Donna J. Gainer fuels her active lifestyle of hiking, bicycling and gardening with a health-conscious diet of mostly whole foods. So, when the 64-year-old received news that she had colorectal cancer in autumn 2025, a wave of emotions hit her.

"My first thought was the heartbreak I felt knowing I would have to call my son to tell him about the cancer diagnosis," recalls Donna. "My second thought was shock that I could have developed cancer with my lifestyle. A cancer diagnosis did not make sense."

Colon cancer screening

Donna's journey began in June 2025 after a colon cancer screening returned abnormal results. Her primary care physician then referred her to Mayo Clinic's Gastroenterology Department for a diagnostic colonoscopy, which identified two polyps in the bends of her colon and one near her appendix.

The complexity of Donna's colonoscopy results prompted further consultation with Dr. Michael Wallace, a Mayo Clinic gastroenterologist. Dr. Wallace shared that, in many cases around the world, large polyps at difficult-to-reach locations in the colon are typically removed surgically.

"Fortunately, here at Mayo Clinic, we have sophisticated techniques for removing even these advanced and large polyps through endoscopy or colonoscopy," says Dr. Wallace.

A review of Donna's case with a multidisciplinary care team led to a plan using two advanced treatments that reduced the risk of recurrence while mitigating the need for more intensive surgery: endoscopic submucosal dissection (ESD) and endoscopic mucosal resection.

Dr. Vivek Kumbhari, a Mayo Clinic gastroenterologist, partnered with Dr. Wallace on Donna's care.

"Care like this is never delivered in isolation. Before the procedure, Dr. Wallace and I carefully reviewed her case and determined that a comprehensive, single-session approach was in her best interest," says Dr. Kumbhari. "That level of collaboration ensures that every decision is thoughtful, evidence-based and tailored specifically to the patient. It's one of the defining strengths of Mayo Clinic."

Donna underwent her comprehensive endoscopic resection at Mayo Clinic in November 2025. She recalls feeling less apprehensive about undergoing the resection than the colonoscopy, citing the thorough yet compassionate care from Dr. Wallace and confidence in Dr. Kumbhari's expertise and ability to operate inside the colon.

"I felt really special that (Dr. Kumbhari) was the one doing my surgery," says Donna. "What meant the most was how warm and reassuring he was when he sat with me before surgery and explained everything. I felt truly blessed to have him as my surgeon."

During the single outpatient procedure, Dr. Kumbhari removed all three polyps without incisions, preserving Donna's organ function and quality of life.

"That is exactly what modern, patient-centered cancer care should look like," says Dr. Kumbhari. 

In a final review of Donna's case, her care team concluded that since Dr. Kumbhari removed all three polyps in one outpatient procedure using advanced techniques, further surgery and its associated risks — including sphincter injury, incontinence or colostomy — were not needed. Donna remains under close surveillance by Dr. Wallace, undergoing endoscopic ultrasound, CT scans and lab work every 90 days.

Since her procedure, Donna has returned to the lifestyle she enjoys, including her outdoor activities.

"I continue to live each day with gratitude, and I am humbled to have two brilliant and skilled surgeons who truly saved not only my colon, but my life," says Donna. "I was back to my daily routines within 24 hours, sometimes forgetting that I underwent a 3-hour procedure."

Donna raises awareness about colorectal cancer by sharing her story in the hope of inspiring even one person to get a screening colonoscopy, even if they consider themselves healthy.

"I want people to know that colon cancer is one of those diseases that can grow silently, without symptoms," says Donna. "Imparting that message is worth sharing a personal and private part of my life."

The post When a healthy life meets an unexpected colon cancer diagnosis appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — In a study published in NEJM Catalyst, Mayo Clinic researchers have demonstrated that chemotherapy can be safely delivered in patients' homes.

The study evaluated Mayo Clinic's Cancer CARE Beyond Walls (Connected Access and Remote Expertise), a model that combines virtual care, remote patient monitoring and in-home clinical services to deliver cancer treatment outside traditional infusion centers.

In the pilot study, a multidisciplinary team delivered 93 IV chemotherapy infusions to 10 patients in their homes. Researchers reported no treatment-related infusion reactions or catheter-related infections, supporting the safety and feasibility of this approach.

"Cancer care has traditionally required patients to spend long hours in infusion centers, often far from home," says Roxana Dronca, M.D., site director of the Mayo Clinic Comprehensive Cancer Center in Florida and director of Mayo Clinic Cancer CARE Beyond Walls. "This model allows us to safely bring high-quality care directly to patients, reducing burden while maintaining the standards patients expect from Mayo Clinic."

The study highlights the potential of home-based chemotherapy to reduce the physical, emotional and financial burdens associated with cancer treatment. Patients avoided travel time and experienced fewer disruptions to daily life while maintaining a continuous connection with their care team through virtual visits and remote monitoring.

Most participants surveyed reported high satisfaction with at-home care and said they would recommend the model to others.

"This approach is about more than convenience," Dr. Dronca says. "It's about improving quality of life during treatment and expanding access to care for patients who may face barriers to reaching traditional cancer centers."

To build on these findings, Mayo Clinic is still enrolling patients in a randomized clinical trial that launched in August 2023 to evaluate home-based chemotherapy compared with standard infusion care. This study will examine safety, patient experience, outcomes and costs, with the goal of expanding access to high-quality cancer care and reducing barriers to clinical trial participation.

Dr. Dronca is the first author of the pilot study, and Cheryl Willman, M.D., the Stephen and Barbara Slaggie Executive Director, Mayo Clinic Cancer Programs, is the senior author. For a complete list of authors, disclosures and funding, review the study.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study demonstrates safety, feasibility of delivering chemotherapy at home appeared first on Mayo Clinic News Network.

March is Colorectal Cancer Awareness Month

ROCHESTER, Minn. — When someone is diagnosed with colorectal cancer — which includes both colon and rectal cancers — many people immediately think "surgery." And it’s true that surgery plays a central role in treatment for most patients. But whether it comes first, and what it entails, depends on several factors, especially where the cancer is located, how far it has grown into surrounding tissues, and whether it has spread, explains Eric Dozois, M.D., chair of colon and rectal surgery at Mayo Clinic in Minnesota.

"For colon cancer, surgery is typically the first and main step when the disease hasn't spread to distant organs. The goal is to remove the cancerous part of the colon along with nearby lymph nodes, which are the first places cancer spreads," Dr. Dozois says. "After surgery, the removed tissue is examined under a microscope to confirm the stage of the disease and decide whether additional treatment, such as chemotherapy, is needed."

In early-stage colon cancer (stages 1 and 2), surgery alone may be curative. Many patients won't need further treatment beyond regular follow-ups. In stage 3 disease, chemotherapy after surgery is usually recommended to help reduce the risk of the cancer returning.

Surgery also may be used in more advanced cases, including relieving symptoms like bleeding or bowel obstruction, or removing tumors in other organs, which might help control the disease, Dr. Dozois adds.

Rectal cancer, found in the last several inches of the large intestine, is often treated differently from colon cancer. Because the rectum is deep in the pelvis next to other organs and structures, such as nerves that control bowel and bladder function, doctors often use a multidisciplinary approach.

"For many rectal cancers, especially those that are locally advanced or close to critical structures, treatment typically begins with chemotherapy and radiation before surgery," Dr. Dozois says. "The aim is to shrink the tumor so it can be removed more completely and safely and reduce the risk that it will come back."

This sequence, called neoadjuvant therapy, is less common in colon cancer but standard in many cases of rectal cancer, which have a higher risk of local recurrence. It often improves outcomes and, in some carefully selected patients, may even allow preservation of more typical bowel function.

Rectal cancer care can involve a team of specialists, including colorectal surgeons, medical oncologists and radiation oncologists, who discuss each case together to tailor the best plan for each patient.

"Whether it's for colon or rectal cancer, the basic aim of surgery is the same: to remove the tumor completely, along with a margin of healthy tissue around it and nearby lymph nodes," Dr. Dozois says. "The surgeon then reconnects the remaining bowel so it can continue normal function."

Many colorectal operations are performed using minimally invasive techniques such as laparoscopy or robotic-assisted surgery, he adds. These methods use small incisions and advanced instruments that allow surgeons to work precisely, leading to fewer complications, less pain and a faster recovery than with traditional open surgery.

For colon cancer, minimally invasive colectomies are common and, in many patients, can be done through several very small incisions. Recovery may be quicker, with patients beginning to eat soon after surgery and returning home in a few days.

For rectal cancer, minimally invasive techniques also are used, but the surgery can be more complex because of the tighter space in the pelvis and the need to preserve nerves. Robotic surgery in particular offers 3D visualization and refined control that can be especially helpful.

Surgery for rectal cancer can sometimes affect bowel function. In some patients, a temporary or permanent stoma, an opening on the abdomen for waste to pass, may be necessary depending on the tumor's location and extent. Even with technically successful surgery, some patients experience changes in bowel habits or control (a condition sometimes called low anterior resection syndrome), urinary difficulties or sexual dysfunction. These are important aspects to discuss with your care team.

Not every colorectal cancer case is the same. The approach is individualized based on:

• Stage of the cancer: how deep it has penetrated and whether it has spread.
• Location of the tumor: rectal cancer often needs a different sequence of therapy than colon cancer.
• Overall health and preferences: patient goals, other medical conditions and recovery expectations all matter.

"Experience matters when it comes to optimizing outcomes in patients with colorectal cancer," Dr. Dozois explains. "That's why it's important to seek care from expert centers that treat a high volume of patients with colorectal cancer each year, use multidisciplinary teams to review each case, and recommend a therapeutic sequence that balances cure and quality of life."

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Chloe Corey, Mayo Clinic Communications, newsbureau@mayo.edu
   

The post Surgery plays a central role in treatment for colorectal cancer – and is usually the first step appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:09) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Polyps in the colon can vary in size and shape. Some are more mushroom-shaped, but that's not always the case. 

"Some polyps spread out more like a bed of moss; they're flat," says Dr. Wallace.

Advances in imaging and tools help care teams detect and treat difficult polyps. 

"Technology has been clearly shown to improve our ability to find more polyps and reduce the miss rate for some of these flat, subtle polyps," says Dr. Wallace. 

Early detection leads to better outcomes. 

"Stage 1 cancer, so-called T1 cancer, we can actually remove that through an endoscope or through a colonoscope, specifically, in a curative way," says Dr. Wallace. "This is something that has had profound implications for patient care." 

Dr. Wallace adds that the most important step is to get screened. 

"Whatever test you choose, get screened," Dr. Wallace says. "This is a preventable cancer. It's one of the very few cancers that we can almost completely prevent. So getting screened starting at the age of 45 — one caveat is — if you have a family history of colon cancer, you need to start even earlier."

Related posts:

• Mayo Clinic Q&A: Treating colorectal cancer with surgery
• (VIDEO) Transforming colon cancer care through precision medicine
• (VIDEO) Treatment options for advanced colorectal cancer

The post Mayo Clinic Minute: AI advances help care teams find hard-to-see colon polyps appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I've been diagnosed with myeloma. What can I expect going forward? 

ANSWER: Myeloma is a cancer that affects specialized antibody-producing cells called plasma cells. Over your lifetime, your body produces hundreds of thousands of different types of plasma cells that protect you from a broad range of bacteria and viruses. The creation of these cells is very precise. But sometimes, a cell slips through the body's quality control system and becomes cancerous. 

When this happens to cells in the bone marrow, cells begin to multiply and take up the space normally occupied by bone marrow, where red blood cells are produced. People with myeloma often experience fatigue because their bodies aren't making enough red blood cells. They also report bone pain due to cancer cells eroding the bone. Proteins produced by these cells can damage the kidneys too. 

Typically, myeloma affects people in their 60s, 70s and 80s. Once they've been diagnosed with myeloma, often by their primary care clinician, the next step is to see an oncologist to confirm the diagnosis. 

Further testing may reveal that they have a premalignant condition called monoclonal gammopathy of undetermined significance (MGUS) or an in-between condition called smoldering myeloma. Neither of these conditions requires immediate treatment, so patients are monitored by their oncologist. 

Treatment options

If patients do need treatment, there are several options to effectively treat the disease, depending on the person's age, other medical conditions and which option is a good fit for them.   

With optimal treatment, myeloma isn't immediately life-threatening. Many patients live for years after their diagnosis, often receiving different treatments over the course of their lives. Treatments have improved so much in 20 years that some patients are able to reach a typical life expectancy. 

One of the standard treatments is a stem cell transplant, also known as a bone-marrow transplant. Stem cells are drawn from the patient, so there's no need to find a donor. A stem cell transplant can prolong control of the disease. 

Four drugs, in pill or injection form, also are used to treat myeloma alone or in conjunction with a stem cell transplant. They don't tend to cause nausea, vomiting or hair loss and are well tolerated by most patients. 

These treatments are: 

• Antibodies targeting CD38, an enzyme present in inflammatory cells and found on the surface of myeloma cells, are injected under the skin to inhibit CD38's activity. 

• Proteasome inhibitor injections affect proteasome, a cell component, from cleaning up excess proteins in the cell. Myeloma cells produce many proteins, and if the cleaning process is blocked, the cells die. 

• Lenalidomide, a thalidomide derivative, given in pill form, acts against the myeloma-affected plasma cells. 

• Dexamethasone, also given in pill form, is related to anti-inflammatory drugs like prednisone and cortisone. When exposed to dexamethasone, myeloma cells die. 

Over the past 20 years, the Food and Drug Administration has approved more than 25 drugs or combinations of drugs for myeloma treatment that have improved on previous options. In addition to drugs, there are two notable developments: chimeric antigen receptor-T cell therapy (CAR-T cell therapy) and bispecific antibodies. 

In CAR-T cell therapy, a person's own T cells are removed and converted into CAR-T cells. They're shipped to a production facility where they're modified with an "anchor" that allows them to bind to a molecule in a myeloma cell. CAR-T cells are then reinjected into the patient. For about three to six months, they hunt down and destroy myeloma cells, eradicating many, if not all of them. 

Some patients may require only one CAR-T cell therapy treatment. One paper found that among patients followed for five years, about one-third never needed additional treatment. 

However, this therapy requires a specialized center, so it isn't globally available. But researchers discovered a way to create a similar treatment, bispecific antibodies. These can be injected into patients where these antibodies recruit the person's own T cells to hunt myeloma cells. These antibodies act like matchmakers, pairing T cells with myeloma cells. 

A common side effect of CAR-T cell therapy and bispecific antibody treatments is increased risk of infection due to very low levels of protective antibodies or immunoglobulins. So part of the treatment includes ensuring they have good immunoglobulin levels. 

Both treatments can, in some cases, trigger extreme inflammation. However, preventive therapies can address this issue. Also, a small minority of patients can develop a Parkinson's-like disease. But by carefully selecting patients and prepping them properly, that risk is greatly reduced. 

During and following myeloma treatment, patients typically can go about their lives. When to begin treatment, as well as the development of new therapies, continues to be explored. 

Rafael Fonseca, M.D., Hematology and Oncology, Mayo Clinic, Phoenix 

The post Mayo Clinic Q&A: Understanding myeloma treatment appeared first on Mayo Clinic News Network.

Jenny Gottfredsen and Shar Ballentine were accustomed to being on the other side of the hospital bed. 

Both nurses at Mayo Clinic Health System in Eau Claire, Wisconsin, spent their days teaching, supporting colleagues and advocating for patients. Within days of one another, however, both began navigating serious diagnoses of their own — experiences that strengthened their friendship and deepened their understanding of vulnerability, resilience and patient-centered care. 

Careers grounded in care 

Jenny's interest in healthcare began early in life. After earning a degree in cardiopulmonary rehabilitation, she went on to complete nursing school and build a career in cardiology. For more than a decade, she cared for patients with heart disease before joining Mayo Clinic seven years ago. Today, she works in Nursing Professional Development while continuing to support cardiology teams. 

Shar brings decades of experience in healthcare. After more than 20 years in academic medicine in Madison, Wisconsin, she relocated to the Eau Claire area in 2021 to be closer to family and begin a new chapter. As a seasoned nurse and team lead, she quickly became a mentor to colleagues — including Jenny, who leaned on Shar's experience as she transitioned into an educator role. 

What began as a professional collaboration grew into a close friendship built on trust, humor and shared values. 

A conversation and an unexpected turn 

That trust mattered the day Shar asked Jenny to meet privately. 

After a routine mammogram led to additional imaging and a biopsy, Shar learned she had breast cancer. Healthy and active with no family history of cancer, she struggled to reconcile the news. She chose to tell Jenny face-to-face. As Shar shared her diagnosis, she noticed Jenny glance at her smartwatch — checking her heart rate rather than a message. 

Moments later, Jenny began experiencing chest pain and arm discomfort. She initially attributed it to anxiety and hesitated to seek care. Shar listened carefully. She asked questions, reflected Jenny's words back to her and stayed present — a familiar Mayo Clinic approach rooted in listening first. 

That hesitation is something Dr. Fearghas O'Cochlain, a Mayo Clinic Health System interventional cardiologist involved in Jenny's care, says he sees far too often. 

"Unfortunately, it happens more often than we'd like. Especially in younger, otherwise healthy people, the first thought is usually, 'It's a pulled muscle,' or 'It's something else.' Heart disease isn't top of mind. Most people haven't experienced what cardiac pain feels like before — it's internal, unfamiliar and hard to describe — so they explain it away," Dr. O'Cochlain says. 

"We do see women, in particular, attributing symptoms to anxiety. Anxiety is real, but it typically doesn't come out of nowhere and feel completely different from anything you've experienced before," he adds. "New, persistent or escalating symptoms — especially chest tightness, arm pain or shortness of breath — shouldn't be ignored. We would much rather see someone in the emergency department and reassure them than ask later why they didn't come in sooner. Care begins with the call." 

Shar allowed Jenny time to process while gently encouraging her to get checked. Eventually, Jenny agreed to go to the emergency department — as long as Shar went with her. 

From educator to patient 

Once evaluated, Jenny's electrocardiogram was abnormal and lab work showed elevated troponins, a protein released into the bloodstream when the heart muscle is damaged. Cardiology teams moved quickly, and she was taken to the cardiac catheterization laboratory (“cath lab”) — a place she knew well, now from a very different perspective. 

She was diagnosed with spontaneous coronary artery dissection (SCAD), a rare cause of heart attack that more often affects younger, otherwise healthy women. Jenny required three stents, an intra-aortic balloon pump, intubation and several days in the coronary care unit. 

The diagnosis was unexpected. Jenny was active, health-conscious and well-versed in cardiology — yet she suddenly found herself on the other side of a condition she had rarely encountered in nursing. 

That surprise is common, Dr. O'Cochlain says, and underscores an important message about awareness — even for people who appear otherwise healthy. 

"Everyone needs to be aware of the signs and pay attention to their own body — especially what feels different," he says. "You're healthy until you're not. Even young, active women are not immune. It's not productive to live in constant fear of a diagnosis, but it is important to know what's normal for you. When symptoms come out of the blue or feel irregular, they deserve to be evaluated." 

Despite Jenny's background in cardiology, SCAD was new to her. The experience gave her a deeper understanding of what patients face when diagnoses are unexpected and frightening. For Shar, supporting Jenny during her hospitalization while beginning her own cancer treatment was challenging but also grounding.  

Both women leaned on humor and honesty as they adjusted to being seen not as nurses and caregivers, but as patients. 

Parallel paths, shared support 

As Jenny began cardiac rehabilitation, Shar showed up, standing nearby during workouts, offering encouragement and conversation. When Shar began chemotherapy, Jenny checked in before and after each treatment, understanding the mental weight of waiting for labs, results and side effects. 

Both were learning how to stay present in their own experiences while continuing to support one another. They made space for difficult days, talked openly and continued moving forward together. "This was chosen for us," Shar says. "So we choose how we're going to make it through." 

Living Mayo Clinic values together 

Throughout their care, Mayo Clinic's team-based approach was evident. Jenny benefited from close coordination between local cardiology teams and specialists at Mayo Clinic in Rochester, Minnesota.  

That collaboration is intentional, Dr. O'Cochlain says, and especially important in complex cardiac events like SCAD. 

"The Mayo Model of Care is what we strive for every day," he says. "We work as a group to care for the patient in front of us, and that means having world experts readily available to one another. It allows us to leverage the best knowledge at the best time in the best way for the patient. 

"In Jenny's case, once we addressed the acute issues in the cath lab, we were able to integrate expertise from Rochester's specialized SCAD team in the Women's Heart Clinic to guide her outpatient follow-up. We can work seamlessly across locations, even when we aren't in the same place." 

Shar's oncology care reflected careful attention to both treatment and quality of life. 

Equally meaningful was how colleagues lived Mayo Clinic values in everyday moments — listening, advocating and showing up as people first. 

Moving forward 

Today, Jenny is feeling well and continuing follow-up care locally. She continues to share her story to raise awareness about SCAD and the importance of listening to symptoms, even when they don't seem to fit expectations. 

Shar’s treatment continues, now transitioning to radiation and ongoing immune therapy, but so does her optimism and her friendship with Jenny. She encourages others to stay current on recommended screenings, especially mammograms. 

Their relationship, shaped by mentorship and strengthened through shared experience, reflects the power of connection in healing. 

They remain nurses and advocates, with a deeper understanding of what it means to be a patient and what it looks like when care begins with listening. 

The post When caregivers become patients: A story of heart, healing and friendship appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have developed a promising new way to deliver treatment directly to cholangiocarcinoma tumors, a rare and aggressive bile duct cancer with limited treatment options, using milk-derived nanoparticles that act like guided delivery vehicles. The findings, published in JHEP Reports, point to a potential targeted genetic therapy designed to attack cancer cells while sparing healthy tissue.

"One significant issue is the lack of medications that treat the specific alterations in these cancers," says Rory Smoot, M.D., surgical oncologist at Mayo Clinic in Rochester and senior author of the study. "Our approach is designed to turn off specific cancer-driving genes while leaving healthy tissue alone."

To do this, the multidisciplinary research team of researchers used a gene-therapy strategy involving small interfering RNA (siRNA), a molecule that can temporarily silence specific genes.

The team screened a vast library of 600 trillion random DNA molecules to find those that could selectively bind to the surface of cancer cells. Using a technique called Cell-SELEX, they discovered a short DNA strand, known as an aptamer, that works like a molecular homing device, enabling it to find and attach to cholangiocarcinoma cells.

That homing device was attached to tiny, fat-based particles made from milk, previously developed by Tushar Patel, M.B., Ch.B., a transplant hepatologist and researcher at Mayo Clinic in Florida, as a biocompatible way to carry treatments through the body. These milk-derived nanoparticles were loaded with siRNA and outfitted with the tumor-targeting aptamer, enabling direct delivery of genetic therapy into cancer cells.

"We showed that this system could deliver gene-silencing therapy straight to the cancer," says Brandon Wilbanks, Ph.D., postdoctoral research fellow at Mayo Clinic and first author of the study. "This led to decreases in cancer growth and an increase in cancer cell death, without harming nearby healthy tissues."

While the findings are preclinical, the technology has been patented by Mayo Clinic, and researchers are now working to optimize gene targets and test the approach across multiple forms of cholangiocarcinoma. The long-term goal is to develop patient-specific gene therapies delivered via this milk-derived platform to improve outcomes for patients.

"These advances bring real hope," says Dr. Smoot. "They show that it may be possible to develop safer, more personalized treatments for patients who currently have very limited options."

This research was funded by the Mayo Clinic RNA Discovery and Translation Program, the Mayo Clinic Department of Surgery, the Mayo Clinic Hepatobiliary SPORE NCI, the Mayo Clinic Center for Cell Signaling in Gastroenterology, JSPS KAKENHI Fostering Joint International Research, and the University of Wisconsin Biology of Aging and Age-Related Diseases.

The researchers report no conflicts of interest. Review the study for a complete list of authors, disclosures and funding.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Chloe Corey, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic researchers use milk-derived nanoparticles to target aggressive bile duct cancer appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I recently found out that my aunt was diagnosed with cancer and may need chemotherapy. When I think of chemotherapy, I picture hair loss, nausea and being too sick to maintain anything resembling a normal quality of life. However, friends have told me that chemotherapy isn't what it used to be. What's changed, and what should someone know about today’s chemotherapy before going into it?  

ANSWER: Hearing the word "chemotherapy" can be frightening. Many people picture difficult side effects based on stories from decades ago or what they've seen portrayed in movies. While chemotherapy is still an important cancer treatment, cancer care today has changed dramatically just within the past 10 years.

One of the most common misconceptions is that everyone diagnosed with cancer will need chemotherapy. In reality, cancer treatment is built on several pillars, including surgery, chemotherapy and radiation therapy. More recently, targeted therapies and immunotherapies have expanded treatment options even further.

Depending on the type and stage of cancer, some people may only need surgery or radiation. Others may benefit from newer treatments that don’t involve traditional chemotherapy at all. Treatment plans are often customized, using one or more approaches based on what is best for the individual.

Chemotherapy drugs have evolved, but some of the biggest improvements have come from advances in supportive care. Today, doctors are much better at preventing and managing side effects that once made treatment especially difficult.

Medications to prevent nausea and vomiting are far more effective than they were in the past. Preventive antibiotics and injections that help boost white blood cell production can reduce the risk of infection. These advances mean many people tolerate treatment better and recover more quickly between treatment cycles than patients did years ago.

Beyond chemotherapy

Beyond chemotherapy, newer treatments such as immunotherapy, targeted therapies and cellular therapies are reshaping cancer care. These treatments work differently than traditional chemotherapy by focusing on specific cancer targets or by helping the immune system recognize and attack cancer cells.

For example, CAR T-cell therapy uses a patient's own immune cells, which are modified to better identify and destroy cancer cells. These therapies can be highly effective for certain cancers, though they also come with their own unique side effects and require careful monitoring by specialized care teams.

There’s no single chemotherapy experience. Side effects depend on the specific drugs used, the cancer being treated and the person receiving care. Not all chemotherapy causes hair loss, and many newer treatments don’t cause it at all. For those at risk of hair loss, there are therapies that protect the hair follicles to minimize the amount of hair lost.

When nausea occurs, it is often limited to a few days rather than an entire treatment cycle. Many people can continue parts of their normal routines, including work and family activities, with adjustments as needed. Your cancer care team can also provide tips for reducing nausea and other side effects such as constipation and weight loss or gain. 

Modern cancer care takes a team approach. In addition to oncologists and nurses, patients often have access to social workers, nutrition specialists, behavioral health providers, palliative care teams and integrative medicine services. These resources can help manage symptoms, support emotional well-being and address the practical challenges that come with a cancer diagnosis.

Palliative care is sometimes misunderstood. It’s not limited to end-of-life care and can be helpful at any stage of cancer treatment, including when care is given with cure being the goal.

Cancer care today is collaborative. Doctors present options, explain benefits and risks and work with patients to choose a plan that aligns with their goals and values. Seeking a second opinion is encouraged and can provide reassurance when making important decisions.

Chemotherapy and cancer treatment are far more personalized than in the past. Advances in science, supportive care and patient-centered decision-making have given patients more options, more support and greater control over their care.

Javier Munoz, M.D., hematologist-oncologist, director, Lymphoma/CLL Program, Mayo Clinic in Arizona

Related posts:

• Mayo Clinic study finds chemotherapy before surgery improves survival in early-stage pancreatic cancer
• Mayo Clinic leads 4 decades of advances in breast cancer care
• Transforming cancer care with treatments at home

The post Mayo Clinic Q&A: What should I know about today’s chemotherapy? appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: After my brother was diagnosed with colorectal cancer, I read that it's often treated with surgery first. Can you tell me more about the surgery?

ANSWER: When someone is diagnosed with colorectal cancer — which includes both colon and rectal cancers — many people immediately think "surgery." And it’s true that surgery plays a central role in treatment for most patients. But whether it comes first, and what it entails, depends on several factors, especially where the cancer is located, how far it has grown into surrounding tissues, and whether it has spread. 

For colon cancer, surgery is typically the first and main step when the disease hasn't spread to distant organs. The goal is to remove the cancerous part of the colon along with nearby lymph nodes, which are the first places cancer spreads. After surgery, the removed tissue is examined under a microscope to confirm the stage of the disease and decide whether additional treatment, such as chemotherapy, is needed. 

In early-stage colon cancer (stages 1and 2), surgery alone may be curative. Many patients won't need further treatment beyond regular follow-ups. In stage 3 disease, chemotherapy after surgery is usually recommended to help reduce the risk of the cancer returning. 

Surgery also may be used in more advanced cases, including relieving symptoms like bleeding or bowel obstruction, or removing tumors in other organs, which might help control the disease. 

Rectal cancer, found in the last several inches of the large intestine, is often treated differently from colon cancer. Because the rectum is deep in the pelvis next to other organs and structures, such as nerves that control bowel and bladder function, doctors often use a multidisciplinary approach. 

For many rectal cancers, especially those that are locally advanced or close to critical structures, treatment typically begins with chemotherapy and radiation before surgery. The aim is to shrink the tumor so it can be removed more completely and safely and reduce the risk that it will come back. 

This sequence, called neoadjuvant therapy, is less common in colon cancer but standard in many cases of rectal cancer, which have a higher risk of local recurrence. It often improves outcomes and, in some carefully selected patients, may even allow preservation of more typical bowel function. 

Rectal cancer care can involve a team of specialists, including colorectal surgeons, medical oncologists and radiation oncologists, who discuss each case together to tailor the best plan for each patient. 

Goal of surgery

Whether it's for colon or rectal cancer, the basic aim of surgery is the same: to remove the tumor completely, along with a margin of healthy tissue around it and nearby lymph nodes. The surgeon then reconnects the remaining bowel so it can continue normal function. 

Many colorectal operations are performed using minimally invasive techniques such as laparoscopy or robotic-assisted surgery. These methods use small incisions and advanced instruments that allow surgeons to work precisely, leading to fewer complications, less pain and a faster recovery than with traditional open surgery. 

For colon cancer, minimally invasive colectomies are common and, in many patients, can be done through several very small incisions. Recovery may be quicker, with patients beginning to eat soon after surgery and returning home in a few days. 

For rectal cancer, minimally invasive techniques also are used, but the surgery can be more complex because of the tighter space in the pelvis and the need to preserve nerves. Robotic surgery in particular offers 3D visualization and refined control that can be especially helpful. 

Surgery for rectal cancer can sometimes affect bowel function. In some patients, a temporary or permanent stoma, an opening on the abdomen for waste to pass, may be necessary depending on the tumor's location and extent. 

Even with technically successful surgery, some patients experience changes in bowel habits or control (a condition sometimes called low anterior resection syndrome), urinary difficulties or sexual dysfunction. These are important aspects to discuss with your care team. 

Approaches to treating colorectal cancer

Not every colorectal cancer case is the same. The approach is individualized based on:

• Stage of the cancer: how deep it has penetrated and whether it has spread.
• Location of the tumor: rectal cancer often needs a different sequence of therapy than colon cancer.
• Overall health and preferences: patient goals, other medical conditions and recovery expectations all matter.

Experience matters when it comes to optimizing outcomes in patients with colorectal cancer. That's why it's important to seek care from expert centers that treat a high volume of patients with colorectal cancer each year, use multidisciplinary teams to review each case, and recommend a therapeutic sequence that balances cure and quality of life.

Eric Dozois, M.D., Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: Treating colorectal cancer with surgery appeared first on Mayo Clinic News Network.

Precision medicine is rapidly transforming modern healthcare. It's a personalized approach that tailors prevention and treatment to each individual — moving beyond the traditional one-size-fits-all model.

Colorectal cancer is one area where precision medicine is reshaping the standard of care for patients like Eric Minnesota. 

At 56, Eric was training for an Ironman triathlon when he got a devastating diagnosis — stage 3 colorectal cancer. 

Eric is sharing his inspiring story to raise awareness for National Colorectal Cancer Awareness Month.

Watch: Transforming colon cancer care through precision medicine

Journalists: Broadcast-quality video (3:10) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic" – Read the script.

Man on a mission

Eric has been an athlete his whole life. He's a soft-spoken man with a gentle demeanor and a never-give-up attitude that defines everything he does. "I've competitively raced mountain bikes for the last 20 years," says Eric. "I'm an outdoors person...hiking, fishing, camping, anything outdoors is what I really enjoy."

Eric's dream has long been to compete in an Ironman triathlon, one of the toughest endurance events in the world. Competitors must complete a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run. That's 140.6 miles in one day.

"From a health point of view, I thought I was nearly at the top of my game based on my age," says the Arizona man. "I've been healthy my whole life — no surgeries, no broken bones...I've never taken a sick day from work in my 25-year career."

Toughest challenge yet

Eric was in the midst of training for Ironman Arizona. All was going as planned. Then one day, Eric began having stomach pain. He went to his doctor who delivered a diagnosis Eric never expected.

"He discovered a significant mass. He relayed to me that I should see a colorectal surgeon as soon as possible to have it evaluated and find out what the next steps should be," recalls Eric. Soon after, Eric got his official diagnosis — stage 3 colorectal cancer.

"The plan was to remove my colon and replace it with an ostomy," says Eric. An ostomy is a surgically created opening in the abdomen that allows waste to exit the body into a bag. It may be needed after colon surgery so the body can eliminate waste.

In preparation for surgery, Eric and his wife, Paula, turned to Mayo Clinic in Arizona. "The doctor at Mayo said a team of specialists would convene as a group to review my case. Mayo was quicker than I ever imagined. The following week they called me to discuss my treatment plan," says Eric.

Hope through innovation

Mayo Clinic's treatment plan included more than surgery as an option. The team explained that by using precision medicine, they were able to determine Eric was a candidate for a nonsurgical approach to treatment called immunotherapy.

"By performing genomic sequencing on the patient's blood and the tumor, we were able to identify a precision treatment approach, including immune therapies, that can sometimes allow a patient to avoid the need for complex and life-altering surgeries," says Dr. Jewel Samadder, a gastroenterologist and cancer geneticist with Mayo Clinic's Early Onset and Hereditary Gastrointestinal Cancers Program.

Immunotherapy works by using the body's own immune system to fight the cancer. The nonsurgical treatment is delivered in a series of treatments by IV infusion. "The treatment is surprisingly easy. To be truthful I feel guilty based on the type of treatment that I had for my cancer versus what other individuals go through. It's just a simple infusion that takes less than an hour start to finish," explains Eric.

Crossing the finish line

Eric crossed the finish line of his immunotherapy treatment in six months. The results were a success. A colonoscopy following treatment showed the cancer was gone. "I won the lottery," says Eric. "The stars aligned with my markers and the care team had the expertise. It was incredible. It was all a perfect fit."

"This is a perfect example of why patients come to Mayo Clinic and see multiple physicians in our multidisciplinary cancer clinics and our early-onset program so that we can understand the cause of their cancer, determine the best treatment approaches, including clinical trials, and sometimes avoid complicated life-altering surgeries when possible, as in this patient's case," says Dr. Samadder.

"As soon as we heard about immunotherapy, we had to try it. This aligned with his goals. I'm just over the moon," says Paula.

Eric was able to keep working and training throughout his treatment. He says his only side effect was mild fatigue. "We spent a lot of time together as a family. Just being able to maintain that quality of life through the treatment was irreplaceable. You just can't put a price on that," says Eric.

"We are so grateful to everyone at Mayo Clinic, especially our oncologist Dr. Christina Wu," says Paula. "I would be lost without her. Thanks to Dr. Wu, I have my husband here with me today."

Celebrating life and love

Eric is back to working on his dream of one day becoming an Ironman triathlete. "Giving up is never an option," says Eric. "You have to turn on the switch, and keep going."

As Eric and Paula celebrate life, they are also celebrating their love. "We just had our 32nd wedding anniversary. These moments, these struggles together, it all has just made us stronger." says Eric. "I'm grateful for Mayo, for everything. I came out a better person."

Related stories:

• Eric and Paula Minnesota with a special message to Mayo Clinic
• Mayo Clinic Minute: Inside a colonoscopy
• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults

The post (VIDEO) Transforming colon cancer care through precision medicine appeared first on Mayo Clinic News Network.