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Tomorrow’s Cure: Shaping a new future for youth with scoliosis

When the spine begins to curve sideways during childhood or adolescence, it can lead to a condition known as scoliosis. While traditional treatments have remained largely unchanged for decades, new advancements are offering young patients and their families more choices — and better outcomes. In this episode of Tomorrow’s Cure, we explore the evolving landscape of scoliosis care and what these innovations mean for the future of spinal health.

Featured experts include Dr. A. Noelle Larson, orthopedic surgeon at Mayo Clinic, and Michelle Marks, executive director of the Setting Scoliosis Straight Foundation. Together, they have developed a shared decision-making tool that helps guide families through the complex process of evaluating treatment options.

Scoliosis treatment is determined by the size of the spinal curve and the child’s remaining growth. A common non-surgical intervention is the use of a hard plastic brace, often worn 13 to 18 hours a day, that can be physically and emotionally demanding for young patients.

Historically, the only surgical option was spinal fusion, in which vertebrae are joined using metal rods and screws to stabilize and straighten the spine. Over time, the vertebrae fuse together. While spinal fusion can be highly effective, it reduces spinal flexibility, which can be challenging for young athletes and active individuals.

Now, a new treatment called vertebral body tethering (VBT) is offering a motion-preserving alternative. This technique uses a flexible plastic cord, which allows for spinal movement while gradually straightening the spine as the child grows. The tether adapts to the patient’s development, offering a more dynamic and less restrictive solution.

“Scoliosis is not cancer or life-threatening per se, but to that patient and that family, it’s life-changing. Going through either a surgery or years and years of bracing takes a toll,” said Marks. “They need support, and they need to know that there are incredible professionals that are spending all their free time trying to advance care in every way they can for patients with scoliosis.”

The goal of Dr. Larson’s and Marks’ decision-making tool is to empower families through shared decision-making. By outlining key considerations identified through extensive research, the tool fosters meaningful conversations between clinicians and families, creating space for thoughtful, informed treatment choices.

“I believe that many parents know what’s best for their own child, and I hope that in my encounter with families, I can educate them and provide options and help translate the best available evidence and the best available research to that family,” said Dr. Larson. “Then the family is really making the decision.”

Importantly, the tool also ensures that the child remains actively involved in their care. “This tool is a way to engage the teenager and ask them questions, ask them to give their opinion,” Dr. Larson continued. “It’s a great opportunity to make sure the child has self-determination.”

Learn more about the latest breakthroughs in scoliosis care in this episode of Tomorrow’s Cure. For more episodes and featured experts, visit tomorrowscure.com. 

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Mayo Clinic AI tool finds early signs of blood mutations linked to cancer and heart disease

(Video animation shows blood stem cells dividing and multiplying. Getty Images).

Deep inside the body, a slow-growing cluster of mutated blood cells can form. This cluster, found in 1 in 5 older adults, can raise the risk of leukemia and heart disease, often without warning. 

To better understand this hidden risk, Mayo Clinic researchers have developed an artificial intelligence (AI) tool to help investigators uncover how it contributes to disease risk and progression.

In a study published in Genomics, Proteomics & Bioinformatics, the tool showed promising results in identifying early signs of this condition, known as clonal hematopoiesis of indeterminate potential, or CHIP.

When blood cells mutate

CHIP starts in the bone marrow, where blood stem cells make the cells that keep organs working, oxygen flowing and the immune system strong. But if one of those cells acquires a mutation in a gene linked to blood cancer, it can multiply abnormally, forming a cluster of mutated cells that gradually expands. 

This can cause CHIP, a condition with no symptoms that researchers link to higher rates of death, especially from heart disease. Because its effects vary, CHIP is hard to track and often goes undetected for years. 

CHIP makes leukemia more than 10 times more likely and raises the risk of heart disease up to four times, even in healthy adults. Finding it earlier could help guide proactive monitoring or preventive care.

A new tool for early detection 

The new tool, called UNISOM — short for UNIfied SOmatic calling and Machine learning — was developed by Shulan Tian, Ph.D., under the leadership of Eric Klee, Ph.D., co-senior author of the study and the Everett J. and Jane M. Hauck Midwest Associate Director of Research and Innovation.  

UNISOM helps clinicians identify CHIP-related mutations in standard genetic datasets, opening new avenues for research and discovery. In the past, that level of detection required more complex and advanced sequencing methods. 

“Detecting disease at its earliest molecular roots is one of the most meaningful advances we can make in medicine,” says Dr. Klee. “UNISOM is just one of many examples of how we’re translating genomic science into innovative tools that support timely and informed care.” 

UNISOM helped researchers detect nearly 80% of CHIP mutations using whole-exome sequencing, which analyzes the protein-coding regions of DNA.  

The team also tested UNISOM on whole-genome sequencing data from the Mayo Clinic Biobank, which captures nearly all of a person’s genetic code. In that data, it detected early signs of CHIP, including mutations present in fewer than 5% of blood cells. Standard techniques often miss these small but important changes.

“We’re engineering a path from genomic discovery to clinical decision-making,” says Dr. Tian, the co-senior author and a bioinformatician at Mayo Clinic. “It’s rewarding to help bring these discoveries closer to clinical care, where they can inform decisions and support more precise treatment.” 

Next, the team plans to apply UNISOM to larger and more diverse datasets to support research and expand its use in clinical practice. 

Review the study for a complete list of authors, disclosures and funding.   

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Mayo Clinic ranked No. 1 hospital in Jacksonville by U.S. News & World Report, with most top-ranked specialties in the state

JACKSONVILLE, Fla. — Mayo Clinic is ranked the No. 1 hospital in metro Jacksonville in U.S. News & World Report’s “Best Hospitals” 2025-2026 rankings. Mayo Clinic in Florida achieved significant gains in the publication’s rankings, earning national recognition in 10 specialties and ranking as the top provider in six specialties within Florida.

“We are proud to once again be recognized as top-ranked in more specialties than any other hospital in Florida by U.S. News & World Report,” says Kent Thielen, M.D., CEO of Mayo Clinic in Florida. “This recognition is a testament to our teams’ unwavering commitment – day in and day out – to providing innovative, differentiated patient care of the highest quality.”

Mayo Clinic in Florida ranked nationally among the top 50 hospitals in these 10 specialties; an asterisk indicates the ones in which it is top-ranked in Florida:

Mayo Clinic in Florida provides diagnosis, medical treatment, surgery and care for more than 175,000 patients each year in 50 specialty areas.

In 1986, Mayo Clinic brought its team approach to caring from Rochester, Minnesota, to the Southeast when it opened a clinic in Jacksonville. Today, the 602-acre campus offers a medical destination for patients who travel from all 50 states and more than 80 countries. Its Florida operation has more than 10,000 staff members.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education, and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.   

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Mayo Clinic in Arizona ranked No. 1 hospital in Arizona for 13th consecutive year by U.S. News & World Report

PHOENIX — Mayo Clinic in Arizona is again named the No. 1 hospital in the state and one of the nation’s top hospitals in U.S. News & World Report’s “Best Hospitals” 2025-2026 rankings. This is the 13th consecutive year Mayo Clinic in Arizona has been ranked the top hospital in the state. For the ninth year, it also appeared on the magazine’s national Best Hospitals Honor Roll.

“We are honored to be recognized as the top hospital in Arizona and one of the top 20 hospitals in the country. This recognition is a testament to the dedication, expertise, and compassion of all our staff. It is through their daily pursuit of excellence that we are able to deliver the highest level of serious and complex care,” says Richard Gray, M.D., CEO of Mayo Clinic in Arizona.

Mayo Clinic in Arizona has also ranked among the top 50 hospitals in the country across 10 specialties and claimed the highest position in the state for each of these areas:

Most of the U.S. News & World Report “Best Hospitals” specialties are measured on factors such as patient experience, patient survival, discharge outcomes, nurse staffing, advanced technology, patient services and reputation as determined by other medical experts. The remaining three specialties – ophthalmology, psychiatry and rheumatology – are measured on reputation only.

Mayo Clinic is a destination for patients seeking hope for serious and complex medical conditions. More than 155,000 patients come to Mayo’s Arizona campuses from all 50 states and more than 60 countries each year. Mayo employs 11,000 staff in Arizona and trains the healthcare leaders of the future through allied health certificate programs, medical degrees, and post-graduate training programs as part of the Mayo Clinic College of Medicine and Science.

In 2025, Mayo Clinic announced Bold. Forward. Unbound. in Arizona, a $1.9 billion strategic investment enabling new care concepts, physical spaces and integrated technologies on the Phoenix campus, further advancing Mayo’s position as a Category-of-One destination for serious and complex care in the Southwest and beyond.

Mayo Clinic’s Transplant Center in Arizona is the top transplant center in the U.S., performing more adult solid organ transplants than any other center in the country. In 2023, transplant teams performed a triple transplant (heart, kidney and liver), and in 2024, Mayo surgeons accomplished one of the first larynx transplants in the country. In 2025, the hospital announced the launch of its new Lung Transplant Program in Arizona, establishing the final cornerstone in its status as a comprehensive, fully integrated adult transplant center.

This year, Mayo Clinic in Arizona was awarded the “Triple Crown” by Healthgrades, one of only 10 hospitals in the country to earn simultaneous top scores for patient safety, experience and outcomes. The Leapfrog Group has recognized Mayo Clinic in Arizona’s patient safety with an A-grade in every grading cycle it has offered.

Since 1987, Mayo Clinic in Arizona has continued to transform healthcare through exceptional patient care, education and research. Development is now underway on Discovery Oasis, a 120-acre biotechnology innovation hub that will co-locate companies from around the world with clinicians, researchers, and educators to advance cures. The design supports a unique collaborative ecosystem that invites innovation and incorporates research facilities, biomanufacturing, and digital and artificial intelligence-based health solutions infrastructure.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

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Mayo Clinic top-ranked in most specialties for 36 straight years in U.S. News & World Report rankings

ROCHESTER, Minn. — Mayo Clinic again leads U.S. News & World Report’s “Best Hospitals” rankings for 2025-2026 – the 36th time since the rankings began. This sustained distinction includes a place on the Honor Roll and more specialties ranked in the top three than any other hospital in the nation.

“We are proud to once again be recognized as a leader in healthcare, a reflection of the unwavering commitment of our staff and their dedication to excellence, innovation and putting patients first,” says Gianrico Farrugia, M.D., Mayo Clinic president and CEO. “This honor reinforces our continued focus on raising the standard of what’s possible in medicine.”

This recognition comes as Mayo Clinic continues to make major investments in shaping the future of healthcare through Mayo Clinic Platform and Bold. Forward. Unbound., which seamlessly blends physical spaces with digital technologies to create new healthcare experiences for patients and staff. This includes integrating artificial intelligence, robotics and automation with a human touch to address patients’ unmet and evolving needs.

U.S. News & World Report’s Honor Roll features the top 20 U.S. hospitals that earn the most points across 15 specialties and 22 procedures and conditions. Mayo Clinic is the only healthcare organization with two hospitals on the list—Mayo Clinic in Arizona marks its ninth consecutive year and Mayo Clinic in Rochester again earned the highest overall point total.

State and regional rankings

Mayo Clinic again ranks No. 1 in the U.S. News state rankings for Minnesota and Arizona and continues to be the top hospital in the Jacksonville metro area. Mayo Clinic Health System in Eau Claire, Wisconsin, has also been recognized as a “Best Regional Hospital” in Northwestern Wisconsin.

“Being top-ranked year after year isn’t just about accolades – it’s about consistent, reliable excellence,” said Sean Dowdy, M.D., chief value officer at Mayo Clinic. “Real quality means providing world-class care, even under pressure and through change. Our teams stay focused on what matters most: the patient.”

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and to providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

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Progress in gene therapy offers hope for long-term knee pain relief

Christopher Evans, Ph.D.

For nearly three decades, Mayo Clinic researcher Christopher Evans, Ph.D., has pushed to expand gene therapy beyond its original scope of fixing rare, single-gene defects. That has meant systematically advancing the field through laboratory experiments, pre-clinical studies and clinical trials.

Several gene therapies have already received approval from the U.S. Food and Drug Administration (FDA), and experts predict that 40 to 60 more could be approved over the next decade for a range of conditions. Dr. Evans hopes a gene therapy for osteoarthritis — a form of arthritis affecting more than 32.5 million U.S. adults — will be one of them.

Recently, Dr. Evans and a team of 18 researchers and clinicians reported the results of a first-in-human, phase 1 clinical trial of a novel gene therapy for osteoarthritis. The findings, published in Science Translational Advances, demonstrated that the therapy is safe, achieved sustained expression of a therapeutic gene inside the joint and offered early evidence of clinical benefit.

“This could revolutionize the treatment of osteoarthritis,” says Dr. Evans, who directs the Musculoskeletal Gene Therapy Research lab at Mayo Clinic.

In osteoarthritis, the cartilage that cushions the ends of bones — and sometimes the underlying bone itself — degenerates over time. It is a leading cause of disability, and notoriously difficult to treat. “Any medications you inject into the affected joint will seep right back out in a few hours,” says Dr. Evans. “As far as I know, gene therapy is the only reasonable way to overcome this pharmacologic barrier, and it’s a huge barrier.” By genetically modifying cells in the joint to produce their own pharmacy of anti-inflammatory molecules, Evans aims to engineer knees that are more resistant to arthritis.

The Evans laboratory found that a molecule called interleukin-1 (IL-1) plays an important role in fueling inflammation, pain and cartilage loss in osteoarthritis. As luck would have it, the molecule had a natural inhibitor, aptly named the IL-1 receptor antagonist (IL-1Ra), that could form the basis of the first gene therapy for the disease. In 2000, Dr. Evans and his team packaged the IL-1Ra gene into a harmless virus called AAV, which they tested in cells and then pre-clinical models. The results were encouraging.

In pre-clinical testing, his collaborators at the University of Florida demonstrated that the gene therapy successfully infiltrated the cells that make up the synovial lining of the joint as well as the neighboring cartilage. The therapy protected the cartilage from breakdown. In 2015, the team got investigational new drug approval to start human testing. But regulatory hurdles and manufacturing challenges kept them from injecting their first patient for another four years. Mayo Clinic has since established a new process for accelerating clinical trial activation that could help researchers launch studies more quickly.

In the recent study, Dr. Evans and his team gave the experimental gene therapy to nine patients with osteoarthritis, delivering it directly into the knee joint. They found that the levels of the anti-inflammatory IL-1Ra increased and remained elevated in the joint for at least a year. Participants also reported reduced pain and improved joint function, with no serious safety issues. Dr. Evans says the findings suggest the treatment is safe and may offer long-lasting relief from osteoarthritis symptoms. “This study provides a highly promising, novel way to attack the disease,” he says.

Dr. Evans has co-founded an arthritis gene therapy company called Genascence to drive the project forward. The company just completed a larger phase Ib study and is in discussions with the FDA about launching a pivotal phase IIb/III clinical trial to evaluate the therapy’s effectiveness, the next step before FDA approval for the therapy.

Review the study for a complete list of authors, disclosures and funding. 

Additional resources:

 

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Mayo Clinic deploys NVIDIA Blackwell infrastructure to drive generative AI solutions in medicine

A group of consultants discuss and review a digital pathology image on a wall monitor.

ROCHESTER, Minn. — Mayo Clinic took a pivotal step toward integrating AI solutions in the clinical setting with the deployment of NVIDIA DGX SuperPOD with NVIDIA DGX B200 systems, an advanced infrastructure that provides state-of-the-art AI compute capabilities.

Mayo Clinic and NVIDIA collaborated to enable the rapid innovation and development of foundation models in support of Mayo’s platform approach to healthcare, contributing to Mayo Clinic’s Bold. Forward. strategy and new innovations for generative AI solutions and digital pathology. These innovations are delivering new insights as Mayo is driving to improve patient outcomes and transform healthcare.

Matthew Callstrom, M.D., Ph.D.

“Our aspiration for AI is to meaningfully improve patient outcomes by detecting disease early enough to intervene. What was once a hypothetical — ‘If only we had the right data’ — is now becoming reality thanks to AI and advanced computing,” says Matthew Callstrom, M.D., Ph.D., medical director of the Department of Strategy and leader of Mayo Clinic’s Generative Artificial Intelligence Program.

The advanced computing infrastructure will initially support foundation model development for pathomics, drug discovery and precision medicine.

The NVIDIA Blackwell-powered DGX SuperPOD is built to efficiently process large, high-resolution imaging essential for AI foundation model training. Designed for speed and scalability, the Blackwell infrastructure enables Mayo Clinic to accelerate pathology slide analysis and foundation model development — reducing four weeks of work to just one, ultimately improving patient outcomes. This advanced computing infrastructure will also advance Mayo Clinic’s generative AI and multimodal digital pathology foundation model development.

Mayo Clinic, in partnership with Aignostics, developed a leading pathology foundation model called Atlas, trained on more than 1.2 million histopathology whole-slide images. With Atlas, Mayo Clinic clinicians and researchers can improve accuracy and reduce administrative tasks. The new computing capabilities will accelerate and improve clinical model development.

Jim Rogers

“This compute power, coupled with Mayo’s unparalleled clinical expertise and platform data of over 20 million digitized pathology slides, will allow Mayo to build on its existing foundation models. We’re transforming healthcare by quickly and safely developing innovative AI solutions that can improve patient outcomes and enable clinicians to dedicate more time to patient care while also accelerating commercial affiliations with other industry leaders,” says Jim Rogers, CEO of Mayo Clinic Digital Pathology.

Journalists: Media kit with images for download available here.

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About Mayo Clinic Digital Pathology
Mayo Clinic Digital Pathology facilitates the global scaling of digital pathology solutions to benefit clinicians and patients, advancing key areas such as scanning, storage, foundation model development and the creation and deployment of cutting-edge algorithms. Working with Mayo Clinic innovators and external collaborators, Mayo Clinic Digital Pathology is wholly owned by Mayo Clinic and seeks to incubate and start impactful companies while investing in and acquiring existing companies, spurring innovation across pathology.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

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(VIDEO) 13-year-old Ava is home with a new heart, kidney following a 22-month hospital stay

After more than 22 months at Mayo Clinic Children’s, 13-year-old Ava Weitl went home to Iowa. She and her family were met with tears and cheers as dozens of members from her care team, who are now considered friends of the family, said goodbye and wished her well. 

This was a day Ava had been looking forward to after a long journey with heart failure, two lifesaving extracorporeal membrane oxygenation (ECMO) therapies, a heart transplant, kidney failure and a kidney transplant. 

Watch: 13-year old Ava Weitl leaves Mayo Clinic Children’s after a 22-month hospital stay

Journalists: Broadcast-quality natsound video is in the downloads at the end of the post. Please courtesy: “Mayo Clinic.”

Born with hypoplastic left heart syndrome (HLHS), a life-threatening condition where the left side of the heart is severely underdeveloped, Ava faced three open-heart surgeries before she would reach her 5th birthday. Within 90 minutes of her birth, her first surgery was performed. Her second surgery was completed months later, but the third, typically required for HLHS patients between the ages of 3 and 4, was not possible due to other medical concerns. 

For a handful of years, Ava’s care team monitored her to see what her body would do. During that time, Ava felt good and was “defying the odds,” as her mom, Christina DeShaw, would say. 

It was in 2021, during third grade, when Ava began to show signs of her heart and lungs struggling. While cardiac catheterization improved the blood flow to her lungs, it was a temporary improvement, and by early 2023, doctors determined a heart transplant was her only option.

Ava’s care team cheers her on as she leaves the hospital
Ava smiles as she says goodbye to a care team member

Officially listed for a heart transplant in February 2023, Ava’s condition worsened, leading to hospitalization at Mayo Clinic in September 2023. That hospital stay was the start of her long journey of constant monitoring and tests, and it wasn’t easy on her family as they navigated life split between Minnesota and Iowa. 

In December 2023, Ava’s condition took a critical turn. Ava was placed on life-sustaining ECMO, which provides heart and lung support when those organs are failing. Then, Feb. 26, 2024, the call came: a donor heart became available. The surgery was successful, but postoperative challenges arose.

Weeks later, complications with her lungs led to a return to ECMO for three months. She also needed a tracheostomy placed. While trying to save her lungs, her kidney function began to fail, leading to another gift of life — a kidney transplant on Jan. 25, 2025, thanks to a donation from her uncle through a kidney exchange with the National Kidney Registry. 

“She’s a walking miracle,” her mother says. “We can’t even wrap our heads around what she’s been through.”

Ava with her family

Ava is excited to be home with her parents, Christina and Brad, her twin brother, Aiden, and her younger brother, Miles. She says she looks forward to hanging out with friends, going back to school and having a barbecue with her family. 

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Mayo Clinic Q and A: Water fitness — why aqua exercise works wonders

DEAR MAYO CLINIC: We have a new fitness facility nearby. The pool schedule shows a number of aqua exercise classes. I’d like to try a water fitness class to add variety to my regular fitness routine, but can I really get a good workout in water?

ANSWER: Regular exercise provides a wide range of benefits, including weight management, improved cardiovascular health and sleep quality. But for many people, common forms of exercise, such as walking, running and weight training, are a struggle due to pain, weakness, mobility issues or fear of falling.

Aquatic exercise is an excellent way to focus on fitness in a gravity-reduced environment. Here’s why:

  • Buoyancy. When standing waist-deep in water, buoyancy reduces your body weight by 50%, making this form of exercise very low impact. This significantly reduces the stress on your weight-bearing joints and bones. 
  • Support. Water provides support for people with balance problems. The constant movement of water during a workout also challenges a person’s balance. The more waves there are, the harder it is to balance and exercise.
  • Resistance. Water’s viscosity slows movement and provides resistance, making aquatic exercise a great, resistance-training workout. With less joint stress, people find they can work out longer and do more repetitions.

All these benefits make water exercise an effective option for anyone recovering from a sports injury to regain range of motion, strength and endurance.   

But these benefits also mean you can get a good, overall workout that improves strength, cardio and flexibility. As with any exercise, check with your healthcare team before starting a new routine. 

Five things to know before jumping into the pool

1. Aquatic exercise is versatile.

Aquatic exercise offers a variety of options and techniques for almost all levels of physical ability. These range from basic, such as walking in the water, to more high-level aerobic activities, such as deep-water running or swimming. 

Standing exercises often are performed in water that’s waist to chest deep, and they typically focus on improving range of motion/flexibility, balance and strength. Resistance training can be amplified by simply increasing the speed and range of movement or adding equipment that increases drag, such as webbed mitts, paddles, noodles or bands.

2. You don’t need to know how to swim.

Having a basic knowledge of swimming or water safety is a good idea for anyone who’s around water, but aquatic exercise doesn’t necessarily involve swimming. The shallow end of any pool or lake will do, since for many of the movements, you only need to be able to stand in the water.

3. Water temperature is important.

Aquatic exercise in lower water temperatures (82-88 F) is generally best for higher-level intensity exercise or people who are prone to overheating, such as those who are pregnant, obese or have multiple sclerosis. Aquatic exercise in warmer temperatures (84-92 F) is better for people with arthritis, fibromyalgia or pain, as well as those who are frail.

4. Be aware of your abilities.

With the increased ease of exercise in water, people often can tolerate longer exercise sessions. As a result, these sessions can be more intense, with larger ranges of motion, which creates the potential of overstressing your body. You may be more fatigued than expected following an aquatic exercise session.

5. Consider group exercises to mix it up.

Group aquatic exercise classes are a great way to socialize, build connections, find support, increase accountability and stay motivated to continue exercising. Classes often are led by instructors who have special training in exercising in an aquatic environment. The instructors are able to offer suggestions for adjusting exercises for individual participants, if needed.

Beyond the basics

Amping up your water workout on your own or in a class may include resistance equipment such as:

  • Foam dumbbells. Lightweight on land, they provide resistance underwater through flotation. They come in a variety of resistance options.
  • Water weights. Strap-on ankle or wrist weights increase resistance during arm and leg exercises.
  • Hand paddles and resistance gloves. They enhance strength training.
  • Buoyancy belt. Helps keep your head above water in the deep end while leaving your hands free. You can run, lift weights and do other workouts using your hands without having to tread water.

People often enjoy working out more in water than on land. When they’re not in pain or afraid of falling and are having fun, it encourages them to exercise more consistently. You can even get in a good workout without getting your hair wet.

Kimberly Olsen, Physical Therapy, Mayo Clinic Health System, Mankato, Minnesota

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Resecting the unresectable: The right place, the right team

CV Rao and his wife, Madhavi 

In April 2023, CV Rao had just returned from a work trip in Europe when he started experiencing abdominal pain on his right side. His wife, a doctor, recognized that he needed to see his primary care physician for an ultrasound scan. 

When the ultrasound didn’t show anything, CV’s care team ordered a CT scan. The results were alarming — a 7 centimeter tumor, the size of a large peach, was in his liver. 

“It was a shock to the system,” CV recalls. 

The initial diagnosis suggested intrahepatic cholangiocarcinoma, a rare and aggressive cancer of the bile ducts.

CV quickly received a PET scan, an MRI and a biopsy at a local hospital which confirmed those suspicions. Within eight days, CV was undergoing chemotherapy to shrink the tumor so he might be eligible for surgery.

After six cycles of chemotherapy, the tumor was reevaluated. The good news was that the cancer was responsive to chemotherapy, and the tumor had shrunk by about 50%. Unfortunately, because the tumor surrounded major blood vessels, local surgeons still deemed it inoperable.

Seeking a second opinion

Determined to explore all options, CV sought a second opinion at Mayo Clinic. 

“I was working on 3D printing investments and kept running into Mayo’s innovative approaches,” he explains. “Everywhere I looked, they had this 3D printing effort where the surgeons were able to visualize what they were operating on using 3D printed organs.”

This led him to believe that Mayo Clinic could offer a solution.

A new hope

Six months after diagnosis, CV and his wife, Madhavi, sat across from Harmeet Malhi, M.B.B.S., a hepatologist at Mayo Clinic in Rochester.

“We want to give every patient every chance. Undergoing surgery was his best chance at being tumor-free.”

Harmeet Malhi, M.B.B.S.

After reviewing his imaging and personalized treatment plan with Dr. Malhi, CV and his wife met with Patrick Starlinger, M.D., Ph.D., a hepatobiliary and pancreas surgeon. 

“Dr. Starlinger looked at me and said, ‘You came to the right place. We can help you with this,'” CV remembers.

All three liver veins appeared to be involved. This type of tumor usually is not removable because there must be at least one vein to drain the liver, according to Dr. Starlinger.

“We told him to continue chemotherapy to maximize his response, aiming to get the tumor even smaller. And then we planned for advanced, complex liver surgery.”

Patrick Starlinger, M.D.

Although CV understood this would be a high-risk procedure, he remembers feeling reassured after speaking with Dr. Starlinger.

“Dr. Starlinger looked at his fellows and said, ‘Would you say this is routine?’ And they all said ‘Yes, it’s a routine surgery for us,'” CV says.

As a native of Austria, Dr. Starlinger explains, “In German, we have a word that means saying ‘yes’ to life, ‘lebensbejahend,’ and that’s how CV approached this. Both CV and his wife had such positive attitudes and a willingness to fight this with all they had.”

CV believes the same can be said of Dr. Starlinger’s approach to his case. 

“The very first day, Dr. Starlinger walked in with a positive attitude, which is one of the things that you realize you absolutely need to get through things like this,” CV says.

Resecting the unresectable

CV’s surgery was scheduled for November 22, 2023, the day before Thanksgiving. 

To prepare for the operation, Dr. Starlinger turned to a 3D printed model of CV’s anatomy, just like the ones that had led CV to Mayo Clinic.

“3D models are incredibly helpful in complex surgical procedures because they allow for optimized surgical planning prior to the actual surgery,” Dr. Starlinger explains.

At 6 a.m. on Nov. 22, CV was taken back to the operating room for the complex, 4.5-hour surgery. 

“We carefully dissected through the liver until we approached the right hepatic vein, which was really the critical portion of CV’s operation,” Dr. Starlinger says. “We had everything prepared to reimplant the only remaining liver vein, but with meticulous precision, using an ultrasound dissection device, we were ultimately able to peel the tumor off the majority of the right hepatic vein and perform a primary repair of the vessel.”

Dr. Starlinger and the surgical team removed roughly 50% of CV’s liver, along with the entire tumor. The surgery was a success.

Experiencing cherished milestones

Nearly two years after his diagnosis, CV is returning to the activities he loved. He has resumed skiing, attended his younger son’s robotics competitions, and even traveled to Switzerland and Austria with his wife. 

“I can’t wait to see my older son graduate and drop him off at college,” he shares with a smile. “We are in a stage of life where a lot of life events are happening. It’s amazing to do these things that are important to the family.”

These moments, once clouded by uncertainty, are now cherished milestones.

Reflecting on his care at Mayo Clinic, CV expresses deep gratitude to the team that provided him with expert and compassionate treatment. 

“The Mayo Clinic staff is beyond what we’ve experienced elsewhere,” he says. “During my seven days in the hospital, we interacted with many nurses, and through changes in shifts, it was just a uniformly amazing experience. Every, every single person we came in touch with was such a positive experience.”

“We wish Dr. Starlinger the longest career possible because the number of lives he has and will save is incredible,” he says. 

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