Mayo Clinic Health Matters

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Caring for transgender and gender-diverse children, teens Oct 29, 2021

Show notes

Transgender is an umbrella term used to describe the spectrum of gender identity and gender expression diversity. Gender identity is the internal sense of being male, female, neither or both. Gender expression — often an extension of gender identity — involves the expression of a person's gender identity through social roles, appearance and behaviors.

For parents, it can be challenging to know how to support a gender-nonconforming or transgender child.

Most children typically develop the ability to recognize and label stereotypical gender groups, such as girl, woman and feminine, as well as boy, man and masculine, between 18 and 24 months. In many cases, children will say how they feel, strongly identifying as a boy or girl — and sometimes — neither or both. While children might go through periods of insisting that they are the opposite gender of their birth sex, if they continue to do so, it was likely never a phase.

It is important to discuss your child's gender identity and gender expression with his or her health care provider to address the health concerns that transgender people face. The health care team also should include a counselor or therapist with training in transgender needs.

On the Mayo Clinic Q&A podcast, Dr. Aida Lteif, a Mayo Clinic pediatric endocrinologist; Nicole Imhof, a pediatric social worker; and Katherine Ley, a pediatric endocrinology nurse, discuss medical care for transgender children.

Additional resource: Trans Student Educational Resources

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Understanding mix-and-match COVID-19 boosters Oct 27, 2021

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The Food and Drug Administration and Centers for Disease Control and Prevention have made booster recommendations for all three COVID-19 vaccines available in the U.S., including authorizing a mix-and-match option for booster shots from Johnson & Johnson (J&J), Moderna or Pfizer.

For people who received Moderna or Pfizer vaccines, booster vaccinations are recommended 6 months or more after finishing the initial two-dose series for those age 65 and older and for younger adults 18 and older who work or live in high-risk settings or have underlying medical conditions that increase their COVID-19 risk.

For people who got the J&J COVID-19 vaccine, booster vaccinations are recommended for those 18 and older and who were vaccinated two or more months ago.

"What mix-and-match means is that regardless of what you got for your primary series, you could get any of the other three vaccines available for use in the U.S. as your booster if you're eligible for a booster," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.

So how do you know which booster vaccination to choose?

"All of the boosters will dramatically boost your antibody response," says Dr. Poland. "I would make the decision about a booster based on how did you respond to whatever you got originally? And are there any unique risk factors that you have?"

People who responded well to the first vaccine with minimal side effects can choose to get the same brand for their booster vaccination. But there are reasons someone might choose a different vaccine. For example, a younger man who initially got the Moderna or Pfizer vaccine might want a J&J booster, because the mRNA vaccines are linked with a slight risk of heart inflammation called myocarditis. And a woman under age 50 might prefer to get a Moderna or Pfizer booster, because the J&J vaccine is linked with a slightly higher risk of a rare blood clotting condition in younger women.

In this Mayo Clinic Q&A podcast, Dr. Poland walks through the recent booster recommendations and the likely timeline for COVID-19 vaccine approval for kids ages 5 — 11.

Research disclosures for Dr. Gregory Poland.

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Mental health toll of ongoing COVID-19 pandemic Oct 25, 2021

Show notes

The COVID-19 pandemic has taken a toll in many ways, including affecting mental health.

Across the U.S., people have been living with a heightened level of stress for more than 18 months due to the ongoing pandemic. Nearly 4 in 10 adults in the U.S. say that worry and stress related to the threat of COVID-19 have played a negative role in their mental health, according to a recent survey.

"We think of just the wear and tear that the pandemic has had on all of us. We kind of think about it almost like an erosion effect over time, with the amount of stressors and different uncertainties that we've been going through," says Dr. Craig Sawchuk, chair of the Division of Integrated Behavioral Health at Mayo Clinic.

"That wear and tear gets to us, and if there hasn't been an opportunity to do some more restorative things, then after a while, people may start to get a little bit more edgy, a little bit more irritable, a little less patient."

Dr. Sawchuk explains that it's important to acknowledge the feelings of anger, frustration and fatigue, and then find strategies to better cope with those feelings. Relaxation exercises that can be done quickly and from anywhere may help you change your mindset.

"As emotions get cranked up, flexibility in our thinking and our ability to problem solve actually goes down," says Dr. Sawchuk. "This is true for all emotions — anger included. So relaxation-related exercises help us focus on things we can control."

On the Mayo Clinic Q&A podcast, Dr. Sawchuk discusses strategies for managing your mental health, and he offers tips for navigating family gatherings during the holidays.

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Advancing colorectal cancer screening with AI Oct 22, 2021

Show notes

Colorectal cancer is the third most common cancer worldwide, accounting for almost 2 million new cancer cases each year, according to the World Health Organization.

Colorectal cancer, also known as bowel cancer, typically affects older adults, although it can happen at any age.

Screening for colorectal cancer is important to identify precancerous polyps that could develop into cancer, and several screening options are available to patients.

But which screening tool is right for you?

"The best screening tool is the one you're willing to get," says Dr. James East, a gastroenterologist at Mayo Clinic Healthcare in London. "There's no point in being set up for a colonoscopy if you're not willing to come for it. And there are a wide range of options now for bowel cancer screening — all of which provide substantial protection against bowel cancer."

Screening test options for colorectal cancer include:

Colonoscopy.
Stool DNA test.
Fecal immunochemical test.
Virtual colonoscopy, or CT colonography.

While effective screening tools exist, research using artificial intelligence (AI) to develop better techniques to detect polyps is hoping to improve screening even further.

"I think the role of AI in endoscopy is huge. And it's it's coming to clinical care," says Dr. East. "This is really translating facial recognition technology, but instead of recognizing faces, the AI recognizes polyps at an astonishing rate during a live colonoscopy. This is really a game changer for us."

On the Mayo Clinic Q&A podcast, Dr. East discusses advances in colorectal cancer screening.

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Changing COVID-19 recommendations mean the science is working Oct 20, 2021

Show notes

As continuing research guides medical recommendations, it seems that there are COVID-19 updates released daily. These recommendations cover a range of topics, including whether COVID-19 booster vaccinations are necessary to whether COVID-19 vaccines can be mixed and matched.

"The fact that recommendations are changing is not evidence people don't know what they're doing," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "It's evidence that they do know what they're doing and are paying close attention to new data that's coming along. Then they're adjusting recommendations based on the latest data."

Dr. Poland continues to urge people to get the latest COVID-19 news from credible sources.

In this Mayo Clinic Q&A podcast, Dr. Poland walks through the recent recommendations, corrects misperceptions and answers a number of listener questions.

Research disclosures for Dr. Gregory Poland.

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Systemic therapies for breast cancer Oct 18, 2021

Show notes

Systemic therapies are drugs that are taken orally or by IV to treat cancer. Types of systemic therapies for breast cancer include chemotherapy, hormone therapy, immunotherapyand targeted drug therapy. Which therapy is used depends on which type of breast cancer is being treated.

"The goal of systemic therapy is simply to either inhibit the growth of cancer cells or to kill them and to eradicate them from the body," says Dr. Matthew Goetz, a medical oncologist at Mayo Clinic. Dr. Goetz is also co-leader of the Mayo Clinic Cancer Center Women’s Cancer Program.

"If you can imagine a patient who is diagnosed with breast cancer, and those cancer cells have spread to other parts of the body, such as the liver, or the bone or the lung, we refer to this as stage 4 breast cancer," says Dr. Goetz. "For those patients, systemic therapy really is the predominant therapy that we would use to slow down, eradicate and eliminate those cancer cells."

While patients have many systemic therapy options, Mayo Clinic research seeks to improve on these treatments and develop new drugs to treat and prevent cancer.

"We're one of six centers in the country that has a specialized program of research excellence, which means that we have a large group of individuals doing research in the area of drug development," explains Dr. Goetz. "For example, we have a group that's developing new vaccines to actually prevent breast cancer. We're excited to see the results of that study."

On the Mayo Clinic Q&A podcast, Dr. Goetz discusses advances in using systemic therapies to treat breast cancer.

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Heart rhythm problems need attention Oct 15, 2021

Show notes

We’ve all experienced our heart rate change. For example, your heart rate increases when you exercise and slows when you sleep. But what if your heart rhythm changes when you aren't expecting it? That condition is known as heart arrhythmia.

Heart arrhythmias, also called heart rhythm problems, occur when the electrical impulses that coordinate your heartbeats don't work properly. This causes your heart to beat too fast, too slow or irregularly.

Arrhythmias may feel like a fluttering or racing heart, and they may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.

It is important to find the cause, says Dr. Elijah Behr, a cardiologist at Mayo Clinic Healthcare in London. "It's very straightforward to investigate," says Dr. Behr. "And we have treatments that can prevent risk, prolong life, and can maintain quality of life for people."

Treatment can include medications, catheter procedures, implanted devices or surgery to control or eliminate fast, slow or irregular heartbeats. A heart-healthy lifestyle also can help prevent heart damage that can trigger certain heart arrhythmias.

On the Mayo Clinic Q&A podcast, Dr. Behr discusses the warning signs of heart arrhythmias and how they are diagnosed and treated.

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Continuing progress in battle against COVID-19 Oct 13, 2021

Show notes

"October is going to be a very exciting month in the U.S., regarding COVID-19 vaccines," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.

"On Oct. 14 the Federal Drug Administration is going to look at COVID-19 boosters for Moderna. On Oct. 15, (the FDA will review) boosters for Johnson & Johnsons' COVID-19 vaccine. And on Oct. 29, the FDA will look at extending emergency use for the Pfizer COVID-19 vaccine for children down to 5 years of age," says Dr. Poland. He adds that vaccinations of children could begin within a couple of weeks of the emergency use authorization.

Dr. Poland also says approval of Merck's antiviral COVID-19 pill is expected soon, too.

"We're excited about this because it's oral," says Dr. Poland. "The nice part about this is you can take it at home, and it fits with the same paradigm we already have in clinical medicine — treating influenza with an antiviral."

In this Mayo Clinic Q&A podcast, Dr. Poland also talks about waning immunities and the approval possibility of mixing and matching COVID-19 booster vaccines being approved. And he reminds women who are pregnant to get a COVID-19 vaccine.

Research disclosures for Dr. Gregory Poland.

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Next steps, new leader for Mayo Clinic Cancer Center Oct 11, 2021

Show notes

Dr. Cheryl Willman was named executive director of Mayo Clinic Cancer Programs, and director of the Mayo Clinic Cancer Center in May. In this role, Dr. Willman is leading the expansion and strategic development of Mayo Clinic Cancer Center locations in Arizona, Florida and Minnesota, as well as newly developing Mayo Clinic global cancer programs in London and Abu Dhabi, United Arab Emirates.

Mayo Clinic Cancer Center is designated by the National Cancer Institute (NCI) as a comprehensive cancer center. At comprehensive cancer centers, staff coordinate innovative cancer care delivery for patients; conduct team-based cancer research to develop better means to prevent, detect and treat cancer; involve communities and patients in research; and train the next generation of cancer health professionals. Mayo Clinic Cancer Center offers its patients access to hundreds of clinical trials in all phases that test new and improved cancer treatments.

"We have a menu of over 300 cancer clinical trials every year that are testing new drugs and bringing treatments to patients," says Dr. Willman. "Cancer clinical trials are essential to advancing our knowledge in cancer care."

Work is underway at Mayo Clinic Cancer Center to grow the Cancer Care at Home program and engage local communities, which can help address disparities in health care. Other initiatives include making advances in radiation therapy techniques and using genomics to develop individualized care for patients.

Mayo Clinic Cancer Center also is expanding the use of patient navigators, allowing cancer patients to have one point of contact to help them navigate the complexities of cancer care that often involves many specialists.

"For a breast cancer patient, for example, that would include breast cancer surgeons, medical oncologists who give chemotherapy, radiation oncologists who give radiation, but also physical medicine and rehabilitation, nutrition, psychosocial support, and access to clinical trials," says Dr. Willman. "A patient navigator becomes the primary contact person for a patient we're caring for and truly navigates them through all of their providers."

On the Mayo Clinic Q&A podcast, Dr. Willman discusses the innovations taking place at Mayo Clinic to improve cancer care for patients.

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Tips to meet the challenges of breastfeeding Oct 08, 2021

Show notes

Breastfeeding has many benefits. Breast milk contains the right balance of nutrients for your baby. Breast milk is easier than commercial formula for babies to digest, and the antibodies in breast milk boost a baby's immune system. Breastfeeding might even help a new mother lose weight after the baby is born.

But breastfeeding can be challenging.

New parents may worry about whether their child is getting enough milk and wonder how often they should breastfeed. And mothers may wonder how their diet affects their breast milk.

New parents shouldn't be afraid to ask for help.

Maternity nurses or a hospital lactation consultants can offer breastfeeding tips, starting with how to position the baby and how to make sure he or she is latching on correctly. Your health care provider, or your baby's health care provider, might offer breastfeeding tips, too.

On the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of Ask The Mayo Mom, discusses breastfeeding tips with Dr. Leslie Kummer, a Mayo Clinic pediatrician.

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