Mayo Clinic Q&A podcast episodes that feature news, information and stories from our cancer experts and patients, hosted by Dr. Halena Gazelka.
Most Recent Episodes
Consider all treatment options for ovarian cancer, including clinical trials
May 20, 2022
Ovarian cancer is the fifth-leading cause of cancer death among women in the U.S. When ovarian cancer first develops, it might not cause noticeable symptoms. It often goes undetected until it has spread within the pelvis and abdomen.
"Unfortunately, ovarian cancer often presents with very common symptoms, and these common symptoms are things that everybody will complain about at some point," explains Dr. John Weroha, a Mayo Clinic medical oncologist. "For example, constipation, bloating, maybe a little weight gain. These are very common symptoms, and oftentimes, people just kind of blow it off as being normal. So, that's how it hides and grows."
Once ovarian cancer is detected, treatment depends on the stage when the disease is diagnosed. Stage 1 — the lowest stage — indicates that the cancer is confined to the ovaries. At this stage, a cure may be achieved with surgery alone. By stage 4, the cancer has spread to distant areas of the body. At this point, treatment is more complex, often involving drug therapies and potentially immunotherapy, which uses the immune system to attack cancer cells.
Dr. Weroha encourages patients to explore all their treatment options, including clinical trials.
"I think one of the biggest misconceptions that I see with patients is that clinical trials are supposed to be a last resort, and that is absolutely not true," says Dr. Weroha. "What we do at Mayo, and really everywhere else, is we try to bring clinical trials to our patients — not because we want to test whether or not this brand-new drug works, but we already believe the drug works. We think it's going to work, and we want to give that to our patients because they can't get it any other way, except through a clinical trial."
On the Mayo Clinic Q&A podcast, Dr. Weroha discusses the latest treatments for ovarian cancer.
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.
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.
Meeting the unique needs of adolescent and young adult patients with cancer
April 5, 2022
While some adolescent and young adult (AYA) patients with cancer receive care in pediatrics, the majority are cared for in adult cancer systems. One of the challenges is that people in the AYA group don't fit well with either patient population.
"If you think about the kinds of things that people in this age group are going through, there's a lot of life transition happening there," explains Dr. Allison Rosenthal, a Mayo Clinic hematologist and oncologist. "So this group really has a lot of unique needs as far as psychosocial development."
AYA patients are 15-39. They may be students in high school or college, may be living on their own, and often are caught between losing coverage under parental health insurance and finding their own. Another common issue is the desire to start a family as fertility can be impacted by cancer and its treatment, which makes conversations about fertility preservation very important.
"There's never a convenient time to be diagnosed with cancer, but particularly inconvenient in this group," says Dr. Rosenthal. "And they often get overlooked because I think people just don't recognize that cancer is really common in this age population as well."
Dr. Rosenthal is leading an effort at Mayo Clinic Cancer Center to change that. The adolescent and young adult cancer center program aims to help AYA patients receive access to age-appropriate care and support. This multidisciplinary approach will include not only cancer specialists but also social workers, health psychologists, and financial and vocational counselors. Another important piece is helping AYA patients transition from pediatric to adult care and plan for cancer survivorship.
"One of the most important things is having survivorship care that focuses on the needs of these patients as they move forward," says Dr. Rosenthal. "We're really fortunate that the majority of young adult patients who get cancer care are going to do well. Thankfully, there are going to be a lot of long-term survivors."
April 4-10 is Adolescent and Young Adult Cancer Awareness Week. On the Mayo Clinic Q&A podcast, Dr. Rosenthal discusses the needs of AYA patients with cancer.
Colorectal cancer on the rise in younger adults
While regular colonoscopies and lower rates of smoking have reduced colorectal cancer rates in older adults, cancers of the colon and rectum are now a leading cause of cancer death among people under 50 in the U.S., according to the National Cancer Institute. The rates of new diagnoses continue to climb in this age group, with the largest increase seen among Alaska Natives, American Indians, and white people.
"We've seen about a 50% relative increase in the percent of patients under the age of 50 who have been diagnosed with colon cancer," says Dr. Jeremy Jones, a Mayo Clinic oncologist. "Unfortunately, there is not an age where I would say you're too young to have colon cancer."
Dr. Jones explains that health care professionals don't yet know what's causing this increase in colorectal cancer rates among younger people. It may be related to an increase in risk factors for colorectal cancer among this age group, such as obesity, a lack of exercise and an unhealthy diet.
Regular screening tests for colorectal cancer can help prevent colon cancer by identifying and removing polyps before they turn into cancer.
National guidelines recommend people of average risk of developing colorectal cancer begin screening at age 45, but those with increased risk factors should consult with their health care team.
On the Mayo Clinic Q&A podcast, Dr. Jones discusses his experiences caring for younger people with colorectal cancer, and why you should talk to your health care team about screening for colorectal cancer by age 45, or sooner if you're at higher risk.
Ask the Mayo Mom: Managing sickle cell disease in children and teens
March 18, 2022
Sickle cell disease is a group of inherited red blood cell disorders. Red blood cells are usually round and flexible, so they move easily through blood vessels. With sickle cell disease, some red blood cells are shaped like sickles or crescent moons, become rigid and sticky. These sickle-cell shaped cells can slow or block blood flow.
The most common type of sickle cell disease is sickle cell anemia. Red blood cells usually live for about 120 days before they need to be replaced. But sickle cells typically die in 10 to 20 days, leaving a shortage of red blood cells, or anemia. Without enough red blood cells, the body can't get enough oxygen, and this causes fatigue.
For a baby to be born with sickle cell anemia, both parents must carry a sickle cell gene. In the U.S., sickle cell anemia most commonly affects people of African, Mediterranean and Middle Eastern descent.
On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center experts Dr. Asmaa Ferdjallah, pediatric hematologist and bone marrow transplant physician, and Dr. Emily McTate, pediatric psychologist, to discuss managing sickle cell disease in pediatric patients and the latest advancements in treatment of sickle cell disease, including bone marrow transplant.
Advances in treating multiple myeloma help extend quality of life for patients
March 14, 2022
Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell.
Healthy plasma cells help the body fight infections by making antibodies that recognize and attack germs. In multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.
Immunotherapy, which uses the body's immune system to fight cancer, is now a standard treatment option for multiple myeloma. Immunotherapy works by interfering with cancer cells' ability to produce proteins that help them hide from the immune system.
"Immunotherapy is really one of the major backbone of now our current treatment for multiple myeloma," explains Dr. Yi Lin, a hematologist at Mayo Clinic. "We have some new agents that really help extend the amount of time that patients are able to live with multiple myeloma."
While there is no cure, treatment options for multiple myeloma are advancing quickly and new immunotherapies, including chimeric antigen receptor (CAR)-T cell therapy, are improving outcomes for patients.
"We always want to strive towards the treatment that we think can offer the longest period of remission," says Dr. Lin. "But balancing that with side effects because we want to keep patients not only living as long as they can with multiple myeloma, but hopefully also with good quality of life."
March is Myeloma Awareness Month. On this Mayo Clinic Q&A podcast, Dr. Lin discusses the use of immunotherapies and other novel approaches to treating multiple myeloma.
Recognizing skin cancer and reducing your risk
February 24, 2022
Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun, but it also can occur on areas of skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer in the U.S.
"And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist.
While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur.
"It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."
Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection:
Look for moles with irregular shape.
Look for moles with irregular, notched or scalloped borders.
- Changes in color
Look for growths with different or uneven colors.
Look for new growth of more than one-quarter of an inch in diameter.
Look for changes over time.
On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.