From complex or serious conditions like cancer and heart disease to the latest news on research and wellness, host Dr. Halena Gazelka asks the questions and gets easy-to-understand answers from Mayo Clinic experts
BA.5 omicron variant fueling latest COVID-19 surge
July 15, 2022
The BA.5 omicron variant is now the dominant strain in the U.S., and it is leading to a new wave of COVID-19 infections. BA.5 was responsible for nearly 54% of COVID-19 cases in the U.S., and BA.4, a similar variant, accounted for another 17%, according to the latest data from the Centers for Disease Control and Prevention.
Experts are concerned because this particular variant appears to be good at evading the immune system.
"This BA.5 variant is hypercontagious, and right behind it, new variants are coming," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "We will continue to generate these variants until people are masked and immunized."
Dr. Poland explains that the transmissibility of BA.5 represents the evolution of the virus to become more contagious and able to evade immune protection from previous infection or vaccination.
"Whether you've been vaccinated, whether you've been previously infected, whether you've been previously infected and vaccinated, you have very little protection against BA.5 in terms of getting infected or having mild to moderate infection," says Dr. Poland. "Thankfully, you still do have good protection against dying, being hospitalized or ending up on a ventilator if you are up to date on your vaccinations."
Due to the consequences of reinfection, including the possibility of long COVID-19, Dr. Poland urges people to continue to take precautions to protect themselves.
"The reality is, it's important to be up to date on the COVID-19 vaccinations that are recommended for your age group, health condition, etc.," says Dr. Poland. "Sometime this fall, we may well have a variant-focused vaccine, so get it when it becomes available. And wear a proper mask properly when you are indoors around people who are not your family or in a crowded outdoor venue."
On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news and answers listener questions.
Advances in managing MS
July 12, 2022
An estimated 2.8 million people worldwide are affected by multiple sclerosis (MS), a potentially disabling disease of the brain and spinal cord. In this disease, the immune system attacks the protective covering around the nerve fibers.
"Multiple sclerosis — the term means multiple scars — is a disease that leads to damage of the central nervous system, which is the brain, the spinal cord and the optic nerve," explains Dr. Eoin Flanagan, a Mayo Clinic neurologist.
Signs and symptoms of MS vary widely. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.
Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.
While there is no cure, treatments can help modify the course of the disease and manage symptoms.
"In the last five to 10 years, we really have strong medications that can keep MS very quiet," says Dr. Flanagan. "We're hopeful that will prevent a lot of the long-term damage that patients used to get in the past where after many years of having an MS diagnosis they may struggle with walking or have additional disability that would develop from those scars. And I think with these new medications we're going to be able to stop MS in its tracks. So it's a really hopeful time for all of our patients with MS."
In addition to medications to manage MS, Dr. Flanagan notes that patients with MS can be monitored in new ways. New technologies include a digital floor mat to monitor a patient's waking, an optical scan that can measure microscopic nerve damage, and a blood test to measure inflammation levels and response to treatments.
"We really are trying to embrace technology here at the Mayo Clinic," says Dr. Flanagan. "We're using these new technologies to both learn more about MS and see how we can better help our patients because, at the end of the day, the needs of the patient come first."
On the Mayo Clinic Q&A podcast, Dr. Flanagan discusses advances in the management of MS.
Ask the Mayo Mom: How exercise benefits mind as well as body
July 8, 2022
The amount of physical activity children need depends on their age. According to the Centers for Disease Control and Prevention, children ages 3 through 5 years need to be active throughout the day while children and adolescents ages 6 through 17 need to be active for 60 minutes every day.
Many common school-age activities — such as playing on playground equipment and jumping rope — help kids get the recommended amout of exercise. Organized sports are a great way to stay fit, too, but team sports aren't the only options. Nature hikes, walking, biking or even dancing to their favorite music can get kids moving.
Including physical activity in a child's daily routine sets the foundation for a lifetime of fitness and good health. And beyond the physical benefits, there are cognitive benefits as well.
"The literature really speaks to the benefit on cognition from cardiovascular exercise," says Dr. Tanya Brown, a Mayo Clinic neuropsychologist. "So we can see a positive benefit on how a child's emotionally feeling as well as cognitively functioning. The brain is developing throughout childhood, so it is really primed to be improved."
Children who get regular exercise have lower levels of depression and stress and higher levels of positive self-image, according to the American Psychological Association. Exercise also is linked to better thinking skills, which leads to improved behavior, attention and academic performance.
Even a short burst of exercise can help.
"To get the cognitive benefits of exercise, it's important to get the heart rate up," says Brandi Brian, a physical therapist at Mayo Clinic and certified neurologic clinical specialist. "Getting the heart rate up for as little as four minutes will have short-term benefits that can kind of help in the moment. Then longer term, improving physical fitness through aerobic activity will have longer-term implications on cognition."
On the Mayo Clinic Q&A podcast, Dr. Brown and Brian join pediatrician and host Dr. Angela Mattke for a discussion focused on the cognitive benefits of exercise for children.
The importance of COVID-19 vaccines for children under 5
July 6, 2022
COVID-19 vaccine recommendations in the U.S. have been expanded to include children ages 6 months to 5 years. The new vaccine recommendations mean children in the under-5 age group can receive a three-dose primary series of the Pfizer vaccine or a two-dose primary series of the Moderna vaccine.
"This age group is one that can't wear a mask or anything else reliably," explains Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases specialist. "And so this is one of the really important layers of protection for them. Vaccinations will help protect the child, the family and the community."
Dr. Paige Partain, a Mayo Clinic pediatrician, says while parents may wonder if getting their young children vaccinated against COVID-19 is necessary, it is important to recognize the benefits.
"When I look at our primary goal, which is keeping kids out of the hospital, keeping them from dying from COVID, we know that vaccines do that very well," explains Dr. Partain. "And we don't have a good way to predict whether your child might be in that small percentage that gets really sick from COVID, so we want to make sure that we give them the best protection. Even for folks that have already had COVID, because the natural immunity that we get from these infections doesn't last as long as we would like. So when we can combine that immunity with the immunity from a vaccine, what we're really doing is giving kids the best protection and the best chance to do well if they do get COVID."
Dr. Partian says the benefits of vaccinating kids younger than 5 goes beyond preventing severe disease and hospitalizations.
"Having our kids vaccinated decreases the chances that they might pass COVID along to someone else, maybe more vulnerable adults that they spend time around or other children under 6 months who aren't old enough to get their vaccine yet."
On the Mayo Clinic Q&A podcast, Dr. Rajapakse and Dr. Partain from the Mayo Clinic Children’s Center join pediatrician and host Dr. Angela Mattke for a discussion on COVID-19 vaccinations for children ages 6 months to 5 years.
Proton beam therapy spares surrounding tissue when treating bone cancer
July 5, 2022
Sarcoma is the general term for a broad group of cancers that begin in the bones and soft tissues of the body, including muscle, fat, blood vessels, nerves, tendons and the lining of your joints. There are more than 70 types of sarcoma.
Bone cancer is a rare disease, accounting for just 0.2% of all cancers. An estimated 3,910 new cases of sarcoma of the bones and joints will be diagnosed in 2022, according to the National Cancer Institute.
Some types of bone cancer occur primarily in children, while others affect mostly adults.
"When we think of sarcomas of the bone, the common types are chondrosarcoma, Ewing sarcoma, and osteosarcoma," says Dr. Safia Ahmed, a radiation oncologist at Mayo Clinic. "While sarcoma can happen in any bone in the body, the most common sites include the pelvis, the spine, and the skull base for most of these tumors."
Treatment for sarcoma varies depending on sarcoma type, location and other factors. Treatments can include surgery, chemotherapy and radiation therapy.
Proton beam therapy is a type of radiation therapy that is more precise than traditional X-ray treatment, which delivers radiation to everything in its path. Proton beam therapy uses positively charged particles in an atom — protons — that release their energy within the tumor. Because proton beams can be much more finely controlled, specialists can use proton beam therapy to safely deliver higher doses of radiation to tumors. This is particularly important for bone cancers.
"When we treat these tumors in the bone with radiation, they need much higher doses of radiation than, say a sarcoma that arises purely in the muscle, what we call a soft tissue sarcoma," explains Dr. Ahmed. "And these high doses of radiation often exceed what the normal tissues around the area can tolerate. So proton therapy allows us to give this high dose of radiation while protecting the normal tissues."
July is Sarcoma Awareness Month. On this Mayo Clinic Q&A podcast, Dr. Ahmed discusses sarcoma diagnoses and treatment options, including proton beam therapy.
How a pancreas transplant can cure diabetes
July 1, 2022
Diabetes is a chronic condition that impairs the body's ability to regulate blood sugar due to inadequate insulin production. Producing insulin is a function of the pancreas — a long, flat gland that sits behind the stomach in the upper abdomen.
People with diabetes can experience significant complications from the disease, including heart disease, chronic kidney disease, nerve damage and vision loss. While advances have been made in diabetes treatments, many people with diabetes struggle with the disease.
"Diabetes is an abnormality in consuming or metabolizing blood glucose," says Dr. Tambi Jarmi, a Mayo Clinic nephrologist. "So diabetic patients have a hard time adjusting their blood sugar to the level that their cells needed. It could be a result of a deficiency in the production of the insulin that comes from the pancreas or it could be a result of resistance to that insulin."
To restore normal insulin production and improve blood sugar control, a pancreas transplant may be an option.
Most pancreas transplants are performed to treat Type 1 diabetes. A pancreas transplant can potentially cure this condition. But such a transplant is typically reserved for those with serious complications of diabetes because side effects can be significant.
In some cases, a pancreas transplant also can treat Type 2 diabetes. A pancreas transplant is often performed in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.
"The idea of a pancreas transplant is to actually cure the diabetes," says Dr. Jarmi. "While treatment with a mechanical pump does a great job, it is not a cure. An organic pump, meaning a pancreas transplant, does cure diabetes."
Pancreas transplants are sourced from a deceased donor, and the organ to be transplanted must match the blood type of the recipient. With the replaced function of the pancreas and natural ability to produce insulin, Dr. Jarmi says patients no longer are diabetic.
On the Mayo Clinic Q&A podcast, Dr. Jarmi discusses pancreas transplant as a cure for diabetes.
Regenerating damaged skin
June 28, 2022
Regenerative medicine is an emerging field that looks to repair, replace or restore diseased cells, tissues or organs. One specialty that's a natural fit for regenerative medicine is dermatology. That's because the skin is the largest organ that regenerates in the body.
"Regenerative medicine is the idea that we can reestablish form and function," says Dr. Saranya Wyles, a Mayo Clinic dermatologist. "So when we are born, we have that baby skin. And as we age, that sort of shifts and changes over time. So how do we utilize regenerative technologies to get that skin to go back to regenerating or restoring that form and function?"
Mayo Clinic's Center for Regenerative Medicine is leading efforts to integrate new regenerative biotherapeutics into clinical care. Dr. Wyles explains the regenerative medicine "toolkit" includes stem cells and platelet-rich plasma, and the latest tool: exosomes.
"I think it's these new technologies within regenerative medicine that we are going to look to directly be playing against that root cause of aging," explains Dr. Wyles.
Products to repair aging skin are in demand, but Dr. Wyles cautions people to make sure there is science-based evidence and not just hype. The focus of Dr. Wyles' lab is to provide a validated scientific approach to conditions such as wrinkles, age spots and thinning skin. Her studies examine the role of cellular senescence as a biomarker of skin aging.
"I think that this is a very exciting time, and we're seeing a convergence of longevity and aging science and regenerative medicine," says Dr. Wyles. "I would just advise you to really ask about the research that's being done and really know the science — and then decide on a product that would be best fitting for you."
On the Mayo Clinic Q&A podcast, Dr. Wyles discusses regenerating damaged skin.
The importance of HIV testing
June 24, 2022
The COVID-19 pandemic has led people to delay testing and treatments for a variety of diseases and conditions. This includes HIV testing.
During the pandemic, the number HIV diagnosis decline, but that decline is most attributed to declines in testing, according to the Centers for Disease Control and Prevention. Experts attribute this decline to less frequent visits to health centers, reduced outreach services, and shifting of public health staff to COVID-19 response activities.
June 27 is National HIV Testing Day, a day to encourage people to get tested for HIV, know their status, and get linked to care and treatment.
But who should be tested?
"The CDC recommends that everyone over the age of 13 be tested for HIV at least once in their lifetime," says Dr. Stacey Rizza, an infectious diseases specialist at Mayo Clinic. "This is endorsed by the Center for Medicare & Medicaid Services and paid for by all private insurance companies. So no matter what your background is, if you've never been tested for HIV, you should get tested. And that's because many people with HIV have no idea they have it. They can be completely asymptomatic for a very long time and not only have the virus causing ill effects on themselves, but they're at risk of potentially transmitting it to others. We need to do a better job in the U.S., particularly as health care providers, to follow that recommendation, and to make sure that every adult has had an HIV test at least once in a lifetime."
If HIV is not treated, it can lead to AIDS. But effective therapies can control HIV, which is why getting tested and seeking treatment is so important.
"We know now that if somebody is on effective HIV therapy, and the virus in their body is suppressed, it's not gone. But it's suppressed. Their risk of transmitting it to somebody else is close to zero," explains Dr. Rizza. "So if you just pause for a minute and think about that implication. That means if every human on planet Earth who had HIV were diagnosed, linked with health care, and on effective therapy, then HIV would be gone from the human race in one generation."
Like many other areas of health care, health disparities play a significant role when it comes to testing, diagnosis and treatment of HIV. Those disparities have been exacerbated by the COVID-19 pandemic. Improving awareness and community outreach can help combat these disparities.
"It's the same old thing that works for every disease state," says Dr. Rizza. "Its education, engagement and role-modeling within the communities. That education is essential. And it needs to be done in the community. We can't wait for people to come to us, and then we'll teach them, we need to get into those worlds, with people who are leaders in those communities, and have ways to bring diagnosis, treatment and preventive measures to them."
Dr. Rizza says disparities in diagnosing HIV face an additional challenge that some other diseases do not: stigma.
"It is just heartbreaking," says Dr. Rizza. "And the stigma that had been around HIV for a very long time is part of what prevents people from coming forward, from taking the initiatives to prevent the disease, to prevent the infection — and also to be diagnosed — out of fear of the answer. And, so, we also need those community leaders to help break down the stigma issue in addition to educating and bringing diagnosis and treatment closer to home."
On the Mayo Clinic Q&A podcast, Dr. Rizza discusses the importance of HIV testing and improvements in therapies to treat HIV.
What to expect after surviving breast cancer
June 21, 2022
After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. But it can occur in people of all gender identities.
Nearly 13% of women in the U.S. will be diagnosed with breast cancer at some point, according to the National Cancer Institute. Fortunately, thanks to earlier detection and advances in diagnosis and treatment, most people diagnosed with breast cancer will survive. Understanding what to expect can make the cancer journey smoother.
"It's important for people to know the road map," explains Dr. Daniela Stan, an internist with the Mayo Clinic Breast Diagnostic Clinic. "What treatments are they expected to have and what's the timeline? What will the side effects be? How can they prepare?"
People who survive breast cancer can have unique needs depending on their cancer type and stage, but there are some experiences many breast cancer survivors will share after treatment.
"Survivors on a daily basis learn how to deal with their cancer, how to pace themselves, how to get help from family and friends, and how to go forward during and after the treatment is completed," says Dr. Stan. "Luckily, there are many, many resources available to deal with the physical and psychological issues of cancer survivorship."
Dr. Stan encourages cancer survivors to talk with their health care team about how nutrition, exercise and controlling stress can help with the long-term effects of cancer treatment and even help prevent cancer recurrence.
On this Mayo Clinic Q&A podcast, Dr. Stan discusses what people can expect after completing breast cancer treatment and how to achieve the best quality of life.
June 17, 2022
As immunity wanes for many vaccinated adults and omicron and its subvariants continue to circulate, it seems that just about everyone knows someone with a case of COVID-19.
The steady increase in COVID-19 infections is due to changing, highly contagious variants, explains Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. Dr. Poland says it’s still important to take the precaution of mask-wearing in public areas, even if you have been vaccinated and have received your boosters.
"I can’t say it enough. This is so hypercontagious that, regardless of having had three or four doses of vaccine or of having previous COVID-19, you still run an appreciable chance of getting COVID," explains Dr. Poland. "The risk in that case is not of death or hospitalization, but of the complications and long-haul symptoms of COVID-19. And that’s what we’re trying to prevent in people."
For parents, there is positive news this week, as the Food and Drug Administration (FDA) advisory panel voted unanimously to authorize emergency use of the Pfizer and Moderna COVID-19 vaccines for children under 5. For this age group, the Pfizer vaccine will be given in three doses while the Moderna vaccine will be given in two doses.
The FDA panel's recommendation now goes to the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention for approval before shots can be administered, possibly beginning as early as next week.
On the Mayo Clinic Q&A podcast, Dr. Poland shares the latest COVID-19 news, answers listener questions, and discusses another infectious disease outbreak: monkeypox.