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American Morning

Bush Gulf Visit; Understanding Lung Cancer

Aired March 08, 2006 - 09:00   ET

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

SOLEDAD O'BRIEN, CNN ANCHOR: Good morning. Welcome, everybody.
I'm Soledad O'Brien.

MILES O'BRIEN, CNN ANCHOR: I'm Miles O'Brien.

A new round of attacks in Iraq this morning and a grisly discovery on a bus in Baghdad.

Plus, President Bush set to arrive in New Orleans this hour. Again, he will deliver -- will he deliver any monetary relief to the region? Big questions for folks there.

S. O'BRIEN: More testimony in the Enron trial today expected to be just intriguing. The prosecution's star witness is back on the stand.

And understanding cancer. Dana Reeve's death puts the disease back in the headlines. We're going to take a closer look at some of the causes, some of the treatments, and whether there is any reason for hope.

That's ahead.

M. O'BRIEN: It's good to have you with us this special hour. In the wake of the shocking death of Dana Reeve, we are dedicating this hour of AMERICAN MORNING to understanding cancer and the risks that you may face.

S. O'BRIEN: We've got lots of help this morning. Dr. Sanjay Gupta is here to help us out. Also, Lance Armstrong's going to join us. He's among our special guests.

We also want your help. You can e-mail us your questions at CNN.com/am or AOL Instant Message, CNN_AM.

We're going to get you -- get to as many of the answers as we possibly can this morning.

First, though, let's update you on some of the top stories this morning.

President Bush is arriving in New Orleans. It's going to happen later this hour. Under quite a bit of fire for his handling of Hurricane Katrina, so he's going to be looking at efforts to rebuild the city and, of course, the critical levees. Of course the Lower Ninth Ward, which we showed you just last week, is essentially like a ghost town.

CNN's Kathleen Koch is live for us at the White House.

Hey, Kathleen. Good morning.

KATHLEEN KOCH, CNN CORRESPONDENT: Good morning, Soledad.

As you mentioned, the president will begin his tour in New Orleans. He'll be getting a briefing on the recovery and reconstruction efforts there before heading to the hard-hit Mississippi Gulf Coast. It's the president's second visit in less than two months at a time when he's been taking some hard hits himself for his administration's handling of the crisis in this region.

Reports this week from two groups say that when hurricane season hits come -- starts on June 1, that the newly reconstructed levee system in New Orleans will actually be weaker than it was before Hurricane Katrina. That's something the Army Corps of Engineers that's doing the work disputes.

And then there was the release of the video of the president participating in that federal briefing on the eve of Hurricane Katrina which raised new questions about the administration's preparedness for the storm. It's all taking a toll.

A new "Washington Post"-ABC News poll show that more than 60 percent of Americans disapprove of the president's handling of Hurricane Katrina. The White House is trying to improve the reception that the president gets when he heads down South. So he is not arriving on site empty-handed.

Among the new aid measures, the White House has announced that the federal government will extend by more than three months the time period during which it will cover all of the costs of debris removal in Mississippi. And Soledad, that's something that's very important when in some areas there less than half the debris has been cleared.

S. O'BRIEN: Oh my gosh. Yes, Kathleen, in some areas nothing's been cleared. I mean, you go to the Lower Ninth Ward, you know, it looks like the hurricane struck -- yes, it looks like the hurricane struck, you know, the day before. Nothing -- nothing has been made any better.

Kathleen Koch at the White House for us.

Kathleen, thanks for the update, as always.

KOCH: Yes.

S. O'BRIEN: Let's get right to Carol from the newsroom. She's got updates on other stories making news today.

Hey, Carol.

CAROL COSTELLO, CNN ANCHOR: Good morning.

Good morning to all of you.

More threats over Iran's nuclear program. In a statement, Iran says the United States has the power to cause harm and pain for threatening to haul it before the U.N. Security Council, but the statement goes on to say that the U.S. is also susceptible to harm and pain. The U.N. atomic agency is meeting now in Vienna.

A series of explosions rocking Iraq. Most of today's attacks targeting Iraqi police. At least five people killed.

Also, a gruesome discovery in western Baghdad. The bodies of 18 men have been found in a minibus. An official telling CNN they were found strangled with their hands tied behind their backs.

The Patriot Act heads to President Bush for his signature. Both the House and the Senate have now approved its renewal. The Bush administration calls it a vital tool in the battle against terrorism, but critics say it tramples on individual rights.

Some lawmakers are trying to stop the Dubai Ports deal by using money meant to pay for the wars in Iraq and Afghanistan. House members have written a measure blocking the ports deal. Today they will try to attach it to a billion-dollar spending bill. That could mean a veto showdown with the White House.

And in Houston, the prosecution star witness expected back on the stand later this hour. Former chief financial officer Andrew Fastow is considered to be the mastermind behind cooking Enron's books. He says he had former CEO Jeffrey Skilling's blessing. We are expected to hear some testimony today from Fastow about Enron founder Ken Lay.

And then, Miles, cross-examination will start. And then the sparks will really start to fly.

M. O'BRIEN: Thank you very much, Carol Costello.

Let's get a forecast in. Chad Myers with that.

Good morning, Chad.

CHAD MYERS, CNN METEOROLOGIST: Good morning, Miles.

(WEATHER REPORT)

M. O'BRIEN: Now Chad, let me have this straight, not a single plane is delayed in America right now? Not a single plane?

MYERS: Not because of weather.

(LAUGHTER)

M. O'BRIEN: OK. All right.

MYERS: All right.

M. O'BRIEN: You're accountable for that. We'll double-check that. No, we believe you.

Three hundred and fifty thousand Americans are living right now with lung cancer. And this morning, as we celebrate the life and legacy of the remarkable Dana Reeve, we're hoping to learn a little bit more about this scourge, this silent killer.

(BEGIN VIDEOTAPE)

M. O'BRIEN (on camera): When we last saw her in January, it seemed as if little had changed. Dana Reeve, as always, the embodiment of grace and courage under fire. So when we heard so suddenly she had lost her batting with lung cancer, we were all the more stunned by the news.

Reeve was only 44 and had never been a smoker. We first heard she was ill last August, a few days after Peter Jennings succumbed to the disease. Once again, we are reminded how lethal lung cancer is.

The disease kills more Americans each year than breast, prostate and colon cancer combined. Nearly 175,000 will be faced with a lung cancer diagnosis this year alone. You might be surprised how many of them are nonsmokers.

UNIDENTIFIED FEMALE: There's 25,000 people a year who get lung cancer who never smoked a day in their life. Dana Reeve is one of them, I'm one of them.

M. O'BRIEN: There is no easy way to test for lung cancer in the early stages of the disease. It's not like breast, colon, or prostate cancers, where early testing has saved countless lives. In fact, when it comes to lung cancer, doctors aren't sure who to screen or even if an early test would increase the survival rate.

DR. MICHAEL THUN, AMERICAN CANCER SOCIETY: We do know that helical CT scanning can find nodules when they're smaller than you can see them on a conventional x-ray, but we don't know whether finding them and removing them will actually improve survival. There's a large trial that will be finished in approximately two years that will answer that question.

M. O'BRIEN: But what about the search for a cure? Lung cancer patients fear the biggest obstacle is not science, but politics.

SHEILA ROSS, LUNG CANCER PATIENT: The money for research and the money for screening and early detection is going to the cancers that have large political constituencies. It's not going to a cancer like lung cancer, even though it's the biggest single killer, because there are not enough survivors to give it political power.

(END VIDEOTAPE)

M. O'BRIEN: Interesting point there. A little later, we will talk to a woman who has survived lung cancer. Doctors only gave her about a year to live. That was more than five years ago.

She will share her story. S. O'BRIEN: Imagine you have a two-year-old daughter and doctors say you have one year to live.

M. O'BRIEN: Oh, man.

S. O'BRIEN: She's got a brutal story.

M. O'BRIEN: Yes.

S. O'BRIEN: Also this morning, champion cyclist and cancer survivor Lance Armstrong is going to join us right here in the studio. He was one of Dana Reeve's close friends. We're going to ask him about the state of cancer research in America today.

M. O'BRIEN: And keep sending your questions our way. We have a bunch of e-mails already, but keep them coming. And IMs, too. CNN_AM is the location for that. That's AOL Instant Message.

Dr. Sanjay Gupta, we have a cancer expert here as well, all here to answer your questions and hopefully give you some useful information.

Stay with us.

(COMMERCIAL BREAK)

S. O'BRIEN: God, you look at the list of all the other cancers combined, and lung cancer affects so many more people. And to some degree, not really a national spokesperson for the disease. The shocking death, of course, of Dana Reeve from lung cancer, only 44 years old, a woman who never smoked, is leading us to devote this hour of AMERICAN MORNING to understanding this disease.

M. O'BRIEN: Dr. Bruce Johnson of the Dana-Farber Cancer Institute and our senior medical correspondent, Dr. Sanjay Gupta, are both here to try to field some of these questions. Obviously a lot of questions out there.

I think the thing that has stunned us all, and it maybe just dawned on a lot of us, is how lethal this type of cancer is, Sanjay.

DR. SANJAY GUPTA, CNN CORRESPONDENT: Yes. I mean, you know, the numbers are astounding. And I remember I was talking about it so much yesterday and people were calling and me and asking me, "Did you say 60 percent of people die in one year?" And...

M. O'BRIEN: Right. It's almost like, did I hear that right?

GUPTA: Yes. I mean, it is -- it is remarkable. Eighty-five percent within five years, also. And I think even more a little daunting is the numbers really haven't changed that much over the last several years. I mean, there's a lot of research going into lung cancer, obviously, but this is tough, tough cancer to beat.

S. O'BRIEN: Let's get to some of the questions, because I think they come right out of that exact point, which is, OK, so, what are the symptoms of lung cancer? This is from Barbara. She's from Ohio.

GUPTA: Yes. And, you know, I mean, a cough -- they can be vague. And I think that's why it makes it so hard, is that, you know, there's no specific thing that you're going to say, oh, I definitely have it now, like a lump, for example, in a breast for breast cancer.

A cough that won't go away, hoarseness for more than a couple of weeks. Some blood tingeing in your sputum. You know, things like that.

If you're a smoker, the warning bells may go off a little bit more quickly. But if you're not a smoker, you're thinking, oh, maybe this is just a bad case of the flu or a cold. If they don't go away, I think the symptoms are the worst...

M. O'BRIEN: Well, when you say don't go away -- Dr. Johnson, what would be the timeframe where you would say, OK, this is something more than the flu here?

DR. BRUCE JOHNSON, DANA-FARBER CANCER INSTITUTE: Well, most of the self-limited respiratory ailments that almost everybody gets, the colds and cough, go away in a matter of one to two weeks.

M. O'BRIEN: OK, so beyond that you get nervous.

JOHNSON: Yes. And one of the characteristics of cancer-related symptoms is that they will start and they will stay away -- they don't fluctuate too much -- and they'll progressively get worse.

M. O'BRIEN: OK.

JOHNSON: And we typically think of the time as a matter of weeks.

S. O'BRIEN: OK. So -- but at that point, if you have had that cough then for now three weeks, does that mean that you are likely going to die from lung cancer?

JOHNSON: Well, obviously most coughs are not related to lung cancer. And one of the things we don't want to do is...

S. O'BRIEN: No, no. I mean, I understand. We don't want to terrify people that they've got...

M. O'BRIEN: Yes.

S. O'BRIEN: But what I mean is, at the point where you finally figure it out, wow, this could be a problem, is it sort of too late already?

JOHNSON: One of the things about a cough, if it's related to lung cancer, is it's gotten big enough that it irritates the airways that produce the -- that produce the cough. And one of the things that's difficult about lung cancer is that by the time it produces symptoms, it typically has grown large enough that it is difficult to have it be surgically resected or... (CROSSTALK)

M. O'BRIEN: Yes, this is the part that scares people...

S. O'BRIEN: Right. Right.

M. O'BRIEN: ... is that your early indicator here is pretty late in the game.

S. O'BRIEN: Is -- right.

GUPTA: And a cough is something people sort of blow off.

M. O'BRIEN: Right.

GUPTA: They don't think about it that much, but that could be a late stage -- late sign, I should say.

S. O'BRIEN: Should we get to some of the e-mail or...

M. O'BRIEN: Yes, I have an IM. Let's share this. This is more on the broader issue of cancer, but this is a good one to get because I think a lot of people are thinking about other forms of the disease as well.

"If cancer runs in the family, what are the odds I will get it?" And does that vary from disease to disease? There is a big genetic component here. Right, Dr. Johnson?

JOHNSON: One of the things that's happened -- and it's one of the areas of research that has been able to characterize what families are predisposed to developing specific kinds of cancer. So, as an example, BRACA 1, it's a breast cancer gene, and they have been able to it identify it in families. And it's actually led to treatments where people will know that they're likely to get breast cancer. And sometimes they will even surgically remove the breast before the people get cancer to prevent it once a person has reached a certain age.

S. O'BRIEN: Is lung cancer like that?

JOHNSON: That's what I was going to get to. One of the things, there isn't a -- there is a very unusual family of -- that gets bronchial (ph) carcinoma. It's an unusual type that typically shows up on both sides. And there's been a family identified where the people get it in their 50s and they have a mutation...

S. O'BRIEN: You're talking about one family, right?

JOHNSON: One family. One family.

S. O'BRIEN: OK. So this...

JOHNSON: They've identified that they're predisposed to developing a certain kind of lung cancer called bronchial (ph) carcinoma, and that was reported late last year in 2005. There's a very large effort of eight institutions that are finding families where it's closely linked, and they found a chromosome, they found one of our 23 chromosomes that the lung cancer is linked to, but they haven't found the specific gene.

S. O'BRIEN: So...

M. O'BRIEN: But if they found that gene, you've got a test potentially, right?

JOHNSON: Yes. And they also have found from doing studies that if you -- if you inherit that particular chromosome from your parents, it does not take very much exposure to cigarette smoke to increase your risks.

S. O'BRIEN: If you're predisposed to it.

JOHNSON: So we're guardedly optimistic of finding one of the cancer predisposing genes which will allow people to know that if you smoke even a little bit, you might get lung cancer. And we hope that we'll get information on that in the next year or two.

S. O'BRIEN: What about radon? Because what if you don't smoke, but, I mean, people -- there's one e-mail question we should get to on radon. This person asks -- it's Linda in Missouri -- "How concerned should I be if I have high tests in my house for radon?"

GUPTA: You know -- and we talked a lot about this. And again, it was remarkable to me because this is the second leading cause of lung cancer, radon.

Now, smoking far away the number one cause, but for nonsmokers radon is certainly up there. It is the number one cause for nonsmokers.

It is this sort of byproduct of uranium. It exists in all soil. I was doing some reading.

Actually, the highest levels in the country are in Iowa, interestingly enough. And it seeps into basements of old homes, and you breathe it there, or at work, or some place you get this exposure to radon. And it's a radioactive substance that causes some alterations in some of your cells, and that causes the cancer. So it's a problem.

You can get it tested. One in 15 homes have levels that are too high. And you can also do something about it. It may be as simple as putting some more gravel around the outside of your home, putting some plastic over that.

Building inspectors all know this. But you've got to get it tested to know for sure.

S. O'BRIEN: You've got to know.

(CROSSTALK) S. O'BRIEN: All right. We've got to take a short break, but we want to remind folks to please send us e-mail questions if you have any, CNN.com/AM, or AOL Instant Message, CNN_AM.

We're going to continue our discussion, getting to some of your questions. And we're going to talk to a lung cancer patient. This is a woman who was given one year to live. She has a 2-year-old daughter at the time.

Well, the good news is that was five years ago. That 2-year-old is now seven years old. And she's going to tell us why she's one of the leaders in the fight against the disease.

And then up next, we talk to cancer survivor Lance Armstrong. He's going to join us live. We'll talk with him about the state of cancer research.

That's ahead. Stay with us.

(COMMERCIAL BREAK)

M. O'BRIEN: An alarming fact about lung cancer you just saw there. We're devoting the entire hour this morning to trying to understand cancer. Big subject.

S. O'BRIEN: Yes. Dana Reeve's sudden death came as a such to so many of us, I think it's fair to say, because of course we sort of heard that the tumor was shrinking and felt that she was getting better.

Lance Armstrong is a cancer survivor, also a friend of Dana Reeve.

Thanks for talking with us. Certainly appreciate it this morning.

LANCE ARMSTRONG, CYCLING CHAMPION: You bet.

S. O'BRIEN: It must have been a complete shock for you when -- when you were first introduced to Dana Reeve, because it was because she is had cancer that you really got to know her.

ARMSTRONG: Right. I mean, that's -- I mean, the bad news is that you meet somebody great like that through the disease.

The good news is you get to meet them and spend time with them and talk on the phone with them and realize that they're a special person. And this is big news because she was "Superman's" wife. And "Superman" was injured and hurt, and she was there.

And we all saw those images and those pictures of this beautiful, amazing caregiver, and then he passes away and then she's -- it's like the worst story.

S. O'BRIEN: Oh, and 18 months, both parents of this young boy...

ARMSTRONG: And then you add in the element of Will. And there's...

S. O'BRIEN: What did she want to know from you? I mean, did you counsel her? Did you just talk to her? Did you just gab?

ARMSTRONG: Well, she had great care here in New York City. So it wasn't as if I could come in and add anything to that. I mean, I was -- I was a cancer survive that had been through that experience and was just somebody that, you know, hopefully brought a little piece of hope and inspiration to the situation.

M. O'BRIEN: You know, what's interesting, as we have been learning a little bit more about lung cancer, is how much the odds are stacked against people who get this disease. There's no -- no real early warning testing like you have with so many other cancers, some of the cancer you dealt with.

ARMSTRONG: Right.

M. O'BRIEN: And how lethal it is once you finally get an inkling of it.

What can be done about that, do you think?

ARMSTRONG: Well, lung cancer is -- we talked about this -- Sanjay and I talked about this yesterday. It's one of these -- it's interesting, because it's the number one killer, but it gets the least funding because many people view lung cancer as something that is a consequence of somebody's lifestyle choice they made, so they either smoked or they...

M. O'BRIEN: So there's a stigma there.

ARMSTRONG: Sure there's a stigma.

M. O'BRIEN: In other words, people say, if you didn't smoke you won't get it, so let's move on, right?

ARMSTRONG: But you've seen the numbers up there with the odds of getting stricken by lung cancer and the fact that people either never smoked or quit smoking 20 years ago and then all of a sudden they have lung cancer. And, you know, that's really not fair.

In Dana's situation, was never a smoker, perhaps a passive smoker, like I guess all of us are, just because of the environment she would have been in. But, you know, it doesn't make the story any easier, and it certainly -- this one, I think this one rips at a lot of people because of -- because of her role as caregiver and as a mom, and as just a beautiful, elegant lady.

S. O'BRIEN: When my mom was diagnosed with carcinoids, a kind of lung cancer, the doctors came in after doing a test and said, hey, really, you didn't smoke. Because I guess they assume that people would come in and sort of lie.

ARMSTRONG: Right. S. O'BRIEN: And -- because she said, "I never smoked," and here she was diagnosed. You know, no one really believed her. And I think there is a stigma.

GUPTA: And Lance, you know, I'm a doc, and, you know, we talked about these numbers earlier, how poor they are for lung cancer. You had some poor numbers as well.

You talk about attitude a lot. You know, the thing you told me, knowledge is power, unity is strength, attitude is everything.

How much -- for people who are watching today, and, you know, grim chances of survival from lung cancer, what do you tell them about attitude?

ARMSTRONG: Well, I mean, I was a coin toss. I was 50-50. And that's not great odds. I mean, I don't want to flip a coin for my life today.

But you look at that situation, and you have to take some bit of hope out of that. If it's 50 percent chance -- and again, it's hard to ask that question, hey, doc, what are my odds?

M. O'BRIEN: Yes.

ARMSTRONG: But, you know, if they say, look, you have a two percent chance of survival based on history, based on what you know, I mean, you have to look at that and say, well, it's better than zero. And so...

S. O'BRIEN: In somebody's...

ARMSTRONG: ... you have to ask hard questions. Get second, third, fourth opinions, however many opinions you need, and just keep plugging away and surround yourself, like I did, you know, with great, positive people that build a team around you and take care of you.

You know what? I mean, if it doesn't work out, you have to -- ultimately, I think you have to die in peace.

S. O'BRIEN: Let me ask you a question about Sheryl Crow, your ex-girlfriend, who was just diagnosed with breast cancer, another just absolute shock. And I guess, you know, because there are more survivors, more money, to some degree, goes into that disease because people are sort of mobilized.

How is she doing? And what do you think of her chances?

ARMSTRONG: You know, it's been a -- it's been a rough week, obviously, with her news...

S. O'BRIEN: Yes, horrible. Horrible.

ARMSTRONG: ... and now this news.

She's doing great. And I think her chances are as close to 100 percent as you can get. She's a strong lady. She caught her cancer very early.

S. O'BRIEN: Oh, thank god.

ARMSTRONG: You know, she'll have a little radiation just as a precautionary thing. But she's going to be fine. And I know Sheryl well. She's a tough lady.

And I still love her very much. And it's hard to be in this position, a month ago breaking up, and now having this news. It's difficult to blend those two. I've never been put in such a difficult situation.

S. O'BRIEN: I bet. I bet. Gosh, tough all around.

Well, thanks for sharing your insight. We really appreciate it.

It's just been -- it has been just a shock, really. And, I mean, I guess because it's such a shock, that's why the numbers of people who get cancer -- I mean, it shouldn't be. The numbers are huge. And we've got to figure out the problem.

ARMSTRONG: And that's the silver lining, is that these women, like Sheryl and like Dana, they were courageous enough to say, I have cancer.

S. O'BRIEN: Right.

ARMSTRONG: And if there is any silver lining, it's that they were courageous enough to share their story. And, you know, we have to take it from here.

I accept it as my responsibility to take it from here and say, that's not acceptable. You know, Dana Reeve shouldn't have died two nights ago and Sheryl Crow shouldn't have breast cancer. And I, perhaps, shouldn't have testicular cancer. But we in this country have to say, after 35 years of declaring war on this disease...

S. O'BRIEN: Yes, war on cancer, and it's 35 years later and we're still fighting it.

ARMSTRONG: Yes. We're not -- we're not -- we're not getting there. And so it's time to make a difference.

S. O'BRIEN: We appreciate your time. Thanks for coming to talk to us.

M. O'BRIEN: Lance Armstrong. Thank you.

We'll talk to another cancer survivor in just is a moment. Melissa Zagon (ph) was given just a year to live when she was diagnosed with lung cancer. That was more than five years ago. We'll share her remarkable story with you.

And keep sending us your questions, e-mail, instant message. Dr. Gupta remains with us, and a cancer expert as well.

S. O'BRIEN: Dr. Johnson, too, is back.

M. O'BRIEN: Yes.

And they will do their best to field your questions. CNN.com/AM, or the IM is CNN_AM.

Stay with us.

(COMMERCIAL BREAK)

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