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
Proton beam therapy spares surrounding tissue when treating bone cancer
July 5, 2022
Sarcoma is the general term for a broad group of cancers that begin in the bones and soft tissues of the body, including muscle, fat, blood vessels, nerves, tendons and the lining of your joints. There are more than 70 types of sarcoma.
Bone cancer is a rare disease, accounting for just 0.2% of all cancers. An estimated 3,910 new cases of sarcoma of the bones and joints will be diagnosed in 2022, according to the National Cancer Institute.
Some types of bone cancer occur primarily in children, while others affect mostly adults.
"When we think of sarcomas of the bone, the common types are chondrosarcoma, Ewing sarcoma, and osteosarcoma," says Dr. Safia Ahmed, a radiation oncologist at Mayo Clinic. "While sarcoma can happen in any bone in the body, the most common sites include the pelvis, the spine, and the skull base for most of these tumors."
Treatment for sarcoma varies depending on sarcoma type, location and other factors. Treatments can include surgery, chemotherapy and radiation therapy.
Proton beam therapy is a type of radiation therapy that is more precise than traditional X-ray treatment, which delivers radiation to everything in its path. Proton beam therapy uses positively charged particles in an atom — protons — that release their energy within the tumor. Because proton beams can be much more finely controlled, specialists can use proton beam therapy to safely deliver higher doses of radiation to tumors. This is particularly important for bone cancers.
"When we treat these tumors in the bone with radiation, they need much higher doses of radiation than, say a sarcoma that arises purely in the muscle, what we call a soft tissue sarcoma," explains Dr. Ahmed. "And these high doses of radiation often exceed what the normal tissues around the area can tolerate. So proton therapy allows us to give this high dose of radiation while protecting the normal tissues."
July is Sarcoma Awareness Month. On this Mayo Clinic Q&A podcast, Dr. Ahmed discusses sarcoma diagnoses and treatment options, including proton beam therapy.
What to expect after surviving breast cancer
June 21, 2022
After skin cancer, breast cancer is the most common cancer diagnosed in women in the U.S. But it can occur in people of all gender identities.
Nearly 13% of women in the U.S. will be diagnosed with breast cancer at some point, according to the National Cancer Institute. Fortunately, thanks to earlier detection and advances in diagnosis and treatment, most people diagnosed with breast cancer will survive. Understanding what to expect can make the cancer journey smoother.
"It's important for people to know the road map," explains Dr. Daniela Stan, an internist with the Mayo Clinic Breast Diagnostic Clinic. "What treatments are they expected to have and what's the timeline? What will the side effects be? How can they prepare?"
People who survive breast cancer can have unique needs depending on their cancer type and stage, but there are some experiences many breast cancer survivors will share after treatment.
"Survivors on a daily basis learn how to deal with their cancer, how to pace themselves, how to get help from family and friends, and how to go forward during and after the treatment is completed," says Dr. Stan. "Luckily, there are many, many resources available to deal with the physical and psychological issues of cancer survivorship."
Dr. Stan encourages cancer survivors to talk with their health care team about how nutrition, exercise and controlling stress can help with the long-term effects of cancer treatment and even help prevent cancer recurrence.
On this Mayo Clinic Q&A podcast, Dr. Stan discusses what people can expect after completing breast cancer treatment and how to achieve the best quality of life.
Palliative care for cancer designed to fit the needs of each patient
June 7, 2022
Palliative care is offered alongside cancer treatment to help people with cancer manage symptoms and improve the quality of life for them and their families. Palliative care is specialized medical care that focuses on relieving patients' pain and other symptoms of serious illness no matter the diagnosis or stage of disease.
"The palliative care team really focuses on addressing symptoms and needs so that we can help people feel as comfortable as they can as they go through their treatment for cancer," says Dr. Deirdre Pachman, a palliative medicine expert at Mayo Clinic. "We do this by focusing and talking about some different interventions. They might be medications, or they might be other procedures for pain that some of our colleagues do. Palliative care is a very team-based approach, so we may involve our nurses, our physical therapists, our social workers really to all be there to help support the patient and make sure that we're addressing their symptoms and their needs."
Palliative care is designed to fit the life and needs of each individual patient. It may include symptom management, support and advice, care techniques that improve comfort and well-being, referrals to other specialists, and advance care planning. Palliative care also offers support for families and those caring for people with cancer.
"The goal of palliative care, along with helping patients manage their symptoms and improving quality of life, is really providing that support to their loved ones or their caregivers, so that they have time to care for themselves and feel well-supported so that they can continue to give to others," says Dr. Pachman.
Research indicates that early use of palliative care services can improve quality of life for people with serious illness, decrease depression and anxiety, increase patient and family satisfaction with care, and in some cases even extend survival.
On this Mayo Clinic Q&A podcast, Dr. Pachman discusses how palliative care can improve quality of life for people with cancer.
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.