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.

When it comes to knee replacement surgery, orthopedic surgeons now have a new tool for the operating room: augmented reality knee replacement. This technology enables a surgeon to view important data using special smart glasses or a helmet-based visor while maintaining their view of the surgical site. In that way, augmented reality differs from virtual reality.

"Think of a fighter pilot in a jet that has a visor over their eyes that's displaying electronic data that is overlaid over what they're seeing in the real world," explains Dr. Michael Taunton, a Mayo Clinic orthopedic surgeon. "So don't confuse this with virtual reality that your kids have at home, that they're playing video games with their eyes covered."

Augmented reality technology superimposes digital content, including data and 3D images, onto the user's view. Surgeons use this information to be precise and receive real-time feedback when removing bone and cartilage, and placing a knee implant. Dr. Taunton explains augmented reality is a new advancement beyond computer-assisted knee replacement. 

"We've had computer-assisted surgery for a while where we take data from the patient's own leg and enter that into a computer, and have it display some of this information to help us understand how best to remove the correct amount of bone in the right angle to make the knee replacement fit better, and have better alignment of the limb after surgery," says Dr. Taunton. "The problem with some of those computer-assisted programs is that there is a screen or computer that we're looking at across the room. So we're having to take our eyes off the patient during surgery." 

The first augmented reality knee replacement at Mayo Clinic was performed in fall of 2021, and the technology is not yet widely available. Research is ongoing to study whether augmented reality can reduce the length of surgery and improve patient outcomes. 

On the Mayo Clinic Q&A podcast, Dr. Taunton discusses the advantages of using augmented reality for knee replacement surgery.

Hospitalizations and deaths due to COVID-19 continue to decline, leading to some optimism about the way forward from pandemic to endemic. But experts still urge caution as the omicron subvariant, named BA.2, has quickly become the dominant strain in the U.S.

"When you look around the nation, all of the metrics, with the exception of BA.2, have fallen precipitously," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "But we need to be very cautious about pretending that the pandemic is over." 

Dr. Poland explains that each time there has been a waning number of COVID-19 infections, people have let down their guard and relaxed precautions, which has led to another surge. Dr. Poland still recommends masking in crowded indoor settings and urges people to be fully vaccinated and boosted against COVID-19 to reduce the chance of infection.

"We're just coming down into a quiet period," says Dr. Poland. "But every time we've seen this set of markers in the past, we've had a new variant that's caused a surge. The question is, will it be BA.2, one of the newer variants that have been identified, or something completely unexpected? We just don't know."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news including potential changes to booster recommendations, data on vaccine protection for pregnant women and the latest information on COVID-19 vaccines for children under 5.

Research disclosures for Dr. Gregory Poland.

Precision medicine aims to customize health care by tailoring medications and treatments to each patient. An important step in being able to personalize treatments is diagnostic testing.

Mayo Clinic BioPharma Diagnostics collaborates with biopharmaceutical, diagnostic, and other biotech companies to enable precision medicine through advanced diagnostics. Diagnostic testing can help find the right answers for each individual patient.

"A laboratory test can either help in making a diagnosis for a disease, or it can help guide the clinician to the right diagnosis or to the right treatment," explains Dr. Alicia Algeciras-Schimnich, medical director of BioPharma Diagnostics.

Accurate and rapid diagnostic testing has many benefits, says Dr. Algeciras-Schimnich.

"The faster we reach the right diagnosis for a patient, the faster we get to the right treatment. It not only improves their outcome, but it has been shown that the overall cost of health care is also reduced by providing the right answers faster."

On the Mayo Clinic Q&A podcast, Dr. Algeciras-Schimnich discusses diagnostic testing, precision medicine and what it means for patients.

Children with cerebral palsy may require lifelong care from a medical care team, but early intervention and treatments can improve function. 

Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature, developing brain, most often before birth. Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or spasticity of the limbs and trunk, unusual posture, involuntary movements and unsteady walking, or some combination thereof.

For children with cerebral palsy, the care team likely will include a pediatrician or physical medicine and rehabilitation specialist, a pediatric neurologist, and a variety of therapists and mental health specialists. These experts give special attention to needs and issues that are more common in people with cerebral palsy, and they can work together with the primary care provider to develop a treatment plan.

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 expert Dr. Joline Brandenburg, a physical medicine and rehabilitation specialist, to discuss important aspects of health for children with neurodevelopmental disabilities and what families and health care professionals can do to offer support.

Every March, Mayo Clinic joins the effort to raise awareness of colorectal cancer, which are cancers that develop in the colon and the rectum.

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.

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.

Last week marked two years since the World Health Organization declared COVID-19 to be a pandemic. While infection rates and hospitalizations in the U.S. continue to decline, there are some areas of concern globally. 

"China, Hong Kong, Ireland, the U.K. and Denmark are seeing surges back up again," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "These countries, many of us experts believe, prematurely dropped mask-wearing and nonpharmaceutical interventions, and really have stopped pushing and encouraging people to get vaccinated. I think that's a mistake."

Dr. Poland explains that public health measures — and vaccination and boosters — are still the best way to protect yourself from COVID-19. 

"What can I say but what we have said all along," implores Dr. Poland. "Hands, face, space and vaccines. It works."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including a study on the true death toll of COVID-19, an update on the BA.2 variant and the latest on vaccines for children under 5.

Research disclosures for Dr. Gregory Poland.

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.

Mayo Clinic living donor Mike Peshut is one of 22 kidney donors who will climb Mount Kilimanjaro with a group called Kidney Donor Athletes. The goal of the One Kidney Climb is to reach the summit on World Kidney Day, which is Thursday, March 10. 

Peshut donated a kidney on behalf of his wife, Annie, in February 2019. Peshut tried to be a direct donor, but he was not a match for his wife. Through paired-organ donation, he became part of a six-kidney donation chain, allowing Annie to receive a kidney. 

In paired donation, two or more organ-recipient pairs trade donors so that each recipient gets an organ that is compatible with his or her blood type. 

Peshut recently met his recipient, who credits him with giving her more time with her family, including her 13 grandchildren.

More than 90,000 people in the U.S. await a lifesaving kidney transplant. An estimated 20 people die every day because a needed is not donated in time.

Now Peshut is focused on sharing his story and encouraging others to become organ donors. The Mount Kilimanjaro climb is a public way to show that living organ donation doesn't limit the donor.

"Don't be afraid. Don't sit on the sidelines," says Mike. "If you're healthy, you can donate a kidney to help save someone else's life. It's really, really rewarding." 

On the Mayo Clinic Q&A podcast, Peshut join host Dr. Halena Gazelka, a Mayo Clinic anesthesiologist, to share his message about organ donation.