Mayo Clinic Q&A

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. 

Acute myeloid leukemia (AML), also called acute myelogenous leukemia, is a cancer of the blood and bone marrow, the spongy tissue inside bones where blood cells are made. The disease progresses rapidly, affecting a group of white blood cells called myeloid cells, which normally develop into mature red blood cells, white blood cells and platelets. "There are acute and chronic leukemias, explains Dr. James Foran, an oncologist at Mayo Clinic. "The chronic ones tend to happen slowly over many years. You can watch it for a period of time until it really becomes active. The acute leukemias come on more quickly and cause people to get sick more quickly. Hence, the word acute."AML occurs when a bone marrow cell develops mutations in its DNA that cause the cell to continue growing and dividing. When this happens, blood cell production becomes out of control. The bone marrow produces immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.Signs and symptoms of AML include: Fever Bone pain Lethargy and fatigue Shortness of breath Pale skin Frequent infections Easy bruising Unusual bleeding Treatment of acute myeloid leukemia depends on several factors, including the subtype of the disease, and a person's age and overall health. At the time of diagnosis, a bone marrow biopsy is performed, and testing is done to determine the subtype of AML. Genetic testing on leukemia cells helps oncologists plan treatment that will give patients the highest chance of remission."There have been massive advances in the last five or seven years," explains Dr. Foran. "We understand that almost everybody with acute myeloid leukemia will have some genetic abnormality in the leukemia cells. Some mutations predict for a lower remission rate with standard chemotherapies. Those are situations where we're looking for new therapies that would be more effective, new strategies — whether that's an immune treatment, a targeted therapy, a different type of chemotherapy. So those mutations really helped guide us on how to apply the new strategies." Dr. Foran says Mayo Clinic is a leader in ongoing research and clinical trials to refine and improve targeted and immune therapy treatments. New approaches include expanding the use of bone marrow transplants and using CAR-T cell therapy. "Mayo Clinic is in the front of the field, I believe. We're studying more targeted treatments to go after cells with mutations, to try to spare side effects, and get the most benefit in treating leukemia," he says. "We're continually and actively looking for new strategies to improve outcomes for patients."On this Mayo Clinic Q&A podcast, Dr. Foran discusses acute myeloid leukemia, including the latest research and advances in treatments.

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 eatingEating 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. ExercisingRegular 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 sleepAdequate 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.

Pituitary tumors are abnormal growths that develop in your pituitary gland. Pituitary tumors can cause too much or too little of the hormones that regulate important functions of your body to be produced. Most pituitary tumors are noncancerous growths called adenomas, which remain in your pituitary gland or surrounding tissues and don't spread to other parts of your body."It's very uncommon for any pituitary tumor to be a malignancy or what one would commonly think about as a cancer or something that would travel elsewhere," says Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon. "Almost all of these are benign tumors." Pituitary tumors are categorized as functioning or nonfunctioning, depending on if they are producing hormones.The signs and symptoms of nonfunctioning pituitary tumors, those that don't make hormones, nonfunctioning are related to their growth and the pressure they put on other structures."Out of all pituitary tumors, about half of them aren't making any kind of a substance," explains Dr. Van Gompel. "And those are called nonfunctioning adenomas or tumors. And they cause problems by putting pressure on things nearby. So they'll either take up enough room where the pituitary gland is so that it doesn't function well, and you have to get medications to replace some of that function. Or you may start to lose vision. That's another very common presenting symptom with these. "Pituitary tumors that make hormones, called functioning, can cause a variety of signs and symptoms depending on the hormone they produce."Functioning tumors cause distinct syndromes," says Dr. Van Gompel. "The three most common are prolactin-secreting tumors, Cushing's and acromegaly." Dr. Van Gompel explains overproduction of prolactin from a pituitary tumor can cause breast milk to develop in women, even when they aren't postpartum. In men, it often affects sexual function. In Cushing syndrome, the body creates too much cortisol. The hallmark signs of Cushing syndrome are a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome also can result in high blood pressure, bone loss and, sometimes, Type 2 diabetes. Acromegaly is a hormonal disorder that develops when the pituitary gland produces too much growth hormone during adulthood, causing bones to increase in size. In childhood, this leads to increased height and is called gigantism. But in adulthood, a change in height doesn't occur. Instead, the increase in bone size is limited to the bones of the hands, feet and face.There are various options for treating pituitary tumors, including removing the tumor, controlling its growth and managing your hormone levels with medications. Surgery often is needed if a pituitary tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. Most often, surgery is done endoscopically through the nasal cavity. The neurosurgeon removes the tumor through the nose and sinuses without an external incision. No other part of the brain is affected, and there's no visible scar.Mayo Clinic is one of the largest pituitary centers in the U.S., evaluating and treating more than 1,600 people with pituitary tumors every year. Dr. Van Gompel explains that being treated at a referral center that sees a high volume of pituitary tumors is important."Here at Mayo, we have huge expertise, and a group of people that know how to manage these adenomas," explains Dr. Van Gompel. "We're fortunate to have excellent colleagues in neuroradiology because the imaging matters to help locate the tumors. We also have a team of endocrinologists who focus specifically on treatment and management of pituitary tumors. And we have surgeons, like me, who focus on adenomas. We're constantly working together studying our outcomes to make sure they're as good, if not better, than they were last year, to improve care for our patients." On the Mayo Clinic Q&A podcast, Dr. Van Gompel discusses options for treating pituitary tumors.

Recently, new treatment options have become available to those living with severe peanut allergies.  We will be exploring what's new in this area and who could potentially benefit.On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Martha Hartz.  Dr. Hartz is a Pediatric Allergist-Immunologist at Mayo Clinic Children's Center and is also an Assistant Professor of Medicine and Pediatrics who will also discuss what is on the horizon in the world of allergy treatment.

One of the potentially painful side effects of cancer treatment is lymphedema. Lymphedema is tissue swelling caused by the buildup of fluid that's usually drained through the body's lymphatic system. Because lymph nodes are an important part of the lymphatic system, lymphedema can be caused by cancer treatments that remove or damage the lymph nodes."During cancer treatment, sometimes lymph nodes need to be removed, and the lymphatic system that travels around and through these lymph nodes, gets damaged as well," explains Dr. Antonio Forte, a Mayo Clinic plastic surgeon. "It's impossible to remove the lymph nodes without damaging the system."Lymphedema most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals. Severe cases of lymphedema can affect the ability to move the affected limb, increase the risks of skin infections and sepsis, and can lead to skin changes and breakdown. An estimated 20% to 40% of patients undergoing an axillary lymph node dissection — removal of lymph nodes from the armpit, which is a common part of surgery for breast cancer — will develop lymphedema.Nonsurgical treatment options include compression bandages or garments, massage, and careful skin care. If compression treatment isn't successful, a microsurgery technique, known as lymphovenous bypass, may be an option.Microsurgery refers to the fact that the surgery is done using powerful microscopes that are magnified 20 to 25 times. Using special dye injected under the skin to identify the lymphatic pathways, surgeons then use small incisions to reroute the lymphatic system by connecting tiny lymphatic vessels to tiny veins, creating a detour around the damaged lymph nodes. The new connection restores the body's ability to drain lymphatic fluids. Dr. Forte specializes in lymphovenous bypass surgery and has seen great benefits for patients. He points out that it's a minimally invasive procedure that can be done in an outpatient setting. The incisions are small, scarring is minimal, and patients can see significant reduction of their swelling."A very good study that was published almost a decade ago looked at patients that had lymphovenous bypass, and on average, 42% of the swelling improved over one year," says Dr. Forte. "Now there are patients that will have much more improvement than that. And some other patients will have very little improvement. But, on average, patients that have lymphovenous bypass surgery improve by 42%."On this Mayo Clinic Q&A podcast, Dr. Forte explains the lymphovenous bypass procedure, who is a candidate for the surgery, and the risks and benefits of this lymphedema treatment.Related Articles: "A regenerative detour for lymphedema." "Video: Lymphovenous Bypass Surgery for Lymphedema."

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"

At Mayo Clinic, the Department of Business Development is the front door to business. From technology commercialization to strategic partnerships, the ultimate goal of innovation at Mayo Clinic is to improve health outcomes and benefit patients.Business Development has two divisions: Mayo Clinic Ventures, which is Mayo's technology development and commercialization group, responsible for assisting Mayo innovators in advancing their invention ideas into actual products.  Corporate Development, which is focused on creating opportunities such as partnerships, joint ventures, and new company formation. "Mayo has about 7,000 active inventors across its campuses, which is quite incredible," says Dr. Clark Otley, medical director for the Department of Business Development at Mayo Clinic. "Every week, I receive a list of the new invention ideas and technologies that they think up, and I am frankly in awe of their creativity and drive to help our patients."  Mayo Clinic Ventures works hand in hand with all three shields at Mayo Clinic — Research, Practice and Education — to advance the best ideas to the marketplace.  "In many parts of health care, a 10% success rate is considered standard," explains Dr. Otley. "Mayo's success rate in achieving at least some degree of commercial success is closer to 30%, thanks to our amazing inventors and the hard work of our Mayo Clinic Ventures staff."  Mayo's key invention activities and innovations align with the strategic plan to "Cure. Connect. Transform." Business Development supports key activities in each of those areas: In Cures, Business Development is partnering with our Research and Practice innovators to advance technologies aimed at restoring vision, diagnosing cancers bodywide through a blood test, manipulating the proximal small intestine to reverse diabetes, controlling recalcitrant seizures and regenerating organs that have worn out, and many more areas. In Connect, Business Development is partnering with innovators in the practice, Center for Digital Health and Mayo Clinic Platform to advance the care of patients with serious or complex diseases in the comfort of their home, caring for pregnant patients in more effective and less disruptive ways, and even extending cancer care beyond the walls of Mayo Clinic. In Transform, Business Development is partnering with Mayo Clinic Platform to advance new, transformative, data-science-based platform solutions that aim to extend Mayo's expertise, powered by artificial intelligence, to patients across the world, in conjunction with colleagues from Mayo Clinic International. Past successes help support future endeavors at Mayo Clinic."The big news is that Mayo is about the hit a milestone related to inventing," says Dr. Otley. "Sometime this winter, Mayo will reach the $1 billion milestone of revenue brought back from our inventing activity, supported by Mayo Clinic Ventures. And the beautiful thing is that those proceeds are reinvested back into our three-shield mission of Practice, Education and Research to maintain the virtuous cycle of invention in patient care."On the Mayo Clinic Q&A podcast, Dr. Otley joins host, Dr. Halena Gazelka, to share an inside look at invention at Mayo Clinic.

Facial paralysis can affect one side or both sides of the face and can affect eye closure, the smile and lower lip movement. Facial paralysis can be caused by a variety of syndromes and can also be the result of a birth defect, a tumor, or trauma.When facial paralysis occurs in children, it impairs a child's ability to move their facial muscles and show facial expression. Surgery can be done to reanimate the face and give children back the ability to show their smiles and expressions on the outside. The Facial Paralysis and Reanimation Clinic at Mayo Clinic Children's Center brings together a team of experts including neurologists, plastic surgeons, optometrists and physical therapists to develop a treatment plan tailored to each child.On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by two experts— Dr. Samir Mardini, a plastic surgeon and chair of the Division of Plastic Surgery and co-director of the cleft and craniofacial clinic at Mayo Clinic Children's Center, and Dr. Waleed Gibreel, a craniofacial and pediatric plastic surgeon at Mayo Clinic — to discuss facial reanimation surgery in children.

Epilepsy is a neurological disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy and epilepsy affects both males and females of all races, ethnic backgrounds, and ages.Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.Medications for epilepsy have improved and remain the most common way to treat epilepsy. Open surgery to remove the portion of the brain that's causing the seizures is still an important treatment option for epilepsy that isn't controlled by medication. In recent years, new treatment options for epilepsy, including minimally invasive options, have developed. The latest treatments include: Deep brain stimulation. This is the use of a device that is placed permanently deep inside the brain. The device releases regularly timed electrical signals that disrupt seizure-inducing activity. This procedure is guided by MRI. The generator that sends the electrical pulse is implanted in the chest. Responsive neurostimulation. These implantable, pacemaker-like devices can help significantly reduce how often seizures occur. These responsive stimulation devices analyze brain activity patterns to detect seizures as they start and deliver an electrical charge or drug to stop the seizure before it causes impairment. Research shows that this therapy has few side effects and can provide long-term seizure relief. Laser interstitial thermal therapy (LITT). This is less invasive than resective surgery. It uses a laser to pinpoint and destroy a small portion of brain tissue. An MRI is used to guide the laser. Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided focused ultrasound, show promise at treating seizures with fewer risks than traditional open brain surgery for epilepsy. "The game is much different now," says Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon. "We've really improved the outcomes for patients. I think it's important to explore treatment options because they can have substantial, meaningful impacts in people's lives."Dr. Van Gompel encourages people with epilepsy to check in with their primary care provider or neurologist about their current treatment, and don't hesitate to seek a second opinion at an epilepsy center, especially if you have side effects from your medications or are continuing to have seizure events.“If you haven't seen a specialist in the last five years, you should see an epileptologist at a specialized care center,” says Dr. Van Gompel. "Epilepsy treatments are changing so rapidly right now with the introduction of robotics and stereotactic techniques that there might be something new that can help you with your seizures or epilepsy management."Research in the field continues to focus on seizure prevention, prediction and treatment. Dr. Van Gompel predicts that the use of artificial intelligence and machine learning will help neurologists and neurosurgeons continue to move toward better treatment options and outcomes."I think we will continue to move more and more toward removing less and less brain," says Dr. Van Gompel. "And in fact, I do believe in decades, we'll understand stimulation enough that maybe we'll never cut out brain again. Maybe we'll be able to treat that misbehaving brain with electricity or something else. Maybe sometimes it's drug delivery, directly into the area, that will rehabilitate that area to make it functional cortex again. That's at least our hope."On the Mayo Clinic Q&A podcast, Dr. Van Gompel discusses the latest treatment options for epilepsy and what's on the horizon in research.

Commercials and advertisements often target parents, suggesting they should give their kids vitamins and supplements to help them grow strong and stay healthy. But is it true?The short answer is no. "By and large, when kids are generally healthy, when they're growing well, when there is no big concern, there's really no need for any extra vitamins or supplements," says  Dr. Erin Alexander, a Mayo Clinic gastroenterologist. Experts agree that most kids should get their vitamins from food, not supplements. The American Academy of Pediatrics states that healthy children receiving a normal, well-balanced diet do not need vitamin supplementation over and above the recommended dietary allowances that they get from the foods they eat. While many young children may be selective about what they eat, that doesn't necessarily mean that they have nutritional deficiencies. Many common foods — including breakfast cereal, milk and orange juice — are fortified with important nutrients, such as B vitamins, vitamin D, calcium and iron. So your child may be getting more vitamins and minerals than you think.Nutrition for kids is based on the same ideas as nutrition for adults. Everyone needs the same types of things, such as vitamins, minerals, carbohydrates, protein and fat. Children need different amounts of specific nutrients at different ages.Food packed with nutrients — with no or limited sugar, saturated fat, or salt added to it — is considered nutrient-dense. Focusing on nutrient-dense foods helps kids get the nutrients they need while limiting overall calories.Nutrient-dense foods include: Protein. Choose seafood, lean meat and poultry, eggs, beans, peas, soy products, and unsalted nuts and seeds. Fruits. Encourage your child to eat a variety of fresh, canned, frozen or dried fruits. Look for canned fruit that says it's light or packed in its own juice. This means it's low in added sugar. Keep in mind that 1/4 cup of dried fruit counts as one serving of fruit. Vegetables. Serve a variety of fresh, canned, frozen or dried vegetables. Choose peas or beans, along with colorful vegetables each week. When selecting canned or frozen vegetables, look for ones that are lower in sodium. Grains. Choose whole grains, such as whole-wheat bread or pasta, oatmeal, popcorn, quinoa, or brown or wild rice. Dairy. Encourage your child to eat and drink fat-free or low-fat dairy products, such as milk, yogurt and cheese. Fortified soy beverages also count as dairy. "When we're thinking about a child's nutrition, it's really important that we think very broadly," says Dr. Dana Steien, a gastroenterologist and director of pediatric nutrition at Mayo Clinic Children's Center. "Macronutrients — protiens, carbohydrates and fats — are where we get our calories. Micronutrients are all our minerals and vitamins." Another important part of a healthy diet is limiting a child's calories from added sugars, saturated fats and salt. Check nutrition labels on food products for information on calories and serving sizes.While most kids get what they need from the foods they eat, there are certain medical situations or conditions where children need nutrient supplementation or specialized diets. For instance, babies born prematurely may require nutritional supplements to help them grow. Some children may develop iron, vitamin D or calcium deficiencies that require supplementation. Another common issue is kids who develop allergies or food intolerances that may require them to follow a modified diet such as gluten-free, low fructose or low lactose. These special diets should be supervised by a dietitian or your child's health care team.On this "Ask the Mayo Mom" edition of the Q&A podcast, Drs. Alexander and Steien join host, Dr. Angela Mattke, to talk about nutrition, supplements and special diets for children.Related Articles: "Should I give multivitamins to my preschooler?" "Nutrition for kids: Guidelines for a healthy diet." "Kids and sodium: Serious risks, alarming realities."

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.

Like all patients, military veterans bring their unique experiences and backgrounds with them as they navigate medical and end-of-life care. At Mayo Clinic, programs are in place to honor military service and care for veterans.Mayo Clinic Hospice is a partner of the We Honor Veterans Program run by the National Hospice and Palliative Care Organization. The Hospice team provides the high level of medical, emotional, spiritual and social care that those who have served in the U.S. armed forces deserve. Team members recognize and honor the hospice patient's military service with a veteran pinning ceremony. Ceremonies are provided after approval by the patient and family and can include anyone whom the military member and family would like to participate, along with the hospice team.“It's just a small, simple way of saying thank you to a veteran,” says Loren Olson, a chaplain with Mayo Clinic Hospice. “We bring a pillowcase that represents their branch of the service and a small pin that they could put on a lapel, or a lot of them put them on their military hats. We bring a coin and a certificate from Mayo Clinic expressing our appreciation and we invite them to share their experiences in the military.”Building on the We Honor Veterans program, Charlie Hall, a Mayo Clinic security operations supervisor, helped develop a "Final Honor Walk" for deceased veterans at his Mayo Clinic Health System location in La Crosse, Wisconsin.Hall served in the Army as an active-duty rifleman with a combat tour to the Balkans and as a paratrooper with close to 100 military parachute jumps. In addition to his role as a security supervisor, Hall and his team in La Crosse meet with families of deceased veterans to arrange a “Final Honor Walk," where family and staff line the hallway to honor veterans while they are moved out of the hospital room in a flagged-draped cart. “The final honor walk is something that I wanted to develop,” explains Hall. “I had worked with the We Honor Veterans program in Rochester, with hospice, and the near-end-of-life things with veterans, all the great things they do there. I had the privilege of doing that, but I saw us being able to do a little bit more in an inpatient setting.” In addition to care at the end of life, it's important to acknowledge the unique needs of veterans every day in the clinical setting. Issues including post-traumatic stress disorder (PTSD) and substance use disorders are more common among veterans than the general population, and they often go hand in hand. More than 2 in 10 veterans with PTSD also have a substance use disorder, according to the U.S. Department of Veterans Affairs. “If a veteran is wearing a hat that signifies their veteran's status if you will, that to me is the OK to come up and thank them for their service,” says Hall. “And I do that routinely here. It's usually a surprise to the veteran. They're usually extremely grateful. Probably the No. 1 thing is to acknowledge them. It's so important to make people feel at ease when care is coming, especially when there are some complex situations with medical care. There are some very sensitive conversations that have to happen. We all know that happens so much easier when we have great rapport with our patients.”“Honoring veterans is part of the culture at Mayo Clinic, at least in my experience,” says Olson. “One of the first things I learned as I came to work the hospice program was that We Honor Veterans partnership with the Veterans Administration is important to us. We want to spend time honoring our veterans. So I do think we have developed a corporate culture that just helps us to think of the specific needs of our veterans.” On this special Veterans Day edition of the Mayo Clinic Q&A podcast, Olson and Hall join host, Dr. Halena Gazelka, for a conversation on caring for veterans.

Barrett's esophagus is a condition in which the lining esophagus becomes damaged by acid reflux, which causes the lining to thicken and become red. Over time, the valve between the esophagus and the stomach may begin to fail, leading to acid and chemical damage of the esophagus, a condition called gastroesophageal reflux disease, or GERD.  In some people, GERD may trigger a change in the cells that line the lower esophagus, causing Barrett's esophagus."The stomach is well designed to handle highly acidic conditions," explains Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London. "But the esophagus is not designed to cope with acid. And so when acid comes up, that acid reflux damages the cells, replacing them with more acid-resistant cells that develop into Barrett's esophagus." While frequent heartburn may be a sign, many people with Barrett's esophagus have no symptoms. Having Barrett's esophagus does increase your risk of developing esophageal cancer. Although the cancer risk is small, it's important for people with Barrett's esophagus to have regular checkups to check for precancerous cells. Those at highest risk for Barrett's esophagus include:  White men over the age of 50. People with family history of Barrett's esophagus or esophageal cancer. People who smoke.  People with excess abdominal fat.  Patients with long-standing reflux lasting more than five years.  "If you have three of those risk factors, then you should have a screening endoscopy for Barrett's esophagus, according to current guidelines," says Dr. East. To screen for Barrett's esophagus, a lighted tube with a camera at the end, called an endoscope, is passed down the throat to check for signs of changing esophagus tissue. A biopsy is often done to remove tissue and confirm the diagnosis.Treatment for Barrett's esophagus depends on the extent of abnormal cell growth in your esophagus and your overall health. Treatments in the early stages can include lifestyle measures and medications to help reduce acid reflux and therefore, the esophageal acid exposure. If the cell damage is more extensive, radiofrequency ablation may be be used. In this technique, a balloon is used to heat the abnormal esophagus tissue and burn it away. Another technique, cryotherapy, applies cold liquid or gas to destroy the abnormal cells.The best way to prevent Barrett's esophagus is to address acid reflux and GERD through lifestyle changes."Lifestyle measures that reduce the risk of reflux are the key here because once Barrett's esophagus develops, it's a permanent change unless we use some of the ablation techniques," says Dr. East. "So absolutely quit smoking, and limit alcohol and caffeine. And even losing a small amount of weight can really help reduce reflux symptoms."On the Mayo Clinic Q&A podcast, Dr. East discusses diagnosing and treating Barrett's esophagus. 

Epilepsy is a neurologic central nervous system disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness.Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis.Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. When a child is diagnosed with epilepsy, families may need support to adjust to this new diagnosis. Parents and schools can partner with the medical team to help."One of the things that's really important for families to remember is they are not fighting this battle on your own," explains Dr. Elaine Wirrell, a pediatric neurologist and chair of Child and Adolescent Neurology at Mayo Clinic Children's Center. "You need to share the diagnosis and inform those who are caring for your child — teachers, daycare, coaches — so they are prepared to help." Medication is generally the first course of treatment for epilepsy. Finding the right medication or combination of medications, and the optimal dosages, can be complex. Many children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life.For some children with drug-resistant epilepsy, surgery is an option. Epilepsy surgery, which is considered when at least two anti-seizure medications have failed to work, removes or alters an area of the brain where seizures originate.Experts at Mayo Clinic Children's Center also are studying neurostimulation treatments for epilepsy, an alternative treatment for children with severe epilepsy or for those who cannot have surgery. This treatment applies electricity to the central nervous system with the goal of reducing seizure frequency and severity.On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Wirrell for a discussion on epilepsy in children.Related articles: "Consumer Health: Treating children with epilepsy." "Mayo Clinic Q&A podcast: Epilepsy Awareness Month."

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.

When someone has a stroke, every second is crucial. The longer it takes to receive treatment, the more likely it is that damage to the brain will occur. "The mantra is 'time is brain,'" explains Dr. James Meschia, a Mayo Clinic neurologist and stroke expert. "The sooner they get treatment, the better patients do."World Stroke Day is recognized each year on Oct. 29. The aim is to teach the public about stroke risk factors and stroke prevention, and to raise awareness about the warning signs of stroke so people recognize when a loved one may be having a stroke and can take action.To recognize the warning signs of stroke, Dr. Meschia says remember the acronym, BE FAST: B stands for balance. Watch for the sudden loss of balance. E stands for eyes. Vision loss in one or both eyes is a warning sign.  F stands for face. Facial droop or if the face looks uneven is a sign of stroke. A stands for arm, but it can be sudden weakness of an arm or leg. S stands for speech, including trouble speaking, slurring words or difficulty understanding speech. T stands for time. This represents both noting the time the symptoms occur and reducing the time it takes to receive medical care by calling 911. There are two main types of strokes: ischemic and hemorrhagic. An ischemic stroke happens when there is a loss of blood supply to an area of the brain. A hemorrhagic stroke happens when there is bleeding into the brain when a blood vessel ruptures. Eighty-five percent of all strokes are ischemic.Globally, 1 in 4 adults over 25 will have a stroke in their lifetime, according to the World Stroke Organization. More than 110 million people in the world have experienced stroke, but thanks to the development of clot-busting drugs and procedures to remove clots using a catheter, outcomes for people who have a stroke are improving."The first big treatment revolution happened in the 1990s. And in 1995 we finally closed in on a dose and a time window to give a clot-busting drug known as tissue plasminogen activator or, tPA," says Dr. Meschia. "Then in 2015, the added benefits of mechanical thrombectomy were clearly established. That is where a catheter is inserted, and, under guidance by an X-ray camera, the tip of the catheter is positioned in or near the clot and the clot pulled out. So used in combination or by themselves, thrombolysis and thrombectomy have been major advances in the therapy."After emergency treatment, most stroke survivors go through a rehabilitation program. Stroke care focuses on helping people recover as much function as possible, with the goal of returning to independent living. The impact of the stroke depends on the area of the brain involved and the amount of tissue damaged.If the stroke affected the right side of the brain, movement and sensation on the left side of the body may be affected. If the stroke affected the left side of the brain, movement and sensation on the right side of the body may be affected. Brain damage to the left side of the brain may also cause speech and language disorders.Dr. Meschia encourages stroke victims to realize that the effects of a stroke are worse at the beginning, and that there is hope for rehabilitation."One of the important points with stroke is that it is sudden in onset, and often maximally severe at onset," says Dr. Meschia. "There are some exceptions, but I would say about 9 out of 10 are maximally severe at onset. And then, over the course of one to three months with appropriate rehabilitation — be it speech, physical or occupational therapy, or a combination thereof — patients do rally and improve significantly. And it is one of the things to be aware of because sometimes patients and families can feel like giving up. I think that would be tragic because, at least in the short term, the prognosis is favorable for some level of recovery."Many strokes can be prevented in the first place by minimizing risk factors. Maintaining a healthy body weight, staying physically active and controlling blood pressure reduce the risk of stroke. Other stroke prevention steps include stopping smoking, eating a healthy diet and managing blood sugar levels. On the Q&A podcast, Dr. Meschia discusses stroke prevention, the warning signs of stroke and the latest in stroke treatments. 

The type of breast cancer a person has and how far it has spread determine the appropriate treatment. Previously, a patient with breast cancer might have received five to six weeks of radiation therapy.But the approach is changing."For many years, we had the understanding that giving a little bit of radiation each day and spreading that treatment out over multiple weeks was the gentlest on the normal tissues, and that would lead to the least side effects," says Dr. Robert Mutter, a Mayo Clinic radiation oncologist. "But over the last decade or two, there's been a lot of research. We found we might be better off giving bigger doses each day and finishing in a shorter period of time. And that might be better at destroying the cancer cells, while limiting side effects of the normal tissue."The use of proton beam radiation therapy is one way the treatment of breast cancer is advancing. Unlike traditional X-ray radiation, proton beam therapy can more precisely target tumors, sparing more normal tissue.The Mayo Clinic Proton Beam Therapy Program uses pencil beam scanning, which Mayo investigators have shown reduces radiation exposure to healthy tissue. This highly targeted therapy is ideal for people with tumors close to or in vital organs, and for young people, whose organs are still developing. Mayo Clinic offers proton beam therapy in Arizona and Minnesota. Recently, Mayo Clinic announced a $100 million gift from the Fred C. and Katherine B. Andersen Foundation to expand Mayo Clinic's proton beam therapy services in Minnesota.  “Protons have this ability to stop on a dime. And that's because they're charged, and they have a mass,” explains Dr. Mutter. “And so we can actually give them just enough energy to travel to the tissue and have them stop. And so all that tissue behind the tumor or the target is spared of radiation exposure. But we're very excited to be able to study proton therapy and to be able to offer proton therapy for patients that we think may benefit, including breast cancer.”In this Mayo Clinic Q&A podcast, Dr. Mutter expands on Mayo Clinic's research and the development of new therapies to minimize patient side effects from radiation, including the increased use of proton therapy. Dr. Mutter also talks about the patient concerns about relapses and how Mayo is using medicines in combination with radiation to reduce relapse risks.

Endometriosis is often a painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus — the endometrium — grows outside the uterus. "Endometriosis is a very common condition," explains Dr. Tatnai Burnett, a gynecologic surgeon at Mayo Clinic. "Most of our studies, which are looking at women who have symptoms, would suggest that about 1 in 10 women, so 10% or so have endometriosis. Now, the difficulty here is that some women do not have significant symptoms and wouldn't go to a doctor, or they minimize their symptoms or think what they are experiencing is normal. So, if anything, that estimate is probably on the low side of what actual reality is."With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit the body, it becomes trapped. Endometriosis can cause pain, which is sometimes severe, especially during menstrual periods. Fortunately, effective treatments are available. Imaging, including ultrasound and MRI, is an important step in evaluating patients with endometriosis and can impact treatment options and surgical planning. "Ultrasound is a great way to start the evaluation of the female pelvis because it's easily accessible," says Dr. Wendaline VanBuren, a Mayo Clinic radiologist who specializes in gynecologic imaging. "And it gives us a lot of information about the ovaries and the uterus. The problem with endometriosis is that, while it can involve the ovaries, it can involve all these sites on the surface of the uterus, the bowel, the ureters and all the structures around it. So, MRI gives us a little bit more of a global perspective of the pelvis. So that's the advantage of using MRI." To better coordinate care for patients with endometriosis, Drs. Burnett and VanBuren instituted an MRI-based interdisciplinary conference at Mayo Clinic that brings together radiology and gynecology."For endometriosis, we realized that a multidisciplinary approach where we review things together was just in the best interest of the patient because it gives us the best coordination of care between the radiologist and the gynecologist," says Dr. Burnett. "It gives us a nuanced interpretation of what the imaging means for the patient. And then it allows us to apply what we see in the imaging to our surgical plan and to the surgical team. We use all the information that we gather to really make the best plan for the patient in regard to the patient's goals and what they need."The team at Mayo Clinic has been sharing the success of this collaborative model and educating other experts through the publication of their research findings and participation in a disease-focused endometriosis panel through the Society for Abdominal Radiology."We all have our own expertise," says Dr. VanBuren. "And when we're able to collaborate and share, hearing the clinical stories, looking at the imaging, putting it together, the considerations for management, whether that be medical or surgical planning, we're really able to make a huge impact. It's exciting to see now collaborations between societies, from gynecology and radiology together."On the Mayo Clinic Q&A podcast, Drs. Burnett and VanBuren discuss the multidisciplinary approach to diagnosing and treating endometriosis.

Hyperthermic intraperitoneal chemotherapy (HIPEC) delivers chemotherapy directly into the abdominal cavity. It is used in conjunction with cancer surgery for people with advanced cancer that has spread inside the abdomen. “Hyperthermic” means warm or hot. “Intraperitoneal” means inside the abdominal cavity, which is encased in a sac called the peritoneum. HIPEC uses high-dose chemotherapy to kill microscopic cancer cells inside the abdominal cavity. The HIPEC procedure is performed immediately after a surgeon has removed all visible cancer in the abdomen. HIPEC is well studied in several types of cancer and being explored as a potential treatment in others. "So really any cancer that's just localized in the abdomen on the surface of the peritoneum could be a candidate," explains Dr. Travis Grotz, a Mayo Clinic surgical oncologist. "We know for sure, based on studies and data that HIPEC works well for cancers of the colon, cancers of the appendix, cancer to the ovaries, cancer of the stomach, and there's even a cancer of the lining of the peritoneum, called mesothelioma. So those would be the cancers I think that are well studied and well accepted. Then, there are more rare tumors that we have less data for, such as cancer to the pancreas or gallbladder or small intestine, that we don't know yet if that's the right treatment."The specific type of chemotherapy used for HIPEC varies depending on the type of cancer being treated. The abdominal cavity is bathed with hot chemotherapy to kill any microscopic cancer cells that might still be present. Heating the chemotherapy enhances its effectiveness because, when it's hot, chemotherapy penetrates the tissue more deeply, increasing the number of cancer cells it can reach.On this Mayo Clinic Q&A podcast, Dr. Grotz explains what HIPEC is, how it is performed, and the risks and benefits of the treatment.Related Articles: "New therapies bring hope for ovarian cancer." "Alternative chemotherapy offers hope for late-stage cancers." "Aggressive treatment turns tide in fighting colon cancer."

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 naps1 to 2 years 11 to 14 hours per 24 hours, including naps3 to 5 years 10 to 13 hours per 24 hours, including naps6 to 12 years 9 to 12 hours per 24 hours13 to 18 years 8 to 10 hours per 24 hoursAdults 7 or more hours a nightCreating 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.

Shoulder replacement surgery is done to relieve pain and other symptoms that result from damage to the shoulder joint. Common conditions that can damage the shoulder joint include osteoarthritis, rotator cuff injuriesand fractures, among others. Thanks to improved surgical techniques and an aging population, the number of shoulder replacement surgeries is increasing."The rate of usage of shoulder replacement in the United States has increased dramatically," explains Dr. Joaquin Sanchez-Sotelo, a Mayo Clinic orthopedic surgeon. "And I think there are two reasons. One is that implants are better. And also, that patients now are more active with their upper extremities later in life. So, they need the procedure because they want to have a life where they can enjoy activities pain-free."Traditionally, shoulder replacement removes damaged areas of bone and replaces them with standard parts made of metal and plastic. Joint replacement surgery could be a challenge if some of the bone is missing, the bone quality is poor, or if a bone graft is not accurate. Now, thanks to new technology, there is another option. Using CT scans and 3D-printed models, some patients can receive joint replacements that are created to be custom fit to their anatomy. "The benefit is you are guaranteeing the patient that the implant is going to fit his or her shoulder, No. 1," says Dr. Sanchez-Sotelo. "No 2., it decreases surgical time tremendously. Because in the past, you had to get exposure and then prepare the bone until it fits one of the off-the-shelf implants. Now you know that the implant is going to fit the patient right out of the box. So surgery time is less." There are some limitations to use of the new implants. People with severe deformities may not be candidates, and people who require surgery quickly may not have time to wait for a custom implant to be built. Despite these limitations, Dr. Sanchez-Sotelo says, like artificial intelligence and mixed reality, custom-fitted joints could be another game-changer in orthopedics and another tool for surgeons to help patients."I think this is going to transform our practice," says Dr. Sanchez-Sotelo. "Technology is advancing so fast in medicine and orthopedic surgery. I'm just excited to see how we can change the operation, make it faster, make it easier, and lead to a much better outcome."On the Mayo Clinic Q&A podcast, Dr. Joaquin Sanchez-Sotelo, discusses advances in shoulder replacement surgery, including custom-fitted implants.The custom-fitted shoulder implant discussed in this podcast is produced by Strkyer. Dr. Sanchez-Sotelo and Mayo Clinic receive consulting fees and royalty payments from Stryker for shoulder arthroplasty products; however, Dr. Sanchez-Sotelo and Mayo Clinic do not have any relevant financial conflicts with this specific device.

Heart failure — sometimes known as congestive heart failure — occurs when the heart muscle doesn't pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath."The most recognized, the most common symptom of heart failure is breathlessness," says Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And the type of breathlessness that patients would describe most often is the inability to lie flat, waking up in the middle of the night or gasping for air."Heart failure is often thought to be a disease of advanced age, but it can actually develop at any time in life. In many cases, heart failure can be prevented or treated if people are aware of the risk factors and warning signs. Coronary artery disease is the main cause of heart failure. Stiffening of the heart muscle is mostly a result of poorly controlled hypertensionor diabetes. Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer. Lifestyle changes — such as losing weight, exercising, reducing salt (sodium) in your diet and managing stress — can improve your quality of life. "All the risks of developing heart attack, if we reduce those risks, we improve their lifestyle," explains Dr. Wamil. "If we reduce the risk of diabetes, hypertension, stop smoking, this will reduce the risk of heart attacks, but at the same time, will reduce the risk of heart failure."Dr. Wamil's research efforts include studies aimed at understanding the connection between diabetes and heart disease and using novel medical imaging techniques to identify heart failure early on. Other research underway at Mayo Clinic includes the use of artificial intelligence and machine learning tools to detect heart failure early."An area of research interest at Mayo Clinic is the use of large databases, such as randomized controlled trials, electronic health care records, and applying not only statistical methods but also AI, machine learning models and algorithms to try to identify how we can detect early signs of heart failure risks," explains Dr. Wamil. On the Mayo Clinic Q&A podcast, Dr. Wamil, discusses warning signs of heart failure and advances in early detection of heart disease.Related posts: "Mayo Clinic London Healthcare expert shares heart failure signs, symptoms people may not be aware of." "Mayo Clinic Q&A podcast: Understanding the connection between diabetes and heart disease." "AI-guided screening uses ECG data to detect a hidden risk factor for stroke." "Mayo researchers use AI to detect weak heart pump via patients' Apple Watch ECGs."

Most people diagnosed with breast cancer undergo surgery to remove their cancer from the breast as well as have lymph nodes removed as part of their treatment. "Surgical resection of the tumor from the breast and also evaluation of the lymph nodes are used for the vast majority of patients with breast cancer, in particular, those patients where the disease is limited to the breast," says Dr. Judy C. Boughey, a surgical oncologist at Mayo Clinic. "One of the areas where often breast surgery does not have a role is if the breast cancer has spread or metastasized to other areas of the body. So for patients with stage 4 breast cancer, surgery has a much more questionable role."Surgery is used to treat most stages of breast cancer, but it is rarely used to treat metastatic breast cancer — breast cancer that has spread to other parts of the body. Breast cancer surgery may be used alone or in combination with other treatments, such as chemotherapy, hormone therapy, targeted therapy and radiation therapy. Breast cancer surgery includes different procedures, such as: Surgery to remove the entire breast (mastectomy) Surgery to remove a portion of the breast tissue (lumpectomy) Surgery to remove nearby lymph nodes Surgery to reconstruct a breast after mastectomy Which breast cancer operation is best for an individual depends on the size and stage of the cancer, other treatment options available, and the goals and preferences of each patient.For people with a very high risk of breast cancer, a preventive (prophylactic) mastectomy may be an option to reduce the risk of future breast cancer. With so many options and decisions to be made, preparing for breast cancer surgery can be a challenge. It's important to be comfortable with your surgeon and to have the support of family and loved ones."Starting on the breast cancer journey is always a very challenging time," says Dr. Boughey. "Lean on your closest loved ones that you let into your inner circle and talk to them about your diagnosis, your treatment and your journey."Dr. Boughey also encourages people to remember that everyone's journey is unique and to rely on your care team for trusted information."I think one thing to be very aware of with breast cancer is it is a very common disease, and every one of us knows someone or someone's relative that has been affected by this disease," explains Dr. Boughey. "Truthfully, breast cancer really is not one disease. And so I would just caution against hearing about your friends and their experience because it may have been a different size tumor and may have been treated a different way. And most importantly, it was likely a different tumor biology. And so you don't necessarily always have to listen to everybody's story and experience because that doesn't mean that yours will be the same. Share with your doctors some of the concerns that you've heard from your friends, from your colleagues, what you may have read on the internet, so that if they're not true, your team can dispel those myths for you and make you feel more comfortable."On this Mayo Clinic Q&A podcast, Dr. Boughey discusses how surgery is used in the treatment of breast cancer.

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.

Through research, clinical trials and biomanufacturing, Mayo Clinic's Center for Regenerative Biotherapeutics is working to develop new types of medicines derived from the human body to treat chronic and age-related diseases. Biologics are therapies that come from human sources — cells, blood, enzymes, tissues, genes or genetically engineered cells — for use in medicines. Biomanufacturing is focused on manufacturing commercial grade biologically based medicines for treatment. Some examples include the use of stem cells, gene therapy and cell therapy, and 3D printing of tissues and organs."The important thing is that there's an opportunity to use these type of therapies to cure rather than just treat patients as we move forward looking at different ways of being able to use these products," says Dr. Julie Allickson, the Michael S. and Mary Sue Shannon Family Director of Mayo Clinic's Center for Regenerative Biotherapeutics. "It's definitely a bright future." Dr. Allickson also is the Otto Bremer Trust Director of Biomanufacturing and Product Development in the Center for Regenerative Biotherapeutics.Mayo Clinic is working to move cellular discoveries from the lab to clinical trial and into commercially available therapies. To move technologies forward, partnerships are key.  Mayo Clinic has formed a strategic collaboration with National Resilience Inc. to establish Rochester, Minnesota as a center for biomanufacturing regenerative technologies. Mayo also has manufacturing facilities in Jacksonville, Florida and Phoenix.Recently, Mayo Clinic, Hibiscus BioVentures, and Innoforce announced the launch of Mayflower BioVentures, a cell and gene therapy accelerator dedicated to identifying and forming companies around technologies that address unmet patient needs. All three organizations have a financial interest in the Mayflower collaboration. Mayo Clinic will use any revenue it receives to support its nonprofit mission in patient care, education and research."There is a lot of investment in the field," says Dr. Allickson. "And Mayo Clinic is certainly prioritizing this across the enterprise, to allow the patients here to have treatments focused on rare and complex diseases. Here at Mayo Clinic, we want to make sure that that happens."On the Mayo Clinic Q&A podcast, Dr. Allickson discusses the near- and long-term future of biomanufacturing and biotherapeutics.

Children learn about racial differences and racial bias from an early age, and parents and caregivers are their first teachers. It's important for parents and other adults to be role models for inclusive behaviors early in the lives of children life to decrease racial bias and improve cultural understanding.Experts encourage parents and caregivers to get comfortable with having difficult conversations about race and bias. "It's important for all children to have these discussions, and as an adult in any child's life, everything that you're doing is modeling for them what's okay and isn't okay," says Dr. Emily McTate, a Mayo Clinic pediatric psychologist. Parents may be surprised to find out that a baby's brain can notice race-based differences as early as 6 months, according to the American Academy of Pediatrics. By age 12, many children become set in their beliefs. When children have questions about racial differences, it's important to keep a child's developmental stage in mind and tailor age-appropriate messages. The American Academy of Pediatrics offers these strategies for helping children understand and deal with racial bias: Talk to your children and acknowledge that racial differences and bias exist. Confront your own bias and model how you want your children to respond to others who may be different than them.  Encourage your children to challenge racial stereotypes and racial bias by being kind and compassionate when interacting with people of all racial, ethnic, and cultural groups. Another important step is teaching kids to be critical consumers of media. "I always think about all the moments, whether you're reading books together or watching animated movies together, whatever it is, and hit the pause button and talk about what's going on," says Dr. Daniel Hilliker, a Mayo Clinic pediatric psychologist. "Why is this person being represented in this fashion? And that can kind of open up the conversation about exploring some different perspectives." On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. McTate and Dr. Hilliker for a discussion on talking to kids about racism.Additional resources: "Talking to Young Children About Race and Racism." "Coming Together: Celebrating Every Child's Race, Ethnicity, Culture!"  "Talking About Race: Who am I?"

The number of people who die from uterine cancer is increasing, particularly among Black women.Also called endometrial cancer, uterine cancer begins in the layer of cells that form the lining, or endometrium, of the uterus. The American Cancer Society estimates that about 65,950 new cases of uterine cancer will be diagnosed in the U.S.this year, and about 12,550 people will die from the disease.Researchers recently reported the results of a study of 208,587 women ages 40 and older with uterine cancer. The study showed death rates for all types of uterine cancer increased significantly by 1.8% per year from 2010 to 2017. Death rates remained stable for the most common form of uterine cancer — Type 1 endometrial cancer — but increased by 2.7% per year for a rarer, more aggressive form called Type 2 endometrial cancer."We do see a rise in diagnosis of uterine cancer," says Dr. Kristina Butler, a Mayo Clinic gynecologic oncologist. "And we feel like that is because there's also a rise of some other illnesses such as diabetes, hypertension and obesity, which are risk factors for uterine cancer. And because we're seeing more people experience those types of illnesses, uterine cancer rates are rising." The study also revealed racial disparities in uterine cancer death rates. Death rates from uterine cancer increased 6.7% annually among Hispanic women, 3.5% among Black women, 3.4% among Asian women and 1.5% among White women. Despite representing less than 10% of cases, nearly 18% of all deaths from uterine cancer occurred in Black women."Addressing health disparities is a huge priority of our national organization, the Society of Gynecologic Oncology," explains Dr. Butler. "I think it's very clear that there are disparities as it relates to patient access to care. Also, opportunities to train providers in cultural competency, so that patients feel very comfortable coming and having that patient-doctor relationship. And we need to improve health care access for women in rural communities and take education to those communities so that those women feel comfortable reaching out to us when they need care." On this Mayo Clinic Q&A podcast, Dr. Butler discusses uterine cancer, disparities related to the disease, and what people can do to reduce their risk of developing this type of cancer.

While childhood cancer is rare, 1 in every 266 children and adolescents will be diagnosed with cancer by age 20, according to the American Cancer Society. Each September, advocacy groups, health care institutions, patients and families recognize Childhood Cancer Awareness Month to help families who receive a cancer diagnosis.“A lot of people still don't know what to do if a child is diagnosed with cancer or where to go,” explains Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. “We want people to know that we know that a cancer diagnosis is scary. We know that it's life-altering. But we also want you to know that there's hope, that we are doing really good things here at Mayo Clinic and elsewhere. And there is hope for a cure, and there is life after childhood cancer.”Dr. Allen-Rhoades says funding is needed for more pediatric cancer research to continue to improve treatments. One area of focus for her has been sarcomas. Sarcoma — the term for a group of cancers that begin in the bones and in the soft or connective tissues — is one of the more common types of childhood cancer. Fortunately, recent treatment advances have increased survival rates. Of children diagnosed with cancer, 84% now survive five years or more. One of the advances in treatment has been improvement in radiation therapy techniques and the use of proton beam therapy to treat pediatric cancers."Radiation therapy works very well for sarcomas," says Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. "And the difference between conventional radiation and proton therapy radiation is that our radiation oncologists are able to contour a little bit tighter with proton therapy. Therefore, the surrounding tissue that is normal is spared from some of the side effects. This is really important in children who are growing because we want them to be able to grow normally."In addition to sparing healthy tissue from the effects of radiation, people who must undergo radiation therapy early in life are less likely to have long-term side effects and complications, such as secondary cancers, with proton beam therapy than with conventional radiation therapy.While treatments and cure rates for sarcomas have improved, Dr. Allen-Rhoades hopes for even better results in the future.“Sarcomas have been a tough nut to crack for sure in terms of research and novel innovative therapies,” says Dr. Allen-Rhoades. “We still have a ways to go, but we're doing much, much better than we were 20—30 years ago. But until we can cure everyone, it will never be enough.”On the Mayo Clinic Q&A podcast, Dr. Allen-Rhoades discusses pediatric sarcomas and the importance of funding for research and support of families dealing with pediatric cancer.

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." 

Treatment for brain tumors in children can differ from treatment for brain tumors in adults, so it is important to seek care from specialists in pediatric cancer and neurology.Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain, or the tissue and structures near the brain. Of the many types of pediatric brain tumors, some are noncancerous, or benign, and some are cancerous, or malignant.Common brain tumors in infants, children and teenagers include: Gliomas These tumors begin in the brain or spinal cord. Types of gliomas include pilocytic astrocytomas, ependymomas and oligodendrogliomas. Medulloblastoma A medulloblastoma is the most common cancerous brain tumor in children. It starts in the lower back part of the brain, called the posterior fossa, and tends to spread through spinal fluid. Treatment and chance of recovery depend on many factors: the type of tumor, its location within the brain, whether it has spread, and the child's age and general health. "The good news is that the really bad tumors are fairly rare," says Dr. David Daniels, a Mayo Clinic pediatric neurosurgeon. "When we look at tumors, we look at their type or classification, and then a grading that goes along with that."Often, a biopsy of the tumor is performed to determine its type and grade. This information helps guide the course of treatment, which can include surgery, radiation therapy and chemotherapy."The biggest thing is that grading," explains Dr. Daniels. "Is this a grade one tumor, which is very benign, or is this a grade four tumor, which is really aggressive? And so our treatment has to match the aggressiveness of that tumor, so to speak." Because new treatments and technologies are continually being developed, several options may be available at different points in treatment. As part of the Mayo Clinic Children's Center, pediatric specialists in Mayo's Pediatric Brain Tumor Clinic work together as a team to develop an individual treatment plan for each child. Typically, a pediatric neuro-oncologist specializing in brain tumors is the child's primary doctor. This doctor coordinates access to other specialists from the pediatric brain tumor treatment team, including pediatric neurology, pediatric neurosurgery, neuroradiology, pediatric endocrinology, neuropathology, pediatric radiation oncology, pediatric oncology, child psychology and pediatric rehabilitation.On this Mayo Clinic Q&A podcast, pediatrician and Ask the Mayo Mom host, Dr. Angela Mattke, is joined by Dr. Daniels to discuss common pediatric brain tumors. Dr. Daniels covers treatment, including when surgery may be an option, and highlights the latest in brain tumor research.

Many institutions that provide cancer care also offer cancer survivorship clinics. These clinics focus on helping people with cancer manage the physical, emotional and social effects of cancer and cancer treatment, as well as improving the overall health and well-being of cancer survivors. "Cancer survivorship visits can be very beneficial for the patients," says Dr. Meghna Ailawadhi, a Mayo Clinic general internist specializing in cancer survivorship. "They can provide a bridge between your primary care and your oncologist, and help patients sort out the posttreatment journey a little bit easier."Cancer survivorship clinics may focus on a specific cancer type or a specific age group, such as children, adults, or adolescents and young adults (ages 15 to 39). Many different specialists may be involved, including medical oncologists; rehabilitation specialists; nutritionists; and other specialties, like cardiology and gastroenterology, if needed. These clinics often help cancer survivors develop a survivorship care plan — a plan tailored to the individual survivor to make sure that person gets the most out of life after a cancer diagnosis. The care plan also can help inform the primary care physicians who care for these patients after active treatment is finished."A survivorship care plan entails the details of their treatment, the details of their cancer journey, their pathology reports, and what kind of treatment — radiation, chemotherapy — they have received," explains Dr. Ailawadhi. "And there's also an assessment and a care plan for the future of how often these patients need to have their surveillance scans, what labs to look for, what signs to look for. It also addresses some of their long-term needs if they are suffering from peripheral neuropathy, chronic diarrhea or other posttreatment effects. So it's an extremely useful document both for the patient and for their primary care providers."On this Mayo Clinic Q&A podcast, Dr. Ailawadhi discusses Mayo Clinic's cancer survivorship clinics, what services they offer, and how to find similar services in your area.Also, check out these cancer survivorship articles: "Mayo Clinic Q&A podcast: Cancer survivorship needs are unique to each survivor." "Consumer Health: Reconnecting with loved ones after cancer treatment." "Mayo Clinic Q&A podcast: Living as a prostate cancer survivor." "Consumer Health: Managing your emotions after cancer treatment." "Mayo Clinic Q&A podcast: Diet and nutrition help cancer survivors return to good health." "Consumer Health: Life after cancer." "Mayo Clinic Q&A podcast: Meeting the unique needs of adolescent and young adult patients with cancer." "Mayo Clinic Q&A podcast: Life after lymphoma."

The first significant change to COVID-19 vaccines since their rollout came this week as the Food and Drug Administration granted emergency use authorization for updated Moderna and Pfizer COVID-19 boosters aimed at the omicron variants. The Centers for Disease Control and Prevention (CDC) also signed off on the recommendation, clearing the way for the new COVID-19 booster to be administered.The new boosters are bivalent vaccines, meaning they target more than one strain of the virus. The new formulation targets the BA.4 and BA.5 omicron variants, in addition to the original coronavirus strain. BA.5 is responsible for nearly 90% of all new COVID-19 cases in the U.S., according to the CDC. The Pfizer bivalent booster is approved for people 12 and up if they have already received their primary COVID-19 vaccine series and it has been at least two months since their last vaccine dose. The Moderna bivalent booster is available on the same timeline to people 18 and up."This booster recommendation is in anticipation that there will be yet another surge as college students, grade school and high school students are gathering back together," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "We're also preparing for cooler weather, meaning more indoor activities, family gatherings and the holidays — often without masks, unfortunately. We still need to take COVID seriously."Another big concern for vaccine experts is the upcoming flu season. The Southern Hemisphere is often an indicator of what's to come for the U.S. Australia's flu season exceeded its five-year average, particularly affecting children under age 5, according to a recent report. Experts worry that the relaxing of masking and social distancing recommendations that were in place for COVID-19 purposes the past two winters will be a factor. These measures also protected people from the flu."When cold weather moves us indoors, a high viral circulation occurs in schools and other indoor settings. I think we are very likely to see a bad flu year," says Dr. Poland. "Now I know we've been predicting that for two years, but for the most part, people wore masks and it didn't happen. I don't think that'll be the case this year. People are not wearing masks, and we are very likely to get hit hard by influenza."On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and touches on other news, including monkeypox, polio and the upcoming flu season.

In some parts of U.S., school has already begun, and over the next several weeks, almost all children will be back in the classroom after the Labor Day holiday. Setting up students for success at school includes parents and caregivers helping kids develop routines and good habits for time management, nutrition and sleep."Having routines is so important not only for our kids, but actually for our families and for us as adults, as well," explains Dr. Tina Ardon, a family medicine physician at Mayo Clinic in Florida. "And routines focusing on sleep are a huge part of how we can do well in an academic setting, but also really important for health in general for our kids. That's why kids grow. That's when brain development can happen. So focusing on a really good sleep schedule and routine is just so important for us to be prioritizing as families."Another important step to prepare for school is to make sure that a child's vaccinations are up to date."With any illness, but particularly for our kids, if we want to keep them from missing school, from missing things that we can prevent, then we should take advantage of the tools we have available," says Dr. Ardon. "So vaccines are one of those great tools that we have, at helping either prevent disease or helping us not get quite as sick from disease." In addition to routine childhood vaccinations, Dr. Ardon recommends all children age 6 months and up be vaccinated against COVID-19 and also receive a flu vaccination when it's available. Another important part of preparing for school is dealing with the anxiety about the unfamiliar — a new environment, a new school, a different classroom. So how can parents help kids navigate the uncertainty?"Keeping open lines of communication with your kids is so important," says Dr. Ardon. There are lots of ways for us to kind of prepare ourselves for either a new classroom or a new school. We can look online at pictures of the new school. We can take advantage of return-to-school activities where you can meet the teacher and walk around preparing your child for that first day. We can talk about what they're maybe excited about or nervous about. Is it homework? Is it new friends, old friends? Just allowing your child to have that conversation with you can alleviate a lot of that stress, as well."On the Mayo Clinic Q&A podcast, Dr. Ardon offers tips on helping kids prepare for back to school.

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.

Cardiac amyloidosis is a type of amyloidosis, which occurs when the body produces abnormal proteins that bind together to form a substance called amyloid. Amyloids can deposit in any tissue or organ, including the heart, kidneys, liver and nerves.When amyloid collects in the heart muscle, it causes irreversible thickening of the heart wall and disrupts heart function. It reduces your heart's ability to fill with blood between heartbeats, resulting in less blood being pumped with each beat. This can result in shortness of breath. Cardiac amyloidosis also can affect your heart's electrical system, resulting in a disturbed heart rhythm.Cardiac amyloidosis typically presents as a form of congestive heart failure. It is often overlooked 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." Dr. Lyle says it's important that patients bring any concerning symptoms to their health care provider as soon as possible.At Mayo Clinic, people with symptoms that indicate they might have cardiac amyloidosis are diagnosed and treated by a team of experts in the Cardiac Amyloidosis Clinic. This specialized care is available at Mayo Clinic's locations in Arizona, Florida and Minnesota.“This approach is a collaborative effort amongst several different specialties, including hematology, cardiology, transplant cardiology, as well as neurology and nephrology,” explains Dr. Lyle. “And our goal is really to provide an efficient evaluation for our patients so that we can quickly come to the correct diagnosis and offer the best treatment option. And we're engaging all of our different specialties for this comprehensive visit to provide the best overall care.” On the Mayo Clinic Q&A podcast, Dr. Lyle discusses diagnosis, standard treatment options and new therapies for treating cardiac amyloidosis.

Whether swimming in the pool, a trip to the lake or a day at the beach, summertime often means sun exposure. And protection from the sun is the focus of Summer Sun Safety Month every August.Skin cancer is the abnormal growth of skin cells. While it most often develops on skin exposed to the sun, but it also can occur on areas of skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer in the U.S."And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist. “We all want to be on the Earth longer, and we appreciate time and aging. But the older we are, the higher our risk for skin cancer.” The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Early detection of skin cancer gives you the best chance for successful skin cancer treatment.While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur."It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection: Asymmetry Look for moles with irregular shape. Border Look for moles with irregular, notched or scalloped borders. Changes in color Look for growths with different or uneven colors. Diameter Look for new growth of more than one-quarter of an inch in diameter. Evolving Look for changes over time. While melanoma is more common with age, pediatric melanoma can occur.“Often, it's not on everyone's radar because we don't believe that children can have skin malignancy, but that is not true,” says Dr. Davis. “It's simply less common. When children get melanoma, they can present with the same signs and symptoms as adults. However, they can also have different symptoms. Pediatric melanoma tends to be skin-colored or amelanotic more commonly than dark or pigmented. So, if a child develops a skin-colored, pink or red bump, or something that used to be flat and then becomes raised, that would be of concern.” On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.

While colorectal cancer is still the third leading cause of cancer deaths in the U.S., continuing improvements in screening and treatment mean many people diagnosed with colorectal cancer now can expect to survive long after diagnosis. The American Cancer Society estimates there are more than 1.5 million survivors of colorectal cancer in the U.S. But what happens after treatment for colorectal cancer treatment is complete? Do survivors of colorectal cancer return to life as they knew it before their diagnosis?"I think there are three main things that I see our patients really concerned with when they start thinking about finishing their treatment for colorectal cancer," says  Dr. David Etzioni, a colorectal surgeon and chair of the Department of Surgery at Mayo Clinic in Arizona. "The first and biggest concern they have is whether or not their disease will completely go away and stay gone. And this is, I think, a fundamental concern for any patient treated for cancer of any kind." Dr. Etzioni explains the other two common concerns for survivors of colorectal cancer are how the treatment will affect their day-to-day quality of life, and whether or not they will need an ostomy bag temporarily or permanently.An ostomy is a surgically created opening in your abdomen that allows waste or urine to leave your body and be collected in a bag or pouch. For survivors of colorectal cancer, this may be temporary to give the colon time to heal. But, depending on the extent of surgery to remove the cancer and the location of the cancer, sometimes a permanent ostomy bag is needed.Dr. Etzioni says education can alleviate the fears patients have about needing an ostomy bag."When I do have a patient who's worried what the bag is and what it might mean for their life — it might be a temporary or permanent bag — we have a lot of educational resources here at Mayo available to them. We often will send them to our osteo nurses, so they can actually try just wearing the appliance before they've undergone the surgery. They can see what it might be like to wear that underneath their clothes," explains Dr. Etzioni. "We also have a support group that consists of patients who have an ostomy. They discuss with each other what challenges they faced, and they're very supportive with each other. And I have a group of patients who are now with an ostomy who I can call on to reach out to a new patient of mine and talk about what it might mean to live with an ostomy. And that's something that I found to be very effective and can really help patients to get over that hump to accept that possibility for cancer treatment."Finally, Dr. Etzioni says the support of family, friends and loved ones is an important part of the journey for patients with colorectal cancer."The patients who undergo treatment with a strong, consistent, omnipresent support system, they simply do better — not just emotionally, but also just in terms of the ability to tolerate treatment," says Dr. Etzioni. "I think they literally have better medical and surgical outcomes."On this Mayo Clinic Q&A podcast, Dr. Etzioni discusses what people can expect after colorectal cancer treatment ends, and how to achieve the best possible quality of life.

When it comes to sports and activities, what a child eats can affect performance. Sports nutrition focuses on not only on good eating habits, but also on what an athlete might need before exercising and after as a part of recovery. Of course, sports nutrition goes beyond simply what you eat. When you eat is important, too. Understanding the right balance and timing of taking in carbohydrates, proteins and hydration can help athletes play their best. Eating a healthy diet ensures that athletes are getting all the nutrients their bodies need to produce energy to perform and to keep muscles, bones, joints and tendons healthy.Parents and kids should know the basics of sports nutrition and understand how supplements work and which products are beneficial. They also should be wary of supplements and products marketed to athletes because many products do not live up to their claims to increase strength, speed, and athletic skills. "Before you even consider supplement, you've got to make sure your diet and the foundation of that diet is solid," explains  Luke Corey, a registered dietician and sports medicine expert with by Mayo Clinic Children's Center. "What I tell my athletes is that unless you have a solid diet in place, eating every couple of hours consuming nutrient dense foods hydrating, well, supplements are not going to do for you what you think they're going to do." On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Luke Corey to discuss sports nutrition for young athletes. Topics discussed include what to eat before and after a workout; supplements and drinks including protein, creatine, electrolytes, and pre-workout caffeinated drinks; and concerns about calorie restrictive diets for athletes in some sports including wresting and gymnastics.

Asthma is a lung condition that causes swelling of the airways. It can make breathing difficult and trigger coughing, wheezing and shortness of breath. It's the most common chronic disease among children, although it affects adults, as well. More than 262 million people globally are affected by asthma, and more than 461,000 have died due to the disease, according to the World Health Organization.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.Unfortunately, childhood asthma can't be cured, and symptoms can continue into adulthood. But with the right treatment, children can keep symptoms under control and prevent damage to growing lungs. Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks.On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children's Center expert, Dr. Manuel Arteta, a pediatric pulmonologist, to discuss asthma in children.

Breastfeeding can be challenging, but help is available for new mothers. Lactation consultants, either at the hospital or through organizations like La Leche League, can help with learning the positions that work best mom and baby, and offer tips that can help with learning this new skill of breastfeeding.While breastfeeding benefits for the baby are well-known, the mother also benefits."It's definitely a great healthy choice for moms to breastfeed," explains Rebekah Huppert, a lactation consultant and nurse at Mayo Clinic. "We know that with breastfeeding, we see a reduction in mom's risk for cancer, primarily breast and ovarian cancer; we see a reduced risk for diabetes; and a reduced risk for cardiovascular issues later in life. It can help reduce bleeding right after delivery by causing some contractions of the uterus. Evidence that shows that breastfeeding helps with weight loss, as well. It just takes a lot of calories to make breast milk, so we burn through those quickly when we're lactating. Those are just a few of the benefits, but they're big ones for moms."The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life before introducing nutritious complementary foods. The organization also encourages social and systemic changes to support mothers who choose to breastfeed.This summer, the American Academy of Pediatrics released new recommendations supporting mothers to continue breastfeeding for two years or beyond. These recommendations align with guidelines provided by the World Health Organization and the American Academy of Family Physicians. Huppert advises women to not feel undue pressure with these new guidelines."It's a sensitive topic for women, especially those who want to do more and find that their body isn't cooperating or sometimes their job isn't accommodating," says Huppert. "So it is important to make sure that moms know that there are multiple ways we nourish our babies. We nourish them by holding them, and by talking to them and reading to them. It isn't just food. And at the end of the day, maternal health — having a mom who is happy and healthy — is going to be the most important thing for a child's growth and development." On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children's Center lactation expert Rebekah Huppert to discuss practical approaches to breastfeeding.

Cancer rehabilitation is available before, during and after cancer treatment. It helps people with cancer maintain and restore physical and emotional well-being, cope with the side effects of cancer, and recover more quickly and more fully from cancer treatment.Cancer rehabilitation involves many types of specialists working together to develop a personal rehabilitation plan that considers a person's preferences, strengths and goals."Cancer rehabilitation aims to help patients maintain function, restore function, and, more broadly, maintain personhood," says Dr. Andrea Cheville, a Mayo Clinic specialist in physical medicine and rehabilitation. "We obviously don't want the process of curing cancer to leave patients with lasting issues that are going to compromise the quality of their life." Cancer rehabilitation can include help from a wide variety of specialists, including physical medicine and rehabilitation, physical and occupational therapy, speech and language pathologists, and psychologists. "All these specialists work in close partnership to develop an individualized program for each unique individual that meets their needs, goals and preferences," explains Dr. Cheville.Dr. Cheville encourages people with cancer to include their family and caregivers in the cancer rehabilitation process. It is important for caregivers to understand the patient's goals and can support the work needed to reach them."The ideal for a cancer rehab team is the full engagement of the caregiver or partner," says Dr. Cheville. " It truly is a partnership and a team effort."On the Mayo Clinic Q&A podcast, Dr. Cheville discusses what's involved in cancer rehabilitation and how it can help people with cancer cope with the challenges that come with cancer diagnosis, treatment and recovery.