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
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.
What parents should know about the new hepatitis outbreak in children
May 5, 2022
At least 16 countries and 10 U.S. states have identified unusual hepatitis cases in children. Experts advise that cases are extremely rare, with about 200 children affected worldwide.
Hepatitis is inflammation of the liver. It is most commonly caused by a viral infection, although there are other potential causes. A common adenovirus is being investigated as a potential cause for this hepatitis outbreak. Adenoviruses are a group of viruses that typically cause respiratory and GI tract infections.
On this special Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke discusses the recent hepatitis outbreak in children with Mayo Clinic Children’s Center experts Dr. Nipunie Rajapakse, a pediatric infectious diseases expert, and Dr. Sara Hassan, a pediatric transplant hepatologist and gastroenterologist.
Ask the Mayo Mom: How and why endoscopy is used in children
May 3, 2022
Endoscopy is a nonsurgical procedure used to visually examine the digestive system with a tiny camera on the end of a long, flexible tube. An upper endoscopy examines the stomach, esophagus and small intestines. A colonoscopy, which is another type of endoscopy, is used to examine the rectum, large intestine and colon.
In children, endoscopy can be used to look for causes of unexplained abdominal pain, to diagnose swallowing disorders or to identify conditions including Crohn's disease, ulcerative colitis and polyps.
Undergoing any type of procedure can be stressful for kids, parents or caregivers. Dr. Pua Hopson, a pediatric gastroenterologist at Mayo Clinic Children’s Center, explains endoscopy is a relatively quick and painless procedure.
"An upper endoscopy typically takes 10 minutes, while colonoscopy may take 30 minutes," says Dr. Hopson. "I tell the kids it takes longer to put them to sleep with anesthesia or sedation than the actual procedure. And once you wake up, your parents will be right by your side."
One condition Dr. Hopson commonly treats in children is eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), known as EoE. This is a chronic immune system disease in which a type of white blood cell (eosinophil) builds up in the lining of the esophagus. This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow. EoE is diagnosed through biopsy using an upper endoscopy.
On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. Hopson to discuss how and why endoscopy is used in children.
COVID-19 news update
April 29, 2022
An estimated 3 out of 4 U.S. children and more than half of all adults have been infected with COVID-19, according to a report released on Tuesday, April 26 by the Centers for Disease Control and Prevention. But a Mayo Clinic expert says more information is needed to get the complete picture.
"This was a convenient sample. In other words, people who were having blood drawn for other reasons were tested,"explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That does not reflect the full population or differences by race or geographic location. And the detection of antibodies does not necessarily mean that you are protected from infection. So, there's a lot of nuance around understanding that headline."
The research study looked at more than 200,000 blood samples and found that signs of past infection rose dramatically during the omicron surge between December 2021 and February.
Other COVID-19 news this week includes a push to make treatments more available, the rising incidence of new omicron subvariants, and changes in mask recommendations. Dr. Poland cautions that COVID-19 is still present and encourages wearing a mask in crowded spaces, even when there isn't a requirement to do so.
"If only one of us is wearing a mask and the other one isn't and is infected, you still have pretty high protection — but not the same level of protection as if both of us wearing one," says Dr. Poland. "So, it's it is not futile to be the only one wearing a mask. In fact, I think it sends a message."
On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and answers listener questions.
Advances in oral cancer treatment, reconstruction
April 26, 2022
Oral cancer refers to cancers that originate in the mouth, tongue and back of the throat. Treatment options, which can vary based on the cancer's location and stage, include surgery, radiation and chemotherapy. The use of anatomic modeling and 3D printing have led to advances in surgical treatments for oral cancer.
"One of the advances that we've seen in the last 20 or 30 years in the treatment of head and neck cancers certainly has to do with the reconstruction," says Dr. Kevin Arce, an oral and maxillofacial surgeon at Mayo Clinic. "Often, we have to remove not only the cancer, but also the surrounding tissue that is normal. And to replace that can be quite challenging. We now have better abilities to reconstruct the structures that have been lost."
Dr. Arce explains advances in the treatment of head and neck cancers now allow surgeons to bring in tissues from different areas of the body and reconstruct a tongue or rebuild a jaw. And the anatomical lab and 3D printing allow surgeons to perform patient-specific reconstruction that helps maintain function.
"With these advancements, patients can obviously not only look the same, but speak and eat as they did prior to the surgery," says Dr. Arce. "At Mayo Clinic, we can do that all in house. We have a group of neuroradiologists and biomedical engineers who are a part of the institution, and we collaborate with them in these types of reconstructions."
Early detection of oral cancer can lead to better treatment options and outcomes.
April is Oral Cancer Awareness Month, aimed at reminding the public about the steps to take to reduce your risk of developing oral cancer. The two main risk factors are tobacco and alcohol use.
"Awareness of oral cancer is important," says Dr. Arce. "It's important to maintain that relationship with either your dentist or your primary care physician so they do at least an annual screen of the oral cavity to make sure that there is nothing unusual or a lesion that needs more attention."
On the Mayo Clinic Q&A podcast, Dr. Arce discusses oral cancer treatment and prevention.
People, partnerships drive innovation in patient care
April 22, 2022
The Department of Medicine, which is the largest department at Mayo Clinic, is helping lead the transformation of health care. Important innovations include moving to digital and virtual care to meet patients where they are, and addressing health equity, all while keeping patients front and center.
"Patients are our North Star," says Dr. Vijay Shah, chair of the Department of Medicine at Mayo Clinic. "We're all about patients all day, every day. So, all of our strategies cascade out of that."
Dr. Shah explains those strategies include practice innovations, digital transformation and internal and external partnerships. Internal partnerships include working alongside the Mayo Clinic Cancer Center, the Center for Digital Health, Mayo Clinic Platformand others focused on improving patient care and developing cures.
These partnerships are leading to innovations in teleheath and at-home care models, as well as new ways to use health data to improve treatments.
And at the core of it all?
"The most important pillar is our people and our culture," explains Dr. Shah. "Because our people are our greatest asset."
On the Mayo Clinic Q&A podcast, Dr. Shah and Natalie Caine, associate administrator, discuss the innovations happening in the Department of Medicine at Mayo Clinic.
Patient navigators help guide the cancer journey
April 19, 2022
A cancer diagnosis can be overwhelming, and patients often have many questions about what their cancer journey will entail. At Mayo Clinic Cancer Center, patient navigators help guide patients through the health care system.
Patient navigators are active members of the health care team, assessing and addressing a patient's immediate needs and identifying obstacles that might prevent them from getting the care they need. Patient navigators help patients and their families access cancer information, find resources to meet day-to-day needs, and offer emotional support.
"Our role as patient navigators is to support with a lot of the nonclinical sides of their cancer journey, whether that's logistics, transportation or issues with lodging when they're coming to a Mayo Clinic site for care," explains Laura Kurland, a Mayo Clinic Cancer Center patient navigator. "Oftentimes, we're helping them understand the finances, whether that's insurance, or other things that are going to be coming up that are going to be financial stressors for them as they're going through their cancer care. And certainly, we're there to lend an ear and offer support as they're learning how to truly navigate the medical system."
The Mayo Clinic Cancer Center has both general patient navigators who assist all patients and patient navigators who serve specific cultural patient populations. Mayo Clinic currently has navigators on staff serving these communities: Hispanic/Latino, American Indian/Alaskan Native and African descent.
Kurland serves the Hispanic/Latino population and explains the important role the culture-specific patient navigators play.
"The patient populations that we work with come with different experiences," says Kurland."So our goal is to understand the values they bring and support them with what their needs are. Whether there are language barriers, or there are just gaps in cultural misunderstandings, our role is to help bridge those gaps, clarify misunderstandings and also be advocates to those populations."
On the Mayo Clinic Q&A podcast, Kurland discusses the importance of patient navigators, why culture-specific navigators are needed, and how she helps patients access the care and support they need.
Understanding the connection between diabetes and heart disease
The World Health Organization reports that the number of people with diabetes has risen from 108 million in 1980 to 422 million by 2014. And that number is estimated to reach 552 million by 2030.
One big concern for people with diabetes is the connection between diabetes and cardiovascular disease. People with diabetes are more likely to develop heart disease and are at higher risk of premature death.
"In people with diabetes, the risk of death due to heart diseases is approximately four or five times higher than in general population," explains Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And this, obviously, is a major concern. There is now a strong research and scientific evidence about this link and association between cardiovascular disease and metabolic diseases, especially diabetes."
So what can be done to help patients?
Dr. Wamil explains that research has shown positive lifestyle changes such as quitting smoking, losing weight, exercising more, developing a healthy diet and controlling blood pressure, can all contribute to better heart health.
"We try to develop personalized management plans, we listen to our patients and try to understand what are the steps that they can take to improve their quality of life and to improve their future life and their health, " says Dr. Wamil.
On the Mayo Clinic Q&A podcast, Dr. Wamil discusses the diabetes and heart disease connection.
Ted Garding is a rare two-time organ donor
April 8, 2022
Fifty-seven-year-old Ted Garding is Mayo Clinic’s first altruistic living liver donor. The living liver donation program allows a healthy person to donate a portion of his or her liver, which then regenerates over time. What makes Ted’s story even better? He's a two-time altruistic organ donor, having previously donated a kidney back in 2010. An altruistic, or nondirected living donor, is a person who donates an organ, usually a kidney, and does not name or have an intended recipient.
"We were taught to help people in need, and we were blessed with good health in our family," says Ted. "And I am well aware that there are a lot of people that aren't as fortunate. Being kind to people and helping people in need has always been the most important thing to me."
When Ted heard about living liver donation, he applied at Mayo Clinic, but expected he might get denied because he has one kidney and is in his 50s. But Ted was accepted, and in October 2021, the transplant happened in Rochester, Minnesota. The recipient reached out a few days later to thank him and told Ted he was her "guardian angel."
"My own personal experience as a double living organ donor, personally, it's changed my life for the better," says Ted. "When you help someone in need, you're naturally going to feel better. I feel as though I've been blessed and that I am the one who received a gift."
April is National Donate Life Month to raise awareness of the need for organ donors. In honor of Donate Life Month, Ted joins the Mayo Clinic Q&A podcast to share his story.