DEAR MAYO CLINIC: My friend was recently diagnosed with leukemia, and I've learned there are several types. How do these differences affect her treatment options and decisions? 

ANSWER: It's true — leukemia isn't a single disease. It's a group of blood cancers, and the exact type plays a major role in how it's treated. Understanding these differences can help patients and families feel more informed and prepared. 

Leukemia is a cancer of the blood and bone marrow, where blood cells are made. Unlike cancers that start in one organ and spread, leukemia is usually considered a whole-body, or systemic, disease right from the beginning. 

In leukemia, the bone marrow produces abnormal white blood cells. These cells don't work properly and can crowd out healthy cells. This can lead to: 

• Fatigue and weakness (from low red blood cells). 

• Easy bruising or bleeding (from low platelets). 

• Frequent infections (from a weakened immune system). 

• Shortness of breath. 

• Bone pain or tenderness. 

• Swollen lymph nodes. 

• Enlarged liver or spleen. 

• Fever or chills. 

• Unintentional weight loss.  

Patients may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses. 

Types of leukemia

There are four main types of leukemia: 

• Acute lymphocytic leukemia (ALL), which is the most common type of leukemia in young children, but it can also occur in adults. 

• Acute myeloid leukemia (AML), which is the most common type of acute leukemia in adults. 

• Chronic lymphocytic leukemia (CLL), which is the most common chronic leukemia in older adults. 

• Chronic myeloid leukemia (CML), which mainly affects adults of various ages. 

They're grouped based on how fast they grow and the type of blood cell involved:  

• Acute leukemias develop quickly and need urgent treatment. 

• Chronic leukemias grow more slowly and may not need treatment right away. 

• Lymphocytic leukemias affect lymphocytes, a type of white blood cell involved in the immune system.  

• Myeloid leukemias affect cells that develop into red blood cells, platelets and other types of white blood cells.  

Each type — and even subtypes within them — can behave quite differently. For example, some people may have a slow-growing form of CLL that may not need treatment for years, while others may have a faster-growing subtype that requires treatment soon after diagnosis. 

Diagnosis

Diagnosis often begins with a routine blood test that shows abnormal cell counts. If leukemia is suspected, a bone marrow biopsy — taking a small sample from the hip bone — is usually needed to confirm the diagnosis. From there, more detailed testing is done, including: 

• Flow cytometry to identify cell types. 

• Cytogenetics to study chromosomes. 

• Molecular testing to look for genetic changes. 

Accurate diagnosis is essential because different types of leukemia require different treatments. Some therapies work only for certain genetic markers, and the expected outcome can vary widely. These tests allow doctors to match patients with therapies that target their specific disease, making leukemia treatment highly individualized.  

Treatment

Treatment may include: 

• Chemotherapy, a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. 

• Targeted therapy, a treatment that uses medicines that attack specific targets in the cancer cells.  

• Immunotherapy, treatments that help the immune system fight cancer. These include CAR-T cell therapy — engineered immune cells that attack cancer cells — and bispecific antibodies that help immune cells find cancer cells. 

• Stem cell transplantation, a treatment that replaces diseased bone marrow with healthy cells, often using donor cells. 

When deciding the best treatment, doctors consider several factors, including: 

• The exact type and subtype of leukemia. 

• Genetic and molecular test results. 

• How quickly the disease is progressing. 

• The patient's age and overall health. 

• The patient's personal preferences. 

The future of leukemia treatment is focused on precision medicine — tailoring treatments to the genetic makeup of each patient's leukemia — and improving long-term outcomes with fewer side effects. With advances in testing and therapy, care is becoming more personalized than ever, offering hope for even better results in the coming years.  

William Hogan, M.B., B.Ch., Hematology, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: Why leukemia type matters for treatment decisions appeared first on Mayo Clinic News Network.

PHOENIX — An international phase 3 study performed at all three Mayo Clinic destination medical centers found that a new immunotherapy helped many patients with an aggressive form of bladder cancer keep their bladder instead of having it surgically removed. The treatment also kept many patients cancer-free for more than two years and caused mostly mild side effects. The findings were published in The Lancet Oncology.

Patients in the study had high-risk bladder cancer that had returned despite standard treatment with bacillus Calmette-Guérin (BCG). For these patients, surgery to remove the bladder is typically the recommended next step. The new immunotherapy treatment, called cretostimogene grenadenorepvec, produced a complete response, with no detectable signs of cancer in 75% of patients, with many of those responses lasting beyond two years.

"Until now, patients whose cancer returned after BCG therapy have had few effective options besides bladder removal," says Mark Tyson II, M.D., lead author of the study and a urologist at Mayo Clinic in Arizona. "This study shows we may be able to offer many of those patients another option without compromising cancer control."

Among patients whose cancer completely disappeared after treatment, about 60% remained cancer-free two years later. In one patient, the cancer has not returned for more than four years after completing treatment. Most treatment-related side effects were mild, temporary bladder symptoms, and researchers reported no severe treatment-related side effects.

"For patients, this isn't just about treating cancer — it's about preserving quality of life," says Dr. Tyson. "Avoiding bladder removal can have a profound impact on daily living. Seeing patients remain cancer-free for years while keeping their bladder is exactly the outcome we've been hoping to achieve."

The study included 115 patients treated at 41 medical centers across North America, Asia and Australia. Two years after starting treatment, an estimated 81% of patients had not needed surgery to remove their bladder. The researchers concluded that cretostimogene grenadenorepvec could become an important bladder-sparing treatment option for patients whose high-risk bladder cancer has returned after standard BCG therapy. They also noted that the treatment has not been directly compared with other bladder-sparing therapies in clinical trials.

The study was funded by CG Oncology. For a complete list of authors, disclosures and funding, review the study. The therapy remains investigational.

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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 Experimental immunotherapy may help patients with high-risk bladder cancer avoid bladder removal surgery appeared first on Mayo Clinic News Network.

After years of living with Crohn's disease and trying treatments that didn't work, Amy Marshak felt she was running out of options. The chronic illness affected her career, her energy and the everyday family moments she cherished most. At Mayo Clinic, she found a new treatment approach and renewed hope for the future.

Watch: A mom's journey beyond Crohn's disease and back to the moments that matter

Journalists: Broadcast-quality video (2:35) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I first started noticing symptoms of my Crohn's disease in the fall of 2018," Amy recalls.

She is a lawyer, a wife and a mom of two.

"It was about six months after my younger daughter was born," Amy says. "She's really never known me as a parent without Crohn's."

Crohn's disease is a chronic inflammatory condition that can cause abdominal pain, weight loss and digestive issues.

"It's really difficult day-to-day living with Crohn's because of the amount of pain I experienced," Amy says. "It really felt like I could do one or the other, be a lawyer or be a mom, to have the energy to do either of those things."

Amy had a portion of her colon and small bowel removed, then went through a series of medications.

"Some of them worked for a short period of time, and then I developed antibodies to them and would never work again," Amy says. "I was sort of at the end of all the options that exist because my Crohn's disease is spread throughout my small intestine."

Months turned into years.

"I worked so hard to find a solution to make Crohn's disease livable but felt no closer to a solution than I was before," Amy says. "I did some research, spoke with my doctor, and they suggested coming to Mayo Clinic." 

In July 2024, Amy traveled to Jacksonville, Florida, to meet Dr. Jana G. Al Hashash, a Mayo Clinic gastroenterologist.

"She really did want something cutting-edge and something different," recalls Dr. Al Hashash, who has collaborated closely with colleagues, including Dr. Ernesto Ayala, a hematologist and oncologist, to treat refractory Crohn's disease.

"What we're performing here is a newer protocol," says Dr. Al Hashash. "This stem cell transplant program is for patients like Amy who have failed multiple medical therapies and whom we want to try to reset the (immune) system."

The process uses chemotherapy followed by the body's own stem cells to reset the immune system and reduce the effects of Crohn’s disease.

"If Crohn's disease comes back, we'd like to see that it's coming back weaker than it was before, with less inflammation and less impact on the body," says Dr. Al Hashash.

"This was really both the best and the only option there was, and that there was another option that had such promise was really exciting," Amy says.

In addition to getting back to her family and career, Amy had another milestone in mind: to be able to sit through a whole family dinner without pain.

"I love family dinners," Amy says. "I think they're a wonderful way to connect with my kids. It just feels frustrating not to be part of that family moment."

Amy's treatment began in early 2025 and kept her in the hospital for nearly two months. She recorded herself reading bedtime stories to her children nightly, who were nearly 1,000 miles away.

About 100 days after treatment, tests confirmed that the stem cell transplant was successful.

"Amy is a beacon of hope for people with Crohn's disease who failed multiple therapies," says Dr. Al Hashash. "She's done fantastic."

Amy's care team continues to monitor her progress. Since returning home, Amy has been able to get back to the things she loves, starting with that family moment around the dinner table.

"I'm excited to be able to play with them more, to be with them more, to have more energy for their projects and ideas," Amy says. "And also, to be able to balance work-life in a way that I haven't been able to balance in the past few years because of my Crohn's."

The post A mom’s journey beyond Crohn’s disease and back to the moments that matter (VIDEO) appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My neighbor recently had an X-ray after hurting their leg, and the doctor found a bone lesion that needs more testing. They're terrified it could mean bone cancer. It got me wondering: Does every bone tumor or bone lesion mean cancer?  

ANSWER: Hearing that an imaging test found a bone tumor or bone lesion can be frightening. Fortunately, most bone tumors aren’t cancerous. The key is finding out exactly what type of tumor or lesion you have, so your healthcare team can recommend the right care. 

A bone tumor is an abnormal growth of cells within the bone. Some bone tumors are benign (noncancerous) and may simply be monitored over time. Others are malignant (cancerous) and require treatment because they can grow, damage the bone or spread to other parts of the body.  

It's also important to understand that primary bone cancer is different from cancer that has spread to the bone from another part of the body. Cancers are named for where they begin. For example, if lung cancer spreads to the bone, it's still lung cancer, not bone cancer. Likewise, if bone cancer spreads to the lungs, it's still bone cancer.  

Knowing where a cancer began helps your healthcare team recommend the most appropriate treatment. Primary bone cancers are also usually not caused by something you did or didn't do, which can be reassuring to know. 

Pain in your bones, muscles or joints is common and is usually caused by conditions other than cancer. However, pain that continues to worsen, doesn't improve over time, wakes you from sleep or is associated with other symptoms, such as swelling, fever, weight loss or limping, deserves medical evaluation. 

In children and teenagers, persistent pain shouldn't automatically be dismissed as growing pains. While growing pains are common, ongoing pain that interferes with sports, school or daily activities should be evaluated by a healthcare professional.  

Persistent back pain in children is also uncommon and should be checked. Another warning sign is a fracture that occurs after little or no trauma. Some bone tumors can weaken the bone enough that it breaks more easily than expected. 

Sometimes bone tumors don't cause symptoms at all. Instead, they’re discovered when an X-ray or other imaging test is performed after a sports injury or another unrelated problem. In these situations, the injury didn't cause the tumor; the imaging simply revealed something that was already there. 

When a bone tumor or lesion is found, your healthcare team will review your medical history, perform a physical examination and determine whether additional imaging, such as a CT scan or MRI, is needed to better understand the abnormality. Based on those imaging findings, a biopsy may be recommended. 

During a biopsy, a small tissue sample is removed and examined under a microscope to determine exactly what type of cells are present. The biopsy results help your healthcare team make an accurate diagnosis and recommend the most appropriate treatment. Waiting for answers can be difficult, but taking the time to make an accurate diagnosis helps ensure you receive the most appropriate treatment. 

Treatment depends on the type of bone tumor. Many benign tumors don't require treatment and can simply be monitored if they're not causing pain, limiting function or weakening the bone. Other benign bone tumors may require surgery. Malignant bone tumors, however, require treatment. Depending on the type of cancer, treatment may include surgery, chemotherapy, radiation therapy or a combination of these approaches. 

Because bone tumors are rare, it's important to be evaluated by a healthcare team with experience diagnosing and treating your specific condition. Specialists, including radiologists, pathologists, orthopedic surgeons and medical oncologists, work together to make an accurate diagnosis and recommend the most appropriate treatment plan. 

If you've been told you have a bone tumor or bone lesion, try not to assume the worst. Many bone tumors are benign, and even malignant bone cancers can often be treated successfully. If you have persistent pain, an abnormal imaging finding or symptoms that concern you, don't ignore them. Talk with your healthcare team. An accurate diagnosis is the first step toward getting the care that's right for you. 

Wendy Allen-Rhoades, M.D., Ph.D., Oncology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: Does a bone tumor always mean cancer? appeared first on Mayo Clinic News Network.

Mayo Clinic oncologist explains risk factors, treatment considerations for patients under 50

PHOENIX — You may have heard that colorectal cancer is increasingly affecting young adults. However, it is not the only gastrointestinal (GI) cancer that doctors are diagnosing in patients below the age of 50, explains Christina Wu, M.D., an oncologist at Mayo Clinic Comprehensive Cancer Center in Arizona.

"People under 50 are not too young to develop gastrointestinal cancers," Dr. Wu says. "If young adults notice new or persistent symptoms, it's important to get them worked up."

At Mayo Clinic, early-onset gastrointestinal cancers are defined as GI cancers diagnosed in people under 50 years old. Research shows that the most common type of early-onset GI cancer worldwide is colorectal cancer, followed by stomach cancer, esophageal cancer and pancreatic cancer. Less common types of early-onset GI cancers include bile duct, gallbladder, appendix, neuroendocrine and small bowel cancers.

"More research needs to be done to understand what causes the rise in incidence of early-onset GI cancers," Dr. Wu says. "We know that certain factors can increase the risk of developing GI cancers, and early detection gives patients a better chance of successful treatment."

Risk factors

Several factors can increase the risk of developing early-onset GI cancers, including genetic conditions, chronic diseases and lifestyle:

• Lynch syndrome and familial adenomatous polyposis are hereditary conditions that are associated with an increased risk of early-onset colorectal cancers.

• Inflammatory bowel disease and primary sclerosing cholangitis can increase the risk of developing GI cancers such as colorectal cancer and cholangiocarcinoma, respectively.

• A sedentary lifestyle, obesity, diets high in processed foods, alcohol consumption, smoking and environmental exposures may be associated with an increased risk of GI cancers.

Early detection and symptoms

Recommendations for when people at average risk for colorectal cancer should be screened vary by country but generally start in their 40s or early 50s. In the U.S., colorectal cancer screening is recommended to start at age 45 for people at average risk; people with risk factors such as a family history of colorectal cancer may need to start screening earlier.

Having a primary care clinician, getting regular health checkups and discussing any health concerns with a healthcare professional can help determine what screening or tests may be needed, depending on individual risk factors.

In some cases, symptoms of early-onset GI cancers may present and be associated with specific cancer types:

• Unintentional weight loss with jaundice and pain may indicate pancreatic cancer.
• Weight loss, pain, and difficulty eating or swallowing may be linked to stomach cancer.
• A persistent change in bowel habits, abdominal pain and iron-deficiency anemia may be associated with colorectal cancer.

"Any new symptoms that are persistent or worrisome should prompt a visit to a healthcare professional to get checked out," Dr. Wu says. "If symptoms are ignored or not investigated, young adults may experience a delay between when they first experience symptoms and a cancer diagnosis. Recognizing symptoms early is important," Dr. Wu explains.

Tailoring care for younger adults  

Young adults diagnosed with GI cancers often need multidisciplinary care due to differences in cancer biology, as well as unique social and life-stage needs.

"Before starting treatment, we perform genetic testing and tumor profiling to identify mutations that may guide targeted therapies," says Dr. Wu. "These advances allow us to provide more personalized and effective treatment for our patients."

In addition, young adults may require support, such as fertility preservation and resources to navigate the emotional and practical challenges of a cancer diagnosis. Mayo Clinic's Early-Onset and Hereditary GI Cancers Program provides specialized, multidisciplinary care for this patient population.

Innovations in treatment

With advances in genetic testing and tumor profiling, cancer care teams can provide more personalized and targeted treatments, including immunotherapy in some cases, and identify patients who may be eligible for clinical trials. Analysis of the tumor helps guide treatment decisions and identify appropriate therapies.

For certain GI cancers, treatment may involve a combination of chemotherapy, radiation (including proton beam therapy) and surgery. Advances in treatment, including minimally invasive approaches and immunotherapy, are improving care for some GI cancers.

Mayo Clinic researchers have been exploring the use of artificial intelligence as an additional aid in the detection of gastrointestinal cancers such as colorectal cancer and pancreatic cancer.

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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:

• Caroline Auger, Mayo Clinic Communications, newsbureau@mayo.edu

The post Colorectal cancer isn’t the only gastrointestinal cancer rising in young adults appeared first on Mayo Clinic News Network.

The brain relies on carefully coordinated electrical signals to control everything from movement and memory to thought and emotion. When those signals become too active or poorly regulated, they can contribute to neurological disorders such as epilepsy. Researchers are working to better understand these abnormal patterns of brain activity and develop new ways to measure and safely influence them without surgery. 

Brian Lundstrom, M.D., Ph.D., is a Mayo Clinic neurologist and physician-scientist whose research focuses on cortical excitability — how active or responsive the brain is — and how noninvasive brain stimulation may help improve the diagnosis and treatment of epilepsy and related neurological disorders.  

As a member of Mayo Clinic's BIONIC (Bioelectronic Neuromodulation with Innovation to Cure) initiative, Dr. Lundstrom shares how advances in bioelectronic medicine are shaping the future of personalized neurological care. 

Watch: BIONIC: AI, Brain Stimulation, and the Future of Neurotechnology

Journalists: Sound bites and with Dr. Brian Lundstrom are in the downloads at the end of the post. Please courtesy: "Brian Lundstrom, M.D., Ph.D./Neurology/Mayo Clinic."

Q: What does it mean when the brain is "hyperexcitable" or has abnormal cortical excitability? 

A: Cortical excitability is one way to describe how responsive the brain is to activity. The cortex is the outer layer of the brain, and neurons — the brain's fundamental cells — communicate with each other through electrical signals. 

In some neurological diseases, the brain can become too excitable. Epilepsy is one example. During a seizure, the brain's electrical activity becomes abnormally high. Many neurological conditions may involve brain activity that is either too high, too low or not properly regulated. 

Q: Your research explores ways to stimulate the brain without surgery. How do these technologies work, and how could they help people with conditions like epilepsy? 

A: Because the brain communicates through electricity, we can also use electrical or magnetic stimulation to try to better understand brain activity. One way is through transcranial magnetic stimulation (TMS). TMS uses magnetic pulses delivered outside the head to stimulate targeted brain regions.  

Another method is transcranial direct current stimulation (tDCS), which uses low levels of electrical current applied through the scalp. These approaches are considered noninvasive because they do not require surgery or implanted devices. 

The goal is to use these targeted, noninvasive stimulations to influence brain activity, helping us better understand brain activity and, ultimately, correct abnormal patterns that contribute to conditions like epilepsy. 

Q: What makes noninvasive stimulation especially appealing compared with traditional approaches for epilepsy, such as medication, surgery or implanted devices? 

A: While medications are highly effective for many people, they don't work for everyone, and some patients experience side effects that affect their daily lives. Our goal is to move beyond that trial-and-error approach by using measurable changes in brain activity to guide treatment decisions earlier and more precisely. 

Surgery and implanted devices can also be very effective, but they're not the right option for every patient.  

That's where noninvasive brain stimulation, like TMS or tDCS, is especially promising. Because these approaches target specific areas of the brain without surgery, they generally don't produce the same whole-body side effects that medications can.  

While additional research is needed, I've also seen patients whose seizures were significantly reduced or eliminated entirely through noninvasive brain stimulation after other treatments hadn't worked. Our hope is to continue refining these approaches so more patients can benefit from safe, personalized therapies. 

Q: What are biomarkers, and why are they important in understanding the brain? 

A: One of the biggest modern challenges in using brain stimulation therapies is that we still don't have simple, precise ways to measure how the brain is working in real time. Before treatments like TMS or tDCS can be used most effectively, we first need to understand how the brain is functioning. 

Biomarkers are measurements that help us understand what's happening inside the brain and help us identify abnormalities. We gather this information using tools such as electroencephalography (EEG), which records the brain's electrical activity, and magnetoencephalography (MEG), which measures the magnetic fields produced by that activity.  

Q: Why is Mayo Clinic the right environment for this kind of research? 

A: Understanding how the brain works is incredibly complex, and solving these challenges requires expertise from many different fields. Neurologists, engineers, imaging specialists, computational neuroscientists, data scientists and many others all play an important role in developing new ways to diagnose and treat neurological disorders. 

One of Mayo Clinic's greatest strengths is that this kind of collaboration is part of how we work every day. Researchers and clinicians from different specialties work side by side, combining discoveries about how the brain functions with technologies that can measure and influence brain activity.  

Many institutions recognize the value of multidisciplinary research, but Mayo Clinic's integrated model makes collaboration especially seamless. Rather than working in separate silos, experts across departments are united by a shared goal of improving patient care.  

Q: How are new technologies, including noninvasive stimulation, advanced monitoring or computational modeling, being used or envisioned within BIONIC research? 

The BIONIC initiative is centered on advancing bioelectronic medicine, which uses technology to better understand, diagnose and treat disease. Traditionally, medicine has relied on medications and surgery, but bioelectronic medicine offers another way to care for patients by measuring and influencing the brain's electrical activity. 

In my research, we're using advanced brain monitoring tools, noninvasive brain stimulation and computational approaches with the goal of combining these technologies so we can develop more personalized treatments and, ultimately, help more patients become seizure-free with fewer side effects. 

Looking ahead, I'm especially excited about the role artificial intelligence (AI) can play. AI can help us bring together information from many different sources to better understand brain activity and guide more precise treatments.  

There are certainly challenges ahead, but I think the potential is extraordinary. By combining these new technologies with the collaborative environment fostered by BIONIC, we have an important opportunity to improve how we diagnose, monitor, and treat epilepsy and many other neurological disorders. 

The post How noninvasive brain stimulation could transform epilepsy care (VIDEO) appeared first on Mayo Clinic News Network.

For millions of people, cartilage damage can lead to chronic pain, limited mobility and require difficult decisions about surgery. Unlike bone, cartilage has little ability to heal itself, leaving many patients with treatment plans that require multiple procedures, lengthy rehabilitation or, eventually, joint replacement. But what if damaged cartilage could be encouraged to repair itself? 

In this episode of "Tomorrow's Cure," orthopedic researchers from Mayo Clinic and Mass General Brigham discuss RECLAIM, an investigational regenerative medicine approach designed to help restore damaged cartilage. The approach uses a patient's own cartilage cells combined with specialized donor cells that help create a healthier environment for healing. Rather than simply filling damaged areas, RECLAIM aims to support the body's natural repair process in a single procedure instead of multiple surgeries.  

Host Lindsey Sievert talks with Daniel B.F. Saris, M.D., Ph.D., and Mario Hevesi, M.D., Ph.D.,  orthopedic surgeons at Mayo Clinic and Christian Lattermann, M.D., chief of the Division of Sports Medicine at Brigham and Women's Hospital and director of research for Mass General Brigham Sports Medicine. Together, they discuss why cartilage injuries have challenged orthopedic medicine for decades and how advances in cell biology, minimally invasive surgery and artificial intelligence (AI) are creating new possibilities. They also explain how collaboration across specialties helped adapt the RECLAIM technology from the knee to the hip, why preserving a patient's natural joint is especially important for active people and what researchers still need to learn before treatments like RECLAIM become more widely available. 

The conversation also explores the future of regenerative medicine, including how AI could help identify patients most likely to benefit from these therapies and how insights from this research may eventually extend beyond cartilage to other tissues throughout the body. While RECLAIM remains under clinical investigation, the episode offers an inside look at how scientific discovery and patient collaboration are shaping the next generation of orthopedic care. 

Listen to the latest episode of "Tomorrow's Cure" wherever you get your podcasts. You can also explore the show's full library of episodes and guests on the show's playlist.  

The post From joint damage to regeneration   appeared first on Mayo Clinic News Network.

On May 30, 2025, the Fountain Hills resident became the first patient to receive a lung transplant through Mayo Clinic's new Lung Transplant Program. Craig had been living with chronic obstructive pulmonary disease (COPD), a progressive lung condition that affects more than 16 million Americans. Although treatments can help manage symptoms, the disease has no cure and gradually makes breathing more difficult over time. 

For Craig, the journey to transplant was years in the making. Barely able to walk 15 feet while using an oxygen tank, Craig's life had become very limiting. 

A former flooring installer, he spent decades working in environments with airborne dust and particles. He also had a family history of COPD. As his disease progressed, everyday activities became increasingly difficult. Breathing became a challenge, and simple tasks required more energy than they once had. Eventually, doctors determined a lung transplant offered the best path forward. 

Now, Craig is celebrating more than a milestone. He's celebrating what he calls his "lung anniversary," one year since the transplant that allowed him to breathe easier, regain his independence and return to the activities he loves. "I’m back to doing nearly everything I did before COPD," he says. "I was eager to get back to my life, but getting in shape takes time. I’m happy to say I’ve just started training for the Thanksgiving Turkey Trot." He's also now back at work as a handyman and once again doing many of the activities COPD had taken away from him. The moments he now enjoys, whether working, spending time with family or simply staying active, are reminders of how much has changed in a single year.  

Watch: The first patient to receive a lung transplant through Mayo Clinic in Arizona's new lung transplant program provides an update on how he's doing

Journalists: Broadcast-quality sound bites of Craig Schere and Dr. D'Cuhna are available in the downloads at the bottom of the posts. Name super/CG: Jonathan D'Cuhuna, MD/Surgical Director of the Mayo Clinic Lung Transplant Program in Arizona/Mayo Clinic.

Throughout his recovery, Craig says he has remained mindful of the donor whose gift made his transplant possible. "The life I have now is possible because of my donor's generosity. I celebrate both my birthday and the day of my transplant because what I can do now is remarkable, and it's only possible because of that gift," says Craig. 

The historic procedure marked not only a turning point in his personal health journey but also a significant milestone for transplant care in Arizona. Some neighboring states do not offer lung transplant programs, meaning patients often must travel far from home, family and support networks to receive care. The Arizona program helps address that gap by allowing more patients to remain closer to home throughout evaluation, transplant surgery and recovery.  

While Craig was the first patient in the new program, he is no longer the only one. In its first year, Mayo Clinic's Arizona lung transplant program brought together a multidisciplinary team of medical and surgical experts to broaden access to care for patients in the region with advanced lung disease.

Dr. Johnathan D'Cunha is the chair of Cardiothoracic Surgery and the surgical director of the Mayo Clinic Lung Transplant Program in Arizona. He performed Craig's transplant. “Craig is now living out loud because he has so much hope ahead. Mayo Clinic Transplant Center is one of the largest and most comprehensive transplant programs in the world, which allows us to care for the most complex and serious patients. The program's success reflects the close collaboration of our Arizona team and strong coordination across Mayo Clinic Transplant Center," Dr. D'Cuhna says.  

For Craig, however, the anniversary is about gratitude. 

"I'm grateful to have this time with my family, my 14 grandchildren and six great-grandchildren, and look forward to what's next for me," says Craig. As he celebrates his first lung anniversary, Craig's story is a reminder of what transplantation makes possible: not just more years of life, but the opportunity to fully live them. 

Learn more about lung transplantation.  

Related

• (VIDEO) Breathing easy thanks to the gift of life and new Mayo Clinic Lung Transplant Program in Arizona

The post One year later: First patient thrives after lung transplant through Mayo Clinic in Arizona’s new lung transplant program (VIDEO) appeared first on Mayo Clinic News Network.

Decentralized approach increases participation among rural and underserved populations

ROCHESTER, Minn. — A Mayo Clinic study published in JAMA Network Open found that bringing some or all clinical trial-related activities directly to patients can help overcome barriers that prevent many people from participating. Increased participation and expanded access to research was observed for people in rural communities and underserved populations.

The study evaluated Mayo Clinic's decentralized clinical trials program, which allows many research activities to take place outside a traditional research site through services such as remote informed consent, video visits, in-home blood draws, remote monitoring and home delivery of oral study medications. Researchers found the approach expanded the geographic reach of clinical trials while increasing participation among patients who have historically faced barriers to enrollment.

Broader participation can help ensure clinical trial findings better reflect the patients who will ultimately receive new treatments.

"Clinical trials shape the future of medicine," says Tufia Haddad, M.D., a medical oncologist at Mayo Clinic Comprehensive Cancer Center in Rochester and the study's first author. "When we put those trial results into clinical practice, we need to make sure they're representative of all the patients we see."

Researchers evaluated 765 clinical trials involving 7,469 participants over 15 months. The percentage of participants living more than 120 miles from a Mayo Clinic campus in Rochester, Minnesota; Phoenix; or Jacksonville, Florida, increased from 18.9% to 29.6%. Enrollment from rural communities increased from 16.6% to 24.9%, while participation among underserved racial and ethnic populations increased from 12.5% to 17.4%.

"We showed that decentralized clinical trial infrastructure can make research access measurable," says Lydia Mercado, M.D., senior research program coordinator at Mayo Clinic in Florida and the study's second author. "By reducing travel requirements and other logistical burdens, we create more realistic opportunities for patients to participate in research."

Bringing research closer to patients

Only a small percentage of patients who are eligible for clinical trials ultimately enroll. In addition to limited awareness of research opportunities, participation often requires frequent visits for physical exams, laboratory testing and safety monitoring — creating significant time and travel burdens for patients and caregivers.

Depending on the study, decentralized clinical trials allow many of those activities to take place closer to where patients live. Participants may review and sign consent forms electronically, meet with research teams through secure video visits, receive in-home blood draws, have oral study medications delivered to their homes, and use wearable devices or other digital tools to monitor their health between visits.

"The most innovative clinical trials are often conducted at academic medical centers, while the majority of healthcare is delivered in community settings," Dr. Haddad says. "We don't want a patient's ZIP code or geography to determine whether they can access these research opportunities."

Researchers emphasize that decentralized approaches do not replace traditional clinical trials but instead move only those activities that can be safely conducted outside a research center. Institutional review boards carefully evaluate study protocols, and research teams determine which assessments can occur remotely while maintaining patient safety and study quality.

"Clinical trials shape the future of medicine. When we put those trial results into clinical practice, we need to make sure they're representative of all the patients we see." - Dr. Tufia Haddad.

Expanding access while maintaining research quality

Researchers also intentionally tracked participation among rural and historically underserved populations to evaluate whether decentralized clinical trials expanded access more equitably.

"We didn't want these decentralized capabilities to widen existing gaps in research participation, but rather our goal was to help close them," Dr. Haddad says. "From the program's inception, we intentionally focused on these metrics."

To help remove technology barriers, the program provides cellular-enabled tablets when needed, selects technologies with demonstrated ease of use, offers technical support and, when appropriate, gives participants options for how they engage with study teams.

"Flexibility is one of the greatest advantages of decentralized clinical trials," Dr. Mercado says. "Studies can be designed around the patient while still meeting scientific objectives."

Shaping the future of clinical trials

The findings support Mayo Clinic's broader Clinical Trials Beyond Walls program, which aims to make research available to all communities.

"Think of what this means for patients who are going through a cancer diagnosis," says Cheryl Willman, M.D., co-author of the study and the Stephen and Barbara Slaggie Executive Director, Mayo Clinic Cancer Programs, and director, Mayo Clinic Comprehensive Cancer Center. Cancer clinical trials are the most common trials at Mayo Clinic that are leveraging decentralized capabilities — 58% of the trials in the study were cancer-related. "Patients are getting access to cutting-edge therapies from the most trusted name in healthcare, all in the healing environment of their home."

The next phase of decentralized trials will focus on expanding collaborations with community healthcare providers so more study activities can be completed closer to patients' homes.

Researchers expect continued advances in mobile diagnostics, remote imaging, digital health technologies and at-home drug treatments that could further reduce the need for travel while maintaining rigorous clinical research.

This work is also part of the Clinical Impact initiative at Mayo Clinic, which aims to bring the promise of clinical trials to more patients, ensuring that they gain access to new therapies as quickly as possible.

"We're already enrolling patients who have never stepped foot in a Mayo Clinic facility," Dr. Haddad says. "The long-term goal is to build an infrastructure that not only serves Mayo Clinic patients but can ultimately help other research organizations reach more patients, regardless of where they live."

For a complete list of authors, disclosures and funding, review the 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.

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 Study finds bringing clinical trials closer to patients expands access to research appeared first on Mayo Clinic News Network.

After receiving a serious diagnosis, one patient turned to several medical institutions in search of answers. Where other institutions saw limitations, Mayo Clinic's interdisciplinary team saw a way forward. 

When Kyle Collett was diagnosed with an advanced tumor affecting approximately 65% of his tongue, life changed overnight.

 At 39 years old, he was a soon-to-be husband and a strategic finance professional.

"Like many people my age, cancer was simply not something I expected to hear," Kyle recalls. "My days were focused on building a future with my family, staying active and planning for what was ahead."

Before Kyle came to Mayo Clinic, the multiple medical opinions he had received had pointed toward a challenging future that included immediate major surgery, a near-total glossectomy (removal of most of the tongue), and a dramatically altered quality of life.

A different approach: Focus on what is possible

Where other institutions saw limitations, Mayo Clinic's interdisciplinary team saw an opportunity to help.

"This was a young patient," says Samip Patel, M.D., an otolaryngologist at Mayo Clinic and lead surgeon in Kyle's case. "He and his fiancée were really just starting their life together when he was diagnosed with a large oral tongue cancer."

"What was unique about this case was that we were able to pause as a multidisciplinary team and ask, 'Is there a way to treat this cancer effectively, but also preserve as much speech, swallowing and quality of life as possible?'"

Kyle quickly recognized that this collaborative team approach meant he was where he was supposed to be for his treatment.

"When nearly every other opinion focused on what I was going to lose, Mayo Clinic focused on what might still be possible," he says. "Rather than applying a one-size-fits-all approach, the team took the time to evaluate my unique situation and develop an individualized treatment plan."

Oral tongue cancers are aggressive, making cure the top priority. However, preserving the components of human identity, speech, swallowing and appearance matters tremendously.

Mayo Clinic overcame this challenge by bringing surgery, medical oncology, radiation oncology, radiology, pathology and therapy teams together early in Kyle's journey.

"Instead of feeling like I was navigating disconnected opinions, Mayo Clinic's teams functioned as one unified group with a shared mission," Kyle says.

Rather than immediate major surgery, Kyle's team recommended induction systemic therapy first. This treatment approach uses full-body medications like chemotherapy or immunotherapy to shrink the tumor and target hidden cancer cells before an operation.

"He had a strong response, and that allowed us to make the surgery smaller and then deliver more targeted postoperative radiation," Dr. Patel explains. "To me, that is the heart of personalized cancer care. The goal was to balance cure with long-term function."

By using neoadjuvant chemoimmunotherapy to shrink the tumor before surgery, the team spared Kyle from losing most of his tongue.

Kyle credits Dr. Patel's ability to explain complex medical information, alongside the commitment of the Radiation Oncology team.

Following surgery, a network of specialists, including speech, physical and lymphatic therapists, helped Kyle regain function and trained his fiancée to do Kyle's required home care.

Today, Kyle enjoys family dinners, travel and joyous conversations about what is next in life.

"The milestone was not just that the cancer was treated," says Dr. Patel. "It was that we were able to treat it in a way that helped protect his long-term function and quality of life. To me, that is real success, not just recovery from treatment, but recovery of life."

Providing confidence, clarity and hope

Dr. Patel notes that for complex head and neck cases, Mayo Clinic designs treatment around the whole person, not just the tumor.

Kyle praises that approach.

"The expertise is extraordinary, but what truly sets Mayo apart is the way it combines innovation, collaboration and humanity," he says. "During one of the most uncertain and frightening experiences of my life, Mayo Clinic gave me confidence, clarity and hope."

The post When others focused on loss, Mayo Clinic focused on possibility appeared first on Mayo Clinic News Network.