As the fire chief for the city of Fargo, North Dakota, Gary Lorenz is accustomed to high-stress emergencies.  

"Firefighters are problem solvers," Gary explains. "When people call 911, and the dispatchers aren’t sure whom to send, they send the fire department."  

But on Oct. 7, 2025, Gary faced a crisis he could not simply delegate.  

During a routine scan for an unrelated issue, doctors discovered a tumor on his left kidney.  

Stunned by the news, Gary recalls pacing the floor at his headquarters fire station, feeling overwhelmed and not knowing what to do next.   

"I am kind of a fixer," says Gary. "Whether it's mechanical or other things, I'm fixing problems all the time, and so when it was my problem, trying to figure out how to fix this, it just seemed big."  

Walking in circles, the reality of his diagnosis set in.  

With the love and support of his wife, who works in the medical field, Gary discussed the next steps and knew exactly where to turn. He reached out to Mayo Clinic.  

Watch: Robotic surgery helps fire chief return to duty

Journalists: Broadcast-quality video (3:01) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

A rapid response and a precise plan  

Within one day, a video conference was scheduled for the following week with Dr. Aaron Potretzke, a Mayo Clinic urologic surgeon.  

Knowing a plan was in place, his family urged him to go ahead with his annual fishing trip that weekend to Lake of the Woods in Canada.  

While driving, Gary received a call from Mayo Clinic asking whether he could meet virtually that Friday instead of the following week. 

During the videoconference, Dr. Potretzke explained how the scans described a single, approximately 4-centimeter bi-lobed tumor, but the exact nature of the growth would not be determined until after it was surgically removed.  

Because of the tumor's location and associated risks, Dr. Potretzke recommended a robotic-assisted radical complete nephrectomy, a minimally invasive surgery using robotic tools to completely remove a kidney through tiny incisions. 

"Dr. Potretzke’s thoroughness, professionalism and confidence greatly helped relieve much of the anxiety I was experiencing," says Gary.  

In short order, Gary received a call on Monday morning from Dr. Potretzke’s office about a last-minute surgical opening for the next day.  

Mayo staff coordinated and communicated with Gary to complete all of the necessary surgical preauthorization. 

Despite this tight timeline and a five-hour drive the night before, he was in the operating room exactly one week after his diagnosis.  

"It’s unheard of to go from start to finish that quickly," Gary says. "It felt like people actually cared how fast it came together."  

Dr. Potretzke says Gary's case was unique because of the multidisciplinary coordination that occurred in such a short time while Gary was several hours from Rochester, Minnesota. 

"To be able to get him into the operating room that fast was not something that we see every day, but it shows that this system works really well — and people at Mayo Clinic go the extra mile in an amazing way to take great care of patients in a thorough and efficient way," says Dr. Potretzke.  

Because of this advanced approach, he spent just a single night in the hospital and was able to return to work four days later.   

Dr. Potretzke will continue to monitor Gary over the next two years for signs of recurrence. 

Reaching a milestone: 100,000 da Vinci robot-assisted surgeries  

Gary's successful journey comes as Mayo Clinic marks a milestone in robotic-assisted surgery.  This summer, Mayo Clinic surpassed 100,000 surgeries assisted by the da Vinci robot.

Mayo Clinic uses advanced surgical robots to perform complex operations with precision, helping patients like Gary experience less pain, spend less time in the hospital and recover faster.  

"At Mayo Clinic in Arizona specifically, it's a marker of how far we've come as a campus from adopting the technology to now defining where complex robotic surgery goes next," says Dr. Michelle Nguyen, a Mayo Clinic transplant surgeon. "Reaching 100,000 cases is a meaningful milestone, but it's the culture of innovation behind it that will define what the next 100,000 look like."  

Much of that progress is being driven by breakthroughs in surgical technology. 

"Robotic-assisted surgery allows us to perform increasingly complex operations with greater precision, control and safety," says Dr. David Yang, a urologist at Mayo Clinic Health System in Mankato, Minnesota. "This translates into improved patient outcomes, less postoperative pain and faster recovery. Perhaps just as importantly, procedures that were once only available at large tertiary care centers can now be performed closer to home."  

That high level of care is a collective effort. 

"Each of those 100,000 robotic surgeries was made possible by our exceptional care teams, including not only surgeons at Mayo Clinic in Florida but nursing teams, anesthesia, surgical staff, custodial support, scheduling and many others," says Dr. Mara Piltin, a Mayo Clinic surgical oncologist. "Each member of our institution plays a meaningful role in allowing us to offer high-volume, high-complexity care to patients in need, and we are grateful for each piece of the puzzle."  

Grateful for the seamless multidisciplinary care  

Reflecting on his clear follow-up scans and rapid recovery, Gary is grateful for the seamless multidisciplinary care he received.   

Highlighting how technology empowers clinical teams, Dr. Potretzke notes that robotic-assisted surgery has been a tremendous asset.   

"Robotic surgery allows us to enhance traditional laparoscopy with 3D and magnified visualization, and articulating instruments that allow for meticulous dissection and sewing in very small spaces," he adds.  

Meanwhile, patients like Gary are thankful for the team at Mayo Clinic.   

"I told Dr. Potretzke I would only share my story if I could brag about him and his team," says Gary. "You really respect the knowledge and training that the care team has." 

The post When a fire chief needed help: How Mayo Clinic’s collaborative care and robotic surgery saved his life (VIDEO) appeared first on Mayo Clinic News Network.

For nearly six years, Bob Morreale has lived with a shoulder replacement. Most days, he does not think about it at all. 

That, he says, is the point. 

For Bob, 56, of Rochester, Minnesota, the road to shoulder replacement began decades earlier. A former Division III college baseball pitcher, he sustained shoulder injuries that led to instability, tissue damage, previous surgeries, and eventually, osteoarthritis. Over time, pain became part of daily life.  

“Turning a doorknob, holding a coffee cup, sleeping on my right side, and throwing became difficult,” Bob says. “It didn’t completely stop me from doing things, but I was constantly making adjustments.” 

Bob knew he needed a more permanent solution to manage his pain. At Mayo Clinic in Rochester, he met with Joaquin Sanchez Sotelo, M.D., Ph.D., an orthopedic surgeon, to discuss whether total shoulder replacement could be an option. 

Like many patients considering joint replacement, Bob wanted to know how long an implant might last and whether he could expect to regain comfortable motion. Dr. Sanchez Sotelo could answer those questions with confidence, drawing on decades of outcomes data from thousands of joint replacement patients treated at Mayo Clinic. 

How decades of patient follow-up help guide your care 

That confidence comes from more than 50 years of systematically tracking patient-reported outcomes. Since performing the first FDA-approved total hip replacement in the United States in 1969, Mayo Clinic has followed joint replacement patients throughout their lives, creating one of the world's largest collections of long-term outcomes data. 

"After surgery, we connect with patients on a regular basis. Even after a surgeon retires, another will step in and continue to check in with patients throughout the remainder of their life," says Matthew Abdel, M.D., chair of the Surgical and Procedural Practice at Mayo Clinic. 

For patients like Bob, that depth of follow-up matters. It allows surgeons to have more informed and honest conversations about what patients can expect — including pain relief, function, durability and whether another surgery may be needed in the future. 

Making an informed decision 

After discussing the benefits, risks and alternatives with his surgeon, Bob decided to move forward with an anatomic total shoulder replacement. Based on his age, anatomy and overall shoulder condition, the procedure offered the best opportunity to relieve pain, restore function and return to the activities he enjoyed.  

Recovery from surgery required patience. Bob spent weeks in a sling and worked through physical therapy to rebuild strength and motion. But as movement returned, so did the ordinary parts of life he had been missing. 

"The results have been remarkable," Bob says. "I have no pain, full range of motion, and can do everything I want to do. My sons are now adults, but I can still play catch with them!" 

How every patient helps improve joint replacement 

Every patient who participates in follow-up contributes to a deeper understanding of long-term outcomes, helping Mayo Clinic refine care and better guide future patients. 

For patients, that means care informed by decades of real-world outcomes, helping surgeons provide clearer expectations about recovery, function and long-term results. 

Like more than 200,000 joint replacement patients treated at Mayo Clinic, Bob continues to participate in periodic follow-up after surgery. 

Nearly six years later, he rarely thinks about his shoulder anymore. 

That's exactly what he hoped for. 

The post Why decades of patient follow-up make a difference in joint replacement care  appeared first on Mayo Clinic News Network.

For patients waiting for a kidney transplant, finding a compatible donor can take time. A paired kidney donation program can make transplantation possible, even when a donor isn't a direct match. That's what reunited two former high school classmates, now teachers, and gave one of them a new kidney and a new lease on life.

Watch: Teachers connect beyond the classroom through paired kidney donation

Journalists: Broadcast-quality video (2:33) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I kind of always knew I needed a new kidney," says Shannon Williams, a 50-year-old elementary school teacher in Leesburg, Florida.

Shannon Williams spent 15 years living with polycystic kidney disease. When dialysis became a reality, she knew she couldn't wait any longer for a transplant.

"I've got to find my own match, so I started looking," says Shannon.

Then, a social media post reached an old friend.

"I didn't know that she had been sick initially," says Kelly Harrington.

"I went to school with Kelly back in high school. We twirled together, and I was a senior; she was a freshman," says Shannon.

"Shannon and I both teach in the same school district," says Kelly.

"Kelly called me, and she said, 'I want to see if I'm a match for you.' She was a match, except for the antibodies," says Shannon.

Although Kelly couldn't donate directly to Shannon, a kidney paired exchange program offered another path.

"Someone may not be appropriate to donate to a particular recipient, but they are a fantastic donor to someone. And so the kidney goes into a national matching pool," says Dr. Shennen Mao, a Mayo Clinic transplant surgeon. "Once a match is found, the kidney is donated to an intended recipient, and our recipient gets a kidney in return."

"When I realized that I could still help Shannon, potentially save her life, give her a longer life, give her a healthier life, it was a bonus," says Kelly.

Then, in January 2026, there was a life-changing phone call.

"(Transplant coordinators) called and said they had a match," says Kelly. "I don't recall ever crying so hard in my life. It was overwhelming, absolutely overwhelming."

Shannon and Kelly drove two hours from their homes in Central Florida to Jacksonville, where the surgeries took place at Mayo Clinic. One of Kelly's kidneys was sent to someone else in need.

"Shannon received a living donor kidney back through the kidney paired exchange program," says Dr. Mao. "It worked right away on the operating room table."

Not long after surgery, Shannon and Kelly were reunited.

"They wanted me to walk right away," says Shannon. "Kelly and I were two doors down from each other, so we got to walk the halls together — just us and our walkers strolling down the hallway."

"That first walk, we felt like superstars," says Kelly. "All of the staff members were just helping us and supporting us."

"The ability and the impact that we can make on our patients is what drives me, both as a transplant surgeon and also as a scientist, to think about the solutions for the future, so that we can help more patients like Shannon," says Dr. Mao.

Before the end of the school year, Shannon and Kelly returned to their classrooms.

"To know that she literally saved my life, I will always be grateful to her," says Shannon. "I always tell her she's my angel."

The post Teachers connect beyond the classroom through paired kidney donation (VIDEO) appeared first on Mayo Clinic News Network.

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

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

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

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

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

Risk factors

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

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

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

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

Early detection and symptoms

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

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

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

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

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

Tailoring care for younger adults  

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

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

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

Innovations in treatment

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

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

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

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

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

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

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

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

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

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

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

A different approach: Focus on what is possible

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Providing confidence, clarity and hope

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

Kyle praises that approach.

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

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

A tiny lung nodule can be difficult to find during surgery. Now, Mayo Clinic surgeons are using fluorescent imaging technology to help locate suspicious nodules with greater precision while preserving healthy lung tissue.

The imaging contrast substance is administered before surgery and travels through the body, binding to certain lung cancer cells. During the procedure, surgeons use a specialized camera to detect the fluorescent signal, causing the cancerous tissue to glow. This allows the surgical team to easily identify and remove targeted tissue.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:06) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Using this fluorescent agent is really helpful because it hones to the cancer cells and binds to one of the receptors on cancer cells," says Dr. Jonathan D'Cunha, a Mayo Clinic cardiothoracic surgeon. "When you're in the operating room, you can use your advanced fluorescent imaging to see the tumor light up."

The technology can help surgeons identify tiny nodules that may be difficult to see or feel during minimally invasive procedures. It also helps distinguish cancerous tissue from healthy lung tissue, allowing for greater precision during surgery.

"We're always looking for tools to be more precise in what we do," says Dr. D'Cunha. "The earlier we can identify and resect, the better chances and better outcomes for patients."

Learn more: Mayo Clinic Lung Cancer Program

The post Mayo Clinic Minute: Lighting up lung nodules during surgery appeared first on Mayo Clinic News Network.

Life on the mat 

For Casey Lamb, the mat has never just been a place to compete. It's where he's spent more than four decades teaching, mentoring and testing himself.

 "It's really who I am," Casey says.  

As a Brazilian jiu-jitsu instructor, gym owner and lifelong competitor, Casey's life has long revolved around helping others grow through the sport he loves. Then chest tightness during training forced him to imagine a future without the life he had spent decades building. 

A diagnosis that raised difficult questions 

While ramping up training at his Rochester, New York, gym for an upcoming jiu-jitsu competition and staying active with his children's wrestling, Casey began experiencing chest tightness and pressure. Having seen friends and students suffer serious heart-related emergencies, he decided not to ignore the warning signs. Hoping for reassurance and a quick return to training, he sought care at his local hospital. 

Instead, he left with an unexpected diagnosis: an ascending aortic aneurysm, a dangerous weakening of the body's largest artery that can tear or rupture without warning. 

Just as devastating for Casey, the diagnosis meant he was told to stop competing and avoid the heavy exertion that had defined both his work and personal life. 

At about 4.7 centimeters, Casey's aneurysm fell below the size threshold at which surgery is typically recommended. Physicians usually continue monitoring an aneurysm until it reaches 5 centimeters or larger. 

Until then, treatment often focuses on reducing risk through lifestyle changes, including avoiding heavy lifting and limiting strenuous activities that can place additional strain on the aorta. 

For Casey, avoiding strenuous activity wasn't a temporary inconvenience. Coaching, training and competing in jiu-jitsu were central to his livelihood and daily life.  

"I'd rather have 15 years doing what I love than 30 years miserable sitting in a chair," Casey says. 

For Casey, the diagnosis threatened far more than his health. It jeopardized the identity he had spent most of his life building. 

Searching for another option 

That conviction led Casey to seek another opinion at Mayo Clinic in Rochester, Minnesota. 

There, the conversation shifted. Instead of focusing only on the size of Casey's aneurysm, specialists from cardiology, vascular medicine, sports cardiology and cardiovascular surgery worked together to understand the person behind the diagnosis — his profession, his goals and the life he hoped to return to. 

Although his aneurysm had not yet reached the standard threshold for surgery, the demands of his life as a coach, competitor and gym owner called for a more individualized approach. 

"Guidelines are essential," says Dr. Thais de Azeredo Coutinho, a Mayo Clinic cardiologist and vascular medicine specialist in the Mayo Clinic Aortic Center. But they don't replace individualized care. Some patients deserve a closer look because their circumstances aren't fully captured by the guidelines. This was Mr. Lamb's situation." 

"It wasn't, 'Here's what you have to do,'" Casey says. "It was, 'Here are your options. What do you want to do?'" 

Rather than asking him to walk away from the sport, Casey's Mayo Clinic care team focused on helping him understand the risks, weigh his options and choose the path that aligned with his goals. 

"Let's figure out how to get you back doing what you want to do," Casey recalls. "We'll tell you the risks; we'll make the risks as low as possible; we'll let you know what they are; and you make the decisions." 

For the first time since his diagnosis, Casey saw a path forward — one that didn't force him to choose between protecting his health and preserving the life he loved. 

After weighing the risks with his care team, Casey decided surgery offered the best chance to continue the activities he wanted. 

A surgery built around his goals 

The expertise and collaboration he experienced at Mayo Clinic gave him confidence in that decision. 

"I believed I was at the best place to have this procedure, with the best surgeon and the best team," Casey says. 

Dr. Gabor Bagameri, a Mayo Clinic cardiovascular surgeon who specializes in complex aortic surgery, repaired the enlarged section of his ascending aorta while preserving his native aortic valve. 

"Our goal wasn't simply to repair the aneurysm," Dr. Bagameri says. "It was to repair it in a way that gave him the best opportunity to safely return to the life he valued." 

For Casey, the operation wasn't simply about repairing his aorta. It was about preserving something equally important: the opportunity to return to coaching, competing and the community he had built on the mat. 

Back to training 

Recovery didn't end after surgery. Working with Mayo Clinic's Sports Cardiology team, Casey gradually rebuilt the strength and confidence needed to return to high-level competition.   

Every walk, every rehabilitation milestone and every workout brought Casey one step closer to a single goal: getting back on the mat. 

"I knew if I made it through surgery, I would get back to where I was because that was the plan we had put together," Casey says.  

Just three months after surgery, that plan became reality. Casey stepped back onto the mats — not as someone watching from the sidelines but as a coach, mentor and athlete once again. 

"I was back on the mats," Casey says. "I was teaching classes. I was training again." 

For the first time since his diagnosis, Casey wasn't wondering what he might lose. He was back doing what he loved. 

His students once again had their longtime coach leading classes, demonstrating techniques and training alongside them. Stepping back onto the mat wasn't simply a return to training, it was proof that the future he feared might slip away was still within reach. 

"For someone like Casey, it's about helping him return to the activities that matter most while understanding the risks involved," says Dr. Kathryn Larson, a Mayo Clinic sports cardiologist who helps athletes safely return to activity after heart conditions and procedures. 

Looking ahead 

Nearly two years after surgery, Casey says he finally feels like himself again. 

Today, Casey continues coaching, training and preparing for future competitions, including a return to the World Master Jiu-Jitsu Championship. 

The chance to pursue those goals again is something he doesn't take for granted. 

"It's just the fact that I've gotten back to it at that level," Casey says. "Doing what I love and what I've gone through, in itself, it's a victory." 

For a man who once feared he might never return to the mat, stepping back onto it became more than a comeback. It became proof that personalized care can help restore the life that matters most. 

The post Personalized heart care helps a martial arts instructor return to competition  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My back pain keeps getting worse. I've tried all the nonsurgical options, but is it time to consider surgery? 

ANSWER: It might be. The back is a highly complex part of the human body with several potential sources of pain — bones, joints, muscles and nerves.  

Joints: On the back of each spinal vertebra is a pair of facet joints that allow you to bend and twist. These two facet joints, together with the disc, enable the bones of the spine to move. Lower in the back is the sacroiliac joint, which connects the spine to the pelvis. As with any joint, these can be affected by arthritis and injury. The discs, which provide cushioning between the vertebrae, can slip out of place, allowing the bones to rub together. 

Muscles: An intricate muscle structure supports the spine. Strains, overuse and underuse can weaken and damage these muscles. 

Nerves: The spinal cord, which is a bundle of nerves, runs through the spine, ending where the mid back and lower back connect — about at your belly button. From there, nerve roots branch to each leg, providing function to your legs. Anywhere along the spine, but especially in the lower back, the nerves can become compressed. It's radiating leg pain that frequently drives patients to seek relief through surgery. 

The first step in finding back pain relief is to be assessed by a healthcare professional, who, as part of the examination, will check your ability to sit, stand, walk and lift your legs. You also may undergo some imaging. This assessment will help your clinician develop a treatment plan.  

Nonsurgical pain-relief options include: 

• Physical therapy. A physical therapist can teach you exercises to increase flexibility, strengthen back and abdominal muscles, and improve posture. Building these exercises into your daily routine can help prevent pain from returning. The therapist also can show you how to modify the exercises and your movement during a back pain episode.  

• Ice/heat. The use of an ice pack or heating pad can help relieve pain from muscle tension and spasms. 

• Pain relievers. These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil); acetaminophen(Tylenol); topical creams and patches that deliver substances through the skin; medicines containing opioids, such as oxycodone or hydrocodone (rarely used); and some antidepressants, including duloxetine (Cymbalta).  

• Muscle relaxants. If mild to moderate back pain doesn't improve with ice, heat or pain relievers, a muscle relaxant is another option.  

• Injections. If other measures don't relieve pain that radiates down the leg, an injection of cortisone plus a numbing medicine might help. 

• Other treatments. Yoga, massage, chiropractic adjustments and acupuncture also may bring relief. 

When these measures are no longer effective, patients typically seek out surgical options. For the best outcomes, it's essential that the surgical procedure matches the problem that needs to be addressed. These can include neurological compression, instability or spine deformity issues.  

A consultation with a surgeon usually includes an examination and imaging to pinpoint the problem, followed by a discussion of what surgical approach will provide the greatest benefit. After the consultation, you may want to talk over your options with family and friends or seek a second opinion to ensure you're comfortable with the plan. 

Before surgery, you'll be thoroughly assessed to determine if you're physically ready for the procedure. This will include evaluating your bone health and ensuring that any medical conditions are stable or optimized. 

The surgery depends entirely on what is needed to correct the problem. Some surgeries are relatively simple, while others may be quite complex. 

Recovery and healing depend on how extensive the surgery was. For instance, a herniated disc may require only a small incision, followed by a short period of limited activity. Recovery from a more involved surgery requiring a large incision may take months. 

However, most people fall somewhere in the middle of this spectrum. They generally feel pretty good within six to 12 weeks, although full recovery typically takes six to 12 months. 

Once a person has recovered, the key is developing a lifestyle that helps prevent back issues from returning. These include building good core muscle strength, increasing mobility, staying active, not smoking, and maintaining a healthy weight and diet. 

Being active and maintaining good core strength not only are essential to recovery from surgery, but they also are key to preventing back pain. 

Mel Helgeson, M.D., Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota  

The post Mayo Clinic Q&A: What’s up with my aching back? Do I need surgery? appeared first on Mayo Clinic News Network.

In this episode of "Tomorrow's Cure," Lindsay Sievert talks with Stephanie Polites, M.D., a pediatric surgeon at Mayo Clinic, and Timothy Lautz, M.D., a pediatric surgeon and surgical oncologist at Lurie Children's Hospital of Chicago, about how fluorescent imaging is helping guide safer, more precise surgery. 

The approach uses fluorescent agents and specialized cameras to make structures glow on a screen. Depending on the procedure, surgeons may use the technology to assess blood flow, identify bile ducts, locate lymph nodes, protect structures such as the ureter or help find tumors. 

"What fluorescence-guided surgery does is essentially make different structures, organs and tumors glow that allows the human eye to see it in a way that wouldn't otherwise be able to do," says Dr. Polites.  

The technology is especially promising in pediatric cancer surgery. Small tumors or areas where cancer has spread can be difficult to see, particularly during minimally invasive procedures. Fluorescence imaging can provide surgeons with additional information as they work to remove cancer while preserving as much healthy tissue as possible. 

Dr. Polites and Dr. Lautz also are studying newer, more targeted fluorescent substances in children. These contrast substances are designed to highlight cancer cells more specifically than earlier dyes. Their clinical trials are evaluating the contrasts' safety, appropriate dosing and whether the technology helps surgeons identify tumor tissue more accurately. 

The physicians describe this as part of a move toward precision surgery, using a child’s tumor biology to guide surgical care. "Different medications are becoming more precise and more tailored to a patient's individual biology and genetics. We're doing the same with surgery, and you're incorporating the individual biology of the different tumors into surgical care. And it just allows us to be more targeted and more precise," says Dr. Polites.  

Although the technology shows promise, fluorescence-guided surgery is not a cure or a replacement for surgical judgment. Instead, it is another tool that may help surgeons operate more safely, remove tumors more completely and reduce the risk of long-term effects for children.  

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

The post Fluorescence-guided surgery: Making the invisible visible  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I have a benign lesion on my liver that needs to be removed. My surgeon said he would use robotic-assisted surgery. Can you tell me more about that? 

ANSWER: Yours is a common question. When people first hear "robotic surgery," they often think of a robot on autopilot doing the procedure. However, that couldn't be further from the truth. The robotic arm is a tool driven by the surgeon, following maps created from preoperative imaging. 

Robotic technology is being used during abdominal surgery for benign and cancerous tumors in the liver, pancreas, colon and rectum, as well as gallbladder removal. 

Your liver helps digest food, rids the body of waste products and makes clotting factors that keep blood flowing well, as well as performs other tasks. Parasites, diseases, viruses, infections, injury, cancer, alcohol use, obesity and inherited factors can all damage your liver. 

Any of these causes may lead to surgery, including the use of robotic technology, which can benefit patients in several ways. 

With open surgery, an incision would be made from the breastbone to your navel or sometimes with a right-angle turn like a hockey stick. The benefits of robotic-assisted surgery include:  

• Smaller incisions, which lead to less blood loss and stress on the body. 

• Reduced postoperative pain.  

• A lower risk of surgical complications.  

In general, with less pain, recovery is faster, and the risk of complications such as pneumonia or intestinal temporary paralysis, which can occur in up to 20% of all open abdominal surgeries, is less because patients are up and moving sooner. 

Prior to surgery, patients undergo a CT scan and MRI, which will provide the imaging needed for your surgeon and for mapping. If surgery is due to cancer, this imaging may have been done periodically to watch for changes or as part of the patient's treatment. 

The surgery includes a team of professionals who administer anesthesia, fluids and blood, if needed, and monitor the heart and blood pressure. Patients also have a urinary catheter inserted most of the time. 

Once the patient is under anesthesia, the surgeon makes multiple incisions slightly less than 1/2 inch long and one incision about 2 inches long, if needed, to remove larger specimens from the abdomen. Using the robot's arms as extensions of their hands, the surgeon uses a variety of tools, including those to make incisions, apply clips, seal structures, sew sutures and remove tissue from the surgical site. Tiny cameras deliver magnified views to allow the surgeon to see the whole process in detail. 

Once the surgery is complete, the incision typically is closed with absorbable sutures and glue so that stitches don't have to be removed postoperatively. No bandages are needed, and patients can shower 48 hours after the surgery. 

Some surgeries require the removal of a portion of the liver. Up to 70% of a healthy liver can be removed and still function effectively. However, if a liver has been damaged by chemotherapy and other causes, as little as 50% may be removed. It's a myth that the liver regenerates. However, the remaining liver segment will grow large enough to function and compensate for the loss. 

While robotic-assisted surgery is minimally invasive, it's still invasive. After surgery, patients are watched for complications from bleeding and anesthesia, as well as any effects on their hearts and lungs, similar to other general surgical procedures.  

In liver surgery, there's also a small risk of bile leakage. Bile is the green fluid produced by the liver and channeled to the small intestine to aid with digestion. Leaks typically can be spotted during surgery, but if one develops, it can be corrected with endoscopic procedures or radiological interventions. 

Opportunities for using robotic technology in liver and abdominal surgeries are expanding. Robotic technology opens the door to training more physicians in its use for surgeries ranging from less complex to more complex. As more surgeons become proficient in its use, the pool of patients who can undergo surgery to benefit their health, recovery and general well-being also widens. 

Guido Fiorentini, M.D., Ph.D., Surgery and Surgical Oncology, Mayo Clinic Health System, Eau Claire, Wisconsin

The post Mayo Clinic Q&A: How is robotic technology changing liver and abdominal surgery? appeared first on Mayo Clinic News Network.