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
Palliative care for cancer designed to fit the needs of each patient
June 7, 2022
Palliative care is offered alongside cancer treatment to help people with cancer manage symptoms and improve the quality of life for them and their families. Palliative care is specialized medical care that focuses on relieving patients' pain and other symptoms of serious illness no matter the diagnosis or stage of disease.
"The palliative care team really focuses on addressing symptoms and needs so that we can help people feel as comfortable as they can as they go through their treatment for cancer," says Dr. Deirdre Pachman, a palliative medicine expert at Mayo Clinic. "We do this by focusing and talking about some different interventions. They might be medications, or they might be other procedures for pain that some of our colleagues do. Palliative care is a very team-based approach, so we may involve our nurses, our physical therapists, our social workers really to all be there to help support the patient and make sure that we're addressing their symptoms and their needs."
Palliative care is designed to fit the life and needs of each individual patient. It may include symptom management, support and advice, care techniques that improve comfort and well-being, referrals to other specialists, and advance care planning. Palliative care also offers support for families and those caring for people with cancer.
"The goal of palliative care, along with helping patients manage their symptoms and improving quality of life, is really providing that support to their loved ones or their caregivers, so that they have time to care for themselves and feel well-supported so that they can continue to give to others," says Dr. Pachman.
Research indicates that early use of palliative care services can improve quality of life for people with serious illness, decrease depression and anxiety, increase patient and family satisfaction with care, and in some cases even extend survival.
On this Mayo Clinic Q&A podcast, Dr. Pachman discusses how palliative care can improve quality of life for people with cancer.
Mayo Clinic Q&A podcast: Getting kids involved in the kitchen
Jun 3, 2022
If your child is a picky eater, the battle over healthy foods can be a challenge. Being fussy about food is common in toddlers and small children, but parents can try some tips and tricks to introduce new foods. One approach to improving eating habits is to get kids involved in the kitchen.
Involving children in meal planning and teaching kids to cook can have multiple benefits. Not only is cooking a necessary life skill, learning how to cook teaches math, science and creativity. Using fresh fruits and vegetables encourages healthy eating and children are more likely to eat food they've helped prepare.
Other tips include:
On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" pediatrician and host Dr. Angela Mattke is joined by Kate Zeratsky, a Mayo Clinic registered dietitian nutritionist, and Jen Welper, Mayo Clinic executive chef, for a discussion on teaching children how to nourish their bodies with healthy foods, encouraging kids to try new foods, and getting kids involved in cooking.
Ask the Mayo Mom: Surgical options to repair pectus excavatum
May 31, 2022
Pectus excavatum is a condition where a person's breastbone is sunken into the chest. While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt.
"The initial diagnosis is often based on appearance," explains Dr. Denise Klinkner, a pediatric surgeon at Mayo Clinic Children’s Center and practice chair of the Division of Pediatric Surgery at Mayo Clinic. "Then when we try to grade the severity, using what's called the Haller index."
The Haller index is calculated by measuring the width of the chest and dividing that width by the distance between the sternum and the vertebral column. This calculation can be performed using a chest X-ray or chest CT scan.
In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms can include:
Surgery can correct the deformity.
The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them:
Many pain control options are available after surgery to improve recovery. Cryoablation temporarily freezes the nerves to block pain after surgery, and can help with recovery and decrease postoperative pain for four to six weeks.
"With the addition of cryotherapy, patients need less narcotic pain medicine and have been able to go home the next day after surgery," says Dr. Klinkner.
On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on minimally invasive pectus repair in children. Dr. Angela Mattke, a Mayo Clinic pediatrician and host, is joined by Dr. Klinkner to discuss options for pectus excavatum repair and what patients can expect after surgery.
Community leaders are key to reaching people underrepresented in research
May 26, 2022
To address health disparities and reach underserved communities, work is underway at Mayo Clinic to raise up community voices through community engagement.
"Community engagement is an ongoing process," explains Dr. Chyke Doubeni, director of Mayo Clinic’s Center for Health Equity and Community Engagement Research. "It's a partnership or collaboration among organizational entities and members of the community. And the sole purpose of this is to solve problems and address priorities that a community sees as being priorities for them."
The Center for Health Equity and Community Engagement Research focuses on disparity-related health promotion and disease prevention in areas including cancer, cardiovascular disease and metabolic illness. One initiative Mayo Clinic is taking part in is the National Institutes of Health's (NIH) Community Engagement Alliance Against COVID-19 Disparities (CEAL) research program. This research program focuses on working with communities hardest hit by the pandemic to provide trustworthy information and improve diversity and inclusion in COVID-19 research.
Eula Dean is a community leader who leads the Arizona CEAL consortium community engagement work group. She is also a member of Mayo Clinic in Arizona's Community Engagement in Research Advisory Board.
"I think that one of the things that helped was we identified individuals in the community who have respect and who already worked in the community," says Dean. "Whether they were located in our churches or they have positions of power in terms of their work, it opened some doors for us to really be able to reach our community."
By partnering with community leaders, the CEAL program was able to reach those who were otherwise reluctant to use the health care system, sometimes due to past experiences.
"We had to honor and listen to those concerns," explains Dean. "We had to explain that we want you to know what's happening with COVID-19, so we are bringing this information to you. And we allowed them to ask their questions. And I think it made a difference. We understand that we still have struggles, but I believe that the manner in which we started with a humble heart to say: 'This is what I've learned. Here's my expertise. I love my family. I want my family to be healthy.' I think those were the things that made a difference."
Dr. Doubeni agrees that building trust is key to the successful partnership between researchers and the community.
"What we want to do as researchers is to be able to build trust and be trustworthy so that people can believe in science and can believe in and trust the health care they need to get," says Dr. Doubeni. "So building that trust through community engagement in research can allow us to be stronger for when the next crisis may come along."
On the Mayo Clinic Q&A podcast, Dr. Doubeni and Dean discuss the work of the CEAL program and the importance of engaging underserved communities in research.
To learn more, read the Raising Up Community Voices in Research blog series, including Eula Dean's essay.
Don’t ignore the warning signs of stroke
May 24, 2022
On average, someone in the U.S. has a stroke every 40 seconds, according to the Centers for Disease Control and Prevention. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.
A stroke occurs when the blood supply to part of the brain is interrupted, depriving the brain of oxygen. It's important to recognize the warning signs of stroke, because prompt treatment can minimize brain damage. Every moment is crucial.
"Strokes commonly occur in people of all ages," says Dr. Robert D. Brown, Jr., chair of Mayo Clinic's Division of Stroke and Cerebrovascular Diseases. "And, so, it's very important that people know what is a stroke, what are the symptoms, and what are the risk factors for stroke."
May is National stroke Awareness Month. In this Mayo Clinic Q&A podcast, Dr. Brown explains the importance of remembering the F.A.S.T. acronym to recognize a stroke:
Learn more about recognizing the signs of stroke:
Consider all treatment options for ovarian cancer, including clinical trials
May 20, 2022
Ovarian cancer is the fifth-leading cause of cancer death among women in the U.S. When ovarian cancer first develops, it might not cause noticeable symptoms. It often goes undetected until it has spread within the pelvis and abdomen.
"Unfortunately, ovarian cancer often presents with very common symptoms, and these common symptoms are things that everybody will complain about at some point," explains Dr. John Weroha, a Mayo Clinic medical oncologist. "For example, constipation, bloating, maybe a little weight gain. These are very common symptoms, and oftentimes, people just kind of blow it off as being normal. So, that's how it hides and grows."
Once ovarian cancer is detected, treatment depends on the stage when the disease is diagnosed. Stage 1 — the lowest stage — indicates that the cancer is confined to the ovaries. At this stage, a cure may be achieved with surgery alone. By stage 4, the cancer has spread to distant areas of the body. At this point, treatment is more complex, often involving drug therapies and potentially immunotherapy, which uses the immune system to attack cancer cells.
Dr. Weroha encourages patients to explore all their treatment options, including clinical trials.
"I think one of the biggest misconceptions that I see with patients is that clinical trials are supposed to be a last resort, and that is absolutely not true," says Dr. Weroha. "What we do at Mayo, and really everywhere else, is we try to bring clinical trials to our patients — not because we want to test whether or not this brand-new drug works, but we already believe the drug works. We think it's going to work, and we want to give that to our patients because they can't get it any other way, except through a clinical trial."
On the Mayo Clinic Q&A podcast, Dr. Weroha discusses the latest treatments for ovarian cancer.
May 17, 2022
The widespread availability of at-home COVID-19 tests have made it easier for people to know if they have the virus, and to take measures to protect themselves and others. But there is a downside. Because the majority of tests are now done at home and often not reported, the official counts on COVID-19 infection rates are not as accurate as they have been in past waves of the virus.
"Because the majority of testing is being done at home, we can no longer tell you accurately about the positivity rate for a given community for a given state like we used to be able to," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "And this is problematic. It means that we lose our ability to understand what's called genetic epidemiology — the ability to trace how these variants are moving, how fast they're moving, and whether they're changing and evolving into yet different subvariants or new variants. We've lost that ability now."
The most recent omicron subvariant, BA 2.12.1, has cases on the rise again and the U.S. passed a tragic milestone last week, reaching 1 million COVID-19 deaths in the country.
In an effort to capture a more accurate picture, the latest tool being used by public health officials to track COVID-19 infection rates is wastewater surveillance. By looking for the presence of the COVID-19 virus shed by people, wastewater surveillance can give a more accurate picture of how much virus is in the community. This detects virus not only from those who test at home, but also from people who are asymptomatic and, therefore, didn't get tested.
On the Mayo Clinic Q&A podcast, Dr. Poland discusses the current state of COVID-19 in the U.S., including what we know about the latest subvariants.
Ask the Mayo Mom: Polycystic kidney disease can affect children, too
May 13, 2022
Polycystic kidney disease is an inherited disorder where clusters of cysts develop within the kidneys, causing the kidneys to enlarge and lose function over time. The cysts, which are noncancerous sacs containing fluid, vary in size, and they can grow to be large. This disorder can occur in children and adults.
The two main types of polycystic kidney disease, caused by different genetic flaws, are:
Polycystic kidney disease also can cause cysts to develop in the liver and elsewhere in the body. The disease can cause serious complications, including high blood pressure and kidney failure.
The disease varies greatly in its severity, and some complications from polycystic kidney disease are preventable. Lifestyle changes and treatments might help reduce damage to the kidneys from complications, but long-term interventions, including dialysis or kidney transplant, are sometimes needed.
On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Christian Hanna, a pediatric nephrologist with Mayo Clinic Children’s Center to discuss PKD in children.
Mohs surgery for melanoma
May 10, 2022
Melanoma is the most serious type of skin cancer. It develops in the cells that produce melanin, the pigment that gives skin its color. Melanoma is one of the most common cancer types in the U. S. Roughly 2% of people will be diagnosed with melanoma of the skin at some point during their lifetime, according to the National Cancer Institute.
Treatment for early stage melanomas usually includes surgery to remove the melanoma. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.
"Mohs surgery is essentially skin cancer removal," explains Dr. Nahid Vidal, a dermatologic surgeon at Mayo Clinic. "It's a surgical removal process that's highly specialized, where we're removing the skin cancer with a goal of not only removing all of it, but also leaving behind as much healthy tissue as possible."
Mohs surgery allows surgeons to verify in real time through pathology that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.
On the Mayo Clinic Q&A podcast, Dr. Vidal discusses skin cancer and the use of Mohs surgery to treat early stage melanoma.
National Nurses Week
May 6, 2022
At Mayo Clinic, the Department of Nursing consists of over 22,000 people, including nurses, patient care assistants, patient care technicians and social workers. Like many health care professionals, the COVID-19 pandemic has been a stressful and challenging time for those in the department..
"Throughout the pandemic, our nurses have continued to be there for their patients," says Ryannon Frederick, Mayo Clinic's chief nursing officer. "Our patient satisfaction actually increased during the COVID-19 pandemic. And that's really due to the excellence from our nursing staff. When you just imagine all the stress and strain they were feeling, and they continued to excel."
Mayo Clinic's multidisciplinary approach relies on nurses to be an integral part of the care team. Frederick says nurses are the closest touch point to the patient, and they often identify opportunities to improve care.
"We encourage nurses to speak up and advocate on behalf of the patients," explains Frederick. "Then we engage them to be part of the solution — to make sure that once we identify the problem, we also have a solution for it," says Frederick. "And our nurses do this each and every single day. "
Each year, May 6-12 is designated National Nurses Week. This week acknowledges and celebrate nurses and the care they provide for their patients.
On the Mayo Clinic Q&A podcast, Frederick shares her own professional journey at Mayo Clinic — from nursing student to chief nursing officer. She also discusses the role nurses will play in leading the future of health care, including the role of nursing research.