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
Onco-regenration — Restoring function after a soft tissue cancer diagnosis
September 3, 2021
Soft tissue sarcoma is a rare form of cancer that has typically been treated using limb salvage surgery combined with radiation therapy. While limb salvage surgery helps patients avoid amputation, patients are often left with substantial functional limitations.
Now advancements in microsurgery are making it possible to harness the body's ability to regenerate muscle strength after surgery to remove soft tissue sarcoma. Mayo Clinic orthopedic oncologists are teaming up with plastic surgeons in a procedure they've coined "onco-regeneration", with a goal of improving a patient’s function and quality of life after surgery.
"Advancements are changing the way we approach patients," says Dr. Matthew Houdek, a Mayo Clinic orthopedic surgeon. "And a big part is the teamwork required to take care of these patients."
Orthopedic surgeons partner with plastic surgeons to deconstruct and reconstruct the tumor location. That includes removing and replacing muscles, nerves and the lymphatic system.
"Advancements in microsurgery techniques have made what we can repair and what we can restore much better," says Dr. Steven Moran, a Mayo Clinic plastic surgeon. "The latest technology now allows us to tension and insert the muscle directly back into the bone. That has been very favorable to restoring function, and it helps us get these patients back to doing what they want to do."
On the Mayo Clinic Q&A podcast, Drs. Houdek and Moran discuss advances in treating soft tissue sarcoma.
Breathing easier with COPD
September 3, 2021
Chronic obstructive pulmonary disease, or COPD, is the third leading cause of death worldwide according to the World Health Organization. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
The main cause of COPD in developed countries is tobacco smoking. In the developing world, COPD often occurs in people exposed to fumes from burning fuel for cooking or heating in poorly ventilated homes. People with COPD are at increased risk of other diseases too, such as heart disease, lung cancer and a variety of other conditions. Although COPD is a progressive disease, it is also treatable.
"If you catch it at an early phase, treatment may consist of helping the patient to stop smoking or taking the patient away from the polluted environment that may be contributing to the disease," says Dr. John Costello, a consultant pulmonologist at Mayo Clinic Healthcare in London. "For those with more advanced disease, long term rehabilitation programs have been very successful in centers that specialize in pulmonary disease."
As a part of rehabilitation, treatment for advanced COPD can include the use of medications, inhalers and oxygen therapy.
On the Mayo Clinic Q&A podcast, Dr. Costello discusses how COPD is diagnosed and the treatment options for COPD.
COVID-19 modeling shows 100,000 people in the U.S. could die over the next 3 months
September 1, 2021
U.S. hospitalizations for patients with COVID-19 have risen almost 500% over the past two months, according to news reports. Also, the number of ICU beds in the South is dwindling.
"We have over 101,000 Americans in the hospital with COVID-19," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "Many of them fighting for their lives in ICUs and on ventilators. We are having over 160,000 new cases and just below 1,000 deaths reported each day."
Dr. Poland says the people who have been vaccinated for COVID-19 have substantially protected themselves, including against the delta variant.
"But for those who are unvaccinated, there is a grave concern," says Dr. Poland. "In fact, if you look at the latest model, in the next three months, it suggests that another 100,000 Americans are likely to die of COVID."
Dr. Poland also responds to concerns that some people are choosing to take an animal medication called ivermectin.
"If I said to you, 'Instead of an FDA-approved vaccine that's been tested in hundreds of thousands of people, let's take a drug that's used to treat parasites — that hasn't been studied, which makes people sick, can cause hallucinations and coma, and can cause birth defects — what would you say?'" asks Dr. Poland.
In this Mayo Clinic Q&A podcast, Dr. Poland talks about waning antibody levels, COVID-19 vaccine boosters, teenagers needing to be vaccinated, and the sharp increase in COVID-19 cases and hospitalizations for young people. He also answers several listener questions.
Pancreas transplant can be a cure for diabetes
Aug. 30, 2021
Many advances have been made in diabetes treatments over the past decade. Diabetes is a lifelong chronic disease with the potential for significant complications. Despite the advances, 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 done 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."
On the Mayo Clinic Q&A podcast, Dr. Jarmi discusses pancreas transplant as a cure for diabetes.
Running injuries in youth athletes
Aug. 27, 2021
Running is a great way for kids to get active and participate in sports. Cross country and track are two of the most popular sports in middle school and high school.
But injuries in young runners are common, often are caused by improper technique or lack of strength and conditioning training. Another cause of injury is increasing mileage too quickly.
In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, discusses injury prevention in young runners with Dr. David Soma, a Mayo Clinic sports medicine specialist and pediatrician; Dr. Luke Radel, a Mayo Clinic pediatrician; and Dr. Stephanie J. Lopez, a Mayo Clinic sports physical therapist.
COVID-19 taking toll beyond patients
Aug. 25, 2021
The Pfizer COVID-19 vaccine has received full approval from the Food and Drug Administration (FDA), as have booster doses of COVID-19 vaccines. These are welcome developments as the COVID-19 delta variant wave continues to rip through many U.S. communities, exhausting and wearing people down.
"I cannot tell you the emotional toll this has taken on us as physicians, nurses, respiratory therapists, and many, many others," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group.
"One of my colleagues said, 'I walk around now and can see people with comorbidities, not wearing a mask, and I can tell you what size tracheal tube they're going to need.' We don't normally think like that, but it's illustrative of the steady 18-month drumbeat of seeing people sick and dying of something we can prevent," says Dr. Poland.
In this Mayo Clinic Q&A, Dr. Poland talks more about FDA approvals for COVID-19 vaccines, goes into detail about the COVID-19 virus replication rate and he answering a listener question about the reliability of home COVID-19 tests. Dr. Poland also explains and speaks to the importance of "cocooning" for protection, especially with newborns and toddlers.
Expanding the donor pool – hepatitis C no longer a barrier to transplant
Aug. 23, 2021
With a goal of shortening the wait time for a solid organ transplant, Mayo Clinic is leading efforts to expand the donor pool by making more organs suitable for transplantation.
Organs from deceased donors are screened thoroughly, and donated organs that tested positive for hepatitis C were previously discarded. But research at Mayo Clinic has changed that.
A recent Mayo Clinic study found that livers from donors exposed to hepatitis C can be safely used for transplant, thanks to improved treatments for hepatitis C infection. New antiviral drugs are so effective that recipients are protected from the infection.
Now, Mayo Clinic Transplant Center has expanded the protocol to use in other organ transplants.
"We were able to expand to kidney transplant, heart transplant and lung transplant within the past few years, and we have been able to do close to 150 kidney transplants, and 25 heart and lung transplants, using organs from donors with hepatitis C," explains Dr. Bashar Aqel, medical director of the Liver Transplant Program at Mayo Clinic in Arizona. "We had in place a treatment protocol and we treat them for hepatitis C immediately after transplant. Treatment was well tolerated, and everybody was cured from the infection. So more than 200 lives saved with organ transplant from donors with hepatitis C, and everybody has achieved the outcome that we are looking for."
On the Mayo Clinic Q&A podcast, Dr. Aqel discusses progress in expanding the donor pool for lifesaving solid organ transplants.
Ask the Mayo Mom / Back-to-School
Aug. 20, 2021
COVID-19 and especially the spread of the delta variant have created a whole new set of challenges this year. And now, children across the US are returning to school during this same time, creating many questions for families.
In this "Mayo Clinic Q&A" podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AskTheMayoMom, is joined by two experts in pediatric infectious disease to discuss the important precautions families can take to keep their kids safe and in school. Also on the program, tips from an elementary school principal to help your child prepare for the school year.
Breaking down the booster terminology for COVID-19 vaccines
Aug. 18, 2021
COVID-19 vaccine boosters are being recommended eight months after a person's second dose of a COVID-19 vaccine.
"A vaccine booster dose is generally an additional dose above and beyond the primary series needed to achieve protective immunity," says Dr. Gregory Poland, an infectious diseases expert and head of Mayo Clinic's Vaccine Research Group. "So the dose that was approved this past week would be better classified as an 'additional dose' for those who are moderately to severely immunocompromised."
Dr. Poland says those people will have already received two doses, but they need the additional dose in order to improve their immune response to the vaccine.
Dr. Poland continues, "Offering a third dose of the same vaccine to older adults, health care providers and essential workers, that would be a 'booster dose.' Then if we used a variant-specific vaccine, which researchers are working on, that would be called a 'variant booster dose,'" says Dr. Poland.
In this Mayo Clinic Q&A podcast, Dr. Poland talks extensively about additional and booster doses of the COVID-19 vaccines, and he discusses the latest COVID-19 research regarding pregnancy and fertility. He also addresses concerns about the variants that experts are predicting will come after the current delta variant.
"So, for the unvaccinated they keep moving into more and more dangerous phases of the pandemic, as each new variant arises," says Dr. Poland.
Cancer caregivers need care themselves
Aug. 16, 2021
When someone is diagnosed with cancer, partners, family members and friends often step into the role of being a cancer caregiver. They are rarely trained for the job of caregiving, but often become indispensable to the person for whom they care, administering medications, managing side effects, communicating with the cancer care team and so much more.
But what about the toll this takes on the caregiver themselves?
"I think the self-care for the caregiver is something that we often forget about, and we often don't emphasize enough on the clinical side," says Dr. Joan Griffin, a researcher in Health Care Delivery at Mayo Clinic. "And it's really important, because it's a long, hard marathon to be a cancer caregiver."
Extended periods of providing care for someone else can affect the caregiver's own quality of life, including their sleep and mood. It can even lead to depression.
On the Mayo Clinic Q&A podcast, Dr. Griffin shares what caregivers of cancer patients can expect and offers tips on how to take care of themselves at the same time.