Dr. Denise Harnois, a Mayo Clinic transplant hepatologist, explains how this innovative strategy is expanding treatment options and improving outcomes.

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Learning you have advanced colorectal cancer that has spread to the liver can be scary. In some cases, a liver transplant may offer hope, providing better outcomes when other treatments aren't an option. 

"In those circumstances where patients have colon cancer that's gone to the liver that doesn't seem to be anyplace else within the body, but they're not eligible for consideration of doing a surgical resection — in those circumstances, we can consider replacing the entire liver, and that involves a liver transplant," explains Dr. Harnois.

It's a complex surgery requiring experts from multiple teams working together.

"We're working together as a team to make sure we are offering the best options for the potential for cure for these patients," she says.

Liver transplants have greatly improved survival rates. One-year survival is 80% to 100%, three-year survival is around 80%, and five-year survival is between 60% and 80%.

"Without consideration of liver transplant, their five-year survival rate would have been 15%. So we can offer a dramatic improvement in survival rates in patients that undergo liver transplant," says Dr. Harnois.

Related posts:

• Liver transplants offer new hope for colorectal cancer patients with liver metastasis
• Mayo Clinic Q and A:  Understanding colorectal cancer
• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults
• Innovative treatments for rectal cancer

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A brain aneurysm, also called a cerebral aneurysm, is a bulge or ballooning in a blood vessel in the brain. Dr. Chris Fox, a Mayo Clinic neurosurgeon, says there are two broad categories of aneurysms: ruptured aneurysms, which are neurosurgical emergencies, and unruptured aneurysms, where there is time to establish a treatment plan that may involve multiple options. 

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"For unruptured aneurysms, we have the ability to plan and make a decision on the best treatment upfront in a nonemergent situation," says Dr. Fox.

But when a brain aneurysm ruptures, prompt medical attention is required. 

"Typically, when we see a patient with a ruptured aneurysm, we treat it as quickly as possible. That's usually within a matter of hours because there's a risk that the aneurysm can rerupture," he says.

Symptoms

Symptoms of a ruptured aneurysm can include severe head pain, nausea, vomiting, confusion and loss of consciousness.

"The classic presentation for a ruptured aneurysm is a patient has the worst headache of their life," Dr. Fox says.

Brain aneurysms are more common in women, and there may be a genetic component because aneurysms can run in families.

"But smoking and hypertension are two of the biggest risk factors for causing an aneurysm or having an aneurysm form," says Dr. Fox.

Related posts:

• Mayo Clinic Q and A: Brain aneurysms don’t always require treatment
• Mayo Clinic Minute: What is a subarachnoid hemorrhage?

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When blood vessels are damaged or blocked, it can deprive your brain of vital oxygen and nutrients, which could lead to a condition called vascular dementia.

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"Vascular changes in the brain most often damage the axons — or cables — that connect different parts of the brain," says Dr. Stephen English, a Mayo Clinic neurologist. "Therefore, signals take longer to travel, so our brains are not working at full speed."

Dr. English says the signs of vascular dementia include problems with reasoning, planning, judgment, memory and other thought processes. Factors that increase the risk of heart disease and stroke also raise vascular dementia risk.

"High blood pressure, high cholesterol, diabetes, smoking, obesity and sleep apnea — these are the modifiable risk factors that, if untreated, can cause wear and tear on the small blood vessels in the brain over time," says Dr. English.

If you are at risk or show signs of vascular dementia, consult a neurologist.

"We can potentially augment some of these risk factors," says Dr. English. "Medications and lifestyle changes can lower blood pressure and cholesterol; we can treat sleep apnea with certain devices or surgeries; and we can help you stop smoking. These are some things that can reduce the risk of developing vascular dementia."

Related posts:

• Mayo Clinic Minute: When to consider deep brain stimulation for essential tremor
• Mayo Clinic Minute: How to reduce your stroke risk
• AI-guided screening uses ECG data to detect a hidden risk factor for stroke

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"Many patients will wonder: 'I have a lump on my arm or my leg. Should I have this evaluated? Who should I see, and when are these symptoms concerning?'" says Dr. Krista Goulding, a Mayo Clinic orthopedic surgeon.

She explains when you should seek medical care, "If you have a lump on your arm or your leg that is growing rapidly or is bigger than the size of a golf ball, this needs rapid attention."

The first step in diagnosing a lump is to get advanced imaging, typically starting with a radiograph or X-ray.

"The next step is to get cross-sectional imaging, which means either an MRI or a CT scan," says Dr. Goulding.

Imaging is then followed by a biopsy to remove a sample of tissue for testing.

"And this helps our multidisciplinary team make decisions about how to treat these tumors because these tumors can be benign. They can be benign aggressive, meaning that they are not cancerous, but they can cause problems locally. And then there can be cancer diagnosis similar to sarcomas and other types of cancers that will need rapid attention," says Dr. Goulding.

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While hay fever alone may not be life threatening, it can be uncomfortable, says Dr. Arveen Bhasin, a Mayo Clinic allergy and immunology expert. She offers these tips for relief from spring pollen and allergies and tells you when it's time to see an allergist.

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"If you're prone towards allergies, you develop an antibody called IGE to that particular allergen. When you're exposed to that allergen, it causes the release of histamine and these other mediators," says Dr. Bhasin.

And that is when spring's unfurling can feel downright bad. The first step is to control your exposures, says Dr. Bhasin.

Some of those environmental control measures include keeping windows at home, in the car and at work closed.

"If it's a dry and windy day, the pollen is blowing. You want to run the air conditioning because, that way, you're recirculating the clean air," she says.

For regular allergy sufferers, start your medication a couple weeks before the season starts.

"First-line treatment is what we call oral antihistamines that help with some of the itching, running, sneezing. And the nasal spray is really helping to focus on some of the congestion and the runny nose," Dr. Bhasin says.

Saline solutions using distilled water are also helpful.

And if these tips don't help? Dr. Bhasin says that is the time to make an appointment.

"The best time to engage an allergist is really when you've tried all the environmental control measures that you can, and you've tried over-the-counter medications, but you're still symptomatic," says Dr. Bhasin.

Using saline solutions or a neti pot

Saline irrigation solutions can be purchased ready-made or as kits to add to water. You can also use a homemade solution. Look for a squeeze bottle or a neti pot — a small container with a spout designed for nose rinsing — at your pharmacy or health food store.

To make up the saline irrigation solution, do not use tap water, as it can contain organisms that could cause infection. Use water that's distilled or sterile. You can also use water that was boiled and cooled. Another option is using water that has been filtered using a filter with an absolute pore size of 1 micron or smaller.

To prevent infections, wash the bottle or pot with hot soapy water and rinse it after every use and leave it open to air-dry. Do not share a container with other people.

Related posts:

• Mayo Clinic Q and A: Is it allergies or a sinus infection
• Mayo Clinic Minute: How to manage hay fever allergy symptoms
• Mayo Clinic Minute: How to get spring allergy relief

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Dr. Umair Majeed, a Mayo Clinic oncologist, says improved treatment options mean better outcomes for patients, even for those with late-stage colorectal cancer.

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Colon cancer is staged from 0 to 4. The stage determines the extent of the cancer — and the treatment.

"Stages 3 and 4 are considered advanced stages, where the cancer goes into the lymph nodes in stage 3 disease, and it goes into distant organs like the lungs, liver or bones in stage 4 disease," says Dr. Majeed.

When colorectal cancer spreads

The liver is the most common organ colorectal spreads to.

"We are offering liver transplantation as an option to select patients. We have a hepatic artery infusion pump program also available for those patients where the cancer has spread from the colon or the rectum to the liver," he says.

The pump delivers chemotherapy directly to artery that supplies the liver. He says, in addition to surgery, treatment options include better drugs, immunotherapy and targeted therapies. 

"We have surgeons who specialize in advanced procedures such as cytoreductive surgery and HIPEC, which is a form of specialized chemotherapy given into the peritoneum for select patients," Dr. Majeed says.

With all these advanced options, Dr. Majeed remains cautiously optimistic.

"Colorectal cancer is a type of cancer where, even if it's stage 4, there is a chance of cure in select cases," he says.

Related topics:

• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults
• Mayo Clinic Minute: Are colon and rectal cancers treated differently?
• Hepatic artery infusion pump therapy for colorectal liver metastases

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March is National Kidney Month, observed annually to raise awareness about kidney disease and promote kidney health. According to Dr. Ivan Porter II, a Mayo Clinic nephrologist, adding too much salt to your diet is not a good thing, and it can increase your risk of chronic kidney disease.

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Your kidneys balance the amount of sodium in your body. If you're getting too much, it builds up in your blood. Your heart works harder to pump and increases blood pressure, raising the risk of heart disease, stroke and kidney disease.

"Chronic kidney disease — that's the way that we describe what occurs when the kidney has issues with filtering wastes and toxins from the blood," says Dr. Porter.

Sodium is added to most processed foods. It's also in a lot of condiments. "So it's very easy for us to get way more sodium than we need. And it's very easy for us to get a dangerous amount of sodium that has some impact on our blood pressure or our overall health," he says.

The recommended daily limit of sodium is 2,300 milligrams, or about 1 teaspoon. Dr. Porter recommends reading food labels. And cut back on the saltshaker by using salt-free seasonings.

"Sometimes you can either stop or reverse some of the initial damage that happens with chronic kidney disease. The longer that the process goes on, the more severe it is, the less likely it is to be able to get back to healthy kidneys. And that's when we have to think about things to replace kidney function like dialysis or transplant," he says.

Additional resources:

• Mayo Clinic Minute: Is Himalayan sea salt a healthy alternative?
• Mayo Clinic Minute: Are you using a salt substitute?
• Mayo Clinic Minute: Hold the salt to help your heart

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Colorectal cancer, the third-most common cancer in the U.S., has been rising among younger people for the past two decades. It is not one type of cancer but two cancers: colon cancer, which starts in the large intestine, and rectal cancer, which begins in the last part of the large intestine, known as the rectum. 

Dr. Derek Ebner, a Mayo Clinic gastroenterologist, notes that colorectal cancer has been increasing in adults under age 50, particularly for rectal cancer. He says it's important to know the warning signs of colorectal cancer and to not delay medical treatment.

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"Historically, colorectal cancer was equally divided along the colon and rectum, but particularly for those with early onset colorectal cancer — age less than 50 — we're seeing higher rates of rectal cancer among the younger onset," says Dr. Ebner.

Case of colorectal cancer has been increasing in adults under age 50, particularly for rectal cancer.

Warning signs and symptoms of colorectal cancer

Dr. Ebner says four key symptoms have been identified for people under 50 who are diagnosed with colorectal cancer.

"Abdominal pain, diarrhea, seeing blood with bowel motions, as well as iron deficiency anemia," he says.

Dr. Ebner notes that blood loss after bowel movements, even if not visibly apparent, can lead to low iron levels.

"If on a blood test, for example, we see a sign of iron deficiency, that would then prompt us to explore further," he says.

Even though it may be embarrassing, he stresses, "If you have any of those symptoms, you need to share it with a healthcare provider. That way, they can navigate those subsequent steps."

Which can lead to early treatment and better outcomes.

Reducing risks of colorectal cancer

While it's not possible to completely prevent cancer, there are ways to reduce your risks and that includes following a healthy lifestyle.

"Abiding by a healthy lifestyle is critical," says Dr. Ebner. "Following a well-rounded diet, staying physically active, for instance, perhaps can be protective. The other key, though, is just being very mindful of those symptoms, and then also underscoring the importance of screening."

• Screening: Talk to your healthcare team about colorectal cancer screening.
• Exercise: Aim for 30 minutes of exercise most days.
• Nutrition: Eat fruits, veggies and whole grains.
• Weight: Maintain a healthy weight.
• Lifestyle: Don't smoke, limit alcohol consumption.

Related posts:

• Innovative treatments for rectal cancer
• Mayo Clinic Minute: What’s the right colorectal cancer screening option for you?

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Colorectal cancer is a term that combines both colon and rectal cancers. The colon and rectum are two different parts of the lower digestive tract. These different cancers also mean different approaches to treatment that may involve the use of radiation and chemotherapy in addition to surgery. 

When it comes to treating cancer, experience matters, says Dr. Eric Dozois, a Mayo Clinic colon and rectal surgeon. And Mayo Clinic has been transforming this type of care for more than 100 years.

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Colon and rectal cancers may be detected during the same screening, but they are treated differently, says Dr. Eric Dozois. 

"Our approach to rectal cancer, for example, often involves more aggressive treatments that help prevent it from coming back," says Dr. Dozois.

Innovation plays a strong role in rectal cancer surgery at Mayo Clinic Comprehensive Cancer Center.

Robotic surgery allows your surgeon to work more efficiently in small spaces, providing an enhanced view of the area where the operation is taking place. Some of the benefits include:

• Surgery performed while the surgeon sits at a console and uses controls to guide high-tech surgical tools.
• Allows surgeons to work in small spaces with three-dimensional visualization, and with more precision, flexibility and control than with conventional techniques.
• Minimally invasive, fewer complications, quicker recovery, fewer urological complications and may reduce nerve dysfunction.

"We're using laparoscopic and robotic platforms to really offer patients surgery that is most up to date in terms of minimally invasive techniques, the least amount of trauma to the patient, but yet achieving the goals of surgery to remove the cancer," he says.

If colon cancer is caught early, surgery may be the only treatment that is necessary, but Dr. Dozois says, "Even in some of the earlier stages, a more aggressive approach that combines chemotherapy, radiation and surgery is necessary to keep it not only from coming back locally, but from spreading to other parts of the body."

Related content:

• Innovative treatments for rectal cancer
• Early Mayo Clinic research finds hope in stem cell therapy for perianal fistulas in patients with Crohn’s disease
• Mayo Clinic Minute: Why millennials should know colon cancer symptoms
• Mayo Clinic Minute: What’s the right colorectal cancer screening option for you?

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Dr. Carrie Jadlowiec, a Mayo Clinic transplant surgeon, says a living-donor kidney transplant has benefits for organ recipients, including better survival rates.

Who is eligible to become a donor and what can you expect? Learn more in this Mayo Clinic Minute.

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"As long as you're healthy and have good kidney function, then you could potentially qualify to be a kidney donor," says Dr. Jadlowiec.

It starts with a thorough medical evaluation.

"That gives us a good sense of where we're starting, and then it also allows us to better predict where will your kidney function be at in five years and 10 years after you donate," she says.

Risks

Both surgical and medical risks are low, thanks to advanced technology.

"For all kidney donors, that risk is less than 1%, which is what we see within the general population," says Dr. Jadlowiec.

It's a minimally invasive surgery. "Meaning that we do it through small incisions, which helps with faster recovery," she says.

Full recovery can take up to six weeks, but many people start feeling better around three weeks after surgery.

"The biggest benefit is the ability to help someone and to really change their life," Dr. Jadlowiec says.

Related posts:

• Mayo Clinic Q and A: Living kidney donation can start a chain reaction
• Mayo Clinic Minute: Why diverse organ donors are needed

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