DEAR MAYO CLINIC: I'd like to become a living kidney donor. What's involved and how do I prepare if I'd like to donate a kidney?

ANSWER: You've made a generous and meaningful decision to become a living kidney donor. More than 90,000 people in the U.S. are on a waiting list for a kidney transplant. 

Your donation offers life-changing benefits for someone with kidney failure. The kidney's role is to filter waste from the bloodstream. Receiving a kidney transplant frees the person from the rigorous schedule and restrictions of dialysis and allows them to participate more fully in life — working, raising a family, traveling and returning to the activities they value. 

Living donor kidney donation can be made in several ways:

• Directed. This means your kidney will go to someone you know — a family member, friend or co-worker. Blood relatives are usually the most compatible living kidney donors.
• Paired. If you aren't compatible with your intended recipient, you may participate in a kidney exchange so that both recipients receive compatible kidneys.
• Voucher (advanced donation). You can donate your kidney now through a national program and receive a voucher for a designated person. If that person needs a transplant in the future, the voucher helps prioritize them for a compatible living donor kidney through the exchange system
• Nondirected. Your kidney goes to someone you don't know, based on medical need and compatibility.

This is a big decision, and you want to go into it feeling well informed. Typically, when you decide to become a living donor, a living donor advocate will contact you, followed by the living donor team, who will explain the risks and benefits, the process, and provide care and support along your donation journey.

Throughout the entire process, you shouldn't feel pressured. If you change your mind, that's OK too. Also, your confidentiality as a donor is protected unless you choose otherwise.

The cost of the donor evaluation and testing is covered by the transplant center or the recipient's insurance. Living donors aren't financially responsible for medical testing related to donation.

Health history and criteria

You'll start your donation journey by filling out a health history form. Living donors are carefully selected based on health criteria. Factors such as chronic diseases, diabetes, previous cancer treatment, certain medications and anything that could affect the future health of your kidneys are considered. Weight, blood pressure and kidney function also are key factors.

If you meet these criteria, you'll undergo a comprehensive evaluation at a transplant center. This includes a physical examination, blood and urine testing, imaging of the kidneys, and consultations with a nephrologist and transplant surgeon. In many centers, this evaluation can be completed in a single day.

Once all this information is gathered, it will be presented at a multidisciplinary living donor meeting where the whole team — living donor advocate, nephrologist, surgeon, nutritionist, pharmacist and social worker — will evaluate the results to determine whether you're an eligible donor. If you're approved, then the donation process begins.

Surgery

The first step is to schedule surgery. The timing depends on whether you're making a directed, paired or voucher donation. The procedure is typically performed laparoscopically using minimally invasive surgical techniques. Most donors stay in the hospital for one night and return home the next day.

After surgery, temporary symptoms such as pain, nausea and constipation are common and managed by your care team. Heavy lifting and strenuous activity should be avoided for the first two weeks, and most donors return to their usual activities within four to six weeks.

Your remaining kidney needs time to adjust, too. To take on the extra work, it will undergo internal changes to improve its filtration capabilities. Typically, donors regain 75% of the function they had from two kidneys.

Follow-up care is an essential part of donation. Transplant centers monitor donors at six, 12, and 24 months after surgery to ensure your long-term health.

By choosing to become a living kidney donor, you offer someone not just a transplant but a renewed opportunity for life.

Pooja Budhiraja, M.B.B.S., Nephrology and Hypertension, Transplant Center, Mayo Clinic in Arizona 

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DEAR MAYO CLINIC: My cousin, who's in her 30s, was recently diagnosed with colorectal cancer. I've always thought of colorectal cancer as something that affects older adults. Why are more young people being diagnosed with colorectal cancer, and is it different when it happens at a younger age?

ANSWER: For many years, colorectal cancer was considered a disease that mainly affected older adults, and screening traditionally began at age 50. Today, however, doctors are diagnosing more people in their late 20s, 30s and 40s.

This shift led to national guidelines being lowered; they now recommend 45 as the age to begin routine colorectal cancer screening. In the past, doctors believed colon polyps, small growths in the colon or rectum, typically took about 10 years to become cancerous. That understanding helped determine when screening should begin.

Colorectal cancer screening

Colonoscopy and flexible sigmoidoscopy are considered the gold standard for screening. Both require bowel preparation the day before, sedation during the procedure and someone to drive you home. These procedures also allow doctors to remove polyps during the same exam.

Stool-based tests are another option. Some look for hidden blood, while others look for cancer-related DNA. These tests generally must be done annually and, if positive, require follow-up with a colonoscopy. For people at higher risk, such as those with a first-degree relative with colorectal cancer, a colonoscopy or sigmoidoscopy is typically recommended instead of stool testing alone.

While screening is important, researchers are still working to understand why more younger adults are being diagnosed.

So far, there isn't a single explanation. In some cases, inherited conditions, such as Lynch syndrome, and inflammatory bowel diseases like Crohn's disease or ulcerative colitis, increase the risk of colorectal cancer. Researchers are studying other possible genetic, environmental and lifestyle factors, but more research is needed to fully understand the rise.

Smoking, alcohol use, higher red meat intake, lower physical activity and sedentary habits are often discussed, but much of the evidence comes from observational studies, and firm conclusions are still lacking. Researchers are also examining whether early life exposures, including during pregnancy, may play a role.

Younger adults sometimes experience delays in diagnosis because they may not yet qualify for screening and symptoms can be subtle. Some data suggest younger patients may have multiple medical visits before receiving a diagnosis, which can contribute to detection at a later stage.

Warning signs or symptoms

Symptoms that young adults should watch for include:

• A consistent change in bowel habits, such as ongoing constipation or diarrhea.
• Blood in the stool, whether bright red or dark.
• Unintentional weight loss.
• Abdominal pain that doesn't go away.
• Iron-deficiency anemia.

Some people attribute rectal bleeding to hemorrhoids, but any blood in the stool should be evaluated. Iron-deficiency anemia, particularly microcytic anemia found on blood tests, should prompt evaluation to determine whether bleeding may be occurring in the digestive tract. That workup often includes a colonoscopy.

Symptoms that persist for several days to weeks should be evaluated.

Treatment options for colorectal cancer

Treatment approaches, including surgery, chemotherapy, radiation therapy and, in some cases, immunotherapy, aren't different based on age alone. However, younger patients often face additional life considerations. Many are balancing school, careers and family responsibilities along with financial pressures. Fertility is also an important concern, since these treatments can affect the ability to have children. For that reason, fertility counseling is often discussed before treatment begins.

In certain rectal cancers, treatment strategies are evolving. Doctors are working on tailoring therapy to reduce long-term side effects while maintaining cure rates.

There's ongoing research focused on prevention, including studies of the gut microbiome and how environmental exposures may influence cancer risk. Advocacy groups such as Fight Colorectal Cancer and the Colorectal Cancer Alliance provide education and support for patients and families. They also work closely with researchers to help ensure that patients have a voice in how clinical trials are designed and conducted.

While much remains to be understood about why colorectal cancer is increasing in younger adults, awareness, timely evaluation of symptoms and appropriate screening remain key.

Christina Wu, M.B., B.Ch., M.D., Medical Oncology, Mayo Clinic in Arizona

Related posts:

• Mayo Clinic Minute: Advancing colorectal cancer care through innovation and screening
• Mayo Clinic Minute: Are colon and rectal cancers treated differently?
  
  

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

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

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

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

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

Treatment options

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

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

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

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

These treatments are: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Beyond chemotherapy

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

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

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

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

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

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

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

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

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

Related posts:

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

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DEAR MAYO CLINIC: As a nonsmoker lung cancer hasn't been a concern of mine, but I recently heard it can affect people who have never smoked. If someone is concerned about lung cancer, what symptoms should they watch for, how is it diagnosed, and what treatment options are available today? 

ANSWER: It can be surprising to learn that lung cancer can develop in people who have never smoked. In fact, up to 20% of lung cancers occur in people without a history of smoking. While smoking remains the leading risk factor, other contributors include secondhand smoke, air pollution, exposure to radon and a family history of lung cancer. 

Possible lung cancer warning signs  

One of the challenges with lung cancer is that it often doesn't cause symptoms in its early stages. When symptoms do appear, the disease is often more advanced, which is why early detection is so important. Currently, people between the ages of 50 and 80 with a significant smoking history may qualify for lung cancer screening, but you should pay attention to symptoms regardless of smoking status. 

Symptoms that occur in or around the lungs include: 

• A new cough that doesn’t go away 
• Chest pain 
• Coughing up blood, even a small amount 
• Hoarseness 
• Shortness of breath 
• Wheezing  

If lung cancer spreads to other parts of the body, symptoms can include: 

• Bone pain 
• Headache
• Unplanned weight loss or loss of appetite 
• Swelling in the face or neck  

If you experience new, persistent or worsening symptoms, make an appointment with a healthcare professional and ask about appropriate screening or diagnostic options. 

Advanced diagnostics and staging 

Diagnosis often starts with imaging. If someone has symptoms, a clinician may begin with a chest X-ray and then move to more detailed imaging, such as a CT scan. Sometimes lung cancer is discovered incidentally, when a CT scan performed for another reason reveals a lung nodule.  

The next step is determining whether a nodule is cancerous or benign. Doctors often can use information from the CT scan to guide next steps. PET scans also may be used to diagnose lung cancer and determine whether it has spread. 

In some cases, a biopsy is needed to confirm the presence of cancer cells. Biopsies can be performed in several ways. A biopsy guided by CT scan uses a needle inserted through the chest wall to collect tissue, while a bronchoscopy involves guiding a scope through the mouth and airways to reach the suspicious spot in the lung.  

Advanced tools have improved accuracy. For example, robotic bronchoscopy allows physicians to reach nodules throughout the lungs through the airways and obtain tissue samples more precisely. This approach also can enable lymph node evaluation during the same procedure, which is critical fordetermining the stage of cancer and developing the best treatment plan.  

Treatment approaches and tissue-sparing options 

Treatment for lung cancer depends on several factors, including the cancer type, stage and the person's overall health. Options often include surgery, radiation therapy (like stereotactic radiation therapy), chemotherapy, targeted therapy, immunotherapy or a combination.  

Surgery is the mainstay for treating early-stage lung cancer. Increased screening has led to more cancer being detected earlier, allowing more patients to benefit from minimally invasive surgical techniques. These procedures often use video-assisted thoracic surgery (VATS) or robotic surgery approaches,and they may involve lung-sparing techniques, such as wedge resections and segmentectomies. Preserving as much healthy lung tissue as possible is important for long-term breathing function and lung health. 

Depending on the extent of the disease, surgeons may remove part of a lung, an entire lobe or, in some cases, the whole lung. During surgery, teams also can use rapid, real-time pathology to confirm complete tumor removal and better understand the extent of the disease.  

In certain situations, treatments such as chemotherapy, radiation therapy or immunotherapy may be given before surgery to shrink the tumor. This approach, known as neoadjuvant therapy, can make surgery possible sometimes for patients who were not previously candidates.  

Lung cancer care often involves multiple specialties. Seeking care at an experienced center, where multidisciplinary teams collaborate closely, helps ensure treatments are tailored to each patient's specific cancer and overall needs.  

Stay in tune with your body 

Even if you've never smoked, awareness of lung cancer is important. Pay attention to symptoms that don't resolve, new or worsening breathing problems, or changes that feel unusual. Talk with a healthcare professional if something doesn't seem right.  

If a lung nodule or other concern is found, today's advanced diagnostic tools can help determine whether it is cancer and guide next steps. Treatment options continue to advance, with many people benefiting from minimally invasive surgery and newer drug therapies that are improving outcomes and quality of life. 

Luis Tapias Vargas, M.D., Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 

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DEAR MAYO CLINIC: My coworker had been telling me they were having pain in their lower back that extended down into their hips. They were diagnosed with a sacroiliac (SI) joint issue. I occasionally experience back pain myself and wonder whether surgical treatments are available for sacroiliac joint problems.

ANSWER: Yes, surgery can help relieve SI joint pain, but it’s usually considered only after the diagnosis has been confirmed and when nonsurgical treatments haven’t worked. Because back pain can come from many sources, finding the true cause is essential before considering surgery. When pain persists or affects daily life, evaluating the sacroiliac joint as a potential cause of the pain can help identify more effective treatment options.

Where is the sacroliac joint?

The sacroiliac joint sits between the base of the spine (the sacrum) and the pelvis. It is one of the body’s largest weight-bearing joints, helping transfer force from the upper body into the legs during activities such as standing, walking and lifting. Arthritis or excessive motion in the joint can lead to significant pain in the lower back, hips or buttocks, sometimes radiating into the legs.

SI joint pain can closely mimic conditions affecting the spine or hips, which makes diagnosis challenging. Research suggests that up to 15% to 30% of people with chronic low back pain may have pain originating from the SI joint. Some individuals live with symptoms for years or even undergo other procedures before the SI joint is correctly identified as the source.

Diagnosis typically begins with imaging to rule out other causes, such as infection or tumors. However, imaging alone is not enough. A physical exam that stresses the joint, followed by a diagnostic injection into the SI joint, helps confirm whether it’s truly responsible for the pain. If an injection significantly reduces your pain, it confirms that the SI joint is the cause.

Surgery isn’t the first step for SI joint pain. Most people begin with conservative treatments, including anti-inflammatory medications, physical therapy or therapeutic injections. These approaches aim to reduce inflammation, improve joint stability and relieve pain without surgery.

Physical therapy may help strengthen supporting muscles, while injections can provide temporary relief, sometimes lasting several weeks or months, although symptoms may return. Surgery is generally considered when pain has lasted longer than six months and hasn’t improved with nonsurgical care.

People with confirmed SI joint pain who don’t find relief through conservative treatments may be candidates for surgery. Certain conditions, such as widespread inflammatory arthritis or serious medical issues that make anesthesia unsafe, may rule out surgery. Smoking can also interfere with bone healing and affect surgical outcomes.

Modern SI joint surgery is typically minimally invasive. Through a small incision near the hip, surgeons place implants across the joint to stabilize it. The implants are relatively small and resemble screws, with specialized surfaces designed to encourage bone growth. Over time, bone grows across the joint, helping create lasting stability and reduce painful movement. The procedure often takes less than an hour, and some patients can return home the same day.

Most people have activity restrictions for about six weeks after surgery. Pain relief may be noticeable early, particularly when excessive joint motion was the cause, while arthritis-related pain may improve more gradually. By six months, about 80% of patients report improved quality of life and pain. Studies show these improvements can last for years.
 
If you’ve been told nothing can be done for chronic low back pain, don’t lose hope. For some people, SI joint pain may be the cause, and effective treatments, including surgery, are available. 

Grant W. Mallory, M.D., Neurosurgery, Mayo Clinic Health System, Eau Claire and La Crosse, Wisconsin

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DEAR MAYO CLINIC: I have atrial fibrillation, and I've heard there's a new kind of ablation that could relieve my symptoms. Can you tell me about it?

ANSWER: If you have atrial fibrillation (AFib), you're not alone — it's the most common heart rhythm disorder, affecting millions around the world. AFib occurs when the heart's upper chambers beat in a fast, irregular way, which can cause symptoms such as palpitations, fatigue, shortness of breath, dizziness and/or reduced ability to exercise. 

For many people, medications can help control symptoms. But when drugs don't work well, cause side effects, or people opt out of that treatment, a procedure called catheter ablation may be another avenue for certain patients.

Catheter ablation is a minimally invasive procedure used to treat abnormal heart rhythms such as AFib. During the procedure, doctors guide thin, flexible tubes, called catheters, through blood vessels in the groin up to and into your heart.  

For AFib ablation, patients are put under anesthesia, and depending on the complexity of the rhythms, the procedure can take several hours. The treatment usually focuses on ablation of muscle tissue that can generate electrical signals and trigger AFib. 

This muscle tissue is found inside the pulmonary veins, which drain blood from the lungs into the left upper chamber of the heart, called the left atrium. By destroying these small areas of the heart, the main electrical impulses that set off AFib are isolated from the rest of the heart.  

Using advanced imaging tools such as X-ray, ultrasound and catheters, doctors can reconstruct a 3D rendering of the heart while it's beating in real time and locate areas of heart tissue that are triggering AFib. This provides a roadmap for pinpointing the areas that are causing AFib. Energy is then delivered through the catheter to disrupt those problem areas, helping the heart maintain a normal rhythm.

For the past 20 years, most AFib ablations have used thermal energy to destroy targeted tissue using:

• Heat (radiofrequency ablation). 
• Extreme cold (cryoablation). 

These approaches can be effective, but they carry risks because heat or cold can unintentionally cause serious and even life-threatening damage to nearby structures, including:

• Injury to the esophagus.
• Narrowing of the pulmonary veins. 
• Damage to the phrenic nerve, which controls the diaphragm and breathing. 

In recent years, a newer form of ablation — called pulsed field ablation (PFA) — has emerged and is generating excitement among heart rhythm specialists and patients.

PFA works in a completely different way. Instead of heat or cold, it uses very brief, high-voltage electrical pulses that last only microseconds. Because PFA is relatively nonthermal, the risks of thermal ablation appear to be dramatically reduced.

The electrical pulses delivered by the catheter create tiny openings in the membranes of heart muscle cells — a process called electroporation. These openings cause targeted cells to stop functioning, eventually die and become scar tissue. 

One of the biggest advantages of PFA is the ability to selectively disable cardiac cells. 

Another benefit is the efficiency of the procedure. PFA procedures are typically faster, meaning less time under general anesthesia, which may be especially important for older adults or people with other medical conditions.

So far, studies suggest that PFA is as effective as traditional ablation techniques. About 65% to 75% of patients remain free of AFib one year after a single procedure without antiarrhythmic medications. Success rates may improve with repeated procedures, continued medication use and other factors. 

Ablation isn't a cure for AFib, and sometimes more ablations aren't always better or the best option. Too much scar tissue in the heart can cause a different set of problems, which is why careful patient selection is essential when weighing the risks and benefits of ablation.

The goal is to relieve symptoms, reduce frequency and duration of episodes, and improve the patient's quality of life.

While promising, PFA is still relatively new. Rare complications include coronary artery spasm; small bubble formation, which can lead to a stroke; or kidney injury. These events aren't common, and their causes continue to be studied.

PFA may expand treatment options for many people with AFib, particularly those with certain conditions where prolonged anesthesia time poses more risk. Whether it's appropriate depends on your type of AFib, symptoms, overall health, prior treatments, modification of risk factors and the goal for AFib treatment.

Talk with a cardiologist or cardiac electrophysiologist to determine whether PFA fits into your personalized treatment plan.

Christopher DeSimone, M.D., Ph.D., Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota

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DEAR MAYO CLINIC: I found out during my pregnancy that I have mitral valve stenosis. How common is valve disease, and what should I know about it?

ANSWER: Valve disease affects how blood moves through the heart, and pregnancy is often a time when symptoms first appear or become more noticeable. Learning about a heart valve condition during pregnancy can be unexpected and overwhelming. Understanding why this happens and exploring treatment options can bring clarity and calm fears.

Pregnancy is often described as the body's ultimate cardiovascular stress test. The heart works significantly harder to support both the mother and the developing baby. Blood volume expands, vascular resistance drops and heart rate increases. These normal physiological changes begin early in pregnancy and peak in the late second to early third trimester.

These changes can unmask symptoms of previously silent valve disease or intensify those of known valve conditions because the heart is being asked to move more blood through a valve that isn't functioning normally. Known valve conditions include:

• Narrowed valves (stenosis)
• Leaky valves (regurgitation)
• Congenital valve abnormalities

Other valve conditions may result from infections, such as rheumatic fever, or changes in the valve's structure over time.

Symptoms

Even women who felt well before pregnancy may begin to notice symptoms around 28 to 30 weeks, when the cardiovascular system reaches its peak workload.

Many common pregnancy symptoms overlap with those of valve disease. Fatigue, shortness of breath, swelling and a faster heart rate can all occur in a healthy pregnancy. It's especially important to evaluate symptoms that begin suddenly or noticeably worsen.

Shortness of breath with activity or when lying flat, unusual fatigue that affects daily routines, swelling in the legs or feet, racing heartbeat, reduced exercise tolerance, or chest pressure should prompt a conversation with a clinician.

Because pregnancy symptoms can mask underlying cardiac issues, clear communication between patients and their care teams is essential. Many patients assume new symptoms are simply part of pregnancy, especially if previous pregnancies were uncomplicated. But when something feels off, listening to that instinct is important.

An assessment of symptoms may include:

• Physical exam.
• Echocardiogram to look at the heart's structure and function.
• Electrocardiogram (ECG) to check the heart's rhythm.
• Additional imaging or testing.

These evaluations help determine whether symptoms are pregnancy-related or caused by cardiac disease.

Treatment

Once valve disease is identified, coordinated care becomes especially important. Many patients benefit from a pregnancy heart team approach that includes specialists in cardiology and maternal-fetal medicine, with support from cardiac surgery or structural heart experts, if needed. Local obstetric teams may remain involved, particularly if delivery is expected to happen closer to home.

The pregnancy heart team approach helps align medical needs with a patient's goals for pregnancy and family planning. Shared decision-making plays a central role. Every situation is different, and treatment choices are shaped by personal values, risk considerations and long-term planning.

Treatment depends on the severity of the condition and how well a patient tolerates the physiologic demands of pregnancy.

Many women with mild or moderate valve disease can continue pregnancy safely with close monitoring. Medications may be used to help manage fluid retention, control heart rate or reduce symptoms.

When valve disease is more severe or symptoms significantly affect daily life, procedures may be done before or during pregnancy. These include:

• Catheter-based procedures to widen a narrow valve or improve function.
• Valve repair to preserve a person's own valve when possible.
• Valve replacement when the disease is advanced or symptoms can't be controlled.

For those who need valve replacement, care teams will discuss the choice between a mechanical or tissue valve, especially for women planning future pregnancies.

• Mechanical valves are durable but require lifelong anticoagulation, which can add complexity during pregnancy.
• Tissue valves typically avoid long-term blood thinners but have a shorter lifespan.

Treatment choices can shape both personal health and a family's future. Clear, collaborative discussions about risks and benefits support confident decision-making.

Expert teams across cardiology, maternal-fetal medicine, imaging and surgery help form a comprehensive plan tailored to each patient's needs.

Any expectant mother should reach out to a clinician if symptoms such as shortness of breath, difficulty breathing when lying flat, chest discomfort, palpitations, swelling that increases rapidly or new fatigue begin to interfere with daily life.

When something doesn't feel right, speaking up is one of the most important steps a patient can take. A strong care team is ready to help navigate each stage of pregnancy to safely support the health of both the patient and the baby.

Katie Young, M.D., Cardio-Obstetrics, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q&A: What to know about pregnancy and heart valve disease appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My husband has been diagnosed with cancer. I know his treatment will be hard on him, and I want to help in any way with his diet. What do you recommend for us?

ANSWER: Cancer treatments can take a toll on a person's body. Your husband's treatment may cause nausea, changes in appetite, taste and smell, diarrhea, or constipation, making it harder to meet his nutritional needs. Fortunately, there are strategies you can use to cope with these side effects.

Supporting nutrition during cancer treatment

Weight changes. Weight changes are common. Weight loss without trying can reduce muscle mass, stamina and quality of life. Weight gain can lead to the development of other diseases, like diabetes or heart disease. Try to maintain your weight during treatment, even if it's outside a normal range.  

Appetite changes. Cancer and cancer treatment may make you lose your appetite or eat more than usual.

• If you lose your appetite: 
  • Eat smaller snacks that are high in calories, including yogurt, nuts, peanut butter and avocado.  
  • Eat more when your appetite is better.  
  • Food may sound unappealing even when you're hungry, making it difficult to eat. Try to find something that's appetizing.  
  • Keep snacks on hand.
• If you eat more when stressed:
  • Choose snacks such as fruits, vegetables and popcorn.    
  • Find ways to manage stress without food, such as going for a walk or calling a friend. 

Nausea. Feeling sick or throwing up due to your treatments makes it hard to eat. Small changes to what and how you eat may help you feel better. 

• Eat foods that are easy on your stomach, such as crackers, toast, broth or broth-based soups, ice pops, hard candies, plain pasta and rice. 
• Eat five or six small meals a day. Smaller meals are often easier to keep down. 
• Don't skip meals or snacks. Even when you're not hungry, try to eat; an empty stomach can make nausea worse.  
• Sip small amounts of fluid during meals and throughout the day.    
• Try pretzels or crackers with your medicines if your care team says it's OK.  

Taste and smell changes. Cancer treatment can alter the taste or smell of food. Some people say food tastes bland. Others say it tastes metallic or too sweet or salty. You may need to try different foods to find what works for you.  

To help with taste changes: 

• Brighten the flavor. Add a little lemon, lime or vinegar unless your mouth is sore.
• Try strong flavors. Use spices such as cinnamon, ginger, basil or rosemary.  
• Make foods sweeter. Add sugar or another sweetener if food tastes bitter or sour.
• Use marinades before cooking.  
• Choose other proteins. If meat doesn't taste good, try beans, nuts or fish. 
• Use plastic or bamboo utensils. These may help if food tastes metallic. 
• Try new foods. You won't have expectations about the taste.  

To help with strong smells: 

• Cook food in the microwave or use a crockpot or instant cooker in the garage.
• Eat foods cold or at room temperature.
• Cover food while it cooks.
• Use a window or fan to help remove unpleasant odors.  
• Drink from a covered cup.
• Ask a friend to cook for you.  

Sore throat, mouth or trouble swallowing. When your throat is sore or it's hard to swallow, eating may be painful or tiring. These tips can help:

• Soften the texture. Opt for smooth foods, such as cooked cereal, mashed potatoes or scrambled eggs.
• Cool things down. Choose smoothies, ice pops or a bowl of ice cream. 
• Take smaller bites and cut food into tiny pieces.
• Avoid what bothers you. Spicy, sour, crunchy or vinegar-based foods, citrus fruits, tomato sauce or carbonated beverages can cause discomfort. 
• Suck on ice chips or ice pops.

Diarrhea and constipation. Bowel changes are unpleasant but common side effects of cancer treatment. 

To help with diarrhea:

• Eat small, frequent meals and snacks.
• Choose soft, low-fiber foods.
• Avoid caffeine and alcohol.
• Limit lactose found in milk and yogurt.
• Avoid sugar substitutes such as sorbitol, xylitol or mannitol, which are often found in sugar-free candy or gum. 
• Drink plenty of fluids, including electrolyte-containing fluids, to stay hydrated.  

For constipation, aim to:

• Drink enough fluid to stay hydrated and keep stools soft. Try to drink eight to 10 cups of water each day. Warm coffee, tea or broth-based soup in the morning can help your bowels move. Use the bathroom when you feel the urge.
• Move your body. Even short walks help your digestive system work better.
• Keep regular mealtimes.
• Eat a high-fiber diet.
  
  

Your husband's care team is an excellent resource for what you can expect during treatment and for the symptoms that may affect his diet and weight.

Grace Fjeldberg, Registered Dietitian Nutritionist, Nutrition/Oncology, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: Diet tips during cancer treatment appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: Our neighbors were selling their home and had it tested for radon. The test was positive. Why should we be concerned about radon, and should we have our home tested too?

ANSWER: The positive test for radon in your neighbors' home has given you a heads-up that your home should be tested as well.

Radon is an odorless, invisible radioactive gas. It's naturally released from rocks, soil and water — and it can get trapped inside your home, office or school. There's no known safe level of radon. Unfortunately, there are no symptoms associated with radon exposure, unlike with carbon monoxide poisoning.

Why radon is so dangerous

Breathing high levels of radon over time can lead to lung cancer since this gas is a Class A carcinogen. It's the No. 1 cause of lung cancer in nonsmokers and the second-leading cause of lung cancer overall. Nationwide, 21,000 people die from radon-caused lung cancer each year.

Smoking and secondhand smoke, combined with exposure to high radon levels, increase your risk of lung cancer. If you or your family are experiencing breathing issues, consult with a pulmonologist.

Radon can be found in any home — old or new — and typically enters through cracks in the foundation caused by natural settling and windows. Radon levels often are higher in lower levels and basements. Across the U.S., 1 in 15 homes have elevated radon levels, and levels are higher in the Midwest. For example, radon levels range from 4.7 picocuries per liter of air (pCi/L) in Indiana to 9.6 pCi/L in North Dakota. The nationwide average is 1.3 pCi/L.

Testing for radon

There's a simple solution to this close-to-home health hazard: testing. That's what the Environmental Protection Agency urges all homeowners to do, especially those in high-radon areas. Testing is the only way to determine the radon level in your home.

You can find radon testing kits at hardware or other home maintenance stores and online. They cost around $20 or less and are easy to use. It typically takes two to seven days for results. Although there's no safe level of radon, look for test results of 4.0 pCi/L or less. 

If your home tests higher than 4.0 pCi/L, then you'll need to have a professional fix the radon issue, which includes installing venting equipment. The equipment looks like a big tube that reaches below the foundation of your home and vents radon up and out of the house. 

The cost of a radon mitigation system varies according to the size and design of your home, as well as the system being installed. Costs average $1,000-$2,000. Check with your local city and county housing agencies to see if they have funds available for low-interest loans or grants for radon mitigation, and learn if you're eligible for these funds.

Once the mitigation system has been installed, your home should be tested again to make sure the fix is effective. Even if your home passes the first test, you should retest every two years.

Also, radon testing isn't required when selling a home. However, if you're a buyer, you should insist on it. If levels are high, you may be able to negotiate the costs of the mitigation with the seller.

Radon testing and mitigation are investments in your home — and in your health.

Elizabeth Morton, Physician Assistant, Pulmonology, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: Why should I be concerned about radon? appeared first on Mayo Clinic News Network.