A Childhood Dream, A Lifelong Mission

When Bradford Hoppe, M.D., was in middle school, he was told to make a collage using magazine cutouts to visualize his future goals. He created an image of a doctor living near the beach.

Today, his artwork has become a reality. Dr. Hoppe serves as a consultant in the Department of Radiation Oncology at Mayo Clinic and lives with his family in Atlantic Beach, Florida. But it’s not just a childhood dream that drives him. After nearly losing both his wife and his father to cancer, he is more determined than ever to transform the future of cancer care.

Following in His Father’s Footsteps

Raised in Los Altos, California, Dr. Hoppe grew up admiring his father’s lifelong career as a radiation oncologist at Stanford Medicine.

Dr. Hoppe says his dad’s work in Hodgkin lymphoma left a lasting impression that made him eager to follow in his footsteps. While traditional radiation could cure the condition, it could also lead to serious long-term side effects such as second cancers or heart complications decades later.

Related Content

What Is Carbon Ion Therapy? A Look Inside the Cancer Treatment

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies?

Read More

“I became interested in this idea of optimizing clinical outcomes while minimizing risk of side effects. I knew I wanted to be part of the next generation of radiation therapy,” says Dr. Hoppe.

After earning a B.S. in biology at Stanford University and an M.D. at Cornell University Medical Center, Dr. Hoppe spent a year in Brazil conducting infectious disease and immunology research. He studied the impact of schistosomiasis, a parasitic disease, on the immune system and volunteered at a leprosy clinic.

“The work in infectious disease was really engaging in Brazil. But when I returned home, I knew I wanted to get back to my first passion: radiation oncology. I wanted to continue to advance the field just like my father had done.”

Shifting Coasts, Deepening Focus

After spending most of his life on the West Coast, Dr. Hoppe moved to the East Coast to pursue a radiation oncology residency at Memorial Sloan Kettering Cancer Center in New York, where he met his future wife, Sonia.

After completing an M.P.H. at Harvard School of Public Health, the couple then moved to Florida where Sonia began working in radiation oncology at Mayo Clinic and Dr. Hoppe became a faculty member at the University of Florida Health Proton Therapy Institute. There, he held the James E. Lockwood Endowed Chair in Proton Therapy and pioneered the development of proton therapy in the management of lymphoma, thymoma and lung cancer before joining Mayo Clinic in 2019.

“My wife had been working at Mayo Clinic as a radiation therapist for about 10 years before I joined,” says Dr. Hoppe. “When Mayo Clinic announced its plans for particle therapy, I knew it was the right move.”

Reimagining Carbon Ion Therapy

Dr. Hoppe is part of a team at Mayo Clinic that is bringing carbon ion radiation therapy to the United States. Similar to proton therapy, carbon ion can be delivered to a specific depth in the body, reducing damage to critical organs. However, unlike proton therapy, carbon ion causes clustered DNA damage, which is more effective in killing cancer cells, particularly with radiation-resistant cancers, and can be completed in less time than a traditional radiation therapy course. 

Mayo Clinic’s Duan Family Building in Florida will provide advanced cancer treatment options that are currently only available in Asia and Europe. The building opened to patients in July 2025, with the first carbon ion treatment expected to be available by 2028.

We are building upon existing strategies and making them better to shape a new future. And we’re getting closer every day.

— Bradford Hoppe, M.D.

Dr. Hoppe and his colleagues have toured and learned from existing carbon ion centers in Japan, Germany, Taiwan, Korea, Italy and Austria. But it’s not a simple copy-and-paste process.

“Mayo Clinic is approaching carbon ion therapy differently than other institutions,” explains Dr. Hoppe. “Traditionally, carbon ion therapy has been limited to rare, hard-to-treat tumors that don’t respond well to other treatments. But with the advances in precision medicine, we are working to identify patients with radioresistant forms of more common cancers who could benefit.”

Leading an International Collaboration

Dr. Hoppe is leading a collaborative clinical trial with centers in Europe and Asia to compare surgical treatment, proton radiation and carbon ion approaches for patients with pelvic bone sarcomas. The team is studying whether patients being treated with carbon ion therapy have higher cure rates compared with proton therapy and better functional quality of life compared with surgery.

Studies like this one will help experts better understand which cancers would benefit from carbon ion therapy.

“The key is knowing which patients will benefit from which treatments,” explains Dr. Hoppe. “It’s difficult for patients who have already undergone radiation unsuccessfully to jump into carbon ion because we don’t want to exceed radiation dose levels to critical structures and cause more problems for the patient. Our goal is to be able to identify the patients who would do better with carbon ion therapy at the time of diagnosis to improve outcomes and spare them from unnecessary side effects.”

A Mission Fueled by Experience

While Dr. Hoppe has realized his childhood dream, his mission has grown even more meaningful.

“My wife and my father both were diagnosed with metastatic cancers more than five years ago that were expected to be terminal,” says Dr. Hoppe. “Both have undergone cutting-edge, personalized treatments and are in remission.”

Dr. Hoppe is building on his father’s legacy — but also creating his own. His research in bone sarcomas is just the beginning.

“I imagine a future where Mayo Clinic will be able to identify patients most suitable for proton therapy and carbon ion radiation therapy through radiomic and genomic signatures. That means better outcomes, fewer side effects and more lives saved. We are building upon existing strategies and making them better to shape a new future. And we’re getting closer every day.”

The post A Childhood Dream, A Lifelong Mission appeared first on Mayo Clinic Magazine.

With his mallet in hand and a quiet buzz of anticipation in the air, John lined up for a jump shot — and executed it perfectly. But as the ball moved toward its target, a sharp pain jolted through his arm and shoulder. The next thing he knew, he was at a nearby emergency room.

"They did an X-ray. It clearly showed my arm was broken in half, and that was rather confusing to me,” John says. “I wasn’t an old guy. I was in great shape. There was no reason for my bones to break.”

John and Gail, who split time between Scottsdale, Arizona, and the coast of Massachusetts, traveled to Boston to meet with an orthopedist, wanting to understand what could have caused such a severe fracture. The MRI results found the culprit: a tumor.

An Unexpected Diagnosis

John was diagnosed with multiple myeloma, a rare cancer of the bone marrow that weakens the bone from the inside out. In his case, the cancer had progressed enough to make his arm susceptible to fracture — even during a relatively low-impact activity such as croquet.

“When the doctors came into my room and told me I had this cancer, I’d never even heard of it. No matter how much you think you can be ready for someone to tell you that, you’re not,” John says. “I figured I was going to die within the next month and was running through all the different scenarios: ‘What can I do? What should I do? What do I have to do before I die?’”

It wasn’t long before John was undergoing his first operation to remove the cancer, followed by radiation, chemotherapy and other infusion drugs. Unfortunately, despite these interventions, the cancer still spread to his other arm, prompting a second surgery. “Here I am, both arms in slings at the same time. That made life challenging,” he says.

As John headed home to Scottsdale postsurgery, his future felt uncertain and hope out of reach. But everything changed after becoming a patient at Mayo Clinic.

Finding Hope

As a resident of the Desert Mountain community in Scottsdale, John was able to utilize Desert Mountain CARE to connect with Leif Bergsagel, M.D., an oncologist at Mayo Clinic in Arizona who specializes in multiple myeloma treatment.

“The moment I got an email from him that said, ‘Sure, I’d love to take you on as a patient,’ there was this relief, joy and exhilaration,” John says. “I went from thinking, ‘I’m not going to find anyone’ to having a terrific doctor at Mayo Clinic. When I read that email, I was dancing around the house the rest of the day.”

Dr. Bergsagel, a David F. and Margaret T. Grohne Professor of Novel Therapeutics for Cancer Research, reassured John that most of what’s found online about multiple myeloma is out of date. “It used to be that multiple myeloma was a death sentence, with a survival rate of about three years. That’s no longer the case,” he says.

Mayo Clinic has developed highly effective new treatments that can keep the cancer at bay, giving patients like John hope.

A Path Forward

In January 2023, John received a stem cell transplant while under Dr. Bergsagel’s care. “After a bone marrow biopsy, it became clear that I was doing extremely well against this cancer,” John says.

Stem cell therapy is just one part of a growing number of treatment options for multiple myeloma. Looking ahead, the future of treating rare cancers such as multiple myeloma may include cutting-edge approaches like CAR-T cell therapy — a promising form of immunotherapy that involves reprogramming a patient’s own immune cells to target and destroy cancer cells.

“It sounds like science fiction. We’re harnessing the patient’s T cells to identify the cancer and eradicate it,” Dr. Bergsagel says. “We take the T cells out of a patient and engineer them to recognize the tumor, then put them back in the patient. They expand exponentially and kill the tumor — and keep it away for years.”

Dr. Bergsagel says the goal is to reach the point of being able to treat cancer like a chronic disease, such as high blood pressure.

"We’re getting closer and closer to that. The future is really bright for patients with multiple myeloma,” he says. “We don’t think that we can cure it just yet, but we think we can control it for decades at this point. We’re looking at ways of improving the quality of life for the patients on those therapies so they can basically lead a normal life.”

Back on the Court

Throughout John’s entire cancer journey, he held onto one vision: getting back to croquet.

"When I had my stem cell transplant, I spent most of the day in bed and I would dream of going back on the croquet court and being able to swing my mallet and enjoy my friends, and play with my wife as a partner,” he says.

Now, that dream is a reality. John is back to playing the game he loves, with gratitude in every swing. But for him, it’s more than a return to normal. It’s a reminder of how far he’s come — and how much more there is to look forward to.

“I’ve got my cancer count down now to virtually indistinguishable levels, which is very encouraging to me,” John says. “Dr. Bergsagel assures me that moving forward, we have a good chance of keeping it there.”

The post Back in the Game appeared first on Mayo Clinic Magazine.

Redefining Cancer Care

Mayo Clinic Comprehensive Cancer Center is pioneering a new era of cancer care, combining decades of research and discovery with the most advanced technology to create a cancer center without walls where anyone, anywhere can receive the highest-quality care. 

Building on more than five decades of important contributions to the field, Mayo Clinic is leading the transformation of cancer research and care. This work is rooted in patient-centered care, multidisciplinary team science and the translation of cutting-edge research — and it is drastically improving outcomes for patients. 

Each year, more than 138,000 patients with cancer are seen at Mayo Clinic Comprehensive Cancer Center, which treats over 200 types of cancer. With more than 360 investigators conducting research and more than 2,150 clinical trial accruals in 2024 alone, Mayo Clinic continues to set the standard for innovation and discovery. 

From designing the next generation of therapies to leveraging artificial intelligence (AI) to advance lymphoma treatment, these innovations are redefining cancer care. 

DESIGNING THE NEXT GENERATION OF THERAPIES

Radiopharmaceuticals are a type of theranostic treatment that offers significant benefits to patients with advanced cancers that do not respond to other therapies or patients who cannot undergo traditional treatment options.  

Mayo Clinic, managing the highest-volume radiopharmaceutical practice in the world, is continuously developing new tools and collaborating with industry partners to develop the next generation of radioisotope imaging and treatment technologies while addressing patient access issues. These collaborations lay the groundwork for testing and applying new radiopharmaceutical treatments for patients with cancer, a priority Mayo Clinic continues to keep at the forefront of its practice. 

Related Content

The Science Behind Theranostics

A groundbreaking approach called theranostics is emerging as a powerful tool in the fight against cancer.

Read More

EARLY DETECTION AND PREVENTION OF MULTIPLE MYELOMA PROGRESSION

Multiple myeloma is preceded by a common benign monoclonal plasma cell expansion called monoclonal gammopathy of undetermined significance (MGUS). In between multiple myeloma and MGUS is a third clinical entity called smoldering multiple myeloma. In this condition, there is more extensive plasma cell expansion than in MGUS, but the malignant features of multiple myeloma are not seen.  

A new study aims to define the genetic events that drive multiple myeloma progression from a benign state to a malignant state. By using next-generation sequencing, researchers analyze genetic mutations and pathways linked to disease advancement. They also study how the tumor microenvironment contributes to progression. The goal is to create a genetic definition of malignant plasma cells, enabling earlier detection and intervention, ultimately transforming how the disease is diagnosed and treated. 

AI MODELS ADVANCE LYMPHOMA TREATMENT

Mayo Clinic investigators are leveraging vision-language foundation models, a type of AI that simultaneously learns from images and text, such as medical scans and patient reports, for personalized care.

Working with more than two decades of data gathered from diverse national cohorts, Mayo Clinic’s team from the Lymphoma Specialized Program of Research Excellence developed a model to improve diagnostics and forecast how a patient with lymphoma might respond to therapy.

A second foundation model will examine single-cell images from blood and bone marrow for more comprehensive characterization of cellular biology to identify targets and develop predictive biomarkers for response to novel therapies.

Related Content

Healing at Home

Mayo Clinic takes cancer care beyond walls and into patients’ homes.

Read More

REVOLUTIONIZING CANCER CARE DELIVERY

Mayo Clinic’s Cancer Care Beyond Walls program delivers care, including chemotherapy, directly to patients in their homes, reducing financial and logistical challenges often associated with travel to Mayo Clinic campuses.  

A recent Mayo Clinic study found that the program is safe and effective, and patients with glioma undergoing chemotherapy reported high levels of satisfaction with telehealth. This unique model removes significant barriers to care, improves treatment adherence, and offers a more convenient and accessible care experience. This work reflects Mayo Clinic’s commitment to exceptional cancer care through advanced technology and personalized approaches. 

Learn more about Mayo Clinic's vision for transforming cancer care.

The post Redefining Cancer Care appeared first on Mayo Clinic Magazine.

“As a young man, I didn’t know what I wanted to do,” he says with a laugh. “I started in physical therapy.”

Growing up in a paper mill town in northern Minnesota, he was the first in his family to pursue higher education. As a physical therapist, he worked in a sports medicine clinic, helping people to jump higher, throw farther, run faster. But eventually he realized he wanted to do more. Physical therapy was rewarding, but he was pushing people who were already at 90% up to 100%. And not all patients were like that.

“I realized that hospitalized older patients were often just trying to get out of bed or rise from a chair. That realization made me redefine my understanding of ‘human performance’ — as a physical therapist I was focused on optimizing human performance, and that experience changed what I thought of as ‘optimizing.’”

A New Path

To find a way to boost that performance, Dr. LeBrasseur went back to school for a Ph.D. Now, as director of the Mayo Clinic Robert and Arlene Kogod Center on Aging and the Noaber Foundation Professor of Aging Research at Mayo Clinic, he’s occupied with a new question, or rather, several questions: “What is aging, in a biological sense? What is this thing that creates so many vulnerabilities? What are the effects of the wear and tear of life on our bodies?”

The big, overarching idea that guides Dr. LeBrasseur and his colleagues at the Kogod Center on Aging is that if doctors can better understand the aging process, that process can be delayed, managed or softened, instead of “playing a game of whack-a-mole,” as Dr. LeBrasseur puts it, with common diseases of aging like Alzheimer’s, Parkinson’s and cancer.

Related Content

What Are Zombie Cells?

These cellular undead linger in your body, accelerating aging and disease.

Read More

In Dr. LeBrasseur’s mind, aging has three hallmarks. First, it’s universal. “You, me, your dog, your coffee machine — it happens to everything and everyone.”

Second, it’s progressive. Aging doesn’t just happen all at once at age 65 or when you retire. It is a process that occurs over your entire lifetime, or even before your lifetime, if you consider the aging of our parents’ reproductive cells.

Finally, it’s intrinsic. “I can be protected from all exposures — put me in a cage, keep me in optimal conditions — and I will still age,” says Dr. LeBrasseur.

An Inevitable Fate

Aging is really because of the laws of physics. Due to the effects of entropy, things — including our bodies — tend to break down and become more disordered over time. The Kogod Center on Aging is measuring damage to the human body, to its cells and tissues. They are delving into the “hallmarks” of aging — damage to DNA, mitochondrial dysfunction, how often the proteins in our body are replaced as they wear out, and top of mind for Dr. LeBrasseur, something called senescent cells.

These are cells that are worn out, used up and damaged. Like an old car, perhaps they can be repaired, or maybe they need to be broken down, their parts recycled and retired. These are the two main fates for old cells: death, by a self-destruct mechanism (called apoptosis), or repaired to carry on.

Senescence isn’t just a part of getting older. In biology, it also plays a role in development. For example, how does an organ know how big to get? That’s senescence. When the cells of a particular organ stop growing and dividing, it’s a signal to the rest of the body that the organ has reached its adult state.

You, me, your dog, your coffee machine — aging happens to everything and everyone.

— Nathan LeBrasseur, Ph.D., M.S.

However, as we age, senescent cells take on a more dangerous role. These are known as zombie cells — damaged cells that, by chance or by mutation, evade both the body's repair mechanisms and apoptosis pathways. These zombie cells simply carry on in their damaged state. They continue to perform their cellular duties, to the best of their abilities, but can cause more problems than they would if they just self-destructed.

When senescent cells linger, that’s bad. They secrete a lot of toxic molecules into the body that hinder normal processes. This manifests in all kinds of ways, and as a body ages, its ability to heal slows, thanks to damaged cells.

“Not only is the ‘seed’ damaged,” says Dr. LeBrasseur, pointing to damaged cells, “but the ‘soil’ is now toxic. Even if there are other healthy cells around, the toxic secretions of damaged zombie cells compromise those healthy cells and their healing process.”

Where to go from here? Dr. LeBrasseur says they don’t have to reinvent the wheel. According to him, the big breakthrough was in 2011, when zombie cells were one of the scientific breakthroughs of the year, as ranked by Science. 

Understanding the Aging Process

A group of researchers at Mayo Clinic, including Dr. LeBrasseur, removed zombie cells in a mouse model and saw that doing so delayed a litany of age-related disorders. By injecting mice with a drug that made senescent cells self-destruct, they delayed the onset of cataracts and muscle weakness. Mice without senescent cells could run and scurry longer than control mice, while maintaining their weight as they aged, something that becomes a struggle for aging humans. The mice didn’t live longer, but they lived healthier, happier lives.

While these sorts of approaches are theoretically possible, more work needs to be done to develop safe and effective senescent cell-targeting drugs for humans. Already, they point to opportunities to potentially manage and ease the process of aging.

“The foundational things for healthy aging are the things that you already know about — exercise, eating well, socializing and so on,” says Dr. LeBrasseur. “These activities are critical for aging well, and I don’t know how much we can change that with just drugs. And you have control. It doesn’t cost money to do those things, but it does take personal effort. Some people are disappointed with those kinds of answers.”

Dr. LeBrasseur says to think of aging with a holistic perspective — choices made all through life have an effect. It’s not the individual meals you eat but the lifetime of food choices, not the one walk but a lifetime of walking every day. In essence, humans prepare their whole lives to become old. Everyone will eventually develop some health condition, and they start to pile up.

But Dr. LeBrasseur wonders: “Can we boost the resilience of older adults before they even get sick and have to undergo harsh treatments like surgeries and chemotherapy?”

In addition to encouraging patients to engage in healthy lifestyle activities, the team at the Kogod Center on Aging is continuing to explore the effects of zombie cells, with the goal of eventually finding ways to prevent their negative impacts on our health. In the future, Dr. LeBrasseur hopes that for older adults, those twilight years can be a whole lot smoother.

The post Guiding Bodies Into Aging Gracefully appeared first on Mayo Clinic Magazine.

Combined Surgery Offers Hope for Severely Obese Liver Transplant Patients

A groundbreaking Mayo Clinic study has found that combining bariatric surgery with liver transplantation provides significant long-term health benefits for patients with severe obesity who traditionally face transplant denial due to their weight.

The research conducted over 10 years compared patients who received liver transplants alone versus those who underwent both procedures simultaneously. The combined approach produced sustained weight loss, reduced risk of type 2 diabetes, and decreased fatty liver disease recurrence without additional surgical risks.

This dual approach is aimed at addressing long-term obesity complications like diabetes, heart disease and cancer, while also preventing fatty liver disease recurrence.

— Julie Heimbach, M.D.

This innovation addresses a growing challenge: More than 41% of liver transplant candidates are obese, with a body mass index (BMI) above 30. Patients with BMI of 40 or greater face frequent transplant denial, creating a critical treatment gap.

“We’ve been amazed by the transformation our patients experience,” says Julie Heimbach, M.D., director of Mayo Clinic Transplant Center and the study’s senior author. “This dual approach is aimed at addressing long-term obesity complications like diabetes, heart disease and cancer, while also preventing fatty liver disease recurrence.”

The multidisciplinary approach protects the transplanted liver from the same metabolic dysfunction that caused the original liver failure. Bariatric surgery remains an effective option for patients with severe obesity due to its proven effectiveness and lasting results.

This breakthrough expands treatment options for vulnerable patients facing life-threatening liver disease.

The post Combined Surgery Offers Hope for Severely Obese Liver Transplant Patients appeared first on Mayo Clinic Magazine.

Keep reading for three exciting advances on the horizon in cancer medicine.

REDUCING SIDE EFFECTS FOR NEW THERAPIES

Immune checkpoint inhibitors are widely used cancer treatments, but about 55% of patients experience serious side effects. Mayo Clinic researchers are studying how specific subtypes of T cells — immune cells that can mistakenly attack healthy parts of the body while targeting cancer cells — contribute to these side effects. Understanding the connection between T cells and side effects could lead to new tools to better predict and reduce side effects, improving patient experiences and outcomes.

Related Content

What Is CAR-T Cell Therapy? Exploring a Promising New Cancer Treatment

CAR-T cell therapy has transformed cancer treatment options — giving more patients hope.

Read More

IMPROVING SURGICAL PRECISION

Mayo Clinic is partnering with the University of Illinois Urbana-Champaign to develop new precision tools to help surgeons perform procedures more accurately, with real-time assessments for surgical decision-making in lung cancer care. The Advanced Research Funding Agency for Health awarded the project a contract for up to $33 million to create “scalable, affordable and easily implementable surgical technology that will transform healthcare.”

BRINGING CARBON ION THERAPY TO NORTH AMERICA

The Duan Family Building opened on our Florida campus in 2025, and by 2028, Mayo Clinic will provide conventional radiation therapy, proton beam therapy and carbon ion therapy in the space.

Related Content

What Is Carbon Ion Therapy? A Look Inside the Cancer Treatment

How does this innovative therapy work, and how does it stack up against other cancer radiation therapies?

Read More

Carbon ion therapy has unprecedented potential to help patients whose cancer resists other forms of radiotherapy, but currently it is only available at 15 facilities in Asia and Europe. Mayo Clinic will be the first to offer this transformative treatment in North America.

Learn more about Mayo Clinic's vision for transforming cancer care.

The post The Next Era in Cancer Medicine appeared first on Mayo Clinic Magazine.

At Mayo Clinic, researchers are at the leading edge in understanding how these zombie cells contribute to aging and disease, with promising developments that could help us age more gracefully.

Understanding the Cellular Undead

Throughout our lives, our cells experience wear and tear. When cells become damaged, they typically have two fates: repair themselves and continue functioning, or self-destruct through a process called apoptosis. Zombie cells, however, take a different path. They become senescent, meaning they neither repair properly nor die off.

First described in 1961 by biologists Leonard Hayflick and Paul Moorhead, a common cell (fibroblast) was found to divide only about 50 times before entering a twilight state. While they continue to perform their cellular duties to the best of their abilities, senescent cells secrete inflammatory molecules and other toxic substances — collectively known as the senescence-associated secretory phenotype (SASP) — that can compromise nearby healthy cells.

According to Nathan LeBrasseur, Ph.D., M.S., director of the Robert and Arlene Kogod Center on Aging at Mayo Clinic, even if there are other healthy cells around, the toxic secretions of damaged zombie cells can poison healthy cells and negatively affect their function. Dr. LeBrasseur is also the Noaber Foundation Professor of Aging Research.

BECOMING A ZOMBIE CELL

CELL DAMAGE

When damaged by injury, disease or environmental cues, most cells either repair themselves or self-destruct via apoptosis. Zombie cells, however, become senescent, meaning they neither repair properly nor die off.

TOXIC SIGNALS

These senescent cells evade the body's normal clearance mechanisms. They linger in the tissue and secrete inflammatory molecules and other toxic substances — collectively known as the senescence-associated secretory phenotype (SASP) — that can compromise nearby healthy cells.

ACCUMULATION

In youth, the immune system is good at identifying and eliminating senescent cells. As we age, this clearing mechanism becomes less effective, allowing zombie cells to accumulate.

SENOTHERAPEUTICS

Removing zombie cells in mice delays the onset of a number of age-related disorders. As a result, scientists are working on developing senotherapeutics — drugs that can kill senescent cells or block their harmful secretions. The hope is that one day these therapies can be used to protect human health as we age.

How Do Zombie Cells Impact Our Health?

When we're young, the immune system is good at identifying and eliminating senescent cells. As we age, this clearing mechanism becomes less effective, allowing zombie cells to accumulate. This accumulation is associated with a long list of age-related conditions like tissue fibrosis, bone degeneration and chronic inflammation.

The presence of zombie cells can significantly affect healing processes. As Dr. LeBrasseur notes, these damaged cells can hinder normal tissue repair, creating an environment where even healthy cells struggle to function properly. This contributes to the progressive nature of aging, where health conditions begin to stack up. What might take 50 years to develop into a person’s first chronic disease might result in a second within just five years, and a third even more quickly.

Related Content

Guiding Bodies Into Aging Gracefully

Dr. Nathan LeBrasseur hopes to find a healthy, robust aging process.

Read More

Scientific Breakthrough of the Year

In 2011, Mayo Clinic researchers made a groundbreaking discovery that was recognized as one of the scientific breakthroughs of the year by the journal Science. By removing zombie cells in mice, they delayed the onset of various age-related disorders including cataracts and muscle weakness. The mice didn't live longer, but they maintained better health throughout their lives — running longer, maintaining weight and showing fewer signs of aging-related decline.

This discovery has led to the development of "senotherapeutics": drugs designed to target zombie cells. Varieties include senolytics, which kill senescent cells directly, and senomorphics, which suppress the harmful secretions of these cells. These approaches show promise in preclinical models, but more work is needed before they can be widely used in humans.

Better Health Through Graceful Aging

While pharmaceutical interventions are still being developed, there are proven ways to manage zombie cell accumulation. Dr. LeBrasseur, a self-described "exercise evangelist," emphasizes that regular physical activity both prevents senescent cell accumulation and promotes their clearance. He says that the usual recommendations for healthy aging — such as regular exercise, a healthy diet and socializing regularly with loved ones — are all critical for aging well.

The work at Mayo Clinic's Robert and Arlene Kogod Center on Aging continues to explore the effects of zombie cells, hoping to find ways to delay or prevent their negative impacts on our health. By taking a holistic, lifelong approach to managing senescent cells, we may be able to extend the individual “health span,” improving quality of life for aging adults everywhere.

The post What Are Zombie Cells? appeared first on Mayo Clinic Magazine.

His ability to fly and run again was restored thanks to a special procedure Mayo Clinic surgeons call "onco-regeneration" — a partnership between orthopedic oncologists and plastic surgeons that returns muscle strength and function to patients who have lost them after surgery to remove soft tissue sarcoma.

Had his condition occurred a few years earlier, Chris may not have made such a remarkable recovery from the severe calf pain that interrupted one of his regular evening jogs just before his 53rd birthday in 2019.

Chris’ wife, Davie, a nurse, insisted he seek medical attention after the swelling of his leg hadn’t subsided in a few days. Local providers initially diagnosed a pulled muscle. But three months later, a concerning lump remained on the back of his knee. An MRI revealed that he had cancer in his thigh.

Davie reached out to a contact she had at Mayo Clinic, Alexander Shin, M.D., an orthopedic hand and microvascular surgeon. It was recommended that Chris make an appointment at Mayo Clinic.

A Rare Diagnosis

Chris flew himself and Davie from their Overland Park, Kansas, home to Rochester, Minnesota, to meet with Mayo Clinic’s Matthew Houdek, M.D., an associate professor of orthopedic surgery and the fellowship director for musculoskeletal oncology.

Chris had myxoid liposarcoma, an extremely rare form of cancer. Although it had been caught before it metastasized, Chris still needed five-day-a-week radiation sessions for five weeks, followed by surgery.

When Chris asked if he should go back home for treatment, Dr. Houdek’s response made the decision clear.

“I could see him thinking about how to nicely say it,” Chris recalls. “He said, ‘Well, I’m sure they’re good, but my team sees this type of cancer every day of the week. Most other places don’t see more than one of this type of cancer a year.’”

That was all it took for Chris to know he should stay at Mayo Clinic.

A Breakthrough Approach

Dr. Houdek and Steven Moran, M.D., a Mayo Clinic plastic surgeon, led the surgical team that operated on Chris in 2019. It quickly became clear there was no saving Chris’ hamstring. Cancer had consumed nearly all of it, and doctors took the rest.

To replace it, they took a latissimus dorsi muscle from Chris’ back and fashioned it into a new hamstring.

“They basically had to play the board game Operation with me,” Chris jokes. “It was amazing.”

The Road to Recovery

It was three months before Chris was allowed to put any weight on his leg. Six months later, he was able to walk up to three miles at a time.

“Mr. Reedy is a testament to how resilient patients with a soft tissue sarcoma are,” Dr. Houdek says. “He did the hard work in the recovery process to get to where he is now.”

By using onco-regeneration, Mayo Clinic surgeons had leveraged the body’s ability to regenerate muscle strength.

“It takes a team to be able to do these procedures,” Dr. Houdek says. “Thankfully we have the collaboration between us, our plastic surgeons, radiation oncologists and medical oncologists to advance functional outcomes for patients undergoing limb salvage surgery.”

Taking Flight Again

Two years after the surgery, Chris was back to jogging. But his real goal was to return to the cockpit.

Chris learned how to fly while in college and is the president and CEO of Butler National Corporation, an aerospace and professional services company. He worried he might not ever pilot a plane again.

“Flying is awesome,” says Chris, who shares two planes with his brother and uncle. “It devastated me to think about not being able to fly again. But Dr. Houdek was always so positive about regenerative medicine. He has outcomes that other people don’t.”

Cleared for Takeoff

Chris’ friends in the aviation community told him that if he could get a recommendation from Mayo Clinic, it would help him in his quest to get his pilot’s medical certificate back. Almost a year to the day from his surgery, with the help of Steven Robinson, M.B.B.S., he received a letter of recommendation from Mayo Clinic’s Section of Aerospace Medicine. Shortly thereafter, the Federal Aviation Administration provided a special medical authorization restoring his pilot privileges.

A 2022 recurrence of cancer also didn’t slow Chris down when a tumor was found on his spine. He sent his MRI results to Dr. Houdek, and a few days later Chris was in Rochester, being introduced to Peter Rose, M.D., an orthopedic surgeon at Mayo Clinic.

Dr. Rose removed the tumor from Chris’ back without hampering his mobility so that Chris could get back to what he loves — living life without limits.

“Within about a month, I was back in action,” Chris says. “Mayo Clinic doctors are phenomenal. They’re skilled and exceptionally intelligent, and they get back to you much quicker than other doctors do when you send them a message. They just take great care of you.”

The post Taking Flight Again appeared first on Mayo Clinic Magazine.

Face in the Mirror: The Story Behind Mayo Clinic’s First Face Transplant

The following is an excerpt from Face in the Mirror by Jack El-Hai — a book that follows the journey of Andy Sandness, who received the first face transplant at Mayo Clinic. Proceeds are invested into furthering medical research and education at Mayo Clinic.

Andy felt calm when he checked into the Rochester hotel where he would spend the night before his face transplant began. He no longer felt scared. Focused on the surgery, he forgot to check on the outcome of the NHL Stanley Cup championship game that day, diehard sports fan though he was. As he prepared for bed, he strove to relax and mentally prepare himself for the momentous event ahead.

The next morning, transplant nurse coordinator Lori Ewoldt walked Andy the short distance from the hotel to Saint Marys. She was relieved to have been able to share some laughs with him the previous night after the ambulance finally made its rendezvous with his taxicab. It was hard not to look at him through a mother’s eyes. He was young enough to be her child. The calmness with which he faced the long surgery ahead impressed her.

After Andy’s admission to the hospital, Mayo Clinic plastic surgeon Samir Mardini, M.D., visited Andy in his room. He and Andy shook hands and started talking. Dr. Mardini explained some technicalities and paperwork they had to get out of the way. He presented Andy with the final consent forms to sign. They had spoken together many times previously about the risks and consequences of the surgery, but discussions just before serious operations often carry a stronger urgency than conversations that happen way in advance, when the surgery seems merely a possibility. Dr. Mardini asked Andy if he was certain he wanted to undergo the transplant.

“Yes, I’m ready,” Andy replied.

“We’re going to do the best we can,” Dr. Mardini said. “Do you have any questions?”

Research fellow Marissa Suchyta, M.D., Ph.D., was present, and Andy’s composure surprised her. “He was so ready for this to happen and had so much trust in the team that he had no hesitation signing those consent forms,” she said.

Hatem Amer, M.D., too evaluated Andy. He once again told Andy about the risks and possible complications of the face transplant. They also discussed Andy’s CMV mismatch with the donor’s tissues and the medications and treatments that could minimize any potential problems. Dr. Amer judged that the risk of Andy undergoing anesthesia was acceptable.

Related Content

AI’s Role in Kataliya’s Heart Transplant Journey

For Kataliya, AI was more than just a technology — it was a lifeline.

Read More

Dr. Mardini asked Mayo photographer Eric Sheahan to take a portrait of Andy to record what Andy looked like before the face transplant. Sheahan introduced himself and explained his mission. He thought his request made Andy uncomfortable. Andy treated Sheahan kindly, but “there was tension in the room,” Sheahan said. Andy did not want to look at the camera, but Sheahan was able to capture images of Andy that showed his high emotions at the time.

Even though the face transplant would not start until the early morning hours of Saturday, the team was notified and ready by midafternoon on Friday. Dr. Mardini suggested to Karim Bakri, M.B.B.S., that they use the time remaining to go home and get some sleep. Both men returned home, but neither slept. Dr. Bakri and his wife had two small children. That week his mother-in-law was a houseguest. To maintain Andy’s privacy and the secrecy of the transplant, Dr. Bakri had to hide from her what he would be doing for the next three days. “She thought I was on call, except that I went out Friday night and didn’t come back until Monday,” he said. He added, smiling: “It was a complicated case, you know.”

Dr. Bakri did not feel stressed, but he was aware of the high expectations he, Dr. Mardini, and the other team members shouldered. They were going into a type of surgery that had never been attempted at Mayo, but their practice on cadavers had led them to believe it could be done successfully. Dr. Bakri described his feelings at the time as “not wanting to disappoint, wanting everything to go really smoothly in something that you’ve never done before.” He did not know what was going to happen, and he felt like he was taking a trip to the moon without knowing if he would be able to return to Earth.

Open image in lightbox

A LOOK INSIDE
FACE IN THE MIRROR

For years, they came in on weekends to plan and practice — nearly 60 surgeons, nurses, and anesthesiologists, preparing to harmonize in a vast medical symphony. For the team at Mayo Clinic, it was their most complex surgery to date: a face transplant.

At the heart of this event was Andy Sandness. He grappled with feelings of isolation and shame after a disfiguring suicide attempt but was determined to reclaim his future, to be seen as ordinary, and to belong again. Alongside him was Dr. Samir Mardini, a surgeon with an intense, unwavering desire to transform medicine and create a new life for his patient.

Their story — told over nearly two decades — is a poignant exploration of resilience, hope, and friendship, as well as an incredible account of medical breakthroughs and scientific discovery that reveals the strength of the human spirit, and the courage to rise above our scars.

Buy Now

Early on Friday, Dr. Mardini held a team meeting. The group included Katie Weimer, vice president of 3D Corporation, the company that had provided the three-dimensional models the team used in its rehearsals. Weimer had been involved from the start in the virtual surgical planning aspects of the surgery. “The day has come,” Dr. Mardini said at the start of the meeting. “We have all put in so much time and effort and thought into this — we could not be more ready.” He felt no need to review the operation itself after so many rehearsals in the cadaver lab. Instead, Dr. Mardini presented a schedule for breaks to ensure a high-performing team at the transplant’s conclusion, when it would be needed most. He asked team members to take breaks when asked, and not do the courteous thing and offer to keep working.

Knowing the transplant surgery was imminent, ophthalmologist Elizabeth Bradley, M.D., had canceled all her other appointments starting Friday afternoon. After the meeting, Dr. Bradley needed stress relief, so she worked out at the on-site fitness center and returned to duty by late afternoon. Dr. Mardini let her and other members of the surgical team know that he would handle last-minute preparations and that they should take it easy, sleeping if possible, until later. The operation was still some hours off, and Dr. Bradley went home to rest. The call to report in came at 2 a.m. Saturday morning, awakening her. She was back at the hospital at 3 a.m.

Andy had presented himself for the face transplant in excellent physical condition, and he seemed to Dr. Mardini to be at prime readiness. The surgeon estimated that Andy had worked out five or six days per week before the operation in addition to his rigorous outdoor activities on the job. “He was healthy-looking and strong in his mind,” Dr. Mardini said. “He said he knew we were preparing hard, and he wanted to do the same.”

Related Content

A Promise Delivered: A New Heart for a New Mom

Promise's new heart has allowed her to celebrate many milestones, including her son's first birthday.

Read More

Andy’s dad, Reed, was able to travel to Rochester on short notice for the operation (he ended up staying in Rochester for three months). After booking a hotel room across the street from the hospital, he got lost trying to find Andy’s hospital room. It took a while for him to find it, but he did. Just before the transplant began, Reed gave Dr. Mardini a handshake and a hug, and Andy told Reed he loved him.

Great care was to be taken with the nerve segments to ensure that Andy’s new facial muscles could accurately respond to signals from his brain. If it was done correctly, then when Andy wanted to smile, impulses from his brain would activate the corresponding transplanted facial nerves to correctly curve the mouth upward rather than close the mouth or perform another unintended movement. The same painstaking process would enable Andy to speak, cry, and perform other facial functions correctly. To ensure that all the nerves matched properly between the donor and Andy, Dr. Mardini asked Mayo resident Waleed Gibreel, M.B.B.S., who would later join Dr. Mardini’s craniofacial team at Mayo, and research fellow Dr. Suchyta to watch and double-check the videos showing the stimulation of the nerves of the donor and patient. Dr. Mardini and the team then knew with certainty which nerves to connect from Andy to the donor.

In Andy’s suite, Mayo’s videographers used an eerily silent overhead video system that they controlled from a console. It had an arm that rose above the surgery and shot straight down. It ran constantly, supplemented by footage from handheld cameras. “We got engaged,” Sheahan said. “We made sure the camera was where it needed to be. We didn’t let somebody stand in the way, and we spoke up when we needed to take a photo, because we were helping Andy [to] have greater success when we spoke up if something was not right.” Sheahan’s aggressive methods in the operating room, shooting in the intense quiet, led him to call himself “the surgeon’s henchman.”

“You weren’t just there to capture images,” said Mayo photographer Kevin Ness. “You engaged yourself in the surgery, so you knew what’s going on and you knew when there was a picture needed. And you were right there, and they didn’t even have to ask you to take a picture. You just did it.”

This photographic diligence was necessary not only to document the face transplant and crucially aid in the surgery but also to preserve what transpired in the surgical suites as a learning aid for surgeons and perhaps face transplants to come. The record of this long weekend for Andy and Dr. Mardini in Saint Marys would teach and inspire caregivers far into the future.

To follow the rest of Andy’s journey, read Face in the Mirror.

The post Face in the Mirror: The Story Behind Mayo Clinic’s First Face Transplant appeared first on Mayo Clinic Magazine.

Although she had been looking forward to getting her license for a long time, she couldn’t sit without being in pain. The sporadic numbness in her leg only made things worse.

In the spring of her freshman year, Miranda took a hard fall on her tailbone. The following fall, despite the lingering pain, she pushed through to run on her high school’s cross-country team in Wayzata, Minnesota. As the season wore on, however, the pain in her back became unbearable — and she was forced to stop running.

Two days after her birthday, when the periodic numbness in her left leg and foot evolved into a complete loss of feeling, she knew something was seriously wrong.

A Life-Changing Diagnosis

An MRI revealed Miranda had a 6-inch, inoperable tumor at the base of her spine.

Nadia N. Laack, M.D., the pediatric oncologist who treated Miranda at Mayo Clinic, confirmed through a biopsy that the cancer was Ewing sarcoma — one of the most common pediatric bone tumors. Unfortunately, the news got worse: The cancer had already spread.

“She had metastatic disease to her lungs, and she was told that she had about a 10% chance of survival,” says Dr. Laack, the Hitachi Professor of Radiation Oncology Research.

But that number didn’t faze her. “I’m a pediatric oncologist — we're eternal optimists. That’s the only way we can do this job. Every patient is a 10%, right?”

When asked if Miranda would benefit from proton beam therapy, Dr. Laack knew they had to give it a shot.

Targeted Treatment, Greater Hope

Unlike traditional X-ray therapy, which affects all tissue in its path, proton beam therapy offers precise control, enabling specialists to focus radiation directly on the tumor while reducing harm to the surrounding healthy tissue.

For Miranda, this precision was critical. X-ray radiation therapy would have treated her entire pelvis, including the uterus, which would no longer be able to accommodate a growing baby. Proton beam therapy allowed for a more targeted approach. One of her ovaries was wrapped up in the tumor, but through proton beam therapy, the other could be shielded. This meant a chance at preserving her fertility.

“Dr. Laack and her team tacked one of my ovaries out of the line of radiation. This forethought gave me the best chance possible at conceiving naturally,” Miranda says. “The fact they moved the other ovary was absolutely life-changing.”

In addition to protecting the uterus and the remaining ovary during proton beam therapy, Dr. Laack designed a comprehensive treatment plan that gave Miranda the greatest likelihood of recovery. She underwent concurrent chemotherapy at Children’s Hospitals and Clinics of Minnesota and proton beam therapy at Mayo Clinic to target the Ewing sarcoma, along with radiation to treat the cancer in her lungs.

“I was very grateful to be able to commute to Mayo Clinic and still go home at night,” Miranda says. “It’s amazing that this treatment was available in my backyard.”

A Future Once Unimaginable

In February 2016, Miranda completed her last proton beam treatment. Since then, she has graduated magna cum laude from the University of St. Thomas in Saint Paul, Minnesota, landed her dream job, met the love of her life, got married, bought a house and had her first child.

“I wanted to find love, own a house and start a family,” she says. “Those were my main priorities after I beat cancer — to live life and live it to the fullest with no time wasted.”

While Miranda has accomplished a lot since her last treatment, one of the most meaningful chapters of Miranda’s journey has been welcoming her son, Everett, into the world. She and her husband, Alec, now center their days around his happiness, giggles and cuddles.

“Mayo Clinic listened to my fears, my hopes and my dreams. It wasn’t enough to simply cure me — they went above and beyond to ensure my quality of life would be the best it possibly could be,” she says. “They understood how important being a mother was to me and acted accordingly. I am forever grateful to Dr. Laack and her team for their contribution to helping me have my miracle baby.”

Miranda had no complications during pregnancy, and she credits the care she received years earlier at Mayo Clinic for making the experience smooth once it came time to start a family. “These are the reasons why it’s important for us to be able to bring in these new technologies to help our patients,” Dr. Laack says.

Looking Ahead

Miranda and Alec have started talking about having another child in the next few years. There’s no rush though — for now, they’re savoring this time with Everett. Because Mayo Clinic made it possible for her to have one child, Miranda is hopeful she can have another.

In her free time, she continues to give back, such as serving on the board of Rein in Sarcoma, a resource for patients and families affected by these uncommon and often misdiagnosed bone and soft tissue cancers.

Looking back, Miranda says she wishes she could tell her 16-year-old self — a young girl who had just received a life-altering diagnosis — how much life was still ahead. What once seemed uncertain has become a life filled with purpose and promise.

“If I could tell her that I would not only survive cancer, but find the love of my life, marry, own a beautiful house on a river, work my dream job and have a child — all by the age of 25 — I don’t think any part of me would have dared dream that big in the moment,” she says. “Simply put, I have a future to look forward to because of Mayo Clinic."

Carey Stanton contributed to this story.

The post A Mother’s Miracle: How Proton Beam Therapy Preserved Miranda’s Fertility appeared first on Mayo Clinic Magazine.