Mayo Clinic Health Matters

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Integrative oncology uses lifestyle medicine approach Feb 07, 2022

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Integrative medicine uses an approach to health care that includes practices not traditionally part of conventional medicine, such as herbs, acupuncture, massage, yoga and meditation. Integrative oncology incorporates these therapies into conventional cancer care.

Integrative oncology helps people with cancer feel better by reducing the fatigue, nausea, pain and anxiety and other symptoms that come with cancer and cancer treatment.

"Integrative oncology is a practice where we are using lifestyle medicine," explains Dr. Stacy D'Andre, a Mayo Clinic medical and integrative oncologist. "We combine all of these modalities to help our cancer patients, not only with the quality of life, but also to hopefully improve outcomes as well."

Focus on diet, exercise and sleep are important parts of integrative medicine, and can help patients during each stage of their journey. This includes managing symptoms and treatment side effects.

"The great thing about this type of practice is that it really empowers the patient, and patients become very active in their care," says Dr. D'Andre. "And because they're the ones doing the work — they're working on their die and they're doing the exercise — we're just guiding them. These are things that they can do and they can control to improve their health and outcomes."

On the Mayo Clinic Q&A podcast, Dr. D'Andre explains how integrative oncology helps people with cancer and discusses integrative medicine research underway at Mayo Clinic.

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What’s new and what’s next to treat congenital heart defects? Feb 04, 2022

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A congenital heart defect means that a child was born with a problem in the structure of his or her heart.

Some congenital heart defects in children are simple and don't need treatment. Others are more complex and may require several surgeries performed over a period of several years.

Improvements in imaging, monitoring and surgical techniques have improved outcomes for pediatric heart surgery patients.

A prenatal diagnosis is scary for parents, but support and care from the cardiology team continue through the child's life and on into adulthood. And support from others, including patient organizations, also helps.

"It can feel like you're alone, especially if the diagnosis is new," says Dr. Elizabeth Stephens, a pediatric cardiovascular surgeon at Mayo Clinic. "It can feel very daunting. But there are many families out there who are not just dealing with congenital heart disease, they're thriving with it. These kids are incredibly resilient."

On the Mayo Clinic Q&A podcast, Dr. Stephens joins Ask the Mayo Mom host Dr. Angela Mattke for a discussion on congenital heart defects and new treatment options.

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Omicron wave wanes, new variant arises Feb 02, 2022

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The number of new COVID-19 cases in the U.S. is dropping as the omicron wave wanes in many places, but some parts of the country lag behind.

"As a nation, it looks like we've kind of gotten to the peak and are now starting on the decline, but it's very uneven," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That's what's happening in the big Northeast cities, and maybe in L.A., for example. But if you look at the rest of the nation, it's not clear that they have peaked yet."

And on the heels of the latest surge, a new omicron subvariant — BA.2 — is emerging. Early indications are that the new subvariant may be more transmissible, but it does not appear to cause more severe disease than the original omicron strain.

Mayo experts, including Dr. Poland, continue to urge COVID-19 vaccinations and boosters as the best defense against the latest variants.

"By getting two doses of vaccine and a booster, or a dose of Johnson & Johnson and a booster, you move yourself into a category of maximal protection such that if you have a normal immune system, you are probably going to have trivial or even asymptomatic disease if you get infected with COVID-19," explains Dr. Poland.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest information on COVID-19 and answers listener questions.

Research disclosures for Dr. Gregory Poland.

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Life after lymphoma Jan 31, 2022

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Treatment advances have increased lymphoma survival rates. But life after treatment for lymphoma can be complicated.

"It's a really good problem to have, if you will, on how to manage some of these short- and long-term effects of lymphoma treatment," explains Dr. Carrie Thompson, a Mayo Clinic hematologist. "As we effectively treat more and more patients, we have more and more patients surviving and more and more patients living with chronic lymphoma, as well."

Lymphoma is a cancer of the lymphatic system, part of the body's germ-fighting network, which includes the lymph nodes, spleen, thymus gland and bone marrow. Lymphoma can affect those and other organs throughout the body.

Of the many types of lymphoma, the main subtypes are Hodgkin's lymphoma and non-Hodgkin's lymphoma. Lymphoma treatment is based on the type and stage of the disease, and the goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission.

Lymphoma survivors need to be monitored for cancer recurrence. Some lymphoma treatments, such as chemotherapy and radiation, can put patients at risk of developing a secondary cancer.

"The No. 1 concern patients have is really the risk of relapse," says Dr. Thompson. "Once somebody has been through treatment, they certainly don't want to don't want to be faced with having to do that all over again. The fear of recurrence sometimes spills over to really being very appropriately vigilant about all health issues and finding that balance between watching for symptoms that may suggest recurrence versus living without uncertainty and a comfortable way to move forward from what's been a really challenging part of somebody's life."

On the Mayo Clinic Q&A podcast, Dr. Thompson discusses what people can expect after treatment for lymphoma and how to achieve the best quality of life.

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Seizure forecasting device could help patients with epilepsy anticipate seizures, take action Jan 28, 2022

Show notes

Despite treatments that include medications, surgery and neurostimulation devices, many people with epilepsycontinue to have seizures. And the uncertainty of when a seizure could occur affects their quality of life.

But what if these people could anticipate a seizure and take action? A recent Mayo Clinic study tested a technology to do just that.

"One of the most disabling aspects of seizures is the unpredictability," says Dr. Benjamin Brinkmann, a Mayo Clinic epilepsy scientist.

The study found patterns could be identified in patients who wore a special wristwatch, allowing about 30 minutes of warning before a seizure occurred. This worked well most of the time for five of six patients studied.

The next step is a larger research study and collecting more data.

"We are putting in for funding to do a larger study and we will spend some time and effort improving our algorithms," says Dr. Brinkmann. "One of the things in this new era that we live in with AI (artificial intelligence) and machine learning is that data is king. We really need to collect lots of data so we can train our algorithms to find these subtle signals."

On the Mayo Clinic Q&A podcast, Dr. Brinkmann discusses how seizure forecasting might help patients in the future.

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COVID-19 testing scenarios — what test and when? Jan 26, 2022

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Testing for COVID-19 is a part of the strategy to end the pandemic. But understanding testing — different types of tests and how and when to use them — can be confusing. Lab-run polymerase chain reaction, or PCR, tests and at-home antigen tests each have a role.

"PCR tests are really sensitive, meaning we can detect really low levels of the virus in a sample," explains Dr. Matthew Binnicker, director of Clinical Virology at Mayo Clinic. "They're very specific, meaning we shouldn't get many false positive results with PCR tests."

At-home antigen tests use a nasal swab and can produce results in 15 minutes, but they also have an increased chance of false-negative results, depending on when you test.

"At-home rapid antigen tests look for a viral protein in the patient sample," says Dr. Binnicker. "So they're quick and easy, but they also have some important limitations."

So if you're worried you might have COVID-19, what test should you take and when?

On the Q&A podcast, Dr. Binnicker walks through various scenarios and makes testing recommendations for what to do if:

You think you’ve been exposed but I don’t have symptoms.
You have symptoms of COVID-19.
You had COVID-19 and want to know if you're “in the clear” to return to work, school or activities.

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Outpatient joint replacement benefits patients Jan 24, 2022

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Nationwide, there is a trend in orthopedic surgery to move total joint arthroplasty, commonly known as joint replacement, from inpatient to outpatient surgery. Patients benefit from the shorter hospital stay, and they are more satisfied recovering in the comfort of their own home.

At Mayo Clinic, physicians from orthopedics and anesthesiology have been working together on this initiative as part of the OASIS project. Oasis stands for Orthopedic Surgery and Anesthesiology Surgical Improvements.

"This is a team approach to practice optimization," explains Dr. Hugh M. Smith, a Mayo Clinic anesthesiologist. "One of our first targets was to try to bring down that length of stay."

A decade ago, a patient who had a knee replacement or hip replacement would likely stay in the hospital for a week, says Dr. Smith. Even four years ago, the average hospital stay was around four days. Now some patients are able to go home the same day.

"It's a patient satisfier," says Dr. Matthew Abdel, a Mayo Clinic orthopedic surgeon. "You recuperate with your family. You recuperate in your own home environment. You don't feel like you're institutionalized. You feel like you're a part of a well model of care, not a sick model."

On the Mayo Clinic Q&A podcast, Drs. Abdel and Smith discuss the OASIS project and outpatient arthroplasty.

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Chest wall deformities in children Jan 21, 2022

Show notes

Chest wall deformities are structural abnormalities in the chest. While present since birth, chest wall deformities might not become noticeable until children hit their adolescent growth spurt.

The most common chest wall deformity, pectus excavatum, is a sunken breastbone that can be repaired with surgery. Another deformity, pectus carinatum, causes the breastbone to protrude out. It is typically treated with bracing. A third, difficult-to-diagnose condition, is slipped rib syndrome. This occurs when cartilage grows abnormally and the ribs rub together, causing nerve pain. Medical and surgical options can be used to treat slipped rib syndrome.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on chest wall deformities in children. Dr. Angela Mattke a Mayo Clinic pediatrician and host of "Ask the Mayo Mom" is joined by Dr. Denise Klinkner, a pediatric surgeon and practice chair of the Division of Pediatric Surgery at Mayo Clinic, and Dr. Stephanie Polites, who is also a pediatric surgeon at Mayo Clinic Children’s Center.

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Why getting infected with COVID-19 is still a bad idea Jan 19, 2022

Show notes

With the highly transmissible omicron variant spread across the U.S., it may seem inevitable that most people will get infected with COVID-19. But Mayo Clinic experts explain why it is important to continue to be vigilant and take measures to avoid COVID-19 infection.

"One of the many negatives about saying, 'Well, I'll just go ahead and get infected and get it over with' is you can spread the virus to highly vulnerable people," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "Parents, grandparents, people too young to be immunized, and people whose immune systems might not be working well are all at risk of more severe disease. While your case may be mild, theirs may not."

Dr. Poland cautions that the sheer number of infections is stressing the health care system, and treatments for omicronare more limited than they were for the delta variant.

"The role of testing and of getting boosted is critical to our response to this, and remember, even though you might have mild disease, every time this virus infects somebody, it is the opportunity for further mutation." says Dr. Poland.

Vaccination, boosting and masking are all necessary to prevent the spread of omicron.

"Your best chance of protecting yourself is to be fully vaccinated, wear a proper mask properly when in public, and to avoid crowded indoor settings," says Dr. Poland.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron surge and answers listener questions.

Research disclosures for Dr. Gregory Poland.

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Advocacy groups can help patients, physicians connect Jan 17, 2022

Show notes

Patient advocacy and support organizations play an important role for patients suffering with diseases or conditions. The goal of these groups is to connect members with others who may be in similar situations and locate resources to manage or treat their condition. But patients aren't the only ones who benefit from these connections. Physicians and researchers also can benefit from getting involved.

"Taking care of patients is my passion," says Dr. A. Noelle Larson, a Mayo Clinic orthopedic surgeon. "So it really comes naturally to be interested and involved in my patients' lives."

Dr. Larson's clinical and research focus is scoliosis. She has become involved with Curvy Girls Scoliosis, a global support group. Two years ago, she attended their national meeting. Spending time with families and children affected by scoliosis gave Dr. Larson a new perspective.

"So often, our encounter in clinic is quite short, and you don't get a sense of the impact of what our treatment has on that child's overall life and well-being," explains Dr. Larson. "These patients know more about living with their condition than the physician does at some level."

Beyond the connections patients and physicians make, the medical community benefits in other ways, as well. Support groups can help organize and inform patients about clinical trials that can lead to innovation.

Dr. Larson has seen this in her own practice. Feedback from patients led to a Mayo Clinic study on vertebral body tether implant as a surgical alternative to fusing the spine.

"That partnership between the families, the patients, and the researchers and doctors, all working together is really critical," says Dr. Larson. "If we really want to make new drugs, new devices, and new treatments, we all have to work together. Because at the end of the day, we all want to get to the same place, which is better care for patients."

On the Mayo Clinic Q&A podcast, Dr. Larson discusses the role of advocacy groups and the patient-physician connection.

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