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Larry King Live

Cindy McCain and Physicians Discuss Preventative Medicine

Aired August 23, 2000 - 9:00 p.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

LARRY KING, HOST: Tonight, Senator John McCain is home from the hospital, recovering from cancer surgery. His wife, Cindy, joins us from Phoenix with an update on his health.

Then a medical roundtable: From Tucson, Dr. Andrew Weil, bestselling author and a leading advocate of combining traditional and alternative medicine. From Minneapolis, Dr. Bernadine Healy, president and CEO of the American Red Cross. And here in Los Angeles, Dr. Art Ulene, author of "Dr. Ulene's Complete Guide to Vitamins, Minerals and Herbs." Plus Dr. Judith Reichman, bestselling author and "Today Show" medical correspondent. And we'll take your calls.

They're all next on LARRY KING LIVE.

Good evening. We have a major program tonight, devoted to preventative medicine, and we begin with Cindy McCain. She joins us from Phoenix, the wife of Senator John McCain.

The senator, 63 years old, was released from the Mayo Clinic yesterday and returned to his home. He underwent more than five hours of surgery on Saturday to remove melanoma from his temple and upper arm.

How did he do, Cindy?

CINDY MCCAIN, WIFE OF SENATOR JOHN MCCAIN: He's great. He's doing just fine. We got him home yesterday. He's up walking around and harassing all of us in the house and generally being John. And we look forward to a speedy recovery.

KING: Were there any initial results from the tests they took of what they removed?

C. MCCAIN: Yes. The pathology on the test that they had done, both on the lymph nodes and certainly the tissue, were all negative. The cancer had not spread, and we were very fortunate, because initially we thought perhaps it had spread. But there's no indication that it spread at all, and it looks like John's recovery is going to be very complete.

KING: A lot of discomfort?

C. MCCAIN: A lot of discomfort, yes. And my husband, as you know, is a very strong person and does not usually display any problem with pain, but he's in a little bit of pain right now.

KING: Any scars it's going to leave, permanent scars?

C. MCCAIN: Well, the incision is certainly large, but the -- he was handled -- the closing was handled by a wonderful plastic surgeon at Mayo, and I think he's going to be beautiful when he recovers.

KING: And even if he wasn't, you'd still love him, wouldn't you, Cindy?

C. MCCAIN: Absolutely.

(LAUGHTER)

KING: How about -- any further treatment involved here?

C. MCCAIN: No. No treatment as far as we know. The one thing that we will have to do and continue to do is frequent screenings. John was being screened relatively frequently, but clearly it wasn't frequently enough. And now every three months, screening, and as you know, basal cells and all those kinds of things are taken off very regularly on him. And if he notices anything that even looks remotely questionable, he'll go in even sooner.

And of course, the most important thing that John could do is to wear sunscreen all the time.

KING: Or stay out of the sun completely, right?

C. MCCAIN: Exactly. Or stay completely out of the sun.

KING: So this -- this cancer is preventive.

C. MCCAIN: It is preventive in some ways. Now my very limited understanding -- and certainly the physicians that will be appearing tonight know more than I do -- but my limited understanding of this is that sometimes it's just because we're fair-skinned. It can't always be presented regardless of how much you try prevent it. Some people are just prone to it.

In John's case, I think it probably could have been prevented, but he, like so many of us, grew up in the age where, you know, water blisters after a full day in the sun were very common, and as a result, he's suffering for it -- from it now.

KING: So you have the same fears as a fair-skinned blonde, right?

C. MCCAIN: Absolutely, absolutely. And I did everything that a blonde shouldn't have done growing up. I put baby oil with iodine on when I was sitting in the sun, which is really stupid, and didn't wear sunscreen properly. And I, too, am going to start screening very regularly with my husband.

KING: Cindy, honestly, how worried were you? C. MCCAIN: I was very worried. I mean, my husband came to me the weekend that the Bushes were at our cabin that night after we had all gone to bed and -- to tell me the news. I knew he'd had the biopsy taken, but he had waited to tell me the outcome until we could be together -- be together in person. And it frightened me. I'll be very honest with you.

But I also know that a large part of recovering from something like this is having the kind of spirit that my husband does. And he's a remarkable fighter. And not only will he recover, but certainly the news of the pathology is a gift from God.

KING: How about the whole family? Is the spirit up?

C. MCCAIN: Spirit's up, yes. Our children were very worried. As you know, the news of this leaked out a little ahead of when we had planned on telling everybody. We had wanted to wait until we knew something substantive and that didn't quite work, and so a lot of our children found out on -- from your network that John had this problem. And so I wish that it happened differently, and once we recovered from that we're fine now.

KING: Does he plan to resume campaigning at all or is he going to take it easy?

C. MCCAIN: Yes. No, he plans on returning to at least some light work after Labor Day, and certainly is very anxious to get back to full-time campaigning. As you know, he's very concerned about our House races and Senate races, and wants to be very involved in those. And I think you'll see him out pretty soon.

KING: Should it be advised that he not appear at outdoor rallies?

C. MCCAIN: I believe so. I think his doctors would tell him that right up front -- please don't appear in outdoor rallies, and if you do, wear a large hat, plenty of sunscreen, et cetera.

My husband is -- you know, this has been an eye-opening experience for all of us, and I'm quite certain that you will see a person that will change his habits drastically with regards to what he does.

KING: You're also helping a lot of people, you know, by coming forward with it.

C. MCCAIN: Yes.

KING: Should fair-skinned people maybe not think about living in Arizona?

C. MCCAIN: No. We encourage everybody to live in Arizona. I think it'S more preventative, as we talked about. You have to be very cognizant of how harsh the rays are, particularly in a place like Arizona and other parts of the country, and how you really do have to take sunscreen and preventive measures very seriously, and we've learned the hard way to not only take it seriously, but to do what your doctor tells you early on, and that is, stay out of sun and use sunscreen.

KING: And it starts in childhood, right?

C. MCCAIN: Yes.

KING: Certainly protect children.

C. MCCAIN: Yes, it does. I know, like I said, when my husband and I both were kids that we ran around in sun too much. Hopefully, I believe my husband and I with our own children have stopped that. We have been very diligent about keeping heavy sunscreens on them all their lives, and we've had pretty good success with them. Although they're teenagers now. We may lose that battle. But we've tried very hard to make sure that their sensitive skins were protected.

KING: One knows how popular one is when one is sick. I would imagine you heard from people everywhere.

C. MCCAIN: We've have heard from every -- so many people from around the world,have called, and written or sent things, it's remarkable, and my husband and I both are very touched by the outpouring of love, and prayers and friendship from around the world. It's been very touching.

KING: When will we see John in public again?

C. MCCAIN: I would guess probably after Labor Day. He doesn't have his stitches out yet, so that's the first hurdle we have to get over, and of course recuperative period. I would imagine sometime after Labor Day he'll be ready to get out a little bit.

KING: He's going to turn 64 next week. He's not going to retire or anything, is he?

C. MCCAIN: No, he's not. Oh no, are you kidding? I think he'll outlive all of us. He has no intention of retiring or doing anything like that. As soon as he recovers from this, he'll be back at it, full steam ahead. And as you know, he has agenda for the next Senate session, which is very full, and he intends to complete that.

KING: And he still wants to pass McCain-Feingold, right?

C. MCCAIN: Absolutely.

KING: No giving up on that.

C. MCCAIN: No giving up on McCain-Feingold or his reform agenda in general. He's very committed to it, and as you have seen, he is -- can be very tenacious with regards to it, and that's exactly where he's headed when the Senate reconvenes.

KING: We look forward to seeing him and you. Wish him a happy birthday.

C. MCCAIN: Thank you.

KING: We'll see you all soon. Thanks, Cindy.

C. MCCAIN: Thank you very much.

KING: Cindy McCain, with an update on her husband, Senator John McCain, and with very good news.

Our panel assembles and we talk about preventing not only cancer, but lots of other things, how you can do it with a top panel, next. Don't go away.

(BEGIN VIDEO CLIP)

SEN. JOHN MCCAIN (R), ARIZONA: I'm very confident, the doctors are very confident, and that we'll have this thing done very quickly, and in a very short period of time I'll be back on the "Straight Talk Express" campaigning for our candidates around the country, as well as for Governor Bush. We expect it to be, relatively short relatively simple, and as I say, I'm very up, I'm confident. I've been in a number of fights in my life, and this is just another one, and I'm sure we will be able to prevail.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

KING: Our topic tonight is preventing disease. Our panel: In Tucson, Dr. Andrew Weil, director of the Program in Integrated Medicine at the University of Arizona, founder of the Foundation for Integrated Medicine and bestselling author; his latest, "Eating Well for Optimum Health." In Minneapolis is the president and CEO of the American Red Cross, Dr. Bernadine Healy, former director of the National Institutes of Health. And here in Los Angeles, Dr. Art Ulene, the best-selling author of "Dr. Ulene's Complete Guide to Vitamins, Minerals and Herbs," the former medical correspondent for the "Today" show, and he has a line of nutritional supplements under his name. And also, here is the woman who replaced him has to medical correspondent for the "Today" show. Dr. Judith Reichman. She's the bestselling author as well of "Relax, This Won't Hurt."

Dr. Ulene, we've discussed with Cindy, and previously with John McCain. Skin cancer is preventable, isn't it?

DR. ART ULENE, AUTHOR, "DR. ULENE'S COMPLETE GUIDE TO VITAMINS, MINERALS AND HERBS": It is preventable. I have personal experience with it. I've had three cancers removed now, fortunately not a melanoma, and as I look back on it, I am certain that there were two factors responsible, one was my severe sun burns as a child. I do remember those blisters as a child. And unfortunately, I played the sun worshiping game as a young adult in California. I now wear sun block. I have a huge safari hat that I wear. But more importantly, I am focused on grandchildren and making sure that the grandchildren get their sunblock.

KING: Dr. Healy, I know you are a cardiologist by expertise, right? But in the area of this prevention and skin cancer, what do you do with that dilemma of loving the sun, loving the way the sun makes us look, hating the results when you get a diagnosis like melanoma? What do you do with that conflict?

DR. BERNADINE HEALY, PRESIDENT & CEO, AMERICAN RED CROSS: I think you have to love your health and love healthy skin. And by the way, sun exposure also wrinkles skin and makes it old before its time. I think the key thing you have to remember is that whenever you are involved in a preventive mode, when you want to prevent illness, you always have a bargain. It means your going have to deny yourself certain things, you know whether it be that high cholesterol food that doesn't agree with you or whether it be too much sun.

But I want to say something that Art Ulene just mentioned -- let's get the message out to parents and grandparents. Your children are the ones most vulnerable now. You can help them. And kids often don't know about prevention.

KING: And they run into sun all the time, right, Dr. Reichman? Kids want to go out.

DR. JUDITH REICHMAN, AUTHOR, "RELAX, THIS WON'T HURT": Absolutely. We think three bad sunburns before the age of 20 and maybe before the age 10, or three outdoor jobs in the summer can quadruple someone's chance for getting melanoma down the lines, and it takes about 20 years until the melanoma develops. So the key is to take those kids, put them in long sleeves, long shirts, long trousers, keep them out of the sun between 10:00 and 3:00, and when we do put on block, put on at least 15, many people think 45 or 50. And that goes for as we get older. And in women, by the way, the increase in melanoma is seen a lot often legs because we are wearing shorts, and short skirts, and we're putting the block on our faces and we're forgetting to put it on legs, where we're getting a great increase in melanoma.

KING: Dr. Weil, is there any room in this field for integrative medicine in the field of skin cancer?

DR. ANDREW WEIL, FOUNDER, FOUNDATION FOR INTEGRATIVE MEDICINE: Absolutely. Yes, absolutely. First of all, let me just say, a lot of people have talked about relying on sun blocks, and I just want to give a caution here. The best protection is saying out of the sun at the time when the rays are at dangerous angle, because there is some question at to whether sun block is as effective about preventing melanoma as it is in preventing other forms of skin cancer and other forms of sun damage. By giving people a sense that they're protected, it may encourage them to stay out in sun longer and increase risk of melanoma, so that's just a caution.

But I think integrative medicine has much to offer in terms of general cancer protection. For example, I think there is good evidence that antioxidants have a strong potential to retard the development of cancer in general and some forms of skin cancer, and I think the advice there is to eat more fruits vegetables. which are the best sources of antioxidants.

KING: We will get into that.

You see nutrition playing a part, Dr. Ulene, in skin cancer?

ULENE: There is no question, I think in cancer generally. I agree with Dr. Weil, and I recommend that everybody's nutritional program start with good foods. I just don't think it is possible to get up to the levels of antioxidants necessary with food alone, and that'S why, as you know, I have flipped 180 degrees on the subject of vitamin supplements. I went from anti-supplement to selling supplements.

KING: We'll take a break and come back with more. We'll get the thoughts of everybody on the idea and get into prevention of lots of diseases and include your phone calls.

I'm Larry King. We'll be right back.

(COMMERCIAL BREAK)

KING: Health has certainly affected politics. In addition to John McCain, Gerald Ford had a stroke, initially misdiagnosed, Dick Cheney and his heart problems, Rudy Giuliani, prostate cancer, Tipper Gore, depression, Bill Bradley, atrial fibrillation.

Dr. Healy, do you share the view that antioxidants are helpful?

HEALY: Well, I think there's a lot of compelling evidence to that effect, and you can't ignore it.

But to what you just said, Larry, you remind me of something I always talked to medical students about, and that is, remember, sooner or later, all of us are patients.

KING: Well put. We're all going to die, Dr. Reichman, right? It's a question of how we live.

HEALY: Well, we hope we don't have to die.

KING: OK, but...

REICHMAN: But we want quality of life, we want to be sure that we're doing the best we can. We don't want to live with regrets. And I think not living with regrets means eating right, exercising, perhaps taking your vitamins, certainly taking your calcium, and there is no question that there is a lot we can do. There was just an article that came out today in "The New England Journal of Medicine," and looked at the nurses study, which has been following over 80,000 women, and they found that in the last 14 years that they have been following them that there has been a significant decrease in heart disease. And two-thirds of that decrease had to do with the fact that their diet changed, they had decreased the amount and the number of women who were smoking, and they were taking hormone-replacement therapy. These nurses had done something to really affect their life and their death rates from heart disease.

KING: Dr. Weil, if we can prevent disease, we have the genome, if we could change genes, are we going to live to 150?

WEIL: I don't know what the maximum human lifespan. There is general agreement that it's somewhere in the range of 120. There is some evidence that it has slowly increased throughout evolutionary time. How much more we can push that, I don't know. But it's clear that people are not supposed to die of strokes and heart attacks in their 40s and 50s. Those are preventable catastrophes. And the greatest thing that we can do to extend longevity is to deal with those premature deaths by -- through appropriate screenings, to attention to various elements of lifestyle, you know, all if that is preventable. And by the way, those catastrophes absorb most of our health care dollars and are a major reason we have such a health care crisis.

KING: Dr. Ulene, if we wiped out cigarettes, took all tobacco, and wiped out liquor, how much -- wouldn't the scale go way up?

ULENE: Well, if you wiped out cigarettes, there is no question longevity would go up and the incidence of disease would go way down.

With alcohol, it's kind of a two-edged sword, because alcohol in moderation may actually have some cardiovascular benefits,

I think the issue is not, how long can I live? I don't care whether I live to 150 or not, and I don't think it's fear of dying -- I ride a motorcycle five days week. I'm not afraid to die. What I am afraid of is being sick and alive, and that's a horrible condition to be in this country, or in any country. So the way I look at prevention, prevention is about enjoying good health until the day you die. When I die, I want to say, what did he die of? I don't know, he looked good to me.

KING: Dr. Healy, how much of it is written in the book? How much can we do? How much of it is the genes? How much can we prevent on a scale?

HEALY: Well, probably, 50-50. I think we have to be fair, it is not all preventable. Many diseases come along, many cancers, like testicular cancer, prostate cancer, where we really don't fully know how you can prevent it. There may be some internal metabolic factors, but they clearly are clearly genetic factors. And when people get sick, they can't be on a guilt trip and say, oh my goodness, I should have prevented it. So it's probably a 50-50 -- 50 environmental, 50 percent genetic -- including melanoma, by the way.

KING: Do you disagree, Dr. Weil?

WEIL: No, I would agree probably 50-50. But in some cases, I think the balance may be -- favor one or other. For example, with prostate cancer, while there may be genetic predisposition to that, I think there is a lot of evidence that it's very much determined by your hormonal status, which is influence by diet, and in particular, diets that are high in fat, high in animal products, low in protective phytochemicals, favor the development of prostate cancer, and it's aggressive behavior, more importantly, because many men develop prostate cancer, but most of those cancers don't go anywhere. KING: Let me take a break. We'll ask Dr. Reichman and the panel, how do we know what to eat? We'll be taking your calls as well. Our subject is preventative medicine.

This is LARRY KING LIVE. Stay right there.

(COMMERCIAL BREAK)

KING: Before we talk about immunization, I want to ask Dr. Reichman, how much are we affected by what we eat?

REICHMAN: I think we're affected amazingly, because we know that obesity is one of the major causes for both disability and mortality in this country.

KING: We're much better off thin than fat.

REICHMAN: Much better off thin. And if you eat a lot of sugar, or if you eat a lot of fat, or if you eat a lot of calories, there is no getting about it, you will get heavy. And we now found in that nurses study I talked about, and they said, oh, well they ate better, and they did better things, and they decreased their risk of heart disease and heart attack, well, their increase in weight was 36 percent, and that decreased their improvement by 8 percent.

KING: How important, Dr. Ulene, is attitude?

ULENE: I happen to think attitude is extremely important.

KING: We don't know why, though. They can't prove it.

ULENE: Well, we don't know exactly why, but there are many studies which show that a positive mental attitude, and social connections, being connected to people, actually reduces your risk of serious illness, and contributes to longevity. Volunteering, men and women who volunteer, the studies show they have a much lower mortality rate.

KING: They're doing better.

ULENE: And it has to do with altruism. That used to be way you got into heaven. Now we think a way to achieve health.

KING: Dr. Healy, what about immunization time? A lot of people assume that we cure diseases, they don't have to be immunized.

HEALY: Well, I think that's a mistake, because one of the reasons that immunization has worked is because we basically create a so-called herd of unity. So the people who opt out are kind of take taking advantage of everyone else who has been vaccinated, but it's very important. Ninety percent of our children are vaccinated. We'd like it to be 100 percent, and there is no reason why things like polio, or measles, mumps, rubella, should be existing in this country today, period.

KING: And we also have the flu season, and everybody should get their flu shot, right? At what age?

HEALY: No, no, I don't think everybody. I think that generally we recommend over the age of 60, but getting a flu shot not quite the same as vaccinated our young people, our young children. I think that's a little bit more controversial and it's not quite the must that it is for young people.

But by the way, could I interject something. I heard about volunteering -- Red Cross volunteers, we need them.

KING: Good plug.

Dr. Weil, immunization has taken us a long way, hasn't it?

WEIL: Absolutely. It's been one of the factors chiefly responsible for improved public health around the world, and I think we can see in many populations now there is an increase in those who do not immunize their children. And if you take the example of pertussis whopping cough, for example, it's quite clear that as more and more people are not immunized, the incidents of that disease begins to increase. So I am a strong proponent of immunization. I think there are questions about the safety of some of our vaccines, the number that we're giving, the ages at which we start them, but clearly, immunization is one of the great advances in modern medicine.

KING: Do we know, Dr. Reichman, how many people get a full medical checkup ever year? Do we know what percentage, and do we know the HMOs pay for it? And what about people who can't afford it?

REICHMAN: Many people don't go because they don't want to go, and others feel that they only go to doctor because they have a complaint and they need something done. But we do know that most people should get checkups every few years, and that should start as children, in our teens.

KING: How many do?

REICHMAN: Probably less than 30 percent are getting the annual checkups that they should be getting

KING: Well, that's number one preventative, isn't it, doctor?

ULENE: Well, it certainly is a critical preventive. One of the concerns I have in the day of -- these days of HMOs is that people go in and assume they're getting a complete medical exam, and actually get only a partial.

KING: Because HMOs won't pay for a lot of it.

ULENE: There seems to be almost a deliberate sloppiness in letting some of the screening tests drop through cracks. I actually had an experience recently where I went to the doctor, blood was drawn, they did not take blood for a PSA, and I demanded that they do it. I was due for a prostate screening test.

KING: Do we know why, Dr. Healy, people don't get physicals? HEALY: Well, I think, people don't necessarily like to go to doctors. I think there's always also a fear of what might happen, what might be uncovered. And also, it is not, you know, they'd rather be out in the sun.

KING: Wouldn't you want to know you have something?

HEALY: Some people might not want to know. Some people deny it. I mean, I think it's part of an active responsibility that someone has to take, and has to say it may not be pleasant. I'd rather be doing something else, but the reality is, long term, I can save myself enormous amount of grief, live longer, be good to my family, if I'd pay attention to preventive medicine, and if I am appropriately screened.

And by the way, it's not necessarily that annual physical, but I think there should be some thought given to the targeted screening test, like for women at 35 and over the age if 40 annual mammograms, PSAs for men, colonoscopy for men and women, starting at the age of 50. I mean, people should know, specifically, what they going to see their doctor for, just not go in and say, do anything.

KING: We'll be back with more. We'll include your phone calls. Don't go away.

(COMMERCIAL BREAK)

KING: Let's reintroduce our panel, include phone calls as well. They are Dr. Andrew Weil, bestselling author, including his most recent, "Eating Well for Optimum Health." He's in Tucson. In Minneapolis, the famed Dr. Bernadine Healy, who gets younger, by the way, president and CEO of the American Red Cross, former director of the National Institutes of Health. Dr. Art Ulene, the best-selling author of "Dr. Ulene's Complete Guide to Vitamins, Minerals and Herbs." He has his own line of nutritional supplements. And the wonderfully bright, vibrant -- I like all our guests tonight -- Dr. Judith Reichman, the bestselling author of "Relax This Won't Hurt." She's the medical correspondent for the "Today" show.

Couple of individual questions. Then we'll go to phone calls.

Are we low -- critical supply of blood supply, Dr. Healy?

HEALY: Well, what we face is a growing demand. I mean, remember, increasing modern medicine has more and more demands, can't do chemotherapy without blood, so we have our growing supply, but our demand is outstripping, so we absolutely have a -- actually, right now, we are in a summer lull, so we are out in a call for blood donations for volunteers. If I can give a plug, 1-800-GIVE-LIFE. Call that number, set up your blood donation.

KING: You had connections to get that number, huh? 1-800-GIVE- LIFE, good idea.

And the headlines, Dr. Ulene. The West Nile Virus in New York, seven people last year, mosquitoes infected birds. What do you do about something like that? What can you do about something like that?

ULENE: Well, the city of New York is spraying right now to try to eliminate the mosquitoes, which are the vector or the carrier of that. I think it's important to stay cool, to stay calm. It's interesting, here in Los Angeles, if you said West Nile Virus, people wouldn't know what you were talking about. So it's important to keep it in perspective. While this is a personal tragedy for small numbers of people, it is not, I think, growing to escape and become a frightening horrible epidemic in this country.

KING: Dr. Weil, what are the implications of the genome?

WEIL: I think they're vast and we can barely begin to contemplate them. One is that we might be able to assess individual risk for particular kinds of diseases that will enable us to take much better preventive action. We may have a whole new array of medical treatments made possible by repairing or changing particular genetic components. I think we're just at the beginning of all of this.

KING: How much, Dr. Reichman, does the aging of America cause a problem? More older people, most money spent in the last year of life, after 80, right, than all the other years?

REICHMAN: I think we've redirected our attention to new challenges, aside from trying to take care of children and adolescents to prevent disease, we're now dealing with diseases as they occur, and we're learning more and more what we can do. With the 50 million, for example, American women that are over the age of 50, what do we do about hormones, what do we do about osteoporosis, what do we do about heart disease, which indeed will be the cause of death for 43 percent of them? And so we are redirecting our resources, we are also realizing that when we do research, we can't do research just on men in 30s and 40s; we have to include older people and women, and that's one of the things that Dr. Healy got started when she was there. We now have to -- at the institute. We now have to do research on men and women and all ethnic minorities in order to get federal funding.

KING: And, Dr. Ulene, do we have enough people who are going into geriatrics?

ULENE: Well, there are never new given the huge explosion that's taking place. But I'd like to say that I don't think the problem is the growing number of older people. The problem is the growing number of older people who allow themselves to become sick and who...

KING: Allow themselves?

ULENE: Allow themselves. Who do not recognize the fact that it is never too late to start changing your life. It is never too late to bring your cholesterol level down, reduce your risk of heart disease. It is never too late to lose the excess weight. It is never too late to stop smoking. And I think that if we could get this message through more effectively to older people, we would see a growing healthy population that would not be a problem, but an opportunity.

KING: Let's take some calls -- Boston, hello.

CALLER: Hi, my question for panel is this: Are people who have had basal cell cancer at greater risk for developing melanomas?

KING: Who wants to take that? Dr. Weil, go ahead.

WEIL: No, they are not. The basal cells are the common kinds of skin cancer. They're correlated with sun exposure. As was said earlier, melanoma is distinct and often correlates more with severe sunburns early in life.

KING: Could you briefly tell me, Dr. Ulene, the difference between melanoma and cancer? They're both cancer, right?

ULENE: Well, melanoma is a cancer of the pigment-producing cells in the skin, which is why you hear...

KING: Freckles.

ULENE: ... about a malignant mole. You see actually a growing thing, and it's important that people recognize. If they see a mole changing. If they see mole with an irregular boarder. If they see mole that becomes asymmetric, unequal on two sides, those are danger signals and they need to get in quickly. That's a -- basal cell cancer is a cancer of a different kind of cell in the skin, and there is still a third one, squamous cell cancer. I have had two squamous cells and one basal cell cancer. And the squamous cells are the most superficial cells. These are all malignancies. The most dangerous one is melanoma. But any cancer, if ignored, can become at least locally destructive and can spread.

KING: Dr. Healy, in your profession, are we ever going to see maybe the end of bypass surgery? Are we going to see drive-through treatment of or something -- you walk out and your arteries are clear?

HEALY: I think if so, it's still a far, far way off. I think the key thing is we have to remember that clogging of arteries, or atherosclerosis, that blocks arteries, is in part related to age; in part, it's related to diet; in part, it's related, obviously, to other risk factors, like high blood pressure and diabetes, but there's also a factor X -- maybe it's genetics -- that leaves a population who have coronary disease, and we don't know what the underlying risk is.

So I don't think going to go away soon, but, boy, we handle it well.

KING: We sure do. And some amazing pharmaceuticals in the area of cholesterol, right?

REICHMAN: Absolutely, the statins -- those are drugs that lower cholesterol. Not only do they really lower the cholesterol, but they have an amazing effect on the stability of the plaque and they can decrease heart attacks and strokes by 60 percent.

KING: And, Dr. Weil, do you balance them with your concept of nutritional medicine? WEIL: Absolutely. I think that...

KING: You're not anti-Lipitor.

WEIL: No. But I think you use that after you've tried the simpler, less expensive lifestyle measures of reducing saturated fat intake, exercising properly, eliminating smoking, and there are as well some supplements that can be used that also prevent the development of atherosclerosis. Antioxidants, again, are useful here, and then judgment can be made later as to whether one of the cholesterol-lowering drugs is necessary.

KING: Is the worst thing in America a cigarette?

ULENE: In my opinion, that's the worst thing in the world. And I think when it comes to this issue of cholesterol and heart disease, we need to be very careful about blaming some people, who really are at much greater risk for cholesterol problems, because of their genetic makeup. No matter how carefully they eat, their blood cholesterol levels are in the 300 and 400 range. We have to be careful of that.

KING: We'll take a break and pick up with Judy and be back with phone calls, right after this.

(COMMERCIAL BREAK)

KING: We are going to get to as many calls as we can.

But Dr. Reichman did want to say something about women and the heart. Because we think heart attack you think male.

REICHMAN: The most important risk factor for a women for heart attack is a family member having a heart attack at a young age.

KING: Male or female.

REICHMAN: Male or female. If a mother had it before the age of 65, a grandmother or aunt, or if her father had it before the age of 65 -- and also both sides of the family -- she is at risk. It doubles her risk. And once more, heart attack is not a male disease. Women get it. They get it later, but when they get it, they are sicker, it is picked up later, and their recovery is not as good.

KING: Stanley, Virginia hello.

CALLER: Hello, Larry. I have been trying to call you for nine years. And I am so glad I got you this time.

KING: So you are calling about a finger problem you are having with the phone.

CALLER: No, I...

KING: Go ahead.

CALLER: I'm calling to talk to one of the doctors.

KING: Go ahead.

CALLER: Either one would be OK. My body doesn't produce red blood cells. And I would like to know from one of them what foods I could eat to make red blood cells.

KING: Dr. Weil.

WEIL: Well, if your problem is that you are iron-deficient and have iron deficiency anemia, which can be diagnosed by blood tests, then you want to eat iron-rich foods, which include things like molasses and beans. You can do some cooking in iron pots. Or you can take an iron supplement. But there could be other reasons for your not producing enough red blood cells. So you need a good diagnosis here.

And by the way, we now have an excellent new pharmaceutical treatment for stimulating the body to make red blood cells. But the key here is to get the diagnosis of why your body is not doing that.

KING: Oh, there's a new pharmaceutical treatment. That's good to know.

WEIL: Yes.

KING: Kansas City, hello.

CALLER: Yes, I have a six-year-old who has Tourette's Syndrome and ADD. I want to ask your panel advice about nutrition, nutritional supplements, and medicines that could help her.

KING: Dr. Weil.

WEIL: Well, I would say...

KING: Tourette's Syndrome. Anyone know any -- Dr. Weil or Dr. Ulene, either one. Dr. Ulene -- OK.

WEIL: I would just like to say quickly, it would be worth experimenting with intake of omega-3 fatty acids, because there is a very exciting research going on about their effect on brain function and stabilizing nervous system problems. It would be worth a try.

KING: Dr. Ulene, you agree?

(CROSSTALK)

ULENE: I also think you want to start with a child who is emotionally -- who is nutritionally sound. But let's recognize that there are many different problems right now. The psychiatrists are now beginning to divide these problems into ADD, into the so-called explosive child syndrome. Some children are suffering from bipolar depression. So I think the most important thing to do is to get a good sound medical and psychiatric diagnosis.

KING: Dr. Healy, were you going to say about Tourette's?

HEALY: No, I was just going to say that there have been some controlled studies that have looked at things like sugar and other things in diet, and they haven't been too convincing one way or the other. So there's a lot more to look at there.

KING: Clearwater, Florida, hello.

CALLER: Hi, Larry. This is a question for Dr. Ulene.

KING: Go ahead.

CALLER: I take 1200 milligrams of calcium. Is it better to take this and/or other supplements at certain times of the day?

ULENE: Well, first of all, I would say that the most important thing you could do is try get your calcium from food. There are studies which show that calcium from food can be taken in unlimited amounts with no side effects, whereas you actually can get into problems with extremely high levels of calcium supplements. The recommended daily allowance for calcium is about 800 milligrams a day.

And my recommendation would be to take it with foods. If you are not eating foods that are high in calcium, take it with foods, divide your doses during the day. And make sure that you are getting enough Vitamin D, because the body can't use calcium without Vitamin D. If you are house-bound, you are not probably getting enough Vitamin D.

KING: How do you know, Dr. Reichman, when to take the pill?

REICHMAN: Vitamins usually should be taken with meals. As far as calcium is concerned, if you are going to take something that has -- that most of the calciums are the Viactives (ph), the Caltrates, the Tums, you want them with food. However, there is calcium citrate that tends to cause a little less bloating for some people, perhaps constipation.

Someone with renal stones could take the calcium citrate fairly safely. That should be taken on an empty stomach. So if you have any questions, number one, look at the back of the bottle to see how much calcium -- elemental calcium there is. Never take more than 500 or 600 milligrams at a time, because you won't absorb it and then you just do it in divided doses.

KING: I take 1000.

REICHMAN: No...

(CROSSTALK)

REICHMAN: ... well, you're only absorbing about 600 milligrams. And then the other thing is, if you are not sure what calcium you are taking, ask your doctor. We feel that the calciums that are synthetic are actually better than those that come from bone meal or from oyster shell because those types of calciums -- the bone meal and oyster shell -- may actually be contaminated with lead. KING: Cresco, Pennsylvania, hello.

CALLER: Hi, Larry. My question for your panel relates to stress in the development of chronic disease. I developed progressive MS late in life at age 46 after three years of very stressful work. And I would like to better understand disease relationship to stress, your ideas on this, and any other doctors you could recommend I speak to.

KING: All right, Dr. Healy: stress and disease.

HEALY: Well, probably the most convincing biological information on stress and disease is the fact that chronic stress can affect your immune system. And when your immune system is depressed, then your are more susceptible to certain illnesses, like infections, viral infections, bacterial infections, and possibly, even -- and cancer.

But the -- there is also a possible association with heart disease, because of the effect on blood pressure. But the links are just harder to study, because everybody reacts to stress differently. So you, again, you have an external stressor, but you also have the responder. And some people can handle stress better than others.

KING: Let me get a break and pick right up on that with more. And some phone calls right after this.

(COMMERCIAL BREAK)

KING: Bolder, Colorado, hello.

CALLER: Yeah, hi.

In regard to the Hepatitis vaccination -- I'd like this directed to Dr. Weil.

KING: All right.

CALLER: If you stay within the country, you see all these brochures at these clinics and all these medical facilities: Everyone should get a vaccination for the Hepatitis B. Is there any kind of danger in getting it if you're not working in a health field. Or just in general, is there any danger or any precaution that you should take for...

KING: Dr. Weil.

WEIL: OK. This vaccine is for hepatitis b, a serious form of infectious hepatitis. There is real controversy about pushing for this as a universal immunization. The thought is that we could eliminate the disease in our population. On the other hand, the question is that a significant fraction of the population is probably not at risk: that is people, as you say, who don't travel out of the country, who don't take -- use intravenous injections, who don't engage in risky sexual behavior.

KING: So what do you recommend?

WEIL: I don't know. I don't know what the answer is there.

KING: Aha! An "I don't know."

WEIL: I don't know.

KING: Four doctors and we've got an "I don't know." Hold it. Does anyone else have an "I don't know"?

REICHMAN: Well, most pediatricians now are immunizing children for hepatitis b, and a lot of times they won't be accepted at their schools or at their camps unless they've had it. Certainly health care workers should have it.

KING: What's the danger...

REICHMAN: Well, hepatitis b is actually a sexually transmitted disease as they get older, and what we want to do is immunize the children so then when they get to their teenage years...

KING: I mean, but is there any danger if everyone had it?

REICHMAN: To my knowledge there is going to be very little danger. There can always be some sort of reaction to it. It's a series of three shots, so you have to follow through.

KING: Do you know of any danger, Dr. Ulene?

ULENE: Well, like everything else, there's a side effect to everything. There is no medical treatment known to man that does not have some risk and some side effects. There's a cost associated with immunizing every single child in the country or every adult. And at some point in time, when you have limited resources, you have to say, "Is this the best way to spend our money?" And I think that's why there's an argument.

KING: And Dr. Healy, do you have a thought on the immunization for hepatitis b?

HEALY: Well, I mean, I think the recommendations really now are for people who are exposed, like health care workers, and for people who are sexually active. I personally question immunizing young children. I think my -- and it's really instinctive. I think there's an element of judgment here because we are not sure. And I would tend to agree: I don't think we're at the point where we should be immunizing everybody...

KING: We'll be back, get another -- get another call in, and our remaining moments in this all-too-swift presentation. Jerry Springer tomorrow night, his first appearance since that murder case. Don't go away.

(COMMERCIAL BREAK)

KING: Our doctors just mentioned something weird about there's always hypocrisy everywhere. You can buy tobacco anywhere; you need a prescription for birth control pills. Morrisville, Vermont, hello.

CALLER: Hi, Larry. Thank you for taking my call. This question is for Dr. Weil.

KING: Yes.

CALLER: I've had persistent stomach problems for 2 1/2 years, and after many tests I was diagnosed with Candida. Do you have any advice for me?

WEIL: Well, I would be careful of that diagnosis and treatments recommended for it, because most people have this organism -- it's a yeast -- in their intestinal tracts, but it may not be the cause of the symptoms that you're having. And there are some doctors out there and alternative physicians who diagnose lots of people with Candida infections and give expensive treatments for it that may not be the cause of your problems.

KING: So how do you know what do if you're a layman?

WEIL: Well, I would get -- make sure you rule out other things, make sure you don't have infection with Helicobacter, a common cause of chronic stomach distress. I would -- I'd want to take a careful dietary history. I'd want to know about caffeine intake, use of cigarettes, alcohol, stress, and so forth.

KING: Is there a lot of misdiagnosis going on?

ULENE: Of course there is.

KING: All the time.

ULENE: This is a complicated subject, and to me the answer is get a second opinion.

KING: Always.

ULENE: Always. When you've got a condition like this that is refractory to diagnosis and treatment, get a second opinion and go to a place where you can find experts in the field.

REICHMAN: Especially if you've had long-term gastrointestinal problems, you should be seeing a gastroenterologist. And this is the time I make my plea for women and men to start getting their colonoscopies after the age 50. You remarked that it was really an easy test.

KING: Nothing.

REICHMAN: We all need screening. For men it's the second-most common cancer and for women it's the third, and it's something that we can pick up before it's cancer by diagnosing if there are polyps.

This woman who's having chronic GI problems should probably see a good gastroenterologist, should get a colonoscopy, should get a breath test for the H. pylori. There are things that should be tested. Candida usually causes vaginitis. I'm not sure it causes all the other things they talk about.

KING: Ellenton, Florida, quickly. Hello.

CALLER: Hi. I'd like to ask the panel, with so many physicians writing diets, like Dr. Atkins and Dr. Weil, sugar busters, et cetera, how do we know who is right and who is wrong?

KING: Dr. Healy, do you have a recommendation for people as to diet books?

HEALY: Well, you're going to have to be confused. I mean, my belief is just to be prudent about your diet and make sure it's one that is a diet for your lifetime. You get into -- it's a behavioral thing you get into. I mean, I have a very simple formula: Make it low-fat, five fruits and vegetables a day, and you know, go light on the rich food, the gooey stuff; a multivitamin calcium supplement, if you're not getting enough calcium through dairy and other things in your diet; and then, eat what you like within those constraints.

But I think -- but I'm concerned about having a fad diet and changing your diet every week.

KING: My plan is if it looks wrong, don't eat it.

ULENE: The research is very clear on this subject. High carbohydrate diets work just as well as high protein diets if you get the fat out and add exercise to your life.

KING: Do you agree, Dr. Weil? We've only got 30 seconds.

WEIL: I think there are many ways to lose weight. The trick is to keep it off, and that can only happen through a change in lifestyle, including adequate exercise.

KING: Dr. Reichman, you agree?

REICHMAN: Absolutely. We have to exercise, get our complex carbs, our fruits and vegetables. Whatever our parents told us was true, and the fads don't change that.

KING: Except maybe my mother who said: "The more fat, the better. You look skinny."

REICHMAN: Well, that was a different thought then.

KING: Thanks for joining us. See you tomorrow night with Jerry Springer. I'm Larry King. Good night.

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