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HOUSE CALL WITH DR. SANJAY GUPTA

Vaccine for Brain Cancer Showing Great Promise; How Reliable Are DNA Tests that Predict Your Medical Future?; Googling Your Medical Records

Aired June 7, 2008 - 08:30   ET

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


SANJAY GUPTA, CNN HOST: Welcome to HOUSE CALL. We're making the rounds this morning of some of the most intriguing medical stories of the week, including a vaccine that shows great promise for brain cancer patients. I've got all the details. And who's at greatest risk for brain cancer? You ever ask that question? You may be surprised at the answer.
Also, how reliable are those DNA tests that say they can predict your medical future? Well, I took the tests. And we're going to get the results right here on this show.

And an inside look at the newest online trend, Googling your medical records. We've got all that coming up on HOUSE CALL.

First up, though, new hope for people with brain cancer. A new vaccine is said to double the survival rate for patients with the most common form of adult brain cancer, something called Agleoblastoma (ph).

Now this brain cancer is aggressive, normally killing half its victims within a year. But researchers in the Tish Brain Tumor Center at Duke Center say this new vaccine doubled the average survival time up to 33 months, also promising it took tumors much longer to grow back after an operation in those patients who received the vaccine.

Now Senator Ted Kennedy is being treated at Duke University Medical Center. One researcher said this vaccine could be one of the senator's options if he chooses to try it.

Now when we talk about malignant tumors, you measure progress in weeks and months, not necessarily hours and days. What we can tell you right now is that Senator Kennedy is getting medications to prevent brain swelling, to prevent seizures. Doctors are also going to be watching very closely for signs of a potential stroke.

In the coming weeks, he's expected to go home to Massachusetts, where he's going to begin chemotherapy and radiation. Now we've talked a lot about this. And I want to show you something here on this GE Advantage Work Station. This is not FDA approved for diagnosis. And this isn't Senator Kennedy's brain, but I want to show you something important here as we sort of recreate the head slice by slice through the brain.

And you can see here as I come to this part of the board, see the eyes here, the nose. This is the parietal lobe. This is the area that we've been talking so much about where his tumor was located. Why this is so important here is that oftentimes when you're operating on these tumors, it is very hard to get out every single piece of the tumor. So radiation and chemotherapy are going to sort of be the name of the game here.

Take a look here. I've recreated this image. Again, the eyes are up here, the nose over here, the paribal lobe in this area. It has tentacles that reach out into other areas of the brain.

Over the next ten to 14 days, after his operation, he's going to get radiation to try and kill off as many of those tumor cells as possible while leaving the healthy cells intact. As I've also mentioned, Senator Kennedy may be a candidate for experimental therapy. That's something that Duke is actually known for.

And I actually had the chance to sit down with the leader in the field of brain cancer. He's Dr. Keith Black. He's the chairman of neurosurgery at Cedar Sinai Medical Center in Los Angeles. And I started by asking him where exactly do we stand in the fight against this deadly disease.

(BEGIN VIDEOTAPE)

KEITH BLACK, DR., NEUROSURGEON: If we're going to find an effective treatment for brain cancer, we need to understand brain cancer. It's sort of this intimate detail and go after sort of where it lives.

We used to believe that, you know, cancers behave more like a human colony and that every cancer cell would divide into daughter cells. Now we understand that cancer behaves more like a termite colony, that you have these cancer stem cells with sort of the queen termite or the queen cancer cell, which only makes up about 2 percent or 3 percent of the cancer, that actually is repopulating the tumor. So the daughter cells will only divide one or two times and then they die.

So most of our treatments in the past has focused on attacking these daughter cells, but the queen cancer cell or the cancer stem cell is more resistant to chemotherapy, more resistant to radiation therapy.

So we're changing our approach now. It's like trying to get rid of termites in your house, rather than killing, you know, all of the termites flying in the house, the strategy now is to go after the queen termite of the cancer stem cell and develop a strategy to kill that.

The other thing that has been very promising is being able to harness the power of the body's immune system. So we have developed at Cedar Sinai in our laboratory, what we call a therapeutic brain cancer vaccine, where we actually take the tumor out at surgery. And we use that to make a vaccine that give us a shot in the arm to help in the fight against the tumor.

We started this about ten years ago. You know, our longest survivor now with the type of tumor that Senator Kennedy has is still alive, you know, ten years out, where, you know, the median survival, you know as you know, is only, you know, a year to 15 months.

GUPTA: Is operating, performing surgery on these types of tumors a good option? You can't get it all out.

BLACK: I believe that if we have a tumor that we can removal surgically, it's clearly a benefit for the patients. If we can remove all of the tumor that we can see on the MRI scan, there's a significant increase in the survival. That doesn't mean that it's curative, but there's a clear benefit. And you know, the benefit that we're seeing is about double the survival than if we only do a biopsy.

GUPTA: Do you believe that there are more brain tumors being diagnosed now versus ten, 15, 20 years ago?

BLACK: There are clearly more brain tumors being diagnosed now than they were in the past. We also know that the lead-in cause of cancer death in people less than 19 is now brain cancer. We've developed effective treatments for leukemia.

The incidents of death from leukemia has gone down. The incidence of brain tumor in the pediatric population has gone up. And it's now the number one killer of cancer in Georgia in people less than 19. And there's been speculation that there could be environmental factors that may be increasing the incidence of brain cancer.

(END VIDEOTAPE)

GUPTA: Dr. Keith Black, thank you so much.

Coming up, a new type of breast cancer has experts stumped.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: We don't know the risk factors for it. We don't know how best to screen for it. And we don't know how best to treat it.

(END VIDEO CLIP)

GUPTA: But what they do know might be just as concerning.

But first, there's a troubling new link between energy drinks and risky behavior. That story minutes away. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. Some quick medical headlines now.

First up, high caffeine energy drinks may give kids more than just the jitters. In fact, there's some new researching suggesting that teenagers who drink these beverages are more likely to engage in high risk behavior, such as unprotected sex and violence. An estimated 30 percent of kids age 12 to 17 regularly consume energy drinks, some which have more than 300 milligrams of caffeine. That's well above the recommended 200 milligrams daily limit. Experts say regular consumption of these energy drinks could be a red flag for parents to monitor risky behavior.

Also in the news, a combination of drugs for treating advanced breast cancer is showing some promise. A new study tested the chemotherapy cocktail on women with Her 2 positive breast cancer who cancers also spread to other organs. Her 2 cancer is an aggressive cancer. And researchers say the drug combination almost doubled the time it took for the cancer to spread. Plus, the median survival for the patients also increased by several months.

And finally, some good news. Some new hope for troops with brain injuries. Thursday marked the ground breaking of a new multi-million dollar treatment center for troops with traumatic brain injury and also for those struggling from post-traumatic stress disorder.

PTSD, as you may know, is an anxiety disorder often happening after a traumatic or life-altering event, such as combat. It can include symptoms such as irritability, getting easily angered, even feeling hyper-alert. A recent study found soldiers who suffered a tremendous brain injury were at much higher risk of getting PTSD.

Anxiety disorders among U.S. troops returning from Iraq and Afghanistan are rising. And the new facility will offer state of the art brain screening technology as well as mental health screenings.

Now just ahead, predicting your medical future. How a swab of your cheek could help determine whether you're at risk for developing heart disease, Alzheimer's, even cancer. That's in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Experts are increasingly baffled by a fast moving aggressive type of cancer that metasicizes quickly and often doesn't respond to common cancer fighting drugs. Now with no effective treatment available, recurrence could be deadly. And there are signs that certain women may be more at risk.

(BEGIN VIDEOTAPE)

CHERYL REED, BREAST CANCER PATIENT: But I didn't want to listen to anything else that was negative or that told me that this is the, you know, the deadliest of all.

GUPTA (voice-over): In 2006, Cheryl Reed learned she had triple negative breast cancer, a rare fast-moving cancer that has experts like Dr. Funmi Olopade stumped.

FUNMI OLOPADE, DR., UNIVERSITY OF CHICAGO: One, we don't know the risk factors for it. Two, we don't know how best to screen for it. And three, we don't know how best to treat it.

GUPTA: Fifteen percent of women diagnosed with breast cancer will have the triple negative type, which doesn't respond to many of the common breast cancer drugs. And Dr. Olopade has found another thing victims of the triple negative cancer have in common.

OLOPADE: African-American women also have a rate that's much higher than young white women. We just say if you feel that your ancestry is more African than European, then you can get triple negative breast cancer.

GUPTA: Though black women are at lower risk of developing breast cancer overall as compared to white women, nearly 50 percent of black women diagnosed under age 55 are triple negative. The five-year survival rate is 15 percent lower compared to other breast cancers.

Researchers think a gene mutation is one factor putting black women at higher risk. But right now, research is preliminary. And clinical trials like the one Cheryl Reed is in at Emory University are trying to develop drugs specifically targeting triple negative cancer cells. Despite the grim statistics, Cheryl's doctors say early detection is key.

RUTH O'REGAN, DR., EMORY WINSHIP CANCER INST.: If you have your screening mammograms done and you get the cancer picked up at a very small stage, it's going to have a good prognosis.

GUPTA: Which is why Cheryl remains optimistic.

REED: And it never occurred to me that I'm going to die from this. It's like, you know, I've got breast cancer, let's take care of it.

(END VIDEOTAPE)

GUPTA: Now researchers think Cheryl and other women may be predisposed to developing triple negative cancer because of an inherited gene known as BRCA 1, also known as Broca (ph) 1.

Now, as we thought about this, what if you could find out your genetic risk for conditions like this one ahead of time? You know, we're constantly reporting on preventing medicine here for the show -- staying healthy, eating right, and exercising, personal DNA testing may one day give that term a whole new meeting.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Alzheimer's, heart attack, cancer, if any of those are part of your genetic destiny, would you really want to know? So I decided to get my own DNA tested with a simple swab of the cheek, services like these, so they can tell you your risk for dozens of diseases.

They can also give you other information like your ancestors, your race, even whether or not you get your eye color from your mom or your dad. More than 30 companies offer personal DNA mapping. It costs anywhere from a couple hundred dollars to a few thousand. I sent a sample to four of them. Generally, the results are available within two to four weeks.

Now most people can get their results confidentially online, but I have decided to come here to this storefront and talk to a genetic counselor. I got to tell you, I don't know my results yet. And it's a little bit nerve-racking. Let's go take a look.

It's all laid out on screen. Orange boxes indicate increased risk. Gray boxes mean average or even lower than average risk.

UNIDENTIFIED FEMALE: This is not a diagnosis. This is not destiny. It is really giving you some information so that you can focus your health care, you can focus your preventive strategies.

GUPTA: It's really remarkable to get this sort of information, your life laid out in orange boxes and gray boxes. What surprised me, colon cancer, psoriasis, Crohn disease, elevated risk. I'm also at elevated risk for heart disease and diabetes. That wasn't very surprising at all.

Other findings, I'm more likely to be lactose intolerant or have wet earwax rather than dry earwax. That was surprising. And have an increased sensitivity to pain. So say the results from 23 and Me.

While different companies came up with similar genetic profiles, one company put me at lower risk for Crohn's disease, not higher. Maybe the science hasn't quite caught up to the promise of deciphering your own DNA.

GEORGE CHURCH, HARVARD MEDICAL SCHOOL: It may never be the strongest part of your medical history, but there will be a tipping point where everybody wants it to be part of their medical history.

(END VIDEOTAPE)

GUPTA: Now as you might imagine, DNA testing has raised the issue of medical privacy. Critics are concerned, insurance companies, employers may use this information against you. However, Congress has just passed a Genetic Non-discrimination and Health Insurance bill called GINA for short. It would prohibit discrimination based on your genetic information. President Bush is expected to sign it into law.

Now straight ahead...

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I started looking through it and sort of e- mail it back and was like, well, what's this about the thyroid?

(END VIDEO CLIP)

GUPTA: Why having his medical records online may have saved this man's life. Should you consider going virtual?

And later in the show, are cancer rates higher for kids in certain parts in the country? A new study says, yes. I'll explain in our "Ask the Doctor" segment. Stay tuned.

(COMMERCIAL BREAK) GUPTA: You know, doctors aren't the only ones who want to know about your health. So does Google, Microsoft. Both are encouraging you to put your health records online, but do you want your most intimate health information in cyberspace?

Well, CNN's medical correspondent Elizabeth Cohen has some answers.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Doug Smith caught his own cancer. Two years ago, Smith had a CAT scan for a possible heart problem He was relieved when his doctors called to say everything was fine.

UNIDENTIFIED MALE: Great news, no aortic tear.

COHEN: But then Smith went online and read the CAT scan report himself. Towards the end, he noticed this little section.

DOUG SMITH, PATIENT: I started looking through it and sort of e- mailed it back and was like well, what's this about the thyroid?

COHEN: That lesion turned out to be cancer. Smith caught it only because he could look at his medical records online. So Smith and his physician, Dr. Jim Jirgis, at Vanderbilt University Medical Center are big fans of online medical records because sometimes doctors don't catch everything.

JIM JIRJIS, DR., VANDERBILT UNIV. MEDICAL CTR.: Most physicians are reviewing an enormous amount of lab results every day.

The patients are reviewing one person's lab results. We've empowered them to be able to get their own test results online.

COHEN: If your doctor doesn't offer online records, you can try doing it yourself. Google, Microsoft, and others have secure sites where you can put your medical records and even your pharmacy records. But many wonder, is it really 100 percent secure? Could someone else see your private health information?

JIRJIS: I think they're very valid concerns.

COHEN: He says these sites go to great lengths to keep information confidential. And remember...

JIRJIS: The world has now changed. And people get kind of cranky when they can't do something online because they're doing everything else online.

COHEN (on camera): Before you decide to put your medical information online, there are several important questions you should ask. First of all, find out if the web site has a secure server. Second of all, find out who else will have access to your information. And third, make sure that there's an audit trail so that if someone else does get access to your information, it will be clear exactly who that person is.

From Empowered Patient, I'm Elizabeth Cohen. Back to you, Sanjay.

(END VIDEOTAPE)

GUPTA: All right, Elizabeth, thanks. And check out CNN.com/empoweredpatient. You can read Elizabeth's column. She has some tips there on getting information off the web if you're concerned. Plus, we have some news on what Google and Microsoft are offering in the way of online medical records. Make sure to check that out.

Coming up next, how one Pennsylvania school made a small change in the lesson plans, which led to huge results in the fight against childhood obesity.

Plus, are your kids at risk of developing cancer? A new report says it may depend on where you live. We'll have the details, that's later in the show.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. As you know, childhood obesity is a vital concern. And tackling the issue has not been easy, but one Pennsylvania school reduced its number of overweight children by half using a very simple method.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): With the economy in a downturn, the burden is falling on schools in many areas to provide nutritious and affordable meals for kids.

EDWARD KOCH, PRINCIPAL, "AIRMILL ELEMENTARY": Nutrition is critical for children's success. If children are well fed, well balanced, our children achieve wealth.

GUPTA: But just getting enough food can be an issue for some families. So getting healthy and often more expensive food becomes an afterthought. The end result of those decisions can be devastating.

CARLA HARRIS, TEACHER: We do have seven children that are obese. We do have several children with diabetes. We have children with rotting and decaying teeth.

GUPTA: But there is some good news. A recent study in The Journal of Pediatrics shows that small steps can make a huge difference.

SANDY SHERMAN, THE FOOD TRUST: We reduced the incidence of students becoming overweight by 50 percent just by making small changes.

GUPTA: And like any good education, it starts in the classroom. SHERMAN: We did training of teachers, we did classroom education. And then we just helped to make some alterations in the lunchroom.

GUPTA: Changes, like replacing soda with water and skim milk. Taking candy out of vending machines and teaching kids how to make better choices. It's a program that makes teachers, parents, and students alike very happy.

UNIDENTIFIED MALE: I have seen an increase in test scores and a decrease in behavioral issues.

UNIDENTIFIED FEMALE: I love it. I don't know if you saw them attacking the fruit, they actually like it. I think if it were more accessible, they would be more willing to try it.

(END VIDEOTAPE)

GUPTA: Coming up next in our "Ask the Doctor" segment, we're talking about childhood cancer rates that might just catch you offguard. Coming up after the break.

(COMMERCIAL BREAK)

GUPTA: It's time for my favorite segment called "Ask the Doctor." Every week we get to hear the medical questions on your mind.

And this week a question from Helen of Cedar Park, Texas. She writes this. "I read that childhood cancer rates are highest in the Northeast. Is that true and why would that be?"

Well, Helen, in fact, it is true. The CDC released a study just this week that looked at cancer programs across the country and found some surprising numbers in the Northeast caught some experts off guard. Here's specifically what they found.

179 kids per million have cancer in the Northeast. That's the highest in the country. The lowest rate is in the South with a national average about 166 per million. The CDC study doesn't say exactly why there are more cancers up north, but experts agree it may be a reporting issue. Some regions could be under reporting, others might be over reporting.

The environment like pollution could also be a factor. Then there are more cancer centers in the Northeast, so it could be that more kids are seeking treatment in that part of the country as compared to others.

Well, unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast on CNN.com/podcast. Remember, this is the place for the answers to all your medical questions.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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