Journalists: For links to video and audio files, see the bottom of this post.
More accurate and more sensitive. When it comes to cancer screenings, those are two attributes you really want. Well, results of two studies suggest that a new, investigational colorectal cancer (CRC) screening test developed in collaboration between Mayo Clinic and Exact Sciences Inc. of Madison, Wis., is highly accurate and significantly more sensitive than other noninvasive tests at detecting precancerous tumors (adenomas) and early-stage cancer.
The screening test, called stool DNA testing, works by finding signature genetic markers in stool samples mailed in by patients. The testing can be done from home, and should be accessible wherever the mail goes.
“Colorectal cancer continues to be an enormously huge problem. It is the number two cancer killer in North America, and only about half of all adults that should be screened for colon cancer are screened for colon cancer,” says lead study author David A. Ahlquist, M.D., a Mayo Clinic gastroenterologist. A simple, accurate test will help to bring screening to more patients.
“The nice thing about the colon is that it is very accessible. A positive test would be followed by a colonoscopy to remove the polyps. And removing the polyps then, will prevent a subsequent cancer from forming,” say Dr. Ahlquist.
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Many athletes know the frustration of being sidelined by tendon disorders, like Achilles tendinitis and tennis elbow. In recent years, doctors have begun treating overused tendons with regenerative therapies that jump-start the body’s own healing process. One technique, a tenotomy, uses repeated needlesticks to break up scar tissue in the tendon, prompting the body’s own cells to begin the rebuilding process.
Another technique is an injection of platelet rich plasma (PRP), a concentrated dose of healing platelet cells that exist in the patient’s blood. In a recent study published in Physical Medicine & Rehabilitation, Mayo Clinic researchers reported that the combination of tenotomy and PRP injections produced significant improvement in patients with long-standing tendon injuries.
“These disorders can be hard to treat, and patients tend to receive one therapy or the other, depending on what a doctor happens to offer. Our study was the first clinical study to investigate the combination of both treatments in injured tendons,” says study author Jay Smith, M.D., of Mayo Clinic’s Department of Physical Medicine & Rehabilitation.
The study included 34 patients with a wide range of tendon and soft tissue injuries, from rotator cuff tendinitis to plantar fasciitis, an inflammation on the bottom of the foot. In the first stage of the two-part treatment, researchers used high-resolution ultrasound technology to guide a needle to the injured area, and the physicians repeatedly poked the tendon with the needle, inducing minor bleeding within the tissue.
“The needle breaks up nonhealing, degenerative tissue and induces bleeding, hopefully converting a chronic, degenerative injury into an acute injury that has healing potential,” Dr. Smith explains. Afterward, patients received an injection of concentrated platelets from their own blood. The platelets release growth factors into the area to start the healing process.
Researchers found maximum benefits tended to occur within four months after the procedure. More than 70 percent of patients had better use of their tendons, and 76 percent reported improvement in pain. In addition, researchers found some indication of tendon healing, which was detected with sophisticated ultrasound imaging.
“Larger studies are still necessary to determine whether the combination is particularly helpful for certain injuries or types of tendons, but this investigation showed these therapies together are safe and effective for some people who have an ongoing tendinopathy,” says Dr. Smith.
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Drug Shows Promise for Metastatic Colorectal Cancer Treatment
A new investigational drug called Regorafenib has been shown to shrink tumor size and improve overall survival in patients with metastatic colorectal cancer. Research was presented at the Gastrointestinal Cancers Symposium of the American Society of Clinical Oncology by Axel Grothey, M.D. of Mayo Clinic.
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Whether you’re a black-diamond skier or a novice on the bunny slope your day can be spoiled by an injury that happens on the last run of the day. End-of-the-day tweaks and spills are more common than you’d think, says physical medicine and rehabilitation specialist Ed Laskowski, M.D., of Mayo Clinic. Muscle fatigue at the end of the day can lead to sloppy technique and injuries such as a tear of the anterior cruciate ligament (ACL) in the knee, which can require surgery and intensive rehabilitation. Dr. Laskowski, a former elite skier who turned his career to medicine, says that recreational skiers can take steps to optimize their protection from injury.
Physical preparation before a big ski weekend can go a long way, according to Dr. Laskowski, who specializes in fitness, wellness, strength-and-stability training, and sports injury prevention strategies. To gear up for a ski holiday, people can do conditioning exercises that make the sport safer:
Endurance exercises, especially with an aerobic component, can help train the muscles so fatigue doesn’t lead to injury at the end of an 8 hour ski day.
Strength training that focuses on the major muscle groups in the legs, especially those used in skiing, can help skiers stabilize and control their bodies. Core exercises to help link upper and lower body movements are also important, as are balance exercises that emphasize stability.
“Ski specific” exercises can help train for the side-to-side motions required by the sport. One simple but effective exercise to prepare for skiing is to practice jumping from side to side over a line of tape on the floor, using both feet and then using one foot at a time.
Dr. Laskowski specializes in Physical Medicine and Rehabilitation and serves as co-director of the Mayo Clinic Sports Medicine Center. A former competitive alpine skier, he served on the Olympic Polyclinic Medical Staff for the 2002 Winter Olympics in Salt Lake City. In 2006, President George W. Bush appointed Dr. Laskowski to the President’s Council on Physical Fitness and Sports.
To schedule an interview with Dr. Laskowski, contact Bryan Anderson (507) 284-5005 or newsbureau@mayo.edu.
Journalists: The following video and audio clips with Dr. Laskowski are available for your use.
Rochester, Minn. – With New Year’s resolutions still fresh in mind, many people are taking bold steps to get fit and build strength. But some strength training exercises, which tend to get passed along at the gym like folklore, may not be based on how the body works best.
“All too often, strength training programs don’t take into account correct biomechanics or even individual body types,” says Mayo Clinic’s Ed Laskowski, M.D., of the Department of Physical Medicine and Rehabilitation. Some strength training exercises, if performed with poor technique, can cause injuries ranging from spontaneous twinges to the aches that come from months of cumulative stress.
The key to safe, effective strength training is doing it right. Dr. Laskowski is available to talk about techniques that get results and help avoid injury. Among his strength training advice is:
Core stability is essential to upper body, lower body and trunk strengthening. Training the core involves not only activating abdominal muscles but also training back muscles. Workouts need to progress beyond fitness balls to upright positions that are similar to life and sport movement patterns.
Many people focus on training the muscles in the chest and in the front of the shoulder. For balanced strength in the shoulder, a training program should emphasize strengthening the muscles in the upper back as well as the back of the shoulder.
Physical medicine and rehabilitation specialists can help people review their workouts to optimize benefit and point out potentially dangerous flaws that may cause injury. Novice or seasoned athletes can ensure a proper foundation by making an appointment to review the appropriate biomechanics of a workout, a football throw, or even a golf swing.
Dr. Laskowski is co-director of the Mayo Clinic Sports Medicine Center. In 2006, he was appointed by President George W. Bush to the President’s Council on Physical Fitness and Sports. He was a member of the Olympic Polyclinic Medical Staff for the 2002 Winter Olympics in Salt Lake City. A specialist in fitness, wellness, injury “protection,” conditioning, and strength and stability training, his strength training workout tips are among the most visited health videos on the Mayo Clinic’s website.
To schedule an interview with Dr. Laskowski, contact Bryan Anderson at 507-284-5005 or newsbureau@mayo.edu.
Doctors have known for years that the incidence of deadly liver cancer is on the rise, but what is causing that trend has remained a mystery. Two Mayo Clinic studies published in the January 3 issue of Mayo Clinic Proceedings offer a clearer picture of the rise of hepatocellular carcinoma (HCC), or liver cancer, which has tripled in the U.S. in the last three decades and has a 10 to 12 percent five-year survival rate when detected in later stages.
“The studies illuminate the importance of identifying people with risk factors in certain populations to help catch the disease in its early, treatable stages,” said W. Ray Kim, M.D., a specialist in Gastroenterology and Hepatology and principal investigator of one study.
W. Ray Kim, M.D.
Dr. Kim’s research group looked at several decades of records in the Rochester Epidemiology Project, a database that accounts for an entire county’s inpatient and outpatient care. The study found the overall incidence of HCC in the population (6.9 per 100,000) is higher than has been estimated for the nation based on data from the National Cancer Institute (5.1 per 100,000). The study also found that HCC, which two decades ago tended to be caused by liver-scarring diseases such as cirrhosis from alcohol consumption, is now occurring as a consequence of hepatitis C infection.
“The liver scarring from hepatitis C can take 20 to 30 years to develop into cancer,” Dr. Kim says. “We’re now seeing cancer patients in their 50s and 60s who contracted hepatitis C 30 years ago and didn’t even know they were infected.”
Eleven percent of cases were linked to obesity, in particular fatty liver disease.
“It’s a small percentage of cases overall,” Dr. Kim says. “But with the nationwide obesity epidemic, we believe the rates of liver cancer may dramatically increase in the foreseeable future.”
Another study looked exclusively at the Somali population, which is growing in the U.S., particularly in Minnesota, where as many as 50,000 Somalis have settled in the last two decades. The East African country is known to have a high prevalence of hepatitis B, a risk factor for HCC.
Researchers investigating records in the Mayo Clinic Life Sciences System confirmed that hepatitis B remains a risk factor, but they were surprised to find that a significant percentage of liver cancer cases in the population are attributable to hepatitis C, which had not been known to be significantly prevalent.
“The study suggests that screening for hepatitis C would be helpful for the Somali population and would enable close surveillance of liver cancer among those at risk,” says lead author
Abdirashid Shire, Ph.D., a Mayo Clinic researcher. “That would greatly improve treatment and survival of Somalis with this type of cancer.”
We are very sorry to report that Officer Shawn Schneider of the Lake City Police Department died earlier this evening in Saint Marys Hospital at Mayo Clinic in Rochester, Minn. The family thanks everyone for their overwhelming support and well wishes during this difficult time. Out of respect for the family’s privacy, media inquiries will be directed to Mayo Clinic Public Affairs at 507-284-5005.
David Hines: a dedicated colleague who loved helping others
David Hines thrilled at flying, thrived on challenge and loved helping people. He died in a helicopter crash early Monday morning along with Mayo Clinic transplant surgeon Luis Bonilla, M.D., and pilot E. Hoke Smith. They were flying from St. Augustine, Fla., to Gainesville, Fla., to retrieve a donor heart and transport it to a transplant recipient waiting at Mayo Clinic in Jacksonville. (story continues below video…)
Colleagues say Mr. Hines was a selfless man with an easy smile who cared deeply about his family and his coworkers. He often said he had the best job in the world and called transplant team members his second family. “It was never about him; it was always about our patients, his teammates, everyone he worked with,” says Linda Boso, his supervisor. “He was a very caring and giving individual who would do anything for anybody.”
Transplant nurse Thomas Mulligan says Mr. Hines was “always ready to help, anything you needed help with, he would do it,” even crawling in a co-workers attic to fix something. “He was real handy,” says Mulligan. “I don’t think there was a co-worker’s house he hadn’t done some work on.”
He brought that same caring attitude to his work as an organ procurement technician, a person who assists a surgeon in procuring an organ and helps keep it viable. “He was always ready to go,” says Mulligan. “Anytime I was on call, he’d say ‘Call me, I’ll go; I want to go’.”
“David was a very valuable member of our Florida transplant team,” says Justin Nguyen, M.D., chair of Transplant Surgery at Mayo Clinic in Jacksonville.
Courteous, kind, dedicated and hard working are words used repeatedly by colleagues describing Mr. Hines.
David Hines
“He was never afraid to go the extra mile to get the job done, and he never hesitated to help out any of his colleagues,” says Dr. Nguyen. “David exemplified all of the Mayo values by continually placing the patients’ interests above all else. He will be missed dearly by all of us.”
Mr. Hines, 57, trained as a medical services specialist with trauma management experience in the Air Force. He spent almost 30 years as an emergency trauma technician in the Air Force National Guard and retired as a master sergeant from the Florida Air National Guard in 2006. He was deputy rescue chief for the volunteer fire department in Solomons Island, Md., for three years before joining St. Luke’s Hospital in Jacksonville as an emergency room technician in 1999. At St. Luke’s, he worked as a patient care technician and an anesthesia technician before transferring to Mayo Clinic’s Transplant Center in 2006. He also was as a procurement technician for LifeQuest for two years.
“David loved to fly, and he loved a challenge,” says Mulligan. “I think the idea of flying and doing something challenging that helped people was so alluring that he had to go for it.”
Mayo Clinic patients and staff were the beneficiaries of that drive. “David was a wonderful friend, employee and teammate,” says Boso. “He always smiled. He was military grown, so you heard a lot of ‘Yes, ma’ams’ from him. We were always teasing him to stop saying that because it made us feel old.”
Mr. Hines is survived by two daughters, Christine Hines and Crystal Griner from Jacksonville and a son, Jonathan Hines from Lusby, Md., and two grandchildren, Keriona Griner and Cassidi Hines.
Dr. Luis Bonilla: Remembered as a loving husband and father, dedicated and talented surgeon
To Ana, Philip, and Anthony, Luis Bonilla was known simply as “Daddy”, a loving and caring father who was very involved in their lives despite his busy career and training. To Tracy, he was a devoted husband, father to her children, and a noble, caring man. Colleagues remember him as being a great person, talented surgeon, and dedicated professional. (story continues below video…)
No one would have imagined that this Christmas would be his last. He died in a helicopter crash early Monday morning along with Mayo Clinic surgical technician, David Hines, and pilot E. Hoke Smith. They were flying from St. Augustine, Fla., to Gainesville, Fla., to retrieve a donor heart and transport it to a transplant recipient waiting at Mayo Clinic in Jacksonville.
Dr. Bonilla had prepared for this work for decades and was just starting a new chapter in his career. It all began when he received his medical degree from the Colegio Mayor de Nuestra Señora del Rosario in Bogotá, Colombia and completed his residency in General Surgery at the University of Valle in Cali, Colombia.
After having completed his medical education, a full surgical training program, and working as a surgeon in Colombia for several years, Dr. Bonilla moved to Rochester, Minnesota in 1993 to pursue a career in cardiothoracic surgery at Mayo Clinic. In order to become a board certified surgeon in the United States, he needed to repeat his training in the United States, and began that in 2005. He went on to complete an additional residency in General Surgery along with an additional full clinical Fellowship in Thoracic and Cardiovascular Surgery at the Mayo School of Graduate Medical Education in Rochester, Minnesota, and completed that in July 2011. All the while, he worked in various surgical roles.
Luis Bonilla, M.D.
He transferred from Rochester to Mayo Clinic in Florida in November 2011 to join the Section of Cardiothoracic Surgery in Florida as a Senior Associate Consultant. There he had hoped to expand the surgical program for lung cancer.
He participated in research and a variety of professional presentations, both domestic and abroad. His clinical interests included cardiothoracic transplant and innovations in cardiac bypass surgery.
Dr. Bonilla is described by colleagues as being dedicated, determined, persistent, and the consummate professional who always put the best interests of his patients first. Throughout his career, his passion was making sure that every patient received the best care possible.
He is survived by his wife, Tracy, a former Mayo Clinic cardiac surgery intensive care nurse whom he met while working in Rochester. They have three children: Ana (12), Philip (9), and Anthony (7).
Statement from the Bonilla family: Mrs. Bonilla and her family request that the media honor the family’s privacy during this time, but issued this statement about her husband:
“Thank you to all who are reaching out to us during this time. Our faith sustains us during this difficult time, along with the love and support of our friends, family, and the community. We are so touched by the many ways people are honoring Luis, his life and career. He was a noble man, wonderful husband, and terrific father. He dedicated his life to his family, faith, and his career, and we knew that everything he did was to care for his family. We will miss him dearly, and will honor his life with many memories and stories of his love for life, his family, and his profession.”
Mayo Clinic is mourning the loss of Dr. Luis Bonilla, a cardiac surgeon, and David Hines, an organ procurement technician who, along with the pilot of the helicopter, perished during a mission to bring the gift of life to a transplant patient.
Every hour across the nation dedicated professionals are on call and in the air, transporting organs and restoring hope to patients in their most desperate hours.
“We’ve been touched by the outpouring of prayer and sympathy from patients, friends and colleagues who understand the demands and sacrifices made by these dedicated transplant teams,” said William Rupp, M.D., vice president of Mayo Clinic and chief executive officer of Mayo Clinic in Florida. “We hope the community honors their sacrifice by supporting organ donation.”
