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

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

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

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

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

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

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

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

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

Goal of surgery

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

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

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

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

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

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

Approaches to treating colorectal cancer

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

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

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

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

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

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

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

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

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

Watch: Transforming colon cancer care through precision medicine

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

Man on a mission

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

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

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

Toughest challenge yet

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

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

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

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

Hope through innovation

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

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

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

Crossing the finish line

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

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

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

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

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

Celebrating life and love

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

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

Related stories

• Eric and Paula Minnesota with a special message to Mayo Clinic
• Mayo Clinic Minute: Inside a colonoscopy
• Housecall: Colon cancer screening — know your options
• Mayo Clinic Minute: Warning signs of colorectal cancer in younger adults

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

Think about the moments that shape a patient's experience at Mayo Clinic. When a patient is in a hospital room with new or worsening symptoms, who helps answer their first questions? Who stays a few extra minutes to explain what happens next? Who checks in again before the day ends? Often, it is a resident or fellow.   

At Mayo Clinic School of Graduate Medical Education (MCSGME), residents and fellows are often among the first to hear patient concerns and the last to leave the bedside. They lead with empathy, curiosity and skill, ensuring that patients feel seen, heard and supported.  

"Mayo Clinic delivers the best care in the world, and we would be unable to do so without the hard work, compassion and collective brilliance of our residents and fellows. They are central to our education and our practice missions, and I'm grateful every day that they've chosen to join us at this stage of their careers. As we mark Thank a Resident and Fellow Day, we extend our deepest appreciation for all they contribute to Mayo Clinic," says Lyell Jones, M.D., dean of Mayo Clinic School of Graduate Medical Education. 

In honor of National Thank a Resident Day on Friday, Feb. 27, we're highlighting patient stories and moments of exceptional care, reminding everyone how often those experiences are made possible by the compassion and clinical excellence of our residents and fellows. Their work reflects the core value of Mayo Clinic — the needs of the patient come first. 

Here is what some patients and fellow care team members had to say about our residents: 

"My most recent visit was with Dr. McEwen, and I truly believe her actions and care saved my life. She thought outside the box into my symptoms and consulted neurology who recommended imaging which showed a vertebral artery dissection. Without imaging, we wouldn't have caught this and started proper treatment. Dr. McEwen did such a fabulous job following up with me, checking in after treatments and in her overall care. My husband, boys and I are grateful for her!" 

• Patient of Courtney McEwen Cho, M.D., Obstetrics and Gynecology resident, Rochester

"When everything in my life felt unmanageable, Dr. Sarah Larson reached out personally and offered to visit me with a behavioral health colleague. They helped me sort through my most urgent needs, find a way to afford my medications and reconnect with mental health care. Her kindness — and willingness to meet me where I was — made me feel supported at a time when I truly needed it." 

• Patient of Sarah N. Larson, M.D., Family Medicine resident, Mankato

"Dr. Khan's attention to every single detail and determination to find a solution was the pinnacle of the Mayo Standard. In addition to his professional demeanor, he was so pleasant. Though a resident, I feel confident Dr. Khan will be a valuable asset to the medical community." 

• Patient of Hamaad Khan, D.O., Physical Medicine & Rehabilitation resident, Florida 

"Dr. Lin provided outstanding care to a patient who was acutely decompensating. She took all the necessary clinical steps and played a key role in coordinating the transfer to a higher level of care when it became needed. Her proactive approach and dedication to patient care were evident throughout. I'm excited to see her growth in the program, and I look forward to collaborating with her in future." 

• Care team associate of Katherine Lin, M.D., General Surgery resident, Rochester

"We were there all day as the team worked to understand what was going on and ran tests to find the diagnosis. I was very impressed with Dr. Shock, who recognized our anxiety and went above and beyond to keep us updated as plans shifted. He tracked down lab and test results to expedite decisions related to the treatment plan. He was direct, communicated clearly, explained issues thoroughly, and he was compassionate and empathetic. He is an asset to your team!" 

• Patient of Jordan Shock, M.D., Transitional Year resident, Arizona

"Dr. Kotsis has shown exemplary excellence and compassion by taking charge of the situation and taking ownership of the patient with very complex medical, oncologic and psychological conditions. He demonstrated clinical judgment and communication skills above and beyond what is expected of his training and experience. What a privilege to work with such rising stars who lead with compassion!" 

• (FNU) Shweta, M.B.B.S., faculty of Christopher Kotsis, M.D., Family Medicine  resident, Eau Claire

About Thank a Resident and Fellow Day 
In 2018, the Gold Humanism Honor Society dedicated a day of recognition for residents and fellows, encouraging medical students at chapters throughout the nation to show their gratitude and appreciation. Thank a Resident and Fellow Day has since expanded to hundreds of programs around the country. 

About Mayo Clinic School of Graduate Medical Education 
Mayo Clinic School of Graduate Medical Education (MCSGME) is shaping the future of healthcare by inspiring and preparing the next generation of physician leaders to transform patient care at Mayo Clinic and around the world. MCSGME advances graduate medical education through innovative, personalized and technology-enabled training that accelerates readiness for practice and leadership. With more than 2,000 trainees across more than 350 residency and fellowship programs spanning Mayo Clinic's Minnesota, Florida and Arizona campuses and Mayo Clinic Health System, MCSGME builds on a legacy of developing physicians who have transformed healthcare since 1915. 

The post Residents and fellows in action: Patient and care team stories  appeared first on Mayo Clinic News Network.

Newsweek named Mayo Clinic the No. 1 hospital in its annual list of the "World's Best Hospitals" for the eighth consecutive year. The rankings were released on Wednesday, Feb. 25.

Newsweek has named Mayo Clinic the No. 1 hospital in the world for the eighth straight year in its 2026 World’s Best Hospitals list.  

"This recognition is a result of the extraordinary expertise, compassion and commitment of our staff, all working together to transform healthcare and find more cures for the benefit of people everywhere," says Gianrico Farrugia, M.D., president and CEO of Mayo Clinic. "Over the past year, we accelerated that transformation by responsibly integrating data, technology and AI into patient care."

The annual Newsweek rankings are based on patient survey results; an international survey of more than 85,000 healthcare professionals; key performance metrics, such as patient safety and quality of care; and implementation of patient-reported outcomes.

Through its Bold. Forward. strategy, Mayo Clinic is reimagining healthcare to ensure patients everywhere receive better answers and better outcomes. By combining deep clinical expertise with responsible digital innovation, the organization is transforming how care is delivered. Central to this effort is Mayo Clinic Platform, which drives the development, validation and deployment of AI in real-world clinical settings with partners across four continents.

See the full "World's Best Hospitals" list.

The post Eight years running: Newsweek names Mayo Clinic ‘World’s Best Hospital’ appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I've noticed that sometimes my heart races or skips a beat. What causes this? Is there treatment for it?

ANSWER: What you're experiencing may be an abnormal heart rhythm, also known as an arrhythmia. Arrhythmias fall into two categories: too fast or too slow. A racing heart or a skipped beat typically falls into the "too fast" category. When an abnormal heartbeat interrupts the normal rhythm, you may feel palpitations — sensations that your heart is racing, fluttering, skipping a beat — or a sense of panic. Often these symptoms are more noticeable at night or when lying down. 

In younger people, typically those in their 20s to 50s, the heart may suddenly speed up from a normal rate to 180-200 beats per minute. This rapid heartbeat can cause lightheadedness, dizziness, anxiety or, in some cases, fainting. 

Fast or skipped heartbeats can originate in either the upper or lower chambers of the heart. Those that begin in the top chamber are called premature atrial contractions (PACs), while those starting in the bottom chambers are premature ventricular contractions (PVCs). Although they can feel alarming, PACs and PVCs generally aren't dangerous or life-threatening. They don't cause heart attacks, strokes or increase the risk of death. 

These irregular heartbeats may be caused by:

• An abnormal electric circuit that people are born with.
• Thyroid disorders.
• Hormonal changes related to pregnancy or menopause.
• Excessive caffeine or alcohol consumption.

If symptoms are infrequent and don't interfere with daily activities, people often learn to live with them. However, if they become bothersome, medication may help suppress the extra heartbeats.

One way to slow a sudden racing heart is by performing a vagal maneuver, which can help interrupt the abnormal rhythm. Vagal maneuvers include bearing down like you are having a bowel movement, blowing into a straw with one end closed, clearing your ears as you might on an airplane, dipping your face in ice-cold water or taking a cold shower.

Evaluation

However, these are temporary fixes. If symptoms persist, patients may be referred for further evaluation, such as an electrophysiology study and possible catheter ablation. During this procedure, catheters are threaded through veins in the groin and guided to the heart. Doctors use specialized wires to find where the arrhythmia is coming from. Then energy is delivered via the catheter to eliminate the abnormal circuit.

Ablation is usually done under twilight sedation and typically is a same-day procedure. Patients need someone with them for 24 hours, should avoid driving for 24 hours and shouldn't lift anything heavy for a week to let the groin incisions heal. After that, they can resume their normal activities.

PACs and PVCs are most common in younger people. For older adults, the most common fast rhythm is atrial fibrillation (AFib) or atrial flutter. These are different types of heart rhythms which become increasingly common with age.

AFib can cause irregular heartbeat, palpitations, chest discomfort, lightheadedness, dizziness, fatigue and sometimes passing out. Some people have no symptoms, and the condition is discovered during routine care or procedures.

Common causes of AFib include untreated sleep apnea, excessive caffeine, binge drinking or overconsumption of alcohol, thyroid disorders, and hormonal changes. In a small group of patients, spicy foods may trigger AFib.

Treatment for AFib

Treatment options include:

• Medication to control fast heart rate.
• Medication to control heart rhythm.
• Catheter ablation.

Ablation for AFib is done under general anesthesia. It's a minimally invasive procedure in which doctors access the heart through the groin and target areas on the left side of the heart responsible for triggering or sustaining the abnormal rhythm. Traditionally, two types of energy — radiofrequency (heat) and cryoablation (cold) — have been used for ablation. 

Most recently, a new, nonthermal option — pulsed field ablation — has been introduced. This energy source selectively targets heart muscle cells. This reduces the risk of serious or life-threatening damage to the surrounding structures, such as the esophagus and the phrenic nerve, which controls the diaphragm and breathing.

Recovery after ablation is similar regardless of the energy source used, including about one week of limited activity.

During AFib, blood can pool in the heart, form clots and cause a stroke. Depending on individual risk factors, patients are often prescribed a blood thinner once they're diagnosed with atrial fibrillation or atrial flutter, even after undergoing ablation. If they're not able to tolerate blood thinners, a permanent device may be implanted in their heart to seal off the left atrial appendage, where most clots form, to reduce the risk of stroke.

If you're experiencing a racing heart, noticing skipped beats or symptoms of an irregular heart rhythm, consult with your healthcare professional or a cardiologist to determine whether further evaluation or treatment is needed.

Divya Korpu, M.B.B.S., Cardiovascular Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin

The post Mayo Clinic Q&A: Is my racing heart an arrhythmia? appeared first on Mayo Clinic News Network.

Postpartum experiences are as unique as the pregnancies that come before them. Because of this, it can be difficult to recognize what's normal and what could be a complication — even if you've given birth before. 

The postpartum period is generally defined as the first six weeks after birth. "Postpartum begins immediately following birth and extends through the time when your body and mind are recovering from pregnancy and delivery," says Dr. Kylie Cooper, a maternal-fetal medicine specialist at Mayo Clinic.

Recovery isn't the same for everyone, and for some people, the postpartum timeline can be longer. While the spectrum of what is considered typical postpartum is wide, there are warning signs of complications you should never ignore.

Dr. Cooper discusses postpartum complications, how to recognize them and when to seek care.

The signs you shouldn't ignore

Dr. Cooper says consistent improvement is the best indicator of typical recovery

"In general, recovery should tend toward improvement. So, if you feel like things are getting worse, or new symptoms come up, we definitely want you to reach out for care."

Dr. Kylie Cooper

The first two weeks after delivery carry the highest risk for serious complications, though they can sometimes occur later. "The most common complications we see in that time frame are high blood pressure, hemorrhage or bleeding complications, infection, anxiety and postpartum depression," says Dr. Cooper.

While many postpartum concerns are common and treatable, some rare but serious complications can develop during this time, which is why new or worsening symptoms should never be ignored.

"These include blood clots, like deep vein thrombosis or pulmonary embolism, as well as postpartum heart issues like cardiomyopathy," says Dr. Cooper.

If you experience any of these symptoms, you should seek care as soon as possible because they can indicate serious complications:

• Worsening pelvic or incision pain, or pain that doesn't improve.
• New, heavy or increased bleeding.
• Headaches that don't improve with medication.
• Confusion or behavior changes.
• Fever or flu-like symptoms.
• Mood changes, anxiety or depression.
• Extreme fatigue that doesn't improve with rest.
• Shortness of breath, trouble breathing or chest pain.

"Symptoms related to pain, mood changes and energy levels can be dismissed as normal postpartum symptoms. While the postpartum time frame can be a challenging time, these symptoms shouldn't be dismissed," says Dr. Cooper.

Mental health-related postpartum complications

After delivery, your body undergoes a significant hormonal shift that can affect your mood and emotions in various ways. While this is expected, symptoms usually improve in a couple of weeks. When these feelings linger or cause depression or anxiety that doesn't improve, it could indicate postpartum depression. In rare cases, a serious and life-threatening condition called postpartum psychosis can develop.

"While 'baby blues' might initially cause people to feel off or be tearful, that should improve, and it should not persist," says Dr. Cooper.

She says these feelings can improve with treatment and support.

If you think you or a loved one are experiencing symptoms of mental health-related postpartum complications, the National Maternal Mental Health Hotline (1-833-TLC-MAMA) and Suicide & Crisis Lifeline (988) offer free and confidential 24/7 resources.

After the six-week postpartum visit

After your six-week postpartum visit, your care will transition back to your primary care team. But this shouldn't mean the end of postpartum care.

"It's becoming increasingly recognized that this is a much longer process, extending up to a year after delivery. I think it's important that we acknowledge that many people are not done recovering at the six-week mark — not by a long shot," says Dr. Cooper.

If you had physical or mental health complications during the postpartum period, this transition is crucial to ensure your long-term wellness. "This is a really important time frame to ensure we help patients establish their preventive care because pregnancy complications can impact long-term health," says Dr. Cooper.

As you continue to monitor your health and well-being during this period, it's important to pay attention to symptoms that may arise or persist beyond the initial recovery phase, as these can often be treated. "Pelvic floor symptoms are often dismissed. For example, there's this misnomer that once you have children, you will have pelvic floor issues. And that's an accepted part of your future, but it shouldn't be," says Dr. Cooper. "These are issues that can be treated and improved."

Getting the support you need postpartum

Support plays an important role in recognizing postpartum complications. Partners, family members and caregivers may notice subtle changes before you do, especially during a time marked by sleep deprivation and physical recovery.

"Sometimes partners or family members are the first to recognize that something isn't right," says Dr. Cooper. "If you notice changes that concern you about your loved one, it's important to speak up and help them seek care."

Dr. Cooper emphasizes that it takes a village to provide postpartum support, and the fetal and maternal care team at Mayo Clinic aims to be part of that village. "In our practice, we have a team approach with obstetric providers, perinatal mood specialists, lactation consultants and pelvic floor physical therapists, and we all work together to make sure that the patient has the care they need."

The post The postpartum experience: Recognizing complications   appeared first on Mayo Clinic News Network.

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.

Editor's note: February is American Heart Month

Heart disease affects women differently than men, and understanding those differences can be lifesaving. Dr. Sharonne N. Hayes, a Mayo Clinic cardiologist and leading expert in the field of women’s heart health, says progress in research, treatment and prevention has accelerated but women still need better information.

Here are four things Dr. Hayes wants women to know, and do, when it comes to protecting their heart health.

Watch: Dr. Sharonne N. Hayes talks about heart disease in women

Journalists: Video sound bites are available in the downloads at the end of the post. Please courtesy: "Sharonne N. Hayes, M.D./Cardiovascular Medicine/Mayo Clinic" 

1. Women get heart disease, and symptoms can be missed.

Dr. Hayes says there are conditions that disproportionately affect women including heart failure with preserved ejection fraction, microvascular dysfunction and heart attacks due to spontaneous coronary artery dissection (SCAD). As a result, women with chest pain or shortness of breath were sometimes told their hearts were fine, only to learn later they did have heart disease.

Women were also historically excluded from clinical trials, meaning researchers are still closing evidence gaps today. Dr. Hayes says women should trust their symptoms and continue advocating for answers when something does not feel right.

2. Knowledge and advocacy can change outcomes.

One of the most encouraging changes Dr. Hayes has seen is the rise of patient advocacy and access to health information. Women are more engaged, more informed and more willing to ask questions.

That shift is especially visible through advocacy organizations such as WomenHeart: The National Coalition for Women with Heart Disease. Women may arrive at the point of care frightened and unsure how to describe their symptoms, or they may feel alone in dealing with their diagnosis. Education, training and peer support can give them tools to feel more confident and empowered.

Dr. Hayes describes the transformation as powerful, driven by knowledge and by the support women find in one another.

3. The future of heart care is promising

Advances in cardiology are moving quickly. Dr. Hayes says treatments that once required open-heart surgery may now be replaced by less invasive procedures, and emerging therapies offer hope that future outcomes may differ from those of past generations.

Study design is important. Representation in research, including artificial intelligence, can influence how findings apply. Dr. Hayes notes the role of patient data breadth in the development of new tools.

4. Prevention starts with habits and partnership.

Dr. Hayes emphasizes that it is never too early or too late to improve heart health. Healthy habits adopted in childhood reduce future risk, and starting an exercise program later in life still improves heart health.

She says prevention comes down to three things: behaviors, choices and knowledge. Staying physically active, avoiding tobacco, and eating a heart-healthy diet that includes fruits, vegetables, whole grains and fewer processed foods all matter. Knowing personal health numbers, such as blood pressure and cholesterol, and understanding family history are also critical.

Equally important is working closely with a healthcare team. Medications should never be stopped without consulting a healthcare professional. If a treatment causes side effects or is not working, there are often other options, says Dr. Hayes, emphasizing the importance of patience and care teams working together to find solutions.

To interview Dr. Sharonne N. Hayes, contact: 

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

The post (VIDEO) Heart disease in women: 4 things a Mayo Clinic cardiologist wants you to know appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — For some patients with the most common type of lung cancer, known as lung adenocarcinoma, there's new hope. In a new study published in Cell Reports, Mayo Clinic researchers have found several previously unknown genetic and cellular processes that occur in lung adenocarcinoma tumors that respond well to immunotherapy.

A recently approved group of drugs — immune checkpoint inhibitors — can boost the body's ability to eliminate a tumor and even keep the cancer from coming back. However, while the medications work well for some people, the drugs aren't effective for many other patients with the disease — and researchers are trying to determine why. 

"Our study describes the events that occur when a patient's tumor harbors only one copy of a cancer-causing gene, which occurs in 20% of cases," says Alan P. Fields, Ph.D., a cancer biologist at Mayo Clinic Comprehensive Cancer Center and the principal investigator of the study. 

The research team found that the missing tumor-driving gene, known as PRKCI, results in tumors that are less aggressive. The missing gene also cultivates a more powerful immune response to tumors. Surprisingly, the research team found the improved immune response occurs with help from unexpected players: senescent tumor cells, also known as "zombie cells," which are typically associated with negative consequences of disease and aging. 

The study identified markers that may predict a positive response to immunotherapy and "ultimately may help clinicians stratify patients who are candidates for immune checkpoint inhibitors," says Joey Nguyen, a graduate student at Mayo Clinic Graduate School of Biomedical Sciences and lead author of the publication. 

Addressing the nation's leading cause of cancer death

Lung adenocarcinoma represents 40% of lung cancers in the U.S. and is the leading cause of cancer death. It's strongly associated with smoking, but it's also the most common type of lung cancer to occur in people who have never smoked, likely because of a combination of genetics and other environmental factors.  

Dr. Fields' lab at Mayo Clinic in Florida has long studied the effect of the PRKCI gene, which drives tumor growth. The gene also suppresses the immune system, keeping cancer-killing immune cells at bay. Because lung tumors depend on the gene to proliferate, Dr. Fields' team was surprised to find that in cases where a copy of the gene is missing, lung adenocarcinoma tumors still occur. Nguyen, who was studying PRKCI in the lab, was inspired to try to learn more about those unusual tumors.  

Early experiments found that the tumors without PRKCI grow less aggressively. The team also found that when PRKCI is missing, lung adenocarcinoma cells behave in an unusual way in their very early development, acquiring characteristics of lung cells that regenerate lung tissue after damage. 

The team collaborated with the lab of systems biology researcher Hu Li, Ph.D., to examine the process at a single cell level. "We found that the loss of PRKCI forces tumor cells to hijack a lung regeneration process to generate a tumor," Nguyen says. 

Tracking the effects of a missing gene

Nguyen also noticed that the tumors without PRKCI showed elevated levels of organized clusters of immune cells, called tertiary lymphoid structures. The presence of those clumped cells can be a sign that immune checkpoint therapy might work for a patient. But were they a result of the single copy of the PRKCI gene? 

Nguyen presented his research at a graduate school seminar where the project caught the attention of postdoctoral fellow Luis Prieto, Ph.D., who had an idea. Dr. Prieto wondered whether the clusters of immune cells might be connected in some way to senescent cells, those that enter a state of arrested development and don't die off. Dr. Prieto works in the lab of researcher Darren Baker, Ph.D., who investigates therapies to eliminate senescent cells in various disease processes.

The collaborating labs were amazed to find that senescent tumor cells actually activate the immune system, leading to the clusters of immune cells that combat the tumor. "The idea that senescent cells may be beneficial in certain settings like this is new to the field, as these 'zombies' are commonly associated with detrimental outcomes," says Dr. Baker, who is a co-corresponding author on the study.

The findings reveal three tumor characteristics that may be used to help clinicians identify candidates for immune checkpoint inhibitors: loss of the PRKCI gene, the presence of senescent tumor cells and an abundance of clustered immune cells. 

Further, says Dr. Fields, his team previously identified an approved drug that can inhibit PRKCI signaling, making a tumor that has the PRKCI gene act more like a tumor without it. 

"Now that we understand how PRKCI is working in a lung tumor, it may be possible to couple a PRKCI inhibitor with immunotherapy, so a future clinical trial that combines these approaches will certainly be an important avenue to explore," he says.

See the study for a complete list of authors, disclosures and funding.

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About Mayo Clinic
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Media contact:

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

The post Mayo Clinic researchers identify why some lung tumors respond well to immunotherapy appeared first on Mayo Clinic News Network.

Antimicrobial Awareness Week, Nov. 18–24, serves as a global call to action to address antimicrobial resistance (AMR) — a growing public health concern that occurs when bacteria, viruses, fungi and parasites stop responding to the drugs designed to be effective against them. 

This resistance makes infections harder to treat and increases the risk of disease spread, severe illness and death.

Adi Shah, M.B.B.S., an infectious disease specialist at Mayo Clinic in Rochester, says AMR frequently happens when microorganisms like bacteria and viruses are exposed to various and repeated episodes of antimicrobial use.

To combat AMR, Mayo Clinic has an antimicrobial stewardship team that leads the effort to promote the careful and correct use of infection-fighting medications. The team works across all three Mayo Clinic campuses in Minnesota, Florida, Arizona, and all Mayo Clinic Health Systems locations.

Among the team's initiatives is an outpatient program that works with pharmacists, doctors, nurses and other healthcare professionals to improve how antimicrobial medicines are used.

"Our efforts have focused both on unnecessary antibiotic prescriptions overall and unnecessarily long durations of therapy," says Dan Ilges, Pharm.D., the clinical pharmacist lead for ambulatory antimicrobial stewardship efforts at Mayo Clinic in Arizona.

This year's theme for Antimicrobial Awareness Week is "Fighting Antimicrobial Resistance Takes All of Us."

Experts underscore that patients play a critical role in the fight. Open communication with healthcare teams is essential. 

"We know that for many germs, exposure to antibiotics and antifungals can increase the risk of resistance developing and resistant germs are more difficult to treat," says Sara Ausman, Pharm.D., the clinical pharmacist lead for antimicrobial stewardship efforts at Mayo Clinic Health System in Eau Claire, Wisconsin.

"Antibiotics are useful tools but aren't always the best treatment option." 

Dr. Ausman notes that for colds, your healthcare team will likely recommend over-the-counter remedies to address symptoms instead of antibiotics.

Additionally, Dr. Ausman emphasizes that if you are prescribed an antibiotic, you should ask about the shortest prescription length that is needed to treat your infection, as well as whether antibiotics are the right choice for your symptoms. She shares that it is important not to save any antibiotic doses for later and to dispose of any leftovers properly at a designated drug disposal site. 

"Antibiotics are intended for the treatment of bacterial infections, but should be used only when necessary," says Dr. Ausman. 

Beyond appropriate antibiotic use, prevention is a powerful tool. Experts emphasize that a few simple, everyday practices help avoid contracting infections:

• Wash your hands. Properly washing your hands removes germs to prevent infection of yourself and those around you.
• Vaccination is an important preventative step to improving public health and preventing the need for antimicrobials.

If you have unused medication, whether antimicrobials, opioids or something else, you can find a safe disposal site here. 

The post Understanding and preventing antimicrobial resistance appeared first on Mayo Clinic News Network.