Mayo Clinic Health Matters

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. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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 children and acknowledge that racial differences and bias exist. Confront your own bias and 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?" Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

While childhood cancer is rare, 1 in every 266 children and adolescents will be diagnosed with cancer by age 20, according to the American Cancer Society. Each September, advocacy groups, health care institutions, patients and families recognize Childhood Cancer Awareness Month to help families who receive a cancer diagnosis.“A lot of people still don't know what to do if a child is diagnosed with cancer or where to go,” explains Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. “We want people to know that we know that a cancer diagnosis is scary. We know that it’s life-altering. But we also want you to know that there's hope, that we are doing really good things here at Mayo Clinic and elsewhere. And there is hope for a cure, and there is life after childhood cancer.”Dr. Allen-Rhoades says funding is needed for more pediatric cancer research to continue to improve treatments. One area of focus for her has been sarcomas. Sarcoma — the term for a group of cancers that begin in the bones and in the soft or connective tissues — is one of the more common types of childhood cancer. Fortunately, recent treatment advances have increased survival rates. Of children diagnosed with cancer, 84% now survive five years or more. One of the advances in treatment has been improvement in radiation therapy techniques and the use of proton beam therapy to treat pediatric cancers."Radiation therapy works very well for sarcomas," says Dr. Wendy Allen-Rhoades, a Mayo Clinic pediatric hematologist and oncologist. "And the difference between conventional radiation and proton therapy radiation is that our radiation oncologists are able to contour a little bit tighter with proton therapy. Therefore, the surrounding tissue that is normal is spared from some of the side effects. This is really important in children who are growing because we want them to be able to grow normally."In addition to sparing healthy tissue from the effects of radiation, people who must undergo radiation therapy early in life are less likely to have long-term side effects and complications, such as secondary cancers, with proton beam therapy than with conventional radiation therapy.While treatments and cure rates for sarcomas have improved, Dr. Allen-Rhoades hopes for even better results in the future.“Sarcomas have been a tough nut to crack for sure in terms of research and novel innovative therapies,” says Dr. Allen-Rhoades. “We still have a ways to go, but we're doing much, much better than we were 20—30 years ago. But until we can cure everyone, it will never be enough.”On the Mayo Clinic Q&A podcast, Dr. Allen-Rhoades discusses pediatric sarcomas and the importance of funding for research and support of families dealing with pediatric cancer. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Peripheral artery disease, or PAD, affects almost 10 million people in the U.S. Approximately one-third of patients will die within five years of a peripheral artery disease diagnosis, and 20% will experience a heart attack or stroke. Peripheral artery disease usually involves pain in the lower limbs caused by reduced blood flow due to narrowing of the arteries. Its symptoms, like reduced ability to walk due to leg pain, often are brushed off as signs of aging. While age is a factor, younger people with diabetes or who smoke also should be checked for the disease. "If you have risk factors for lower-extremity PAD — diabetes, tobacco use, high cholesterol, high blood pressure, as well as age — it's really important to have those conversations with your provider about your ability to exercise or walk if you are having any limitation," explains  Dr. Amy Pollak, a Mayo Clinic cardiologist. Peripheral artery disease is detectable and treatable, but it's often not diagnosed early enough. This means patients are often not treated with the most aggressive therapies. Health disparities play a big role, with the highest rates of peripheral artery disease occurring in Black men and women."There is an amputation epidemic," says Dr. Pollak. "And I don't use that word epidemic lightly. In today's climate, I use it intentionally. Depending upon where you live in our country, you may be at a higher risk of having an amputation for lower-extremity PAD, and not always be offered a revascularization procedure. So there is a lot of work that needs to be done to raise awareness of PAD, both for patients and health care providers."A new PAD Action Plan spearheaded by the American Heart Association is hoping to do just that. The plan serves as a roadmap for reducing the burden of peripheral artery disease by improving the awareness, diagnosis and treatment of PAD. The plan also highlights the many gaps and opportunities in PAD research to further reduce preventable complications and deaths for future generations."The incidence of PAD is set to triple in the United States in the coming years," says Dr. Pollak, who is a co-chair of the PAD Action Plan. "So we have an important opportunity to not only prevent that from happening, but to prevent heart attacks and strokes to help people live longer lives with a greater degree of functional ability by diagnosing and treating PAD. When it comes to the health disparities, we need to be doing even more outreach to populations that have been historically not focused on with that important information about what PAD is, how it can present, and what treatment options there are."On the Mayo Clinic Q&A podcast, Dr. Pollak discusses the importance of early diagnosis of PAD to reduce the risk of amputation, heart attack and stroke.Related posts: "Mayo Clinic Minute: How is peripheral artery disease diagnosed?" "Peripheral artery disease can signal cardiovascular trouble for heart, brain and legs."  Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Treatment for brain tumors in children can differ from treatment for brain tumors in adults, so it is important to seek care from specialists in pediatric cancer and neurology.Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain, or the tissue and structures near the brain. Of the many types of pediatric brain tumors, some are noncancerous, or benign, and some are cancerous, or malignant.Common brain tumors in infants, children and teenagers include: Gliomas These tumors begin in the brain or spinal cord. Types of gliomas include pilocytic astrocytomas, ependymomas and oligodendrogliomas. Medulloblastoma A medulloblastoma is the most common cancerous brain tumor in children. It starts in the lower back part of the brain, called the posterior fossa, and tends to spread through spinal fluid. Treatment and chance of recovery depend on many factors: the type of tumor, its location within the brain, whether it has spread, and the child's age and general health. "The good news is that the really bad tumors are fairly rare," says Dr. David Daniels, a Mayo Clinic pediatric neurosurgeon. "When we look at tumors, we look at their type or classification, and then a grading that goes along with that."Often, a biopsy of the tumor is performed to determine its type and grade. This information helps guide the course of treatment, which can include surgery, radiation therapy and chemotherapy."The biggest thing is that grading," explains Dr. Daniels. "Is this a grade one tumor, which is very benign, or is this a grade four tumor, which is really aggressive? And so our treatment has to match the aggressiveness of that tumor, so to speak." Because new treatments and technologies are continually being developed, several options may be available at different points in treatment. As part of the Mayo Clinic Children's Center, pediatric specialists in Mayo's Pediatric Brain Tumor Clinic work together as a team to develop an individual treatment plan for each child. Typically, a pediatric neuro-oncologist specializing in brain tumors is the child's primary doctor. This doctor coordinates access to other specialists from the pediatric brain tumor treatment team, including pediatric neurology, pediatric neurosurgery, neuroradiology, pediatric endocrinology, neuropathology, pediatric radiation oncology, pediatric oncology, child psychology and pediatric rehabilitation.On this Mayo Clinic Q&A podcast, pediatrician and Ask the Mayo Mom host, Dr. Angela Mattke, is joined by Dr. Daniels to discuss common pediatric brain tumors. Dr. Daniels covers treatment, including when surgery may be an option, and highlights the latest in brain tumor research. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Many institutions that provide cancer care also offer cancer survivorship clinics. These clinics focus on helping people with cancer manage the physical, emotional and social effects of cancer and cancer treatment, as well as improving the overall health and well-being of cancer survivors. "Cancer survivorship visits can be very beneficial for the patients," says Dr. Meghna Ailawadhi, a Mayo Clinic general internist specializing in cancer survivorship. "They can provide a bridge between your primary care and your oncologist, and help patients sort out the posttreatment journey a little bit easier."Cancer survivorship clinics may focus on a specific cancer type or a specific age group, such as children, adults, or adolescents and young adults (ages 15 to 39). Many different specialists may be involved, including medical oncologists; rehabilitation specialists; nutritionists; and other specialties, like cardiology and gastroenterology, if needed. These clinics often help cancer survivors develop a survivorship care plan — a plan tailored to the individual survivor to make sure that person gets the most out of life after a cancer diagnosis. The care plan also can help inform the primary care physicians who care for these patients after active treatment is finished."A survivorship care plan entails the details of their treatment, the details of their cancer journey, their pathology reports, and what kind of treatment — radiation, chemotherapy — they have received," explains Dr. Ailawadhi. "And there's also an assessment and a care plan for the future of how often these patients need to have their surveillance scans, what labs to look for, what signs to look for. It also addresses some of their long-term needs if they are suffering from peripheral neuropathy, chronic diarrhea or other posttreatment effects. So it's an extremely useful document both for the patient and for their primary care providers."On this Mayo Clinic Q&A podcast, Dr. Ailawadhi discusses Mayo Clinic’s cancer survivorship clinics, what services they offer, and how to find similar services in your area.Also, check out these cancer survivorship articles: "Mayo Clinic Q&A podcast: Cancer survivorship needs are unique to each survivor." "Consumer Health: Reconnecting with loved ones after cancer treatment." "Mayo Clinic Q&A podcast: Living as a prostate cancer survivor." "Consumer Health: Managing your emotions after cancer treatment." "Mayo Clinic Q&A podcast: Diet and nutrition help cancer survivors return to good health." "Consumer Health: Life after cancer." "Mayo Clinic Q&A podcast: Meeting the unique needs of adolescent and young adult patients with cancer." "Mayo Clinic Q&A podcast: Life after lymphoma." Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

The first significant change to COVID-19 vaccines since their rollout came this week as the Food and Drug Administration granted emergency use authorization for updated Moderna and Pfizer COVID-19 boosters aimed at the omicron variants. The Centers for Disease Control and Prevention (CDC) also signed off on the recommendation, clearing the way for the new COVID-19 booster to be administered.The new boosters are bivalent vaccines, meaning they target more than one strain of the virus. The new formulation targets the BA.4 and BA.5 omicron variants, in addition to the original coronavirus strain. BA.5 is responsible for nearly 90% of all new COVID-19 cases in the U.S., according to the CDC. The Pfizer bivalent booster is approved for people 12 and up if they have already received their primary COVID-19 vaccine series and it has been at least two months since their last vaccine dose. The Moderna bivalent booster is available on the same timeline to people 18 and up."This booster recommendation is in anticipation that there will be yet another surge as college students, grade school and high school students are gathering back together," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "We're also preparing for cooler weather, meaning more indoor activities, family gatherings and the holidays — often without masks, unfortunately. We still need to take COVID seriously."Another big concern for vaccine experts is the upcoming flu season. The Southern Hemisphere is often an indicator of what's to come for the U.S. Australia's flu season exceeded its five-year average, particularly affecting children under age 5, according to a recent report. Experts worry that the relaxing of masking and social distancing recommendations that were in place for COVID-19 purposes the past two winters will be a factor. These measures also protected people from the flu."When cold weather moves us indoors, a high viral circulation occurs in schools and other indoor settings. I think we are very likely to see a bad flu year," says Dr. Poland. "Now I know we've been predicting that for two years, but for the most part, people wore masks and it didn't happen. I don't think that'll be the case this year. People are not wearing masks, and we are very likely to get hit hard by influenza."On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news and touches on other news, including monkeypox, polio and the upcoming flu season. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy