ulcerative colitis and polyps. 

Undergoing any type of procedure can be stressful for kids, parents or caregivers. Dr. Pua Hopson, a pediatric gastroenterologist at Mayo Clinic Children’s Center, explains endoscopy is a relatively quick and painless procedure.

"An upper endoscopy typically takes 10 minutes, while colonoscopy may take 30 minutes," says Dr. Hopson. "I tell the kids it takes longer to put them to sleep with anesthesia or sedation than the actual procedure. And once you wake up, your parents will be right by your side."

One condition Dr. Hopson commonly treats in children is eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), known as EoE. This is a chronic immune system disease in which a type of white blood cell (eosinophil) builds up in the lining of the esophagus. This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow. EoE is diagnosed through biopsy using an upper endoscopy.

On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Hopson to discuss how and why endoscopy is used in children.

The retina is a thin layer of tissues, cells, and nerves that line the back wall inside the eye.  This layer has millions of light sensing cells that receive and organize visual information according to the Mayo Clinic.

On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Brittni Scruggs, an ophthalmologist at Mayo Clinic Children’s Center. Dr. Scruggs is a physician, surgeon, and scientist with a research laboratory at Mayo Clinic studying gene therapy and stem cell therapy for retinal degenerations, including for children. 

She treats all ages, ranging from newborns to adults. Dr. Scruggs is a member of the national workgroup developing ACMG evidence-based guidelines for diagnosis and clinical management of inherited retinal diseases.
Dr. Mattke and Dr. Scruggs explore retinal issues in children and discuss eye safety and health. 

An estimated 3 out of 4 U.S. children and more than half of all adults have been infected with COVID-19, according to a report released on Tuesday, April 26 by the Centers for Disease Control and Prevention. But a Mayo Clinic expert says more information is needed to get the complete picture. 

"This was a convenient sample. In other words, people who were having blood drawn for other reasons were tested,"explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That does not reflect the full population or differences by race or geographic location. And the detection of antibodies does not necessarily mean that you are protected from infection. So, there's a lot of nuance around understanding that headline." 

The research study looked at more than 200,000 blood samples and found that signs of past infection rose dramatically during the omicron surge between December 2021 and February.

Other COVID-19 news this week includes a push to make treatments more available, the rising incidence of new omicron subvariants, and changes in mask recommendations. Dr. Poland cautions that COVID-19 is still present and encourages wearing a mask in crowded spaces, even when there isn't a requirement to do so.

"If only one of us is wearing a mask and the other one isn't and is infected, you still have pretty high protection — but not the same level of protection as if both of us wearing one," says Dr. Poland. "So, it's it is not futile to be the only one wearing a mask. In fact, I think it sends a message."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and answers listener questions.

Last week marked two years since the World Health Organization declared COVID-19 to be a pandemic. While infection rates and hospitalizations in the U.S. continue to decline, there are some areas of concern globally. 

"China, Hong Kong, Ireland, the U.K. and Denmark are seeing surges back up again," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "These countries, many of us experts believe, prematurely dropped mask-wearing and nonpharmaceutical interventions, and really have stopped pushing and encouraging people to get vaccinated. I think that's a mistake."

Dr. Poland explains that public health measures — and vaccination and boosters — are still the best way to protect yourself from COVID-19. 

"What can I say but what we have said all along," implores Dr. Poland. "Hands, face, space and vaccines. It works."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including a study on the true death toll of COVID-19, an update on the BA.2 variant and the latest on vaccines for children under 5.

Research disclosures for Dr. Gregory Poland.

If you've been vaccinated for COVID-19, you're able to go shopping, eat in restaurants and travel on airplanes without the same worry of becoming infected with COVID-19 that existed just months ago. But for those who are unvaccinated, getting infected with COVID-19 — even with just minor symptoms — should be a concern, according to Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.

"For those who have been vaccinated, life is resuming back to a sense of normalcy," says Dr. Poland. "But for the unvaccinated, they now live in a dangerous phase of the pandemic, where we're seeing circulating variants that are much more transmissible and may cause worse cases of the disease than what happened last year at this time. I think the people who are unvaccinated may not realize that."

In this Mayo Clinic Q&A podcast, Dr. Poland also offers information on more COVID-19 studies underway and he talks about COVID-19 vaccine research protocols that will be able to help scientists with other vaccine research, such as HIV vaccine research. Also, he answers listener questions, such as, "Does someone who has already been infected with COVID-19, really need to be fully vaccinated for COVID-19 or would just a booster be needed?"
Research disclosures for Dr. Gregory Poland.

A bone marrow transplant is a procedure that infuses healthy blood-forming stem cells into your body to replace your damaged or diseased bone marrow. Bone marrow transplants may use cells from your own body (autologous transplant) or from a donor (allogeneic transplant). Bone marrow transplants can benefit people with a variety of both cancerous (malignant) and noncancerous (benign) diseases.

On this episode of Mayo Clinic Q&A, Dr. William Hogan, director of the Mayo Clinic Bone Marrow Transplant program, discusses bone marrow transplant.

More than 200,000 people in the U.S. will be diagnosed with lung cancer in 2022, according to the National Cancer Institute. A new lung cancer diagnosis can be scary and confusing, but having a support system can help.

"Probably the best advice I give patients with lung cancer is to build your village of support around you," says Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon. "Always see if you can have somebody come with you for your appointment, just to help you emotionally deal with things, to help you record what's being said, to help you collect that information, and then to also advocate for you."

If the cancer is confined to the lungs, surgery may be an option for treatment. Surgery is performed to remove the lung cancer and a margin of healthy tissue around the cancer site. Procedures to remove lung cancer include:

• Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue.
• Segmental resection to remove a larger portion of lung, but not an entire lobe.
• Lobectomy to remove the entire lobe of one lung.
• Pneumonectomy to remove an entire lung.

The surgeon also may remove lymph nodes from a patient’s chest to check them for signs of cancer. The type of operation used for lung cancer treatment depends on the size and location of the cancer as well as how well a person’s lungs are functioning. 

Dr. Blackmon recommends that patients explore all their surgical options.

"When you look at actual surgical options, you have minimally invasive surgery, or open surgery," explains Dr. Blackmon. "And the minimally invasive surgery has a lot of different options as well. Not every lung cancer surgery can be done minimally invasively. But if it can, certainly, the patient benefits."

Another important consideration is having your lung cancer surgery performed at a center that does a high volume of cases and is familiar with the type of procedure needed.

"When you go to have your car worked on — you go to the dealership that deals with your car specifically and someone who does it every day — they're going to be doing a better job than going to someone who's never even seen that type, make or model of car," says Dr. Blackmon. "I think we do that in life all the time. And it makes sense to do it in medicine, and in surgery especially." 

After surgery for lung cancer, patients are often worried about short-term side effects, like shortness of breath and pain, as well as long-term worries about cancer recurrence. Both should be addressed as part of a cancer survivorship plan.

"Survivorship is part surveillance and part symptom management," says Dr. Blackmon. "The survivorship program here at Mayo Clinic really focuses on treating the whole patient. We have things like massage therapy. We have acupuncture. We have meditation. We have all kinds of resources that help patients to get their life back, get back in shape, and get all the parts of their body whole again as they start to heal from this really big surgery. But one thing that is so important is to continue to go back for that survivorship care with continued symptom monitoring and continued surveillance. That five-year period after the lung cancer surgery is so critically important."

On this Mayo Clinic Q&A podcast, Dr. Blackmon discusses what people can expect after surgery for lung cancer, and how to achieve the best quality of life.

When it comes to the heart, it can be scary to seek care when you think you might be having a problem. Tests may be necessary to evaluate your heart, and the unfamiliar terminology associated with these tests can be confusing and intimidating.

Understanding terms like electrocardiogram, echocardiogram, coronary angiogram or stress test may help alleviate the fear.

"Whenever we order these tests, we don't want you to have anxiety," says Dr. Christopher DeSimone, a Mayo Clinic cardiologist. "These tests are all done for a reason: to get you a diagnosis and to help you feel better. "

On the Mayo Clinic Q&A podcast, Dr. DeSimone breaks down the terminology and explains what to expect during cardiac testing and evaluation.

While still relatively rare, the rate of primary liver cancer has been increasing in recent decades, disproportionately affecting minority populations. 

"Research has shown that Blacks and Hispanics are less likely to be diagnosed with liver cancer at an earlier stage, compared to whites," says Dr. Sumera Ilyas, a Mayo Clinic gastroenterologist. "And that, in turn, means the odds of being eligible for potentially curative treatments are lower for these patients."

These disparities are due to many potential reasons.

"These differences in diagnosis may be due to differences in access to primary or subspecialty health care. They may also be due to differences in surveillance," explains Dr. Ilyas. 

The National Cancer Institute estimates that more than 42,000 new cases of liver cancer will be diagnosed in 2021, representing 2.2% of all new cancer cases in the U.S. 

The most common type of primary liver cancer is hepatocellular carcinoma. Other types of liver cancer, such as intrahepatic cholangiocarcinoma and hepatoblastoma, are much less common. 

"The vast majority of liver cancers — over 90% — occur in patients who have a chronic liver disease," says Dr. Ilyas. "Cirrhosis, or advanced scarring of the liver, is the strongest risk factor for hepatocellular carcinoma."

Chronic infection with the hepatitis B or hepatitis C viruses also increases your risk of liver cancer.

A wide range of treatment options for primary liver cancer are available. Which treatment is used depends on the stage of the disease. 

On the Mayo Clinic Q&A podcast, Dr. Ilyas discusses liver cancer diagnoses and treatment options, and the importance of prevention.

The Food and Drug Administration and Centers for Disease Control and Prevention have approved the first of several COVID-19 vaccines developed in response to the pandemic. The first vaccine has been distributed to all 50 states, and vaccinations are underway. Development of safe and effective COVID-19 vaccines has been an extraordinary effort of science and engineering.

"This is a milestone human achievement by any measure," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the rollout of COVID-19 vaccines in the U.S. and the timeline for vaccinations.
Research disclosures for Dr. Gregory Poland.

After cancer treatment, cancer survivors are eager to return to good health. The right diet and nutrition can play a big role in improving long-term health so cancer survivors can enjoy the years ahead.

Diet and nutrition recommendations for cancer survivors are no different from the recommendations for anyone who wants to improve their health: Eat a balanced diet with an emphasis on vegetables, fruits and whole grains; drink alcohol moderately, if at all; and maintain a healthy weight.

"Both the American Cancer Society and the American Institute for Cancer Research recommend the same exact diet for cancer survivors that we recommend for cancer prevention," says Dr. Dawn Mussallem, a Mayo Clinic hematologist and oncologist. "A low fat-diet is recommended. That's a predominantly whole food, plant-based diet that is rich with vegetables; whole grains; colorful fruits; and things like beans, lentils, seeds and nuts. This is really the essential diet that's good for all health and health-related diseases, not just cancer." 

Maintaining a healthy weight is important to overall health, but some cancer survivors may struggle to maintain weight during and after treatment due to nausea or lack of appetite.

"For underweight patients, it is very important that they work with a dietician," says Dr. Mussallem. "These patients need healthy, high calorie-dense foods and they may need to eat smaller portions throughout the day."

On this Mayo Clinic Q&A podcast, Dr. Mussallem, discusses what cancer survivors should know about diet and nutrition.

The COVID-19 pandemic has been challenging for families, as children and adults have had to face stressors and adapt to change. Distance learning and the need for physical distancing from friends have been particularly challenging for children and adolescents. Trying to help them cope it their feelings and frustrations about the pandemic has stressed parents and caregivers.

This edition of the Mayo Clinic Q&A podcast features an #AskMayoMom episode hosted by Dr. Angela Mattke, a pediatrician at Mayo Clinic Children's Center. Joining Dr. Mattke to discuss building resilience and emotional well-being in children are Dr. Paige Partain, a Mayo Clinic pediatrician, and Hannah Mulholland, a Mayo Clinic pediatric social worker.

When it comes to malignant tumors in the brain and spinal cord, glioblastoma is the most common. Glioblastoma is an aggressive form of cancer that forms from cells called astrocytes in the brain or the spinal cord. Glioblastoma can occur at any age, but it's more common in older adults. It can cause worsening headaches, nausea, vomiting and seizures.

Glioblastoma can be difficult to treat. Current treatments include surgery, radiation and chemotherapy, but thanks to research and clinical trials, new therapies are being developed.

"We're coming together as a community to treat this," says Dr. Wendy Sherman, a Mayo Clinic neurologist. "We're getting more patients on trial and we're being smarter about our trials. It's an exciting time for our field, and I'm very hopeful that we're going to make progress on this."

A cure is often not possible, but disease management and treatment may slow progression of the cancer and decrease the side effects.

On the Mayo Clinic Q&A podcast, Dr. Sherman discusses glioblastoma diagnosis, treatment, and research.

Running is a great way for kids to get active and participate in sports. Cross country and track are two of the most popular sports in middle school and high school. 

But injuries in young runners are common, often are caused by improper technique or lack of strength and conditioning training. Another cause of injury is increasing mileage too quickly.

Common injuries include patellar tendonitis, Osgood-Schlatter disease, illiotibial band syndrome, and shin splints. 

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, discusses injury prevention in young runners with Dr. David Soma, a Mayo Clinic sports medicine specialist and pediatrician; Dr. Luke Radel, a Mayo Clinic pediatrician; and Dr. Stephanie J. Lopez, a Mayo Clinic sports physical therapist.

A congenital heart defect means that a child was born with a problem in the structure of his or her heart.

Some congenital heart defects in children are simple and don't need treatment. Others are more complex and may require several surgeries performed over a period of several years.

Improvements in imaging, monitoring and surgical techniques have improved outcomes for pediatric heart surgery patients. 

A prenatal diagnosis is scary for parents, but support and care from the cardiology team continue through the child's life and on into adulthood. And support from others, including patient organizations, also helps.

"It can feel like you're alone, especially if the diagnosis is new," says Dr. Elizabeth Stephens, a pediatric cardiovascular surgeon at Mayo Clinic. "It can feel very daunting. But there are many families out there who are not just dealing with congenital heart disease, they're thriving with it. These kids are incredibly resilient."

On the Mayo Clinic Q&A podcast, Dr. Stephens joins Ask the Mayo Mom host Dr. Angela Mattke for a discussion on congenital heart defects and new treatment options.

The amount of sleep you need depends on various factors — especially your age. While sleep needs vary significantly among individuals, there are general guidelines for different age groups.

For kids, getting the recommended amount of sleep on a regular basis is linked with better health, including improved attention, behavior, learning, memory, the ability to control emotions, quality of life, and mental and physical health.

Mayo Clinic experts recommend these general sleep guidelines for each age group:

Infants 4 months to 12 months 12 to 16 hours per 24 hours, including naps
1 to 2 years 11 to 14 hours per 24 hours, including naps
3 to 5 years 10 to 13 hours per 24 hours, including naps
6 to 12 years 9 to 12 hours per 24 hours
13 to 18 years 8 to 10 hours per 24 hours
Adults 7 or more hours a night
Creating good sleep habits is important. Dr. Julie Baughn, a Mayo Clinic pediatric sleep medicine specialist at the Mayo Clinic Children's Center, suggests the follow do's and don'ts for healthy sleep:

Healthy sleep "Do's"

Have an age-appropriate bedtime.
Have a bedtime routine that is relaxing and consistent.
Have the environment quiet and dark.
Have your child be active during the day.
Have regular meals.
Have the same bedtime weekdays and weekends.
Healthy sleep "Don't's"

Get rid of the crib too early.
Expect your young child to “sleep in.”
Use electronics before bed.
Dr. Baughn remind parents that setting expectations is key to helping children develop a healthy bedtime routine.

"Kids are really good at knowing what you're going to say yes to at bedtime," says Dr. Baughn. "And they're just having kind of normal bedtime resistance, which is a normal part of growing up, of testing limits, trying to stay up later. Consistency is key."

On the Mayo Clinic Q&A podcast, Dr. Baughn joins Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AsktheMayoMom to answer some common questions about sleep problems in children, including getting your child to go to sleep and stay asleep, the safety of melatonin for kids, and determining when should your child see a sleep specialist.

With wildfires burning in the western U.S., smoke is affecting air quality for hundreds of miles. Wildfire smoke can irritate the eyes and respiratory system, and also can be dangerous for the elderly and people with heart and lung conditions.

On the Mayo Clinic Q&A podcast, Dr. Clayton Cowl, chair of the Division of Preventive, Occupational and Aerospace Medicine at Mayo Clinic, discusses the health risks of breathing in wildfire smoke and what you can do to protect yourself.

Drug shortages continue to be a major health care issue in the U.S., with more than 200 ongoing and active shortages per year since 2018. 

"Drug shortages are not new to health care," explains Dr. Mary Gilmer, director of pharmaceutical supply and procurement for Mayo locations across the Midwest. "But, really, over the last two years with the COVID-19 pandemic, the shortages have really exposed the vulnerability of our global drug supply chain. And these drug shortages remain high, despite decades of continued and increased awareness, effort and significant resource investment in these drug shortage programs at the highest level." 

At Mayo Clinic, the Pharmacy and Theruapuetics Committee has strategies and an organized approach to managing each drug shortage that's encountered.

"We engage our staff right down to the front-line team members when we're experiencing a shortage," says Dr. Gilmer. "When we place an order for a medication, and we do not receive sufficient quantities of what we're needing to take care of our patients, that's when we start escalating it, and really coordinating around how we understand and identify shortages so that we can best proactively manage them. So that's getting everybody on board for awareness, and any changes in our electronic health system that we need — or engaging our formulary colleagues to understand what alternatives or substitutes we can use." 

In addition to work done internally, Mayo Clinic also has taken a leadership role in combating drug shortages across the U.S., including joining the End Drug Shortages Alliance. The coalition is a collaboration of health system, supply chain and industry partners seeking to prevent drug shortages by solving pharmaceutical supply challenges and increasing transparency.

Mayo was also a founding member of Civica Rx, a nonprofit generic drug company whose goal is to reduce shortages of essential medications that hospitals use. Civica Rx recently announced plans to manufacture and distribute affordable insulin. 

"We often talk about mitigating the impact of a drug shortage, but our goal is really to get further upstream and actually end them and stop them from happening,"says Dr. Eric Tichy, chair of the Division of Pharmacy Supply Solutions at Mayo Clinic. "So we do a lot of advocacy with the government and different regulatory agencies. And anytime someone says they want to help end or manage drug shortages, we're always interested in what that opportunity is."

On the Mayo Clinic Q&A podcast, Drs. Gilmer and Tichy discuss Mayo Clinic's work to combat drug shortages.

Pediatric growth charts track growth in infants, children and adolescents. While children can go through brief periods where they gain or lose a little weight, if children don't gain weight or grow well, they may be diagnosed with failure to thrive.

On the other end of the nutrition spectrum are children with non-alcoholic fatty liver disease. This occurs when too much fat is stored in the liver and can cause problems for the liver’s normal functioning.

This edition of the Mayo Clinic Q&A podcast features an #AskMayoMom episode, which is hosted by Dr. Angela Mattke, a pediatrician at Mayo Clinic Children's Center. To discuss the nutrition spectrum in children, Dr. Mattke is joined by Dr. Dana Steien, a pediatric gastroenterologist at Mayo Clinic, and Dr. Sara Hassan, a pediatric gastroenterologist and transplant hepatologist at Mayo Clinic.

The start of a new school year is always a time that’s filled with excitement and anxiety. This year, COVID-19 is making back to school even more challenging for kids, teachers and parents. Whether in person, online or a hybrid approach, this school year will be different for students and staff. How can you and your child have a healthy mindset for this school year?

On the Mayo Clinic Q&A podcast, Dr. Craig Sawchuk, chair of the Division of Integrated Behavioral Health at Mayo Clinic, shares helpful tips and strategies to be resilient and handle the challenges of a school year during the COVID-19 pandemic.

The current COVID-19 surge numbers could worsen in coming days as experts prepare for a post-Thanksgiving holiday increase in cases. Increased positivity rates lead to more people needing hospitalization, straining the health care system and medical staff.

On the Mayo Clinic Q&A podcast, Dr. Elie Berbari, chair of the Division of Infectious Diseases at Mayo Clinic, explains how Mayo Clinic is managing staff, supplies and space during the COVID-19 surge.

Inflammatory bowel disease is common, and it is becoming more common in many populations.

Dr. William Faubion Jr., a Mayo Clinic gastroenterologist, says inflammatory bowel disease is an umbrella term that covers Crohn's disease and ulcerative colitis, and that inflammatory bowel disease is an emerging public health problem.

"The most recent estimates would be that, depending on where you live and what region in the world you live, as many as 1 in 250, to 1 in 300 people may be affected with inflammatory bowel disease," says Dr. Faubion.

Dr. Faubion points out that inflammatory bowel disease is a combination of a complex genetic disease and an immunologic disease, as well as environmental variants or triggers.

In this Mayo Clinic Q&A podcast, Dr. Faubion explains that inflammatory bowel disease is very different from irritable bowel syndrome. He also describes symptoms, tests and treatments for inflammatory bowel disease, including how researchers are using artificial intelligence to determine the right medication for each patient.

After skin cancer, prostate cancer is the most common type of cancer in men. One in 8 men will be diagnosed with prostate cancer in his lifetime, according to the National Cancer Institute.

While some types of prostate cancer grow slowly, and may need minimal or even no treatment, other types are aggressive and can spread quickly.

So if you’ve been diagnosed with prostate cancer. Now what?

"It's very important to know the extent or stage of the cancer," says Dr. R. Jeffrey Karnes, a Mayo Clinic urologist and chair of the Division of Community Urology at Mayo Clinic in Rochester, Minnesota.

Diagnosis and staging are done using tests, including ultrasound, MRI and biopsy.

Prostate cancer that's detected early — when it's still confined to the prostate gland — has the best chance for successful treatment. Prostate cancer treatment options depend on several factors, such as how fast the cancer is growing, whether it has spread, as well as the potential benefits or side effects of the treatment.

On the Mayo Clinic Q&A podcast, Dr. Karnes discusses treatment options for prostate cancer and the latest in clinical trials and research.

In the midst of the COVID-19 global health crisis, Mayo Clinic is changing the way patient care is provided.

"I think, as an organization, we've made close to a decade of progress over the course of one year," says Mayo Clinic President and CEO Dr. Gianrico Farrugia. "The COVID-19 pandemic pushed us faster and further than we could have imagined. We're now tangibly stronger than we were pre-COVID — in our practice, in education, in research and in operation and business agility."

One example, says Dr. Farrugia, has been with virtual and digital care. "We all want to see our patients in person," explains Dr. Farrugia. "But the other side of the coin is that it's important to meet patients where they are, to make health care easier for their daily lives. What we're seeing now is that we can do both physical and virtual care really well and do it seamlessly."

"The pandemic served to reinforce our 2030 'Bold.Forward.' strategy, which is to cure more patients, to connect people and data, to create new scalable knowledge, and to transform health care through our unique Mayo Clinic platform," says Farrugia.

In this Mayo Clinic Q&A podcast, Dr. Farrugia says, "Amidst all the grief and the loss that we all experienced, there's a lot we have gained and now it's incumbent on us to make sure we use it to transform health care." Listen as Dr. Farrugia describes how that transformation is happening at Mayo Clinic.

Regular activity is good for the heart, but patients with heart conditions may wonder if it is safe to exercise. Mayo Clinic's Sports Cardiology Clinic is a specialty clinic where a team of cardiologists, exercise physiologists, and other specialists evaluate and treat heart conditions with a goal of keeping athletes active in sports.

But who could benefit from sports cardiology?

"We're trying to target three different types of patients," says Dr. Brian Shapiro, a Mayo Clinic cardiologist. "Of course, that elite athlete, whether it be professional, collegiate or even high school, as we're able to see patients from 15 years and older. Second, the weekend warriors — people who want to get out there and start running again, or biking, doing triathlons and things of this nature. And, finally, those patients who may actually have cardiac disease and have never worked out."

The Sports Cardiology Clinic also can advise patients how to improve training and performance. The evaluation involves a stress test.

"A cardiopulmonary stress test is the cornerstone of the evaluation we will do with these patients," says Dr. Bryan Taylor, a Mayo Clinic cardiopulmonary exercise physiologist. "We are trying to do two things. One, we're trying to understand the baseline level of fitness of the overall heart and lung and musculoskeletal fitness the person has. But the stress test is also a first sweep where potential issues might be identified. And we can understand if exercise is limited, is it due to a heart condition or a lung condition or something else?"

On the Mayo Clinic Q&A podcast, Dr. Shapiro and Dr. Taylor discuss sports cardiology evaluation, monitoring and treatment options.

Eric Berg has had seizures due to epilepsy since he was 12 years old. This past year, his seizures increased in frequency, affecting his day-to-day life and his ability to work. With encouragement from his fiancee, Eric sought treatment at Mayo Clinic.

At Mayo Clinic, experts are using a new way to treat some seizure disorders: repetitive transcranial magnetic stimulation, or rTMS. This treatment uses a magnetic field to stimulate certain areas of the brain. While often used to treat depression, repetitive transcranial magnetic stimulation also is showing promise in treating seizures.

On the Mayo Clinic Q&A podcast, Eric Berg shares his story. His physician, Dr. Jeffrey Britton, a neurologist and chair of the Division of Epilepsy at Mayo Clinic, also joins the podcast and explains how repetitive transcranial magnetic stimulation is used to treat seizure disorders.

Mayo Clinic recently performed the first-ever shoulder arthroplasty procedure that used mixed reality technology in the United States. This technology provides surgeons with a 3D holographic view of the patient's preoperative plan, allowing the surgeon to visualize, rotate and interact with a surgical plan during the procedure.

On the Mayo Clinic Q&A podcast, Dr. Joaquin Sanchez-Sotelo, a Mayo Clinic orthopedic surgeon, explains how mixed reality technology helps put the surgical plan into action.

Dr. Sanchez-Sotelo and Mayo Clinic have a financial interest in Wright Medical Group N.V., which developed the mixed reality technology.

Getting ready for a new school year can be exciting for children, parents and caregivers. But it also can be stressful and scary. Whether kids are heading to school for the first time or moving to a new school, it is common to be nervous when facing change. 

"It's important to let our kids know that it's really normal to feel this way," says Dr. Marcie Billings, a Mayo Clinic pediatrician. "Just try to support your kids and let them talk through their fears, talk through their challenges that they're dealing with. And don't think that you need every answer. It's really just about listening." 

Another common concern for parents is mental health and wellness and preparing their children to deal with the challenges of a new school year. 

Adding to the challenge is the fact that this is now the third school year affected by the COVID-19 pandemic. Parents and students will need to understand masking and vaccination recommendations to help navigate the classroom setting as safely as possible.

In addition to COVID-19 vaccinations, it is important to make sure children are up to date on other childhood immunizations, including preparing to get a flu shot as soon as it is available this fall.

"Being vaccinated against COVID-19 and current on all childhood vaccinations is a really important part to returning to school safely," says Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases physician.

Dr. Rajapakse points out that masking recommendations may differ by school and region based on levels of transmission, but children who choose to wear masks should be supported by staff and other students.

"There are certain children, for example, children with weakened immune systems or children who have people in their family with a weakened immune system, who may still choose to mask even if community transmission is low," explains Dr. Rajapakse. "I think it's important to recognize that anyone who wants to wear a mask in an indoor setting should be supported in doing so." 

On the Mayo Clinic Q&A podcast, "Ask the Mayo Mom" host Dr. Angela Mattke, a pediatrician in Mayo Clinic Children’s Center, is joined by Dr. Billings and Dr. Rajapakse for a discussion on back to school topics, including COVID-19, monkeypox, mental health in kids and teens, nutrition and sleep.

During the COVID-pandemic, we've heard a lot about telemedicine. While still a relatively new concept, advances in technology have made telemedicine a reality in hospitals, clinics, even the E-R.

On this episode of Mayo Clinic Q&A, emergency room physician Dr. Christopher Russi and physician assistant Erin Mason will explain how Mayo Clinic is using telemedicine in the emergency department.

Congenital ear anomalies or malformations are birth defects that affect the shape and position of the ear. Common anomalies include microtia, or small ears; prominent ears; or a missing ear. These malformations are not only cosmetic but also they can affect the function of the ear. Otoplasty is a surgical procedure to change the shape, position or size of the ears.

This edition of the Mayo Clinic Q&A podcast features an #AsktheMayoMom episode hosted by Dr. Angela Mattke, a pediatrician at Mayo Clinic Children's Center. Joining Dr. Mattke to discuss congenital ear anomalies is Dr. Waleed Gibreel, a Mayo Clinic craniofacial and pediatric plastic surgeon.

Stress, isolation and limited access to resources are fueling rising rates of substance abuse and overdoses during the COVID-19 pandemic. While coronavirus has been the focus of so much attention this year, the opioid crisis has continued unabated and has even worsened. More than 40 states have reported increases in opioid related deaths, according to the American Medical Association.

On the Mayo Clinic Q&A podcast, Dr. Tyler Oesterle, a psychiatrist and addiction expert at Mayo Clinic, discusses opioid use disorders and treatment options, including virtual medicine available during the pandemic.

The COVID-19 pandemic has brought public awareness to vaccines and how vaccines work. A vaccine is any agent that causes the immune system to remember a specific disease-causing entity, thereby preventing future infections. In the case of COVID-19, that's a coronavirus.

At Mayo Clinic, decades of research have led to development of a new vaccine platform — a single-cycle adenovirus nasal vaccine — that is now being tested in a phase 1 clinical trial for COVID-19.

“Single-cycle is particularly potent as a nasal vaccine, fighting SARS (severe acute respiratory syndrome) at its site of entry,” says Dr. Michael Barry, director of Mayo Clinic’s Vector and Vaccine Engineering Laboratory.

On the Mayo Clinic Q&A podcast, Dr. Barry discusses the research behind vaccine development and the possibility of future applications for the new vaccine platform.

The latest direction in cancer treatment has been toward potential cancer vaccines and immunotherapies. As these therapies become standard, continued research is important to understand how the body interacts with these treatments. A recent Mayo Clinic study found a unique form of immunosuppression caused by brain cancer that could inhibit the effectiveness of cancer vaccines and immunotherapies. The findings were recently published in the journal, Brain.

On the Mayo Clinic Q&A podcast, Dr. Aaron J. Johnson, a professor of immunology at Mayo Clinic, and Dr. Katayoun (Kathy) Ayasoufi, a research associate in Dr. Johnson's lab in the Department of immunology, discuss the importance of basic science research and explain how understanding the immunosuppression caused by brain cancer could lead to improved treatments for patients.

Each week, the Mayo Clinic Q&A podcast shares the latest information on COVID-19. On today's episode, Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group, answers listeners' coronavirus questions.

Dr. Poland discusses how to stay safe from the virus while exercising outdoors, whether temperature checks help screen for COVID-19, and how to deal with holiday travel and gatherings this year.
Research disclosures for Dr. Gregory Poland.

Welcome to Q & A, a new weekly podcast from Mayo Clinic. On this podcast, we will welcome Mayo Clinic physicians, nurses, dietitians and patients for wide-ranging interviews on newsworthy topics, emerging treatments, and complex conditions. Our goal – reach patients and consumers where they are and share medical information and health and wellness news from Mayo Clinic experts.

Subscribe now and look for episodes starting January 2020.

Like many organizations, Mayo Clinic is working to address disparities and equity in health care. This work is important not only in the clinic setting, but also in addressing equity issues in medical research and clinical trials.

Clinical trials are research studies used to determine whether an intervention, such as a drug, device or other therapy, is safe and effective for people. People in racial and ethnic minority groups are underrepresented in clinical trials.

"That's a real concern and a real issue because you want to make sure that the results of the clinical trial are applicable to the whole population," says Dr. Gerardo Colon-Otero, a Mayo Clinic oncologist and medical director for the Center for Health Equity and Community Engagement Research at Mayo Clinic in Florida.

While efforts are underway at Mayo Clinic to promote inclusive participation in clinical trials for all populations, Sonya Goins, a Mayo Clinic patient who has participated in clinical trials, says that more work needs to be done to reach members of underserved groups and help them understand the benefits of participating in clinical trials.

"Firstly, when it comes to diverse communities, people need to be aware that these studies are out there, and that they give you hope," says Goins. "That's the reason why I do them. It's because they give me hope."

On the Mayo Clinic Q&A podcast, Dr. Colon-Otero and Goins join host Dr. Halena Gazelka for a conversation about equity in research and clinical trials.

The COVID-19 pandemic continues to create challenges, including returning to school with hybrid learning modules for children. There are also anxieties and uncertainties to navigate, while trying to follow COVID-19 guidelines.

In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, talks about the concerns her patients have, and what important things parents and caregivers should take into consideration when helping children stay healthy.

The gallbladder is a small, pear-shaped organ that sits just beneath the liver, on the right side of the abdomen. Slender tubes that carry bile fluid also are also located in that area. Because of the relatively hidden nature of the gallbladder and bile ducts, cancers can grow without being detected. Late detection can mean a poor prognosis.

Dr. Kabir Mody, former co-chair of the Hepatobiliary Disease Group at Mayo Clinic Cancer Center, says February is the awareness month set aside to educate people about these rare cancers.

In this Mayo Clinic Q&A podcast, Dr. Mody talks about symptoms, detection, surgical interventions and treatments for gallbladder and bile ducts cancers.

Transplants are identified as nonelective surgeries, and transplant patients have faced urgent medical needs during the COVID-19 pandemic.

"Our practice, like many others across the country, did slow down in March and April of this year," says Dr. Patrick Dean, a Mayo Clinic transplant surgeon. "Patients and providers were concerned ― appropriately so ― about what would happen with this pandemic and whether it would be safe to have a transplant or for that matter any health care that wasn't absolutely emergent."

In this "Mayo Clinic Q&A" podcast, Dr. Dean talks about taking care of transplant patients; overcoming surgery challenges during the pandemic; the increased risks transplant patients have of developing SARS-CoV-2, the virus that causes COVID-19, because of compromised immune systems; and the important need for COVID-19 testing.

Polycystic kidney disease is an inherited disorder where clusters of cysts develop within the kidneys, causing the kidneys to enlarge and lose function over time. The cysts, which are noncancerous sacs containing fluid, vary in size, and they can grow to be large. This disorder can occur in children and adults.

The two main types of polycystic kidney disease, caused by different genetic flaws, are:

• Autosomal dominant polycystic kidney disease (ADPKD). Signs and symptoms of ADPKD often develop between the ages of 30 and 40. In the past, this type was called adult polycystic kidney disease, but children can develop the disorder.Only one parent needs to have the disease for it to pass to the children. If one parent has ADPKD, each child has a 50% chance of getting the disease. This form accounts for most of the cases of polycystic kidney disease. 
• Autosomal recessive polycystic kidney disease (ARPKD). This type is far less common than is ADPKD. The signs and symptoms often appear shortly after birth. Sometimes, symptoms don't appear until later in childhood or during adolescence.Both parents must have abnormal genes to pass on this form of the disease. If both parents carry a gene for this disorder, each child has a 25% chance of getting the disease.

Polycystic kidney disease also can cause cysts to develop in the liver and elsewhere in the body. The disease can cause serious complications, including high blood pressure and kidney failure.

The disease varies greatly in its severity, and some complications from polycystic kidney disease are preventable. Lifestyle changes and treatments might help reduce damage to the kidneys from complications, but long-term interventions, including dialysis or kidney transplant, are sometimes needed.

On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Christian Hanna, a pediatric nephrologist with Mayo Clinic Children’s Center to discuss PKD in children.

Ductal carcinoma in situ (DCIS) is an early form of a non-invasive breast cancer that begins as abnormal cells inside the milk ducts in the breast. It typically doesn't show signs or symptoms and it's estimated that up to 40% of cases eventually become invasive if not treated.

The current standard treatment is to perform a lumpectomy or a mastectomy in more extreme cases. Clinical trials are underway to determine if some patients with ductal carcinoma in situ might be able to avoid surgery.

"In addition to considering proton therapy to target the cancer, Mayo Clinic is conducting a clinical trial that involves a vaccine that could boost immunity against the HER2 receptor," says Dr. Amy Degnim, a surgeon with the Mayo Clinic Cancer Center. "HER2 is a protein that in some cases is on the outside of cancer cells and for women with ductal carcinoma in situ, these receptors are present in about 50% to 60% of the cases."

In this Mayo Clinic Q&A podcast Dr. Degnim, and one of her patients, Helen Gagoud, discuss receiving a ductal carcinoma in situ diagnosis and determining treatment, as well as the hopeful vaccine research at Mayo Clinic.

The COVID-19 pandemic has put a hold on many activities. But one thing that shouldn't fall by the wayside is your child's health.

In this Mayo Clinic Q&A episode, Dr. Nipunie Rajapakse, a pediatric infectious disease specialist, discusses the importance of routine checkups, including keeping up with vaccination schedules.

At least 16 countries and 10 U.S. states have identified unusual hepatitis cases in children. Experts advise that cases are extremely rare, with about 200 children affected worldwide. 

Hepatitis is inflammation of the liver. It is most commonly caused by a viral infection, although there are other potential causes. A common adenovirus is being investigated as a potential cause for this hepatitis outbreak. Adenoviruses are a group of viruses that typically cause respiratory and GI tract infections. 

On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke discusses the recent hepatitis outbreak in children with Mayo Clinic Children’s Center experts Dr. Nipunie Rajapakse, a pediatric infectious diseases expert, and Dr. Sara Hassan, a pediatric transplant hepatologist and gastroenterologist.

During to the COVID-19 pandemic, teleworking and distance learning has become a necessity. The new normal means many people needed technology to do their jobs, and that is certainly true at Mayo Clinic. Information technology (IT) has aided Mayo Clinic during the pandemic in two significant ways. One, thousands of employees moved out of their offices and into their homes to work. And two, patients now more than ever are being seen by their health care providers using video visits and tele-health.

On the Mayo Clinic Q&A podcast, Mark Henderson, division chair of IT at Mayo Clinic, discusses how IT has aided in the COVID-19 response.

Sweating. Freezing. Sweating. Freezing. That's the “nordic cycle,” or alternating between a sauna and cold water. More spas are offering both hot and cold therapies as part of their services, and at-home sauna tents and ice baths are becoming more and more popular. But how beneficial are these methods of extreme temperature exposure for your health? And are they always safe?

On this episode of Health Matters, we talk with sports medicine specialist Dr. Amy Beacom about the sweating, the shivering and whether this should be part of your routine.

Find us online at Mayo Clinic Press for more health and wellness articles, podcasts and books.

Do you have feedback, questions or topic suggestions? Email us at mcppodcasts@mayo.edu.

We’ve all experienced our heart rate change. For example, your heart rate increases when you exercise and slows when you sleep. But what if your heart rhythm changes when you aren't expecting it? That condition is known as heart arrhythmia. 

Heart arrhythmias, also called heart rhythm problems, occur when the electrical impulses that coordinate your heartbeats don't work properly. This causes your heart to beat too fast, too slow or irregularly.

Arrhythmias may feel like a fluttering or racing heart, and they may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms. 

It is important to find the cause, says Dr. Elijah Behr, a cardiologist at Mayo Clinic Healthcare in London. "It's very straightforward to investigate," says Dr. Behr. "And we have treatments that can prevent risk, prolong life, and can maintain quality of life for people."

Treatment can include medications, catheter procedures, implanted devices or surgery to control or eliminate fast, slow or irregular heartbeats. A heart-healthy lifestyle also can help prevent heart damage that can trigger certain heart arrhythmias.

On the Mayo Clinic Q&A podcast, Dr. Behr discusses the warning signs of heart arrhythmias and how they are diagnosed and treated.