Predicting Alzheimer’s Before It Starts

Mayo Clinic researchers have developed a prediction model that can estimate an individual’s risk of developing memory and thinking problems associated with Alzheimer’s disease years before symptoms appear.

The tool looks at basic health information, including age, sex, genetic makeup and brain imaging of amyloid protein, to predict a person’s likelihood of developing mild cognitive impairment or dementia within 10 years or over their remaining lifetime.

The model is built on data from more than 5,500 participants in the Mayo Clinic Study of Aging, one of the world’s most comprehensive long-running brain health studies. By following participants for years and carefully tracking medical outcomes, researchers were able to create one of the most complete pictures of who is likely to have cognitive decline.

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Brain scan results showing amyloid buildup proved to be the strongest predictor of lifetime risk. The research also revealed that women and people carrying a particular gene variant, known as APOE 4, face higher lifetime risk than the general population.

This breakthrough comes at a pivotal moment: The Food and Drug Administration recently approved therapies that remove amyloid from the brain and can slow disease progression in people with mild cognitive impairment or early dementia.

Knowing who is at risk before symptoms begin could help physicians determine when to begin therapy and guide patients in making proactive lifestyle changes.

This work is part of Mayo Clinic’s broader Precure initiative aimed at intercepting disease before it evolves into complex, hard-to-treat conditions and was supported by the National Institute on Aging, the GHR Foundation, Gates Ventures, and the Alexander Family Foundation.

A version of this story was published on Mayo Clinic News Network.

The post Predicting Alzheimer’s Before It Starts appeared first on Mayo Clinic Magazine.

The System Never Sleeps

Eric Klee, Ph.D., applied to medical school and subsequently pulled his application.

What made all the sense in the world for young Eric to do with his life made none in his own mind. His father was a Mayo Clinic pathologist and his mother a nurse. His siblings were all in the process of becoming clinicians themselves.

For an institution built more than 160 years ago by a family of medical practitioners, the Klees were as close to a modern story of the Mayo family as one could get.

"I was born and raised in Rochester, Minnesota,” Dr. Klee says. “I was surrounded by medicine.”

Dr. Klee was very interested in healing patients, but he didn’t want to study biology as an undergraduate followed by years of medical school.

"I knew once I got into medical school, I’d be doing residency and locked into a long-term career,” Dr. Klee says. “That’s why I pulled my application.”

His quest to find a career led him in the late 1990s to the office of Franklyn Prendergast, M.D., Ph.D., a friend of his father, searching like so many others did for some advice from the visionary clinician.

The conversation with Dr. Prendergast, who passed away in 2023, would chart Dr. Klee’s direction and set the stage for the future.

“I was interested in engineering and technology. I was interested in medicine. I wanted to figure out how it all came together,” Dr. Klee recalls. “Dr. Prendergast said, ‘Eric, there’s an emerging field called bioinformatics. It doesn’t actually exist yet, but I promise you it will in five years, and it’ll be important for at least 30 years to come.’”

Today, Dr. Klee, who first graduated with a degree in electrical engineering, has found his answer to what it means to practice medicine as an engineer. And it’s transforming how Mayo Clinic cares for patients with the rarest diseases.

BUILDING BEHIND THE SCENES

Dr. Klee, who is recognized as the Everett J. and Jane M. Hauck Midwest Associate Director, Research and Innovation, Center for Individualized Medicine, has spent his career building systems that aid doctors in new ways. As a leader in Mayo Clinic’s rare disease research and digital innovation efforts, he and his teams have created platforms that keep diagnosing patients years after their genetic sequencing tests. These platforms automatically watch for new scientific discoveries while families sleep, multiplying the impact of the organization’s expertise far beyond exam rooms.

His work represents a distinctive Mayo Clinic approach. It’s focused on cross-disciplinary collaboration where mindsets like his in engineering meet clinical needs. Infrastructure investments from a decade ago enable today’s artificial intelligence (AI) breakthroughs, and through it all, the institution’s commitment to patients extends even when they’re not physically present.

I was interested in engineering and technology. I was interested in medicine. I wanted to figure out how it all came together.

— ERIC KLEE, PH.D.

From increasing diagnostic success rates for rare diseases to being at the forefront of AI initiatives in the Mayo Clinic Comprehensive Cancer Center, Dr. Klee has found his own path to honoring the family calling — one that feeds his soul in ways a traditional practice would not have.

Choosing to study engineering led to an opportunity with the medical device maker Medtronic before going back to graduate school. After obtaining his doctorate degree, the pull of Mayo Clinic brought him back to Rochester, where he would practice medicine in a different way through systems and infrastructure.

None of this was more apparent than in the rare disease space, where finding answers requires something far beyond traditional clinical care — even at a place steeped in subspecialty expertise.

THE RARE DISEASE PARADOX

There are more than 6,800 identified rare diseases, generally considered to be diseases that affect fewer than 200,000 people in the United States at any time. Altogether, rare diseases affect an estimated 25 million to 30 million Americans, according to the National Human Genome Research Institute. These conditions span so many specialties that even the most skilled clinicians around the world can struggle to see the complete picture.

“A patient might have cardiac symptoms, neurological issues, immune system concerns and physical differences — but when these signs are scattered across different body systems, it creates what we call the ‘elephant problem,’” Dr. Klee explains. “Each specialist sees their part clearly, but few clinicians can observe the whole elephant at once.”

Even further, what happens if the latest breakthrough occurs after an episode of clinical care? What then?

“Our understanding of what genes and what variants cause disease is growing,” Dr. Klee says. “So what we know today is different than what we knew six years ago, six months ago or even six days ago. When you have a static report, you miss out on what we’ve learned since that test.”

To address this challenge, in 2022 Dr. Klee’s teams launched an automated system called RENEW. The tool is built to literally renew clinical test results by looking at what’s been learned since the last time the test was run or the patient’s data was accessed.

The system works with elegant simplicity.

RENEW automatically pulls in newly published discoveries of disease-causing genetic variants from research labs around the world. It compares these findings against Mayo Clinic’s database of unsolved patient cases — nearly 2,000 and growing.

Special filters whittle down the flood of new genetic information to focus only on what’s meaningful and could explain a patient’s symptoms.

When it flags a match, a team of genomic researchers digs deeper by reviewing medical records and clinical histories and correlating DNA alterations with new findings. The question they ask: Could this newly described variant be the answer someone’s been waiting years to hear?

So far, RENEW has delivered dozens of definitive diagnoses for Mayo Clinic patients with rare and previously unexplained diseases. And it takes less than a minute per patient to run the analysis.

“Every time we get a diagnosis, it makes me feel proud of what we’ve been able to accomplish at Mayo,” Dr. Klee says. “It’s this concept that the patients put trust in — not my team, not a single clinician — they put their trust in Mayo Clinic, and Mayo Clinic as an organization has supported this type of really challenging work.

“The parents and families, they believe that someday we will call them with an answer. And it’s incredibly gratifying for everyone when we do.”

VISIONARY LEADERSHIP, VISIONARY BENEFACTORS

A bigger question is why does this happen seemingly so often at Mayo Clinic? While Dr. Klee’s engineering background might seem like an unconventional foundation for rare disease research, at Mayo Clinic, cross-collaboration and diverse skill sets aren’t just accepted — they are championed.

But even the best collaborative culture needs infrastructure to reach its potential. Mayo Clinic leadership invested in this space a decade ago, and it’s paying dividends today.

“One thing that has set Mayo Clinic apart from a lot of other academic medical centers was the foresight of our institution, and now President and CEO Gianrico Farrugia, M.D., to think about data organization,” Dr. Klee says. “While other health systems were still figuring out electronic health records, Mayo Clinic was organizing all its clinical data in the cloud, creating Mayo Clinic Platform, de-identifying patient information and making it available for research.”

It was a massive investment bolstered by visionary benefactors despite an uncertain future, and the foresight it unlocked has set the stage for something much bigger.

“It opened the door for the transformative power of what we’re starting to realize in artificial intelligence, agentic AI and other emerging capabilities,” Dr. Klee says. “That realization is you’re only as successful as the data you have organized and readily available.”

In other words, Mayo Clinic didn’t just build strong and secure data systems. It built the foundation for the AI tools and future breakthroughs that didn’t even exist when the foundation was laid.

This work extends through Mayo Clinic Research enterprise priorities, including the Research Data Atlas, an initiative led by Dr. Klee to unify and mobilize research data at scale. It brings diverse research datasets into a secure, cloud-based environment where they become discoverable, interoperable and ready for advanced analysis. By increasing access to high-quality, harmonized data, the Research Data Atlas strengthens collaboration across the institution and accelerates Mayo Clinic’s ability to advance artificial intelligence-enabled discovery and translational research.

That infrastructure has allowed Dr. Klee to expand his impact beyond rare diseases. When Cheryl Willman, M.D., the Stephen and Barbara Slaggie Executive Director of Mayo Clinic Cancer Programs and Director of the Mayo Clinic Comprehensive Cancer Center¹, approached Dr. Klee about leading data and AI initiatives in oncology, he identified a chance to scale what he’d learned.

“I saw the opportunity in the Cancer Center to take a lot of what we had done in the Center for Individualized Medicine with regard to how we think about our genomic data and other omics data and organizing it to have an impact by breaking down barriers and opening doors to new discoveries.”

The same engineering mindset now applied to a different problem — making the data frictionless, accessible and useful across the entire enterprise to create systems that multiply the impact of every researcher, clinician and discovery.

RETURNING TO HIS ROOTS

Back to that conversation nearly 30 years ago in Dr. Prendergast’s office about the field that didn’t exist.

Bioinformatics employs hundreds of researchers at Mayo Clinic alone. And Dr. Prendergast’s prediction it would be important for at least 30 years has turned out to be conservative.

While Dr. Klee doesn’t have the same deep physician-patient relationships others in his family do, he keeps working on hope and healing in the way only an engineer could — leading teams who are building systems that never stop looking and leveraging infrastructure built with the forethought of what might be to come.

Because of that, in a cloud server room tonight, the system Dr. Klee championed runs. New databases of discovery are being checked against organized data files of patients. Algorithms are filtering results for meaningful changes.

And when tomorrow comes, a multidisciplinary team may get a notice to review results that could contain an answer someone has been waiting years to hear.

What kind of medicine can an engineer build? The kind that practices medicine even when patients aren’t there — because at Mayo Clinic, the needs of the patient come first, whenever and wherever they are.

1. Dr. Willman is also recognized as the David A. Ahlquist, M.D., Professorship in Cancer Research. ↩︎

The post The System Never Sleeps appeared first on Mayo Clinic Magazine.

Precision Without Compromise

In the mid-2000s, Nadia Laack, M.D., a pediatric radiation oncologist at Mayo Clinic, saw an opportunity for patients. Mayo Clinic in Rochester was in the midst of designing a new facility for proton beam therapy — a powerful form of radiation that uses streams of protons to destroy tumor cells.

Dr. Laack knew that many patients would benefit the most from pencil beam scanning, the newest form of proton beam therapy. With this precise tool, she could direct protons at the exact contours of a tumor without injuring nearby organs.

But there was a catch. With pencil beam scanning, patients must remain perfectly still. For cancers in the lungs or abdomen, even the subtle movement of breathing could throw the beam off target.

And to prevent young children from wiggling, any form of proton therapy requires anesthesia, which greatly lengthens time in the treatment room.

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As a result, existing proton beam facilities only offered pencil beam scanning for cases where movement could be more controlled. These facilities also strictly limited the number of children they would treat each day so that, from a financial perspective, they could reserve more space for adults who could be moved in and out quickly.

Dr. Laack found these compromises unacceptable. Her colleagues agreed. Mayo Clinic would build the first proton beam facility in the United States that would exclusively offer the more advanced pencil beam scanning approach without limiting access for children.

To do so would come with significantly more work for Dr. Laack and her team, who partnered with engineers and physicists to design new tools to adapt to patients’ movements. And she brought on anesthesiologists to help engineer new ways to move kids in and out of treatment more quickly.

The Mayo Clinic Richard O. Jacobson Building housing the state-of-the-art proton beam facility opened in 2015. And Dr. Laack’s team has never had to turn away a child.

“We didn’t want anything to stand in the way of our ability to treat kids who needed our care,” she says.

Promise in Pencil Beam

Dr. Laack was committed to building a pencil beam scanning facility because she saw how much potential the treatment had to reduce the long-term side effects of radiation for many patients.

Traditionally, patients received radiation with photons, X-rays that pass into the body, through the tumor and out the other side of the body.

Photon radiation is an effective treatment for many cancers and is still commonly used today. But its path through the body requires radiation oncologists to limit the dose or risk damaging healthy tissue.

Proton beam therapy works by using a particle accelerator to whip protons up to a super high velocity — nearly the speed of light. A technician then directs these highly energized protons at a tumor. As protons pass into the body, they release most of their energy within the tumor, minimizing the radiation hitting healthy tissue around the cancer.

Pencil beam scanning is an even more targeted form that delivers protons packed into balls the size of pencil erasers, rather than a scattering of protons covering a wider area.

That precision is critical for children who could develop long-term side effects — such as growth, fertility or vision issues — if healthy tissue is damaged along with the tumor. Adults too can benefit from pencil beam scanning when tumors are situated in sensitive areas such as the brain, spinal cord, heart, lungs, liver and other abdominal organs.

Making Pencil Beam Possible

Dr. Laack and her team from the Division of Medical Physics collaborated with colleagues in the Department of Engineering to design tools to follow tumors in real time and only deliver protons when the tumors are on target. The team developed a respiration tracking tool, for example, that they place on a patient’s abdomen to capture the movement of breathing. They can then automatically trigger the proton beam to pause each time a tumor moves above or below the beam’s reach with each breath in and out.

To open access for more children, the team worked with Mayo Clinic anesthesiologists to figure out how to shorten treatment time. Their solution: prepare children for treatment outside of the pencil beam scanning room.

In the pretreatment area, a young patient lies on a specialized mobile table and begins receiving anesthesia from a compact delivery system. Once asleep, the child is then wheeled on the table into the pencil beam treatment room without interruption to anesthesia. Then a robotic arm docks onto the treatment table and moves it into the beam position. The robotic arm also has a compact anesthesia system built into the base, so the transfer of anesthesia tubes and lines is quick and seamless.

When designing this solution, the team was inspired by how anesthesia is delivered on the Mayo Clinic’s medical helicopters, says Dr. Laack. “You have a tight space in a helicopter too, and you don't want anesthesia lines in the way.”

In the proton beam treatment rooms, technicians use advanced imaging techniques to quickly pinpoint the precise location of the tumor. The robotic table adjusts and aligns the child perfectly so that the pencil beam directly hits the tumor.  

Commitment to Research and Care

Dr. Laack’s passion for designing the best possible cancer care began when her grandfather was diagnosed with leukemia. At the time, she was a college student at Colorado State University. She knew she couldn’t learn enough fast enough to help him. But she committed then to studying cancer so that she could help others.

As a medical student at Loma Linda University in California, Dr. Laack conducted research alongside her coursework, earning a master’s in physiology with a focus on breast cancer research.

She envisioned herself as a full-time cancer researcher. But then she began clinical rotations and discovered how much she values working with patients. “I was still passionate about studying cancer biology,” she says, “But the patient interaction was what brought me the most meaning and joy.”

It is so important to have all the tools in our toolbox so we can continue offering these patients the very best care.

— Nadia Laack, M.D.

As a radiation oncology resident at Mayo Clinic, she discovered that she was especially drawn to helping one patient group in particular: children. Working with kids facing difficult diagnoses was emotionally challenging, she says. “But I felt this was where I was needed the most.”

Today, Dr. Laack cares for patients of all ages, with a special focus on children. She also continues her research.

Before launching the proton beam facility, for example, Dr. Laack and her team spent a decade studying proton therapy and developing computer models that could project how effective and safe their new pencil beam facility would be for treating a wide range of cancers, including brain, breast, prostate and lung. After opening, they led more than 70 clinical trials to confirm that their proton therapy treatment resulted in the best outcomes. 

“The safety of our patients is the highest priority,” she says.

Accelerating Radiation Therapy Innovation for Patients

Today, Mayo Clinic’s proton beam therapy program has treated more than 10,000 patients, and soon, Mayo Clinic and Dr. Laack will have yet another radiation tool available for patients.

Within a few years, the recently constructed Duan Family Building at Mayo Clinic in Florida will be the first clinic in North America to offer a new technology: carbon ion therapy.

Carbon ion therapy is precise, much like proton therapy. But because carbon ions are more massive than protons, their impact is even more damaging to a tumor — making this form of radiation especially effective for patients with large or resistant tumors.

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Dr. Laack was an early proponent of bringing carbon ion therapy to Mayo Clinic. She recognized that Mayo Clinic staff were uniquely positioned to develop the new technology because of the knowledge they had already gained in proton therapy.

“We believed strongly that if anybody in North America was going to offer carbon ion therapy to patients, it needed to be Mayo Clinic,” she says. “We have the physics, the engineering and the physician expertise to be able to do it well and safely.”

Few of Dr. Laack’s pediatric patients require carbon ion therapy because pediatric tumors typically respond well to photon or proton therapy. But for some adult patients, and for children with treatment-resistant tumors, the technology could fight off cancer better and faster than existing therapies. Dr. Laack wanted to ensure that carbon ion therapy would be available for these patients.  

“Patients with some of the most difficult cancers — the hardest of the hard — come to us for hope and healing,” Dr. Laack says. “It is so important to have all the tools in our toolbox so we can continue offering these patients the very best care.”

The post Precision Without Compromise appeared first on Mayo Clinic Magazine.

Leading the Charge in Carbon Ion Therapy

Laura Vallow, M.D., stands at the forefront of a medical milestone: bringing carbon ion therapy to the United States.

As chair of the Department of Radiation Oncology at Mayo Clinic in Florida, Dr. Vallow leads a team of physicians, scientists and international collaborators who are advancing research in carbon ion therapy, an advanced cancer treatment that uses high-energy carbon particle beams to precisely target tumors.

“It’s not just another form of radiation,” says Dr. Vallow. “Carbon ions have unique biological properties. Our goal is to unlock that full potential.”

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Small-Town Roots, Big Ambitions

Raised in a small town 35 miles south of Chicago, Dr. Vallow grew up surrounded by family — including 28 cousins, a mom who served as a nurse, an uncle who was the fire chief, and another uncle who was the police chief. Hard work, helping others and service to the community were constant themes.

“There was always this closeness in my family,” she says. “Work and family were intertwined, and they had fun doing it. No one pushed me toward a specific career. Instead, they taught me to find my passion and work hard at it.”

For Dr. Vallow, that passion was science. She attended the University of Illinois where she earned a degree in biochemistry. During her years as an undergraduate student, she joined Argonne National Laboratory, where she worked alongside Ph.D. scientists and presented at national conferences, building the confidence to envision a future in science.

“I realized I could do this — and succeed,” she says. “I was excited for a life of helping and impacting others through science.”

Finding Medicine

Eager to continue her scientific career, Dr. Vallow entered Stritch School of Medicine, Loyola University Chicago where radiation oncology quickly captured her interest.

“Radiation oncology has this fascinating technology you get to explore,” she says. “It’s the perfect blend of science, technology and patient care.”

These are diagnoses that too often are a death sentence. Despite decades of work, progress has been limited. Carbon ion therapy gives us a real chance to change that.

— Laura Vallow, M.D.

After completing her residency at Rush Presbyterian St. Luke’s University, she joined Mayo Clinic in 2001. Specializing in breast radiation oncology, Dr. Vallow became a leader in clinical trials and advancing innovations to improve outcomes for patients with breast cancer, such as shorter treatment courses and effective positioning for minimal impact on heart and lungs during treatments. In 2021, she became chair of the Department of Radiation Oncology.

“Once I started at Mayo Clinic, I knew that I never wanted to go anywhere else,” she says. “I love the integration of science and patient care. It’s a wonderful thing to take care of patients in this environment where everyone pushes you to be your best.”

Shattering Limitations

Today, Dr. Vallow no longer runs a single lab. Instead, she oversees multiple research efforts, including collaborations with carbon ion centers in Asia and Europe. At the center of her work is Mayo Clinic’s new integrated oncology building — the Duan Family Building — which will house the nation’s first carbon ion treatment facility.

Current radiation therapy applies a one-size-fits-all approach, using general parameters that don’t account for biological differences between tumors and normal cells. Dr. Vallow wants to change that.

“We envision profiling tumors to understand which patients will benefit most, and at which dose,” she says. “That’s how we’ll shatter current limitations to make treatments more personalized — and more powerful.”

Her department is already advancing this vision. One prospective study, led by colleague Bradford Hoppe, M.D., compares outcomes and quality of life for patients with bone sarcoma receiving traditional care at Mayo Clinic versus those treated at international carbon ion centers.

Through studies like this, the team will extend carbon ion benefits to more people with more types of cancer.

Shaping the Future

Dr. Vallow credits Mayo Clinic’s leadership with taking bold steps to bring carbon ion therapy to the U.S.

“Many institutions have talked about it, but no one has done it,” she says. “Our responsibility is to do this so well and lay out the research so impeccably that others can follow, and together we’ll expand access to carbon ion nationwide.”

Under her leadership, the department is poised to continue to grow as Mayo Clinic opens its doors to patients in need of carbon ion therapy. Dr. Vallow’s vision includes tackling some of the most intractable cancers, such as glioblastoma and pancreatic cancer.

“These are diagnoses that too often are a death sentence,” she says. “Despite decades of work, progress has been limited. Carbon ion therapy gives us a real chance to change that.”

And now, with carbon ion therapy on the horizon, Dr. Vallow’s passion continues to drive her to reshape the future of cancer care.

“I didn’t always know I would end up as a physician researcher, but now, I couldn’t imagine doing anything else.”

The post Leading the Charge in Carbon Ion Therapy appeared first on Mayo Clinic Magazine.

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.

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“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 150,000 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 2,500 cancer clinical trial accruals each year, 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. 

PERSONALIZING MELANOMA CARE

Many patients diagnosed with melanoma undergo surgery to determine whether the disease has spread to their lymph nodes. Yet surgeons find no cancer in nearly 80% of those procedures. To address this challenge, Mayo Clinic researchers, in collaboration with SkylineDx, developed a genomic test that helps physicians better assess a patient’s risk before surgery.

In a national study of more than 1,700 patients, the test accurately identified those at low risk for lymph node involvement — 93% of low-risk patients had no cancer in their nodes. The test analyzes the activity of eight genes from the original tumor sample and combines that information with patient age and tumor thickness to guide treatment decisions.

By using the biology of each patient’s tumor, Mayo Clinic researchers are advancing more precise melanoma care while sparing some patients from unnecessary surgery.

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. 

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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.

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Healing at Home

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

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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.

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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 six exciting advances on the horizon in cancer medicine.

REDEFINING THE FUTURE OF LUNG CANCER

Rather than relying on screening alone, Mayo Clinic researchers are building advanced artificial intelligence (AI) tools to transform how we detect and treat lung cancer. Beginning with patients who have early-stage, biopsy-confirmed disease, the team connects their diagnosis with high-quality imaging, pathology, molecular data and long-term outcomes.

By learning from confirmed cases, these tools can recognize patterns that signal which cancers are most aggressive and who is at greatest risk. This approach does more than improve detection. It reveals new opportunities to intervene sooner and guides the development of innovative therapies. Together, these efforts aim to improve survival, personalize care and change the trajectory of lung cancer for patients and their families.

ENHANCING AI ACCURACY IN RADIATION ONCOLOGY

A team of Mayo Clinic investigators developed a new way to improve AI for identifying head and neck tumors.

While AI can automatically outline tumors on PET and CT scans, it sometimes marks areas that are not truly cancer. To address this, the research team paired imaging AI with a large language model that reads and interprets radiologists’ reports. This model extracts tumor locations from the written diagnosis and crosschecks them against the AI-generated outlines.

When the system detects a mismatch, it removes the incorrect outline. This approach significantly improves accuracy and eliminates false-positive tumor markings. By combining advanced image analysis with expert clinical interpretation, the team is building a smarter, safer tool that supports more consistent cancer treatment planning.

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REVEALING HIDDEN DRIVERS OF PEDIATRIC LEUKEMIA

Mayo Clinic researchers are uncovering new molecular mechanisms that drive leukemia, opening the door to more precise and effective therapies. Their work focuses on how a missing control protein, called HEB, allows a cancer-driving gene known as MYC to become overactive.

When this control is lost, a section of DNA switches into overdrive, turning on MYC and fueling leukemia. Researchers identified another protein, TCF-1, that plays a critical role in this process. When TCF-1 is blocked, leukemia cells are unable to form, making it a promising new target for therapy. The team also discovered that leukemia cells produce unique RNA signals not found in healthy cells.

Because these signals appear only in cancer, they may offer a powerful new way to target leukemia while sparing normal tissue. Ongoing studies are exploring how shutting down these signals could stop leukemia at its source.

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.

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.

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.