Watch: The Mayo Clinic Minute

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Endometrial cancer begins in the endometrium, the lining of the uterus. 

"We are seeing an increase in patients under the age of 45, where particularly our patients who may be in their 20s or 30s and still want future fertility," says Dr. Evelyn Reynolds, a Mayo Clinic gynecologic oncologist.

Standard treatment for endometrial cancer is a hysterectomy, a surgery to remove the uterus. But for some younger patients who want to preserve their ability to become pregnant, there may be another option. 

"There are certain criteria that, if a patient meets, they may be a good candidate for fertility-sparing treatment," says Dr. Reynolds. "Lower-grade tumors that are confined to the endometrium are the ideal ones for treatment that can spare the uterus. There are different ways in which we can do targeted resection of the tumor."

Which is bringing hope to eligible patients who want to have children in the future. 

"We don't make assumptions. It's always a conversation with the patients, and it's a multidisciplinary approach," says Dr. Reynolds. "I want them to know that there are options." 

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Watch: the Mayo Clinic Minute

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Unlike many cancers that form solid tumors, leukemia is a cancer of the blood-forming cells in the bone marrow.

Dr. Arana Yi says, "Leukemia affects the production of the blood cells and can circulate through all the body from the beginning." 

Leukemia isn't a single disease. There are several types that can behave differently. According to Dr. Arana Yi, "It is a group of cancers with different subtypes. Some develop very quickly, while others progress slowly." 

Leukemia can affect people of all ages. Symptoms can include persistent fatigue, unusual bruising or bleeding, frequent infections, fever, night sweats, unexplained weight loss and shortness of breath. 

"If those are persistent, it is important to review and be evaluated by a doctor for a possibility of a blood count checkup," Dr. Arana Yi mentions. 

Research is helping doctors identify genetic changes that may be driving a patient's leukemia. That information can help guide treatment. 

Dr. Arana Yi says, "This allows us to use targeted medicines, immune-based therapies, sometimes with less traditional chemotherapy or chemo-free regimen." 

Recognizing possible symptoms and seeking medical evaluation can help doctors diagnose leukemia and determine appropriate treatment. 

"Recognizing symptoms since the beginning, and early evaluation with the doctors is key to diagnose the acute leukemia as soon as possible," Dr. Arana Yi concludes. 

The post Mayo Clinic Minute: Leukemia isn’t like other cancers (VIDEO) appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A large prospective study published today in Nature Medicine found that a blood test designed to detect multiple cancers identified cancer signals across 17 broad cancer types, such as ovarian, lung, breast and colorectal cancers, and many which do not have recommended screening tests.

Mayo Clinic was among the institutions participating in the prospective, interventional study, which enrolled 35,878 adults age 50 and older. Karthik Giridhar, M.D., a Mayo Clinic medical oncologist, was a study investigator and senior author.

The multicancer early detection (MCED) test analyzes small fragments of DNA that cells release into the bloodstream. Researchers use patterns in these fragments to detect signals associated with cancer. When a cancer signal is detected, the test also predicts the likely location of the cancer to help physicians determine appropriate follow-up testing.

Among 32,007 participants included in the study's performance analysis, 287 had a positive MCED test result. Cancer was diagnosed in 173 of those participants. The test had a positive predictive value of 60.3% and specificity of 99.64%. Among participants with a true-positive result, the test correctly predicted one of the two most likely cancer signal origins in 91.3% of cases.

"One of the challenges in cancer screening is that most cancers do not have an established screening test," says Dr. Giridhar. "This study helps us better understand how a multicancer blood test might complement existing screening approaches by identifying cancer signals that otherwise may not be detected through routine screening."

Researchers found that 72.8% of cancers detected by the MCED test were cancer types without U.S. Preventive Services Task Force grade A or B screening recommendations. Among the 151 participants with at least one newly diagnosed primary cancer detected by the test, 53% had stage 1 or 2 disease and 70.9% had stage 1, 2 or 3 disease.

Giridhar also notes that these tests are not yet a substitute for established cancer screenings. Instead, they may supplement existing screening approaches and help expand understanding of cancer detection.

PATHFINDER 2 was a single-arm study, and its endpoints were descriptive, with no comparator group or formal hypothesis testing. The authors say randomized trials and further follow-up are needed to determine the clinical utility of MCED testing in routine clinical practice. The study also used an earlier version of the test that has since been replaced by a commercially available version.

The study was designed and funded by GRAIL Inc., which also participated in data analysis and interpretation and preparation of the manuscript. Dr. Giridhar reports consulting and advisory relationships with GRAIL and other organizations and travel expenses from GRAIL. A complete list of author disclosures is included in the published study.

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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:

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

The post Multicancer blood test detects 17 cancer types in large prospective study appeared first on Mayo Clinic News Network.

After unexplained pain, stiffness and abnormal movements led to dystonia diagnoses, Mayo Clinic specialists tailored deep brain stimulation and ongoing care to Emma and Lauren Fink's individual symptoms and goals. 

In September 2024, 14-year-old Emma Fink reached for a volleyball during gym class when something suddenly went wrong. 

"I went to bump the ball, and my shoulder blade popped out of place," Emma says.  

Her right shoulder blade shifted sharply upward and remained fixed in place. She describes the pain as feeling like "someone was punching me over and over." 

At the emergency department, imaging showed that Emma's shoulder was not dislocated. The cause of her shoulder blade's fixed position remained unclear, and muscle relaxants provided no relief. 

Watch: Deep brain stimulation helps sisters with dystonia return to the activities they love

Journalists: Broadcast-quality video (4:49) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

When Emma's symptoms pointed to a movement disorder 

For months, Emma could not raise her arm, sleep comfortably, write with her dominant hand or wash her hair. Emma, a normally laid-back teenager who loved drawing, archery and spending time with friends, had to relearn everyday tasks with her left hand while living with constant pain. 

Emma was initially treated for a suspected sports injury. When her shoulder did not improve with treatment, Mayo Clinic sports medicine specialists in Rochester, Minnesota, contacted Dr. Amy Rabatin, a physical medicine and rehabilitation specialist at Mayo Clinic. 

Before seeing Emma in person, Dr. Rabatin was brainstorming with the sports medicine team, reviewing photographs, considering ways to control Emma's pain and asking another question: Who else needed to be involved? 

Suspecting a neurologic cause, Dr. Rabatin helped connect Emma with Dr. Keith A. Coffman, a Mayo Clinic neurologist who specializes in pediatric-onset movement disorders. 

Dystonia diagnosis brings answers 

When Dr. Coffman evaluated Emma, he recognized signs of dystonia, a movement disorder that can cause involuntary muscle contractions and painful, sustained tightening. He compares the sensation to a charley horse that does not release. 

Dystonia can affect any voluntary muscle and can look very different from one person to the next. Emma's presentation was especially unusual, Dr. Coffman says, because her arm had remained locked in position for months. 

The diagnosis brought clarity but not a quick fix. Drs. Rabatin and Coffman continued coordinating Emma's medication management, rehabilitation and evaluation of additional treatment options to address her pain, movement and function. 

Considering deep brain stimulation for dystonia 

When medications did not adequately control Emma’s worsening symptoms, Dr. Coffman recommended deep brain stimulation (DBS). 

DBS uses implanted electrodes to deliver adjustable electrical stimulation to areas of the brain involved in movement. It can lessen symptoms of dystonia, but it is not a cure.

For Emma and her family, the next step did not require starting over with a new care team. Dr. Coffman could evaluate her for DBS alongside Dr. Kai Miller, a Mayo Clinic neurosurgeon, through Mayo Clinic's Pediatric Deep Brain Stimulation Program in Rochester. 

At first, Emma was hesitant about brain surgery. 

Dr. Coffman and Dr. Miller talked with Emma and her parents, Angie and Andy Fink, about the potential benefits, limitations and risks. They also addressed Emma's questions, including how much of her hair would need to be shaved. As the physicians answered her questions, Emma became more comfortable considering the procedure. 

"I just wanted to be better," Emma says. "Anything to make me better." 

Emma notices a change after DBS activation 

Dr. Miller performed Emma's DBS surgery in April 2025. When Dr. Coffman activated the device several weeks later, Emma felt the muscles around her shoulder release. 

"I could feel my shoulder shift down, and then all my muscles finally relaxed," she says. "It felt like it was floating." 

Within minutes, Emma could move an arm she had been unable to use for nearly eight months. 

After watching Emma live with persistent pain, Angie struggled to believe the change could last. 

"I remember thinking, 'We're going to wake up tomorrow, and it's going to be back to the way it was. This can't be real,'" Angie says. "I had some disbelief that it worked so well, so quickly, and then gratitude that we had the expert team to make it happen for her." 

The moment affected Emma's care team too. 

"When we turned Emma's device on and she got relief, we all cried," Dr. Coffman says. 

A second dystonia diagnosis in the family 

As Emma recovered and rebuilt her strength through occupational therapy with Katie Cossette, OT, and physical therapy, her younger sister, Lauren, began experiencing rapid blinking and unusual movements of her head and neck. 

She also had a long history of tightness and pain in her legs that worsened with activity. 

During one of Emma's DBS programming appointments, Angie described Lauren's symptoms. Dr. Coffman asked to see Lauren and later confirmed that she, too, had dystonia. 

Their specific condition is classified as presumed monogenic dystonia, meaning it is likely tied to a change in a single gene that has not yet been identified. Dr. Coffman says this is the second most common form of dystonia in children. 

Individualizing care for each sister 

Sharing the same condition did not mean Lauren's treatment would mirror Emma's. Still, like her sister, Lauren wanted to try medication before considering DBS. 

The team gave her time to make the decision on her own terms. But as Lauren's symptoms worsened, the effects became harder to ignore. Softball, a sport she loves, grew more difficult as her bat speed slowed and fatigue set in more quickly. 

After watching her sister benefit from DBS and talking through her own concerns with her care team, Lauren underwent DBS surgery in February 2026. 

When her device was activated, Lauren noticed almost immediately that walking felt easier. 

"I didn't realize I wasn't supposed to feel that uncomfortable tightness in my legs when I moved," she says. 

Fine-tuning deep brain stimulation over time 

As Emma and Lauren grow and their symptoms change, they return to Dr. Coffman to fine-tune their DBS settings around the activities that matter most to them. For Lauren, that means softball. 

During a recent appointment, she stood in the clinic swinging a bat while Dr. Coffman adjusted her DBS settings on a tablet. With each change, she described what she felt. 

When the stiffness eased and her swing felt natural again, they knew they had found the right setting. 

Returning to school, sports and everyday life 

Across specialties, Emma and Lauren's care team continues to share updates about their symptoms, rehabilitation and personal goals, so their treatment can adjust as their needs evolve.  

Although the family may meet with each specialist separately, Angie says their care has never felt divided. 

"It feels like when we talk to one of them, we're talking to all of them," she says.  

Today, Emma is returning to archery, drawing and time with friends. Lauren continues to practice softball, work on her strength training and has plenty of energy for her family and friends. 

Looking back on how far both girls have come, Angie and Andy say they are grateful for the Mayo Clinic care teams that helped Emma and Lauren return to the rhythms of teenage life. 

"Through this all, we felt like we were in good hands," Andy says. "If there’s any place in the world we would have wanted this done, it would have been right here."

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DEAR MAYO CLINIC: Our daughter plays field hockey, and it can get physical on the field with collisions and falls. We're worried that we won't know if she gets a concussion. What signs should we watch for? 

ANSWER: With school team sports amping up, student-athletes are at greater risk of concussion. In addition to coaches, parents play a role in spotting signs of symptoms. A possible concussion isn't something to brush off. It's a form of mild traumatic brain injury.  

During a concussion, the brain moves within the inner walls, sliding back and forth. This can be due to a violent blow to the head and neck or upper body, a collision, or a hard fall during practice or a game. Typical symptoms include: 

• Headache. 

• Ringing in the ears. 

• Upset stomach. 

• Vomiting, nausea.  

• Fatigue or drowsiness. 

• Blurry vision or hazy spots in their vision field. 

• Confusion or feeling as if in a fog. 

• Amnesia about what happened. 

• Dizziness. 

• Slowness getting up after a play. 

• Changes in behavior, such as irritability and crankiness. 

• Loss of balance or unsteadiness in walking. 

• Ringing in the ears that doesn't go away. 

It's important to know that no two concussions are the same. While student-athletes often compare themselves with teammates or friends who have had concussions, one athlete may experience only one symptom, and another may have several. The absence of a particular symptom doesn't rule out a concussion; all potential symptoms should be taken seriously. 

Concussion symptoms may not appear immediately. An athlete may seem fine at first but develop symptoms later. Athletes may also minimize or hide symptoms because they're worried about being removed from a game or missing future competitions. That makes it especially important for parents, coaches and athletic trainers to pay attention not only to what an athlete says but also to changes in how they look or behave.  

A concussion doesn't require a direct blow to the head. If someone is pushed, falls backward or experiences a whiplash-type motion, that action can cause the brain to move within the skull. If parents see that type of injury or their child reports concussion-like symptoms afterward, they should be alert for changes. For younger athletes, it may be difficult to explain exactly what they're feeling. Parents know what's typical for their child, so recognizing that something seems "off" can be important. 

Today's school sports concussion protocols require that if a student-athlete has possible concussion symptoms, they shouldn't return to play that day and not return until cleared by a healthcare professional. 

At home, parents should continue monitoring symptoms. If their child's symptoms get worse, they should receive medical attention right away. Parents also should watch how symptoms change in the following days. Symptoms often begin to improve within the first several days, with recovery typically progressing over about 7 to 14 days. If symptoms aren't resolving after about two weeks, more evaluation may be needed. This could include referral for physical therapy and therapies that address lingering problems, such as problems with balance and dizziness. 

Recovery also involves more than getting an athlete back onto the field. Returning to school should come before returning to sport. If a student can't tolerate a full school day, they shouldn't be participating fully in athletics. Some students may need temporary academic adjustments, such as additional time for tests, help with note-taking, or reduced exposure to screens if computers or projected displays make symptoms worse. 

Concussions can be challenging because there's often no outward sign of injury, such as a cast or crutches, that shows others something is wrong. That can make it tempting for an athlete — or the people around them — to underestimate the injury. Protecting the brain and giving it adequate time to recover needs to be the priority. For young people, that means remembering they are students first and athletes second. 

Kimberly Penkert, Sports Medicine, Mayo Clinic Health System, Mankato and New Prague, Minnesota 

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Helix to generate clinical whole genome sequencing and multi-omics data from one million biospecimens, advancing precision medicine as the standard of care

ROCHESTER, Minn. and SAN MATEO, Calif. — Precure, LLC today announced the selection of Helix as its multi-omic laboratory and AI tools provider supporting plans to generate comprehensive molecular data from approximately one million biospecimens and accelerate the integration of molecular insights into routine clinical care at Mayo Clinic and across health systems more broadly.

Less than a week ago, Mayo Clinic announced the launch of Precure, LLC, with founding partner Thermo Fisher Scientific, to help transform how the life sciences community understands the biological changes that occur as disease develops before symptoms occur. Precure, LLC brings together clinical expertise, de-identified longitudinal health information and population-scale molecular data to accelerate the development of new approaches to care.

Helix will provide both advanced AI tools for delivery of genomics into the clinic and biomarker driven research, and population scale multi-omic capability that encompasses clinical whole genome sequencing (WGS) and research grade proteome sequencing. Linked with longitudinal clinical information and high performance compute infrastructure, the objective is to create new opportunities for prevention, diagnosis and treatment.

“Our goal is to generate genomic information that can help inform patient care while creating a powerful resource for discovery,” said Aaron Mangold, M.D., chief medical officer, Precure, LLC. “We are working to make clinical whole genome sequencing and multi-omics a foundation of care, helping us detect disease sooner and act earlier.”

Building on prior work which utilized Helix’s Exome+ ^® sequencing technology, Precure, LLC extends that collaboration by leveraging Helix's experience providing workflow orchestration, (CLIA/CAP) genomic sequencing, data infrastructure, and AI tools to its health system partners. Precure, LLC and Helix have selected Ultima Genomics’ UG200™ Ultra Sequencing Platform as part of the program’s large-scale multi-omics initiative. Helix will use a fleet of Ultima’s next-generation platforms to generate high-quality genomic data for WGS and read-out for proteomics at scale.

“The genome is becoming an enduring patient resource, providing a precision baseline for a lifetime of care,” said James Lu, M.D., Ph.D., CEO of Helix. “Helix brings together the laboratory and data capabilities to make this possible at scale.”

Mayo Clinic's involvement in Precure, LLC is intended to advance its nonprofit mission. Any financial returns to Mayo Clinic would be reinvested in its mission of patient care, research and education. Visit mayo.edu/research/precure for more information.

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About Precure, LLC
Precure, LLC is a Mayo Clinic-controlled company established to generate and responsibly integrate population-scale molecular data with longitudinal clinical information. Precure, LLC creates the infrastructure and scale needed to enable external collaborations, disease-focused discovery and the development of new diagnostics, therapeutics and other healthcare solutions. It complements Mayo Clinic’s investigator-led research and clinical translation activities.

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 Helix
Helix is an enterprise genomics company connecting clinical care and discovery. Its platform brings together clinical sequencing, integration of genomic information into healthcare, and research tools built on linked genomic and longitudinal clinical data. Through its health system partnerships, the Helix Research Network and GenoSphere, Helix helps healthcare and life sciences organizations apply genomics to patient care and the development of new diagnostics and treatments. Learn more at www.helix.com.

Media contacts:

• Tom Millikin, Mayo Clinic Communications, newsbureau@mayo.edu
• Caty Reid, Helix, helix@highwirepr.com

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ROCHESTER, Minn. — Mayo Clinic researchers have identified a strategy that could help chimeric antigen receptor-T cell therapy, or CAR-T cell therapy, overcome a major barrier to treating solid tumors: Cancer cells can change in ways that allow them to hide from immune cells designed to attack them.

In a preclinical study published in Molecular Cancer, researchers found that drugs used to treat advanced thyroid cancer can restore a marker on aggressive thyroid cancer cells, making the cancer visible again to specially engineered CAR-T cells. Combining the drugs with CAR-T cell therapy resulted in better tumor control and survival in preclinical models than either approach alone.

Rather than further modifying CAR-T cells to recognize cancers that have lost their targets, researchers sought to change the tumor so the target reappears.

"We often think about engineering the immune cell to overcome resistance," says co-senior author Saad Kenderian, M.B., Ch.B., a hematologist and oncologist at Mayo Clinic in Minnesota. "This work shows another possibility."

Making an aggressive cancer visible again

CAR-T cell therapy engineers T cells — immune cells that help protect the body from disease — to recognize a specific target, or antigen, on cancer cells. The approach has transformed treatment for some blood cancers but has been less successful against solid tumors.

One reason is that solid tumors can lose or reduce the antigens CAR-T cells are designed to recognize, making it more difficult for the engineered cells to identify and destroy the cancer.

The Mayo Clinic team focused on the thyroid-stimulating hormone receptor (TSHR), a protein found primarily on thyroid cells. CAR-T cells targeting this receptor showed strong antitumor activity against thyroid cancers with high TSHR levels. Their effectiveness was more limited against anaplastic thyroid cancer, the most aggressive form of the disease with low or no TSHR expression.

Turning the target back on

Researchers investigated whether they could restore TSHR through a process known as redifferentiation, in which aggressive cancer cells regain some of the biological features they had lost.

They used drugs that inhibit the mitogen activated protein kinase (MAPK) signaling pathway, including trametinib and dabrafenib, which are approved to treat advanced thyroid cancer.

In patient-derived models of anaplastic thyroid cancer, MAPK inhibition increased TSHR expression on tumor cells. When researchers combined the drugs with TSHR-targeted CAR-T cells, the combination produced stronger tumor control and survival than either treatment alone.

"One of the key discoveries from our work is that antigen density matters. We showed that restoring TSHR expression with combination therapy can sensitize aggressive thyroid tumors to CAR-T cell attack, effectively turning a suboptimal target into a more vulnerable one. This approach may provide a new framework for enhancing CAR-T therapies across solid tumors where target expression is limited," says co-first author Claudia Manriquez Roman, Ph.D., process development engineer at Mayo Clinic in Minnesota.

Researchers also found that the MAPK inhibitors did not appear to interfere with the CAR-T cells' ability to multiply or attack cancer cells. Instead, the drugs created a temporary window in which  the CAR-T cells could target cancer cells that had previously escaped detection.

TSHR expression declined after MAPK inhibitor treatment stopped, but two weeks of concurrent treatment was sufficient to improve CAR-T cell activity in the preclinical models.

"What’s exciting about this approach is that we're taking advantage of the cancer cell's own biology to restore TSHR expression by blocking MAPK signaling with molecular targeted drugs," says co-senior author John Copland III, Ph.D., cancer biologist and translational researcher at Mayo Clinic in Florida. Dr. Copland noted that approximately 2,500 Americans die per year from metastatic thyroid cancer disease. 

A potential strategy beyond thyroid cancer

Although the study focused on thyroid cancer, the concept could have implications for other solid tumors where treatments use immune therapy that targets similar surface markers.

Researchers are completing studies needed to support phase 1 clinical trial testing of TSHR-targeted CAR-T cells. The therapy could be studied alone in patients whose tumors continue to express TSHR or in combination with MAPK inhibitors in patients whose tumors have lost TSHR expression.

The researchers hope the approach ultimately could lead to another treatment option for patients with cancers that no longer respond to available therapies.  

For a complete list of authors, disclosures and funding, read 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.

Media contact:

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

The post Study shows reprogramming thyroid tumors may improve CAR-T cell therapy appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My older sister was recently diagnosed with thickened heart muscle, and her doctor recommended a procedure called a "septal myectomy." I’ve never heard of it before. What does this surgery do, and how do doctors know when it's the right treatment? 

ANSWER: Hearing that someone you love may need heart surgery can be scary, especially when you're also trying to understand an unfamiliar heart condition. Treatment usually starts with medication. However, for some people, surgery becomes the best option when symptoms continue despite medical therapy.  

Your sister's condition is called hypertrophic cardiomyopathy, or HCM. It's a relatively common genetic condition that affects about 1 in 500 people. It causes the heart muscle to become abnormally thick, most often in the wall between the heart's two main pumping chambers. As a result, the normal pathway where blood leaves the heart can become blocked. 

HCM can affect the heart in two ways. The muscle may become obstructive from the thickening, or it may become stiff. Both forms can cause symptoms such as shortness of breath, chest pain, fatigue, low energy and reduced endurance. The obstructive form caused by the thickened heart muscle is the one that surgery can often correct. Most people with HCM have this type, which is why septal myectomy can be an effective treatment for appropriately selected patients. 

Doctors usually diagnose HCM with an echocardiogram, an ultrasound that lets them see the heart and measure the thickness of the heart muscle. Because HCM is a genetic disease, blood tests can identify some genetic mutations. However, not every mutation can be detected with a blood test, so imaging remains the primary way doctors diagnose the condition. 

Treatment

Treatment usually begins with medications such as beta blockers, calcium channel blockers and newer medicines called myosin inhibitors to help manage symptoms. Surgery is rarely the first treatment that is recommended. Instead, it is considered when symptoms continue despite medication or when patients are not able to tolerate their medical therapy. That's why deciding whether surgery is the right treatment depends not only on the diagnosis but also on how well symptoms respond to medication. A cardiologist experienced in treating HCM can help determine when it's time to consider surgery or another form of septal reduction therapy called alcohol septal ablation. During this procedure, a small amount of alcohol is delivered through a catheter to shrink a portion of the thickened heart muscle and improve blood flow. In general, this procedure is reserved for patients who cannot undergo surgery. 

A septal myectomy is an open-heart operation that removes the portion of thickened heart muscle blocking blood flow. During the procedure, echocardiographic imaging helps surgeons identify where the muscle is thickened. Afterward, imaging confirms that blood flow out of the heart and the function of the heart valves have returned to normal. 

Like any heart operation, septal myectomy has risks. When it's performed at a center with expertise in this procedure by an experienced surgeon, the risk of death or a major complication like stroke is less than 1%. Another possible complication is the need for a pacemaker because the area where the muscle is removed is close to the heart's electrical system; in specialized centers, this is usually less than 2%. 

After surgery, most patients stay in the hospital for about five days. Recovery takes about six to eight weeks. During that time, patients are encouraged to stay active by getting up, walking and moving around. The main restriction is avoiding heavy lifting until the breastbone heals. By two or three months, many people can return to activities such as exercising, running and weightlifting.  

One of the biggest benefits of the procedure is a significant improvement in quality of life. People who were limited by their symptoms before surgery often are able to return to the activities they enjoy afterward. Many patients need less medication after surgery, and others no longer require it. Growing evidence also suggests surgery may help people live longer than medication alone. 

Because HCM is a complex disease, experience matters. Patients considering septal myectomy should feel comfortable asking where the procedure will be performed and how much experience the multidisciplinary care team has treating HCM. Centers with expertise in HCM use a multidisciplinary approach, bringing together cardiologists, surgeons, imaging specialists, genetic experts and other specialists to determine the best overall treatment plan for each patient. 

Joseph Dearani, M.D., Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: When is surgery needed for a thickened heart muscle? appeared first on Mayo Clinic News Network.

After being diagnosed with high-risk acute myeloid leukemia at age 19, Sky Toyne came to Mayo Clinic for a potentially curative stem cell transplant. Thanks to advances in transplant medicine, a lifesaving donation from her brother, and comprehensive care that addressed both her physical and emotional recovery, Sky overcame leukemia and returned to the life she loves.  

In August 2021, Sky Toyne had just begun her sophomore year of college at a university in Iowa, where she was born and raised. With a love of learning and being active in organizations, she was excitedly thinking about her next semester. Should she run for an executive position in her sorority or study abroad in Australia?  

Soon after the fall semester began, Sky started getting bad headaches. As the weeks went on, she experienced more symptoms — frequent colds, extreme neck aches and fatigue.   

On Oct. 7, Sky woke with intense head and neck pain and a whooshing sound in her ears. Her mom drove her to the student health facility, where initial tests were inconclusive. Bloodwork, however, revealed dangerously low blood counts, and Sky went to the hospital immediately. 

After receiving blood transfusions in the emergency department, Sky was admitted to the oncology floor. A bone marrow biopsy the next morning confirmed leukemia.  

Further testing showed that Sky had acute myeloid leukemia (AML), and she had several mutations that put her at high risk of recurrence. To give her the best chance at a cure, she would need a bone marrow, or stem cell transplant.  

"I decided to go to Mayo Clinic since it's the best hospital in the world and a leader in transplant," says Sky.  

She completed induction chemotherapy at the hospital in Iowa and traveled with her parents to Mayo Clinic in Rochester, Minnesota, to meet Dr. William Hogan, a transplant hematologist. 

"His expertise was astounding, and we immediately knew I was in good hands," says Sky.  

Hope through innovation 

"Sky's leukemia carried genetic abnormalities that we know place patients at much higher risk of relapse if treated with chemotherapy alone," says Dr. Hogan. "Fortunately, she had responded very well to her initial treatment and achieved a deep remission, which gave us an important opportunity to move toward a potentially curative stem cell transplant." 

Stem cell donor matching depends on inherited immune system genes called human leukocyte antigen (HLA) genes. People with mixed ancestry, like Sky, often inherit combinations of HLA genes that are less commonly represented in donor registries, which means there may be fewer unrelated volunteers who share that exact genetic combination. 

Because a perfectly matched unrelated donor wasn't readily available, Sky required a haploidentical, or half-matched, bone marrow transplant. Unlike a traditional transplant, a haploidentical transplant uses a donor who shares approximately half of the patient's immune system genes — usually a parent, child or sibling.  

"This has probably been one of the biggest advances in transplantation over the past two decades, allowing nearly every patient to have a potential donor," says Dr. Hogan. 

Sky's brother, Speed, agreed to be her donor.  

"I will admit that I was nervous about the donation procedure, but the decision to be the donor was an easy one," says Speed. "It was simply what needed to be done to give my sister a chance." 

The therapies Sky would receive could permanently affect reproductive function. Her care team worked closely with reproductive endocrinology colleagues so she could undergo egg retrieval before transplant.  

"Our goal is never simply to cure leukemia — it's to help patients return to meaningful, fulfilling lives," says Dr. Hogan. "We needed to consider her long-term quality of life, including her fertility, education, career goals, emotional well-being and the many decades of life that hopefully lie ahead after treatment. Those conversations were just as important as the medical treatment itself." 

On Feb. 25, 2022, Sky received the transplant and celebrated her "rebirthday." As the months progressed, Sky was recovering physically, but she began struggling mentally.  

"Transplant recovery is not just a physical process. That's why psychological support is an essential part of transplant care, not an afterthought," says Dr. Hogan. 

Honoring her past and embracing the future 

"The nurses and physician assistants were amazing. They would give me pep talks," says Sky. "A nurse who also had leukemia when she was younger suggested the idea to hold a ceremony for my past self."  

Sky, who had lost her hair, bought a wig, and the nurse made her a flower crown. With her care team and loved ones in attendance, people wrote and read eulogies, and then she did the same, saying goodbye to her past self. 

"It was so meaningful that my care team did that for me, and it really helped me get over my mental block," says Sky. "What I appreciated most about Mayo Clinic was its holistic approach. They cared for my mental health just as much as my physical health, which helped me have the best possible outcome. I felt seen by every staff member, many of whom became like family." 

On her 100^th day post-transplant, Sky rang a bell to celebrate her semipermanent remission. She's hoping to ring the bell again on her five-year transplant anniversary on Feb. 25, 2027, to signify permanent remission.  

"Transplantation is never something a patient accomplishes alone. It requires extraordinary courage from the patient, incredible support from family and the coordinated efforts of a large multidisciplinary team," says Dr. Hogan. 

Life beyond leukemia 

Sky returned to school full time, served in an executive position in her sorority and was a leader in many other campus organizations. Since she continued her classes part time during treatment, she was able to graduate from college on time in May 2024. 

Now 24, Sky earned a master's degree, ran her first half-marathon in March and enjoys traveling around the country.  

"Because of advances in molecular diagnostics, targeted therapies, donor selection, transplant techniques and supportive care, she has returned to an active, healthy life," says Dr. Hogan. "Seeing someone like Sky thriving years later is deeply rewarding for everyone involved and reminds us why these advances matter." 

The post Life beyond leukemia: How innovation and compassion helped Sky reclaim her future  appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers report encouraging results using a new radiation technique called minibeam radiotherapy to treat patients with treatment-resistant cancers in or near the skin. The technique delivers very high doses of radiation through closely spaced, extremely narrow beams while limiting radiation exposure to healthy tissue between the beams. 

In a study published in the International Journal of Radiation Oncology, Biology, Physics, researchers found symptoms improved in 86% of patients. Among 40 tumors evaluated, 22.5% disappeared, 25% shrank and 45% remained stable.

"What's encouraging is that patients were able to tolerate these higher radiation doses, even though many had cancers that had resisted previous treatments," says Michael Grams, Ph.D., co-first author of the study and radiation oncology medical physicist at Mayo Clinic Comprehensive Cancer Center. "We're also seeing evidence that this type of radiation may work together with the body's immune system. That could give us another way to approach difficult-to-treat cancers."

The findings suggest that minibeam radiotherapy may do more than change how radiation is delivered. It also may affect tumor biology.

Rethinking how radiation is delivered

Conventional radiation therapy aims to deliver enough radiation to destroy cancer cells while limiting damage to surrounding healthy tissue. Advances in technology have made it possible to target tumors with increasing precision.

"Tumors that require high doses of radiation and have infiltrated sensitive parts of the body provide the most formidable challenge for us. Ideally, we could treat the tumor and preserve function," says Scott Lester, M.D., co-author and a radiation oncologist at Mayo Clinic Comprehensive Cancer Center. "We want to eliminate the cancer and simultaneously promote healing to get the best functional outcome for our patients."

Mayo Clinic researchers began studying minibeam radiotherapy five years ago, building on preclinical research. They developed a device called a tungsten collimator that divides a conventional radiation beam into 0.5-millimeter beamlets spaced 1 millimeter apart from center to center.

The resulting pattern creates areas of high radiation exposure, or "peaks," separated by areas of low exposure, or "valleys." Researchers believe this pattern allows healthy tissue to repair and regenerate more effectively than with conventional radiation therapy. "The treatment can also be completed in two or three sessions instead of 10 to 30 sessions, making it particularly meaningful to patients," says Dr. Grams.

Studying minibeam radiotherapy in patients for the first time

The clinical trial treated 36 patients with 46 tumors, 40 of which could be evaluated. Patients had advanced skin cancers, including melanoma and squamous cell carcinoma, or soft tissue sarcomas. Ninety percent of patients had received at least two previous cancer therapies, and all tumors had been resistant to other treatments. 

Of the 46 tumors, 39 tumors (85%) were treated with minibeam radiotherapy alone, while seven (15%) also received planned conventional radiation therapy.

At a median follow-up of about 15 months, 22.5% of evaluable tumors had disappeared, 25% had shrunk and 45% remained stable. At 12 months, the estimated local control rate — meaning the cancer had not progressed in the treated area — was 89% overall and 92% among tumors receiving minibeam radiotherapy alone.

Patients also experienced substantial symptom relief.

"The study suggested a compelling benefit to quality of life for patients, from relief from pain and bleeding to restoring daily physical functions," says Kimi Chauhan, M.D., a resident in radiation oncology at Mayo Clinic and co-first author of the study.

Patients experienced fewer radiation-related side effects than typically seen with conventional radiation despite receiving higher radiation doses. "The treatment appears to support tissue healing while attacking cancer, making it particularly relevant for complex cases where conventional options are limited," says Dr. Lester. 

Understanding the immune response

Researchers also observed an unexpected finding that raises questions about how minibeam radiotherapy may interact with the immune system.

In 11% of patients, cancer outside the area treated with minibeam radiation also responded, even though patients received no other cancer treatments. This phenomenon, known as an abscopal response, can occur when radiation delivered to one tumor is associated with a response in cancer elsewhere in the body.

"This represents an important shift in how we think about radiotherapy because our results suggest that you don't necessarily need to treat all of the tumor with an ablative dose," says Robert Mutter, M.D., chair of research in the Department of Radiation Oncology and co-leader of the Novel Therapeutics and Therapeutic Modalities Research Program at Mayo Clinic Comprehensive Cancer Center. "We may be able to exploit the distinct ways that tumors die after minibeam radiotherapy to personalize treatment and activate the immune system to fight the cancer."

What's next for minibeam radiotherapy research

Researchers are conducting laboratory studies to better understand the mechanisms that trigger the immune response and which patients are most likely to benefit. An ongoing phase 1 clinical trial is testing increasing doses of minibeam radiotherapy. The team is also developing studies investigating its use in early-stage breast cancer in combination with immunotherapy and during surgery for unresectable pancreatic cancer.

"Minibeam radiotherapy gives us another potential treatment tool for complex cancers," says Dr. Grams. "The goal is now to understand where it can have the greatest impact for patients."

For more information, funding and authors, read the study.

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About Mayo Clinic
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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 first to study minibeam radiotherapy in patients with difficult-to-treat cancers appeared first on Mayo Clinic News Network.