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    Health & Fitness

    Mayo Clinic Health Matters

    Mayo Clinic Health Matters brings you the latest medical advice, news and research to help you live a happier, healthier life. Join host Kristen Meinzer in conversation with Mayo Clinic’s leading medical experts as she asks all the questions you’re eager to (or maybe even afraid to) ask, letting curiosity lead the way. Wondering if you might have ADHD? Or how your pet affects your health? Be part of an informative—and fun—discussion about one of the most important topics: your health.

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    Latest Episodes:
    Imaging plays key role in improving endometriosis treatment Oct 21, 2022
    Show notes

    Endometriosis is often a painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus — the endometrium — grows outside the uterus.

    "Endometriosis is a very common condition," explains Dr. Tatnai Burnett, a gynecologic surgeon at Mayo Clinic. "Most of our studies, which are looking at women who have symptoms, would suggest that about 1 in 10 women, so 10% or so have endometriosis. Now, the difficulty here is that some women do not have significant symptoms and wouldn't go to a doctor, or they minimize their symptoms or think what they are experiencing is normal. So, if anything, that estimate is probably on the low side of what actual reality is."

    With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit the body, it becomes trapped. Endometriosis can cause pain, which is sometimes severe, especially during menstrual periods. Fortunately, effective treatments are available.

    Imaging, including ultrasound and MRI, is an important step in evaluating patients with endometriosis and can impact treatment options and surgical planning.

    "Ultrasound is a great way to start the evaluation of the female pelvis because it's easily accessible," says Dr. Wendaline VanBuren, a Mayo Clinic radiologist who specializes in gynecologic imaging. "And it gives us a lot of information about the ovaries and the uterus. The problem with endometriosis is that, while it can involve the ovaries, it can involve all these sites on the surface of the uterus, the bowel, the ureters and all the structures around it. So, MRI gives us a little bit more of a global perspective of the pelvis. So that's the advantage of using MRI."

    To better coordinate care for patients with endometriosis, Drs. Burnett and VanBuren instituted an MRI-based interdisciplinary conference at Mayo Clinic that brings together radiology and gynecology.

    "For endometriosis, we realized that a multidisciplinary approach where we review things together was just in the best interest of the patient because it gives us the best coordination of care between the radiologist and the gynecologist," says Dr. Burnett. "It gives us a nuanced interpretation of what the imaging means for the patient. And then it allows us to apply what we see in the imaging to our surgical plan and to the surgical team. We use all the information that we gather to really make the best plan for the patient in regard to the patient's goals and what they need."

    The team at Mayo Clinic has been sharing the success of this collaborative model and educating other experts through the publication of their research findings and participation in a disease-focused endometriosis panel through the Society for Abdominal Radiology.

    "We all have our own expertise," says Dr. VanBuren. "And when we're able to collaborate and share, hearing the clinical stories, looking at the imaging, putting it together, the considerations for management, whether that be medical or surgical planning, we're really able to make a huge impact. It's exciting to see now collaborations between societies, from gynecology and radiology together."

    On the Mayo Clinic Q&A podcast, Drs. Burnett and VanBuren discuss the multidisciplinary approach to diagnosing and treating endometriosis.


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    Hot chemotherapy for late-stage cancers Oct 18, 2022
    Show notes

    Hyperthermic intraperitoneal chemotherapy (HIPEC) delivers chemotherapy directly into the abdominal cavity. It is used in conjunction with cancer surgery for people with advanced cancer that has spread inside the abdomen. “Hyperthermic” means warm or hot. “Intraperitoneal” means inside the abdominal cavity, which is encased in a sac called the peritoneum.

    HIPEC uses high-dose chemotherapy to kill microscopic cancer cells inside the abdominal cavity. The HIPEC procedure is performed immediately after a surgeon has removed all visible cancer in the abdomen. HIPEC is well studied in several types of cancer and being explored as a potential treatment in others.

    "So really any cancer that's just localized in the abdomen on the surface of the peritoneum could be a candidate," explains Dr. Travis Grotz, a Mayo Clinic surgical oncologist. "We know for sure, based on studies and data that HIPEC works well for cancers of the colon, cancers of the appendix, cancer to the ovaries, cancer of the stomach, and there's even a cancer of the lining of the peritoneum, called mesothelioma. So those would be the cancers I think that are well studied and well accepted. Then, there are more rare tumors that we have less data for, such as cancer to the pancreas or gallbladder or small intestine, that we don't know yet if that's the right treatment."

    The specific type of chemotherapy used for HIPEC varies depending on the type of cancer being treated. The abdominal cavity is bathed with hot chemotherapy to kill any microscopic cancer cells that might still be present. Heating the chemotherapy enhances its effectiveness because, when it’s hot, chemotherapy penetrates the tissue more deeply, increasing the number of cancer cells it can reach.

    On this Mayo Clinic Q&A podcast, Dr. Grotz explains what HIPEC is, how it is performed, and the risks and benefits of the treatment.


    Related Articles:

    • "New therapies bring hope for ovarian cancer."
    • "Alternative chemotherapy offers hope for late-stage cancers."
    • "Aggressive treatment turns tide in fighting colon cancer."

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    So your kid won’t sleep — addressing common childhood sleep problems Oct 14, 2022
    Show notes

    The amount of sleep you need depends on various factors — especially your age. While sleep needs vary significantly among individuals, there are general guidelines for different age groups.

    For kids, getting the recommended amount of sleep on a regular basis is linked with better health, including improved attention, behavior, learning, memory, the ability to control emotions, quality of life, and mental and physical health.

    Mayo Clinic experts recommend these general sleep guidelines for each age group:

    Infants 4 months to 12 months 12 to 16 hours per 24 hours, including naps
    1 to 2 years 11 to 14 hours per 24 hours, including naps
    3 to 5 years 10 to 13 hours per 24 hours, including naps
    6 to 12 years 9 to 12 hours per 24 hours
    13 to 18 years 8 to 10 hours per 24 hours
    Adults 7 or more hours a night
    Creating good sleep habits is important. Dr. Julie Baughn, a Mayo Clinic pediatric sleep medicine specialist at the Mayo Clinic Children's Center, suggests the follow do's and don'ts for healthy sleep:

    Healthy sleep "Do's"

    Have an age-appropriate bedtime.
    Have a bedtime routine that is relaxing and consistent.
    Have the environment quiet and dark.
    Have your child be active during the day.
    Have regular meals.
    Have the same bedtime weekdays and weekends.
    Healthy sleep "Don't's"

    Get rid of the crib too early.
    Expect your young child to “sleep in.”
    Use electronics before bed.
    Dr. Baughn remind parents that setting expectations is key to helping children develop a healthy bedtime routine.

    "Kids are really good at knowing what you're going to say yes to at bedtime," says Dr. Baughn. "And they're just having kind of normal bedtime resistance, which is a normal part of growing up, of testing limits, trying to stay up later. Consistency is key."

    On the Mayo Clinic Q&A podcast, Dr. Baughn joins Dr. Angela Mattke, a Mayo Clinic pediatrician and host of #AsktheMayoMom to answer some common questions about sleep problems in children, including getting your child to go to sleep and stay asleep, the safety of melatonin for kids, and determining when should your child see a sleep specialist.


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    Custom-fitted joints a new option in shoulder replacement surgery Oct 11, 2022
    Show notes

    Shoulder replacement surgery is done to relieve pain and other symptoms that result from damage to the shoulder joint. Common conditions that can damage the shoulder joint include osteoarthritis, rotator cuff injuriesand fractures, among others.

    Thanks to improved surgical techniques and an aging population, the number of shoulder replacement surgeries is increasing.

    "The rate of usage of shoulder replacement in the United States has increased dramatically," explains Dr. Joaquin Sanchez-Sotelo, a Mayo Clinic orthopedic surgeon. "And I think there are two reasons. One is that implants are better. And also, that patients now are more active with their upper extremities later in life. So, they need the procedure because they want to have a life where they can enjoy activities pain-free."

    Traditionally, shoulder replacement removes damaged areas of bone and replaces them with standard parts made of metal and plastic. Joint replacement surgery could be a challenge if some of the bone is missing, the bone quality is poor, or if a bone graft is not accurate.

    Now, thanks to new technology, there is another option. Using CT scans and 3D-printed models, some patients can receive joint replacements that are created to be custom fit to their anatomy.

    "The benefit is you are guaranteeing the patient that the implant is going to fit his or her shoulder, No. 1," says Dr. Sanchez-Sotelo. "No 2., it decreases surgical time tremendously. Because in the past, you had to get exposure and then prepare the bone until it fits one of the off-the-shelf implants. Now you know that the implant is going to fit the patient right out of the box. So surgery time is less."

    There are some limitations to use of the new implants. People with severe deformities may not be candidates, and people who require surgery quickly may not have time to wait for a custom implant to be built.

    Despite these limitations, Dr. Sanchez-Sotelo says, like artificial intelligence and mixed reality, custom-fitted joints could be another game-changer in orthopedics and another tool for surgeons to help patients.

    "I think this is going to transform our practice," says Dr. Sanchez-Sotelo. "Technology is advancing so fast in medicine and orthopedic surgery. I'm just excited to see how we can change the operation, make it faster, make it easier, and lead to a much better outcome."

    On the Mayo Clinic Q&A podcast, Dr. Joaquin Sanchez-Sotelo, discusses advances in shoulder replacement surgery, including custom-fitted implants.

    The custom-fitted shoulder implant discussed in this podcast is produced by Strkyer. Dr. Sanchez-Sotelo and Mayo Clinic receive consulting fees and royalty payments from Stryker for shoulder arthroplasty products; however, Dr. Sanchez-Sotelo and Mayo Clinic do not have any relevant financial conflicts with this specific device.


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    Reducing the risk of heart failure Oct 07, 2022
    Show notes

    Heart failure — sometimes known as congestive heart failure — occurs when the heart muscle doesn't pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath.

    "The most recognized, the most common symptom of heart failure is breathlessness," says Dr. Gosia Wamil, a cardiologist at Mayo Clinic Healthcare in London. "And the type of breathlessness that patients would describe most often is the inability to lie flat, waking up in the middle of the night or gasping for air."

    Heart failure is often thought to be a disease of advanced age, but it can actually develop at any time in life. In many cases, heart failure can be prevented or treated if people are aware of the risk factors and warning signs.

    Coronary artery disease is the main cause of heart failure. Stiffening of the heart muscle is mostly a result of poorly controlled hypertensionor diabetes. Proper treatment can improve the signs and symptoms of heart failure and may help some people live longer. Lifestyle changes — such as losing weight, exercising, reducing salt (sodium) in your diet and managing stress — can improve your quality of life.

    "All the risks of developing heart attack, if we reduce those risks, we improve their lifestyle," explains Dr. Wamil. "If we reduce the risk of diabetes, hypertension, stop smoking, this will reduce the risk of heart attacks, but at the same time, will reduce the risk of heart failure."

    Dr. Wamil's research efforts include studies aimed at understanding the connection between diabetes and heart disease and using novel medical imaging techniques to identify heart failure early on. Other research underway at Mayo Clinic includes the use of artificial intelligence and machine learning tools to detect heart failure early.

    "An area of research interest at Mayo Clinic is the use of large databases, such as randomized controlled trials, electronic health care records, and applying not only statistical methods but also AI, machine learning models and algorithms to try to identify how we can detect early signs of heart failure risks," explains Dr. Wamil.

    On the Mayo Clinic Q&A podcast, Dr. Wamil, discusses warning signs of heart failure and advances in early detection of heart disease.


    Related posts:

    • "Mayo Clinic London Healthcare expert shares heart failure signs, symptoms people may not be aware of."
    • "Mayo Clinic Q&A podcast: Understanding the connection between diabetes and heart disease."
    • "AI-guided screening uses ECG data to detect a hidden risk factor for stroke."
    • "Mayo researchers use AI to detect weak heart pump via patients’ Apple Watch ECGs."

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    Surgical options for breast cancer treatment Oct 04, 2022
    Show notes

    Most people diagnosed with breast cancer undergo surgery to remove their cancer from the breast as well as have lymph nodes removed as part of their treatment.

    "Surgical resection of the tumor from the breast and also evaluation of the lymph nodes are used for the vast majority of patients with breast cancer, in particular, those patients where the disease is limited to the breast," says Dr. Judy C. Boughey, a surgical oncologist at Mayo Clinic. "One of the areas where often breast surgery does not have a role is if the breast cancer has spread or metastasized to other areas of the body. So for patients with stage 4 breast cancer, surgery has a much more questionable role."

    Surgery is used to treat most stages of breast cancer, but it is rarely used to treat metastatic breast cancer — breast cancer that has spread to other parts of the body. Breast cancer surgery may be used alone or in combination with other treatments, such as chemotherapy, hormone therapy, targeted therapy and radiation therapy.

    Breast cancer surgery includes different procedures, such as:

    • Surgery to remove the entire breast (mastectomy)
    • Surgery to remove a portion of the breast tissue (lumpectomy)
    • Surgery to remove nearby lymph nodes
    • Surgery to reconstruct a breast after mastectomy

    Which breast cancer operation is best for an individual depends on the size and stage of the cancer, other treatment options available, and the goals and preferences of each patient.

    For people with a very high risk of breast cancer, a preventive (prophylactic) mastectomy may be an option to reduce the risk of future breast cancer.

    With so many options and decisions to be made, preparing for breast cancer surgery can be a challenge. It's important to be comfortable with your surgeon and to have the support of family and loved ones.

    "Starting on the breast cancer journey is always a very challenging time," says Dr. Boughey. "Lean on your closest loved ones that you let into your inner circle and talk to them about your diagnosis, your treatment and your journey."

    Dr. Boughey also encourages people to remember that everyone's journey is unique and to rely on your care team for trusted information.

    "I think one thing to be very aware of with breast cancer is it is a very common disease, and every one of us knows someone or someone's relative that has been affected by this disease," explains Dr. Boughey. "Truthfully, breast cancer really is not one disease. And so I would just caution against hearing about your friends and their experience because it may have been a different size tumor and may have been treated a different way. And most importantly, it was likely a different tumor biology. And so you don't necessarily always have to listen to everybody's story and experience because that doesn't mean that yours will be the same. Share with your doctors some of the concerns that you've heard from your friends, from your colleagues, what you may have read on the internet, so that if they're not true, your team can dispel those myths for you and make you feel more comfortable."

    On this Mayo Clinic Q&A podcast, Dr. Boughey discusses how surgery is used in the treatment of breast cancer.


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    Mayo Clinic working to support Hispanic patients, staff Sep 30, 2022
    Show notes

    The Somos Latinos Mayo Employee Resource Group (MERG) was created in 2016 to promote, educate and celebrate the cultural heritage of Hispanic and Latino staff members and improve the patient experience.

    While the Somos Latinos MERG is based at Mayo Clinic in Rochester, Minnesota, Hispanic and Latino MERGs also are active elsewhere across Mayo.

    "Resource groups are the response to promoting inclusivity as well as championing a team-based approach for all staff," explains Carlos Rodriguez Jr., a senior strategist at Mayo Clinic and chair of the Somos Latinos MERG. "Essentially, our task is simple: to create a community that people feel a part of. And that's what we work to achieve every day."

    The work of MERGs supports several initiatives underway at Mayo Clinic to improve the experience for Hispanic and Latino patients. For example, Mayo is using in-person interpreters when possible, as well as video and phone interpretation, and making patient education materials available in Spanish. Another support option for patients is the Spanish-speaking patient coordinator program.

    "The patient coordinator programs are meant to have an individual whose job it is to help the patient navigate the health care system," says Dr. Enid Rivera-Chiauzzi, a Mayo Clinic OB-GYN and physician chair of the Somos Latinos MERG. "It's really complicated to figure out where you're supposed to be for an appointment, where you're supposed to park, who you were supposed to call, and really understanding what happened during your visit. And even if you are proficient in English and Spanish, it's just the culture. Maybe where you grew up is different than here. So the person who is matched with you is a bilingual individual who can help you navigate the health care world."

    Mayo Clinic also offers support to patients from Latin America who seek care. Representative offices in several countries — Colombia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama and Peru — are staffed by people who speak the local language, and can answer questions, help request appointments and make travel arrangements.

    "If you think about a patient representative on the ground in a given country, it really affords the patient the opportunity to connect with Mayo Clinic and start the process before they get to us," explains Rodriguez. "One of the differentiating propositions of Mayo Clinic is the integrated approach. The overall health care system is difficult to navigate, particularly when you're not familiar with the environment. So starting that conversation and engagement early is key to making the long-term relationship with Mayo Clinic a positive one."

    Closer to home, work is underway at Mayo Clinic to build a Latino mentorship program for clinical staff that will ultimately benefit patients.

    "We want to create a community of physicians and health care professionals who have been supported along their journey by other Latino and Latina health care professionals, therefore increasing our numbers," explains Dr. Rivera-Chiauzzi. "Our aim is to have more of us in these positions, which will help our patients see more people who look like them, or at least be as equally represented as they are in the community in general. That doesn't mean, 'Oh, I can only see a doctor that looks exactly like me and is exactly like me.' But we want to be in an environment where we can see all kinds of people and then whatever excellent person takes care of me, I feel like 'Oh, this person welcomes me.' That's important."

    To celebrate Hispanic Heritage Month, which takes place Sept. 15-Oct. 15, Dr. Rivera-Chiauzzi and Rodriguez join the Mayo Clinic Q&A podcast to discuss Mayo Clinic's efforts to support Hispanic and Latino patients and staff.


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    Manufacturing new treatments with biotherapeutics Sep 27, 2022
    Show notes

    Through research, clinical trials and biomanufacturing, Mayo Clinic’s Center for Regenerative Biotherapeutics is working to develop new types of medicines derived from the human body to treat chronic and age-related diseases.

    Biologics are therapies that come from human sources — cells, blood, enzymes, tissues, genes or genetically engineered cells — for use in medicines. Biomanufacturing is focused on manufacturing commercial grade biologically based medicines for treatment. Some examples include the use of stem cells, gene therapy and cell therapy, and 3D printing of tissues and organs.

    "The important thing is that there's an opportunity to use these type of therapies to cure rather than just treat patients as we move forward looking at different ways of being able to use these products," says Dr. Julie Allickson, the Michael S. and Mary Sue Shannon Family Director of Mayo Clinic's Center for Regenerative Biotherapeutics. "It's definitely a bright future." Dr. Allickson also is the Otto Bremer Trust Director of Biomanufacturing and Product Development in the Center for Regenerative Biotherapeutics.

    Mayo Clinic is working to move cellular discoveries from the lab to clinical trial and into commercially available therapies. To move technologies forward, partnerships are key.

    Mayo Clinic has formed a strategic collaboration with National Resilience Inc. to establish Rochester, Minnesota as a center for biomanufacturing regenerative technologies. Mayo also has manufacturing facilities in Jacksonville, Florida and Phoenix.

    Recently, Mayo Clinic, Hibiscus BioVentures, and Innoforce announced the launch of Mayflower BioVentures, a cell and gene therapy accelerator dedicated to identifying and forming companies around technologies that address unmet patient needs. All three organizations have a financial interest in the Mayflower collaboration. Mayo Clinic will use any revenue it receives to support its nonprofit mission in patient care, education and research.

    "There is a lot of investment in the field," says Dr. Allickson. "And Mayo Clinic is certainly prioritizing this across the enterprise, to allow the patients here to have treatments focused on rare and complex diseases. Here at Mayo Clinic, we want to make sure that that happens."

    On the Mayo Clinic Q&A podcast, Dr. Allickson discusses the near- and long-term future of biomanufacturing and biotherapeutics.


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    Ask the Mayo Mom: Talking to kids about racism Sep 23, 2022
    Show notes

    Children learn about racial differences and racial bias from an early age, and parents and caregivers are their first teachers. It's important for parents and other adults to be role models for inclusive behaviors early in the lives of children life to decrease racial bias and improve cultural understanding.

    Experts encourage parents and caregivers to get comfortable with having difficult conversations about race and bias.

    "It's important for all children to have these discussions, and as an adult in any child's life, everything that you're doing is modeling for them what's okay and isn't okay," says Dr. Emily McTate, a Mayo Clinic pediatric psychologist.

    Parents may be surprised to find out that a baby's brain can notice race-based differences as early as 6 months, according to the American Academy of Pediatrics. By age 12, many children become set in their beliefs.

    When children have questions about racial differences, it's important to keep a child's developmental stage in mind and tailor age-appropriate messages. The American Academy of Pediatrics offers these strategies for helping children understand and deal with racial bias:

    • Talk to your childrenand acknowledge that racial differences and bias exist.
    • Confront your own biasand model how you want your children to respond to others who may be different than them.
    • Encourage your children to challenge racial stereotypes and racial bias by being kind and compassionate when interacting with people of all racial, ethnic, and cultural groups.

    Another important step is teaching kids to be critical consumers of media.

    "I always think about all the moments, whether you're reading books together or watching animated movies together, whatever it is, and hit the pause button and talk about what's going on," says Dr. Daniel Hilliker, a Mayo Clinic pediatric psychologist. "Why is this person being represented in this fashion? And that can kind of open up the conversation about exploring some different perspectives."

    On this Ask the Mayo Mom edition of the Mayo Clinic Q&A podcast, host Dr. Angela Mattke is joined by Dr. McTate and Dr. Hilliker for a discussion on talking to kids about racism.


    Additional resources:

    • "Talking to Young Children About Race and Racism."
    • "Coming Together: Celebrating Every Child's Race, Ethnicity, Culture!"
    • "Talking About Race: Who am I?"

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    Why are more people dying of uterine cancer? Sep 20, 2022
    Show notes

    The number of people who die from uterine cancer is increasing, particularly among Black women.

    Also called endometrial cancer, uterine cancer begins in the layer of cells that form the lining, or endometrium, of the uterus. The American Cancer Society estimates that about 65,950 new cases of uterine cancer will be diagnosed in the U.S.this year, and about 12,550 people will die from the disease.

    Researchers recently reported the results of a study of 208,587 women ages 40 and older with uterine cancer. The study showed death rates for all types of uterine cancer increased significantly by 1.8% per year from 2010 to 2017. Death rates remained stable for the most common form of uterine cancer — Type 1 endometrial cancer — but increased by 2.7% per year for a rarer, more aggressive form called Type 2 endometrial cancer.

    "We do see a rise in diagnosis of uterine cancer," says Dr. Kristina Butler, a Mayo Clinic gynecologic oncologist. "And we feel like that is because there's also a rise of some other illnesses such as diabetes, hypertension and obesity, which are risk factors for uterine cancer. And because we're seeing more people experience those types of illnesses, uterine cancer rates are rising."

    The study also revealed racial disparities in uterine cancer death rates. Death rates from uterine cancer increased 6.7% annually among Hispanic women, 3.5% among Black women, 3.4% among Asian women and 1.5% among White women. Despite representing less than 10% of cases, nearly 18% of all deaths from uterine cancer occurred in Black women.

    "Addressing health disparities is a huge priority of our national organization, the Society of Gynecologic Oncology," explains Dr. Butler. "I think it's very clear that there are disparities as it relates to patient access to care. Also, opportunities to train providers in cultural competency, so that patients feel very comfortable coming and having that patient-doctor relationship. And we need to improve health care access for women in rural communities and take education to those communities so that those women feel comfortable reaching out to us when they need care."

    On this Mayo Clinic Q&A podcast, Dr. Butler discusses uterine cancer, disparities related to the disease, and what people can do to reduce their risk of developing this type of cancer.


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