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HOUSE CALL WITH DR. SANJAY GUPTA

Cancer Death Rates on the Rise: What You Can Do to Help Prevent Cancer; How Food Shortages Could Bring About the Next Pandemic; How to Save Money Using Your Health Benefits

Aired December 13, 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: Good morning and welcome to HOUSE CALL, the show that helps you live longer and stronger.
New this week, cancer death rates are on the rise. So, what's going on? We have a doctor on the frontlines who's going to give us the reasons and more importantly, tell us three things we can do today to help prevent cancer.

Then, Anderson Cooper and I go on the road, finding out how food shortages could bring about the next pandemic. I'll explain.

Plus, do you have a flexible spending account? Discover what you can do in the next couple of weeks that could save you some money, all of it using your health benefits.

We start, though, with the medical headlines. First up, the future of health care in the United States. President-elect Barack Obama has picked former Senate Majority Leader Tom Daschle for two important roles, Secretary of Health and Human Services and Director of the White House office on health reform.

Daschle's assignment, addressing the health care challenges facing the nation, including the high costs, the quality of health care and the nearly 46 million Americans who don't have health insurance at all.

Also in the news, a troubling reality. In another year, cancer could surpass heart disease as the world's number one killer. That's according to a new international report. Experts say by 2030, there will be 27 million new cancer cases worldwide, 17 million deaths due to cancer, and 75 million people living with cancer five years after their diagnosis.

One major culprit has been tobacco and remains tobacco. Something has to be done about this. 1.3 billion people around the world smoke, officially making tobacco the number one preventable cause of death.

Now, another headline that caught my attention from that report, last century, 100 million people died from using tobacco. This century, 1 billion are expected to die from tobacco unless something changes. These numbers are so startling, something so preventable.

And joining me to be able to get into these new cancer numbers, Dr. Otis Brawley, head of the American Cancer Society, my friend as well. Thanks so much for joining us.

OTIS BRAWLEY, DR., CHIEF MEDICAL DIRECTOR, ACS: My pleasure.

GUPTA: You know, you do such a good job putting some of these numbers into context for us. My understanding is the numbers across the globe are increasing, yet the numbers in the United States are decreasing. What is going on? Is this an access issue?

BRAWLEY: Well, what's happened is all the bad habits that we have in the United States, smoking, diet and other things, we're exporting them outside of the country. They're going to third world countries, as well as to middle income countries. Now, more than 40 percent of all smokers live in India and China. That wasn't true 20 years ago.

GUPTA: Well, what is helping here in this country now?

BRAWLEY: We've gotten the word out about cancer control. Smoking rates have been going down for 40 years for men, for about 30 years for women. We're doing a lot better in terms of diet and exercise. We're doing a lot of things. And yes, incidence rates are actually going down in the United States. Mortality rates are going down in the United States. But as we look around the world, we're going to have an epidemic of cancer.

GUPTA: You travel all over the world in your role now with the ACS. What is the relationship in terms of deaths -- from cancer deaths to other chronic diseases?

BRAWLEY: Well, let me tell you. A lot of people think about infectious diseases a lot. If you sum up the number of people who die from HIV/AIDS, from tuberculosis and malaria, sum up those three diseases, cancer kills more people. Cancer is a chronic disease, is a major problem. By 2010, we estimate that more people are going to die from cancer than cardiovascular disease. Many of the reasons why they're going to die are preventable. It especially evolves around smoking.

GUPTA: You've talked about the simple things, relatively simple things people can do now. If you had to come up with a top three list of things people could do to try and bring these numbers down, what would they be?

BRAWLEY: Well, first off, if we could get rid of tobacco use altogether, that would help us a great deal. Second thing after getting rid of tobacco use, I would say that we need to start looking at diet and exercise. And everybody needs to try to get as close as possible, ideal body weight. In the world as a whole, responsible sexual practices would be number three. In the United States, where we have a very good health care system, I'd like to get people into that health care system and stress some preventive aspects of medicine.

GUPTA: You know, there's -- it's interesting. People ask me all the time, as they ask you, if they're diagnosed with cancer, what to do, where to go, who to see. Is there a disparity of care within the United States?

BRAWLEY: Tremendous disparity of care within the United States. The quality of care received can vary by region. It can vary by area of a city. You know, in North Georgia, for example, we have evidence that seven percent of black women who are diagnosed with early stage breast cancer get no treatment beyond the diagnosis. It's two percent of white women. They all have poverty and disenfranchisement in common.

GUPTA: Well, Dr. Brawley, some good news, some bad news obviously in here but always useful news from you. Thank you so much.

BRAWLEY: My pleasure.

GUPTA: We're going to keep on cancer, talk about it a lot. You know, it's an interest of mine and interest of yours as well. I should point as well that you're one of our experts now on our newly minted Web site, cnnhealth.com. This is something we're excited about, a chance for you to connect with a lot of your fans and viewers here at home and around the world. Thanks so much again.

BRAWLEY: Thank you.

GUPTA: Really appreciate it.

Coming up, could panic attacks damage your heart? That's a question. I'm answering that as we reach into our mail bag.

But first, take a look at this.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: When I look around in this forest, part of what I'm thinking is what's the diversity of viruses out there?

(END VIDEO CLIP)

GUPTA: Heading into the jungle with a virus hunter. We're looking for the next pandemic. Stay with us.

(COMMERCIAL BREAK)

GUPTA: You're watching HOUSE CALL. Deadly viruses lurking in the blood of forest animals. So how quickly can disease spread from the jungle to your neighborhood? Startling details just ahead.

Plus, only a few more days left in 2008. Find out how to save money using those last-minute health benefits. I did this. Do it before it's too late.

And a school principal taking charge, not just in the classroom, but in the lunchroom as well. There's one food students in her school have to live without. We'll tell you what it is.

HOUSE CALL's back in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Seeing some of this week's most viewed stories on the health page now. Watch this.

An American man goes to China for a weight loss camp. He's already lost nearly 240 pounds and he's not done yet. You can watch his journey.

And 10 years after the little blue pill burst onto the scene, the question is this -- is Viagra living up to the hype?

Plus, could you be programmed to feel lonely? A new book suggests your genes may be a deciding factor in whether one person feels more lonely than another. Check out those stories and other stories as well at cnnhealth.com. Got lots more information there. Check it out, but do it after the show because you're going to want to watch this.

If you think the food crisis in Africa doesn't affect you, think again. Soaring prices are forcing many people deep into the jungles to hunt game, exposing them to deadly microscopic pathogens that could trigger the next global health pandemic. Now, Anderson Cooper and I traveled with researchers deep into the forest to investigate whether another virus is inevitable.

(BEGIN VIDEOTAPE)

ANDERSON COOPER, CNN ANCHOR (voice-over): January 2008. Rising food prices touch off riots around the world. In Haiti, ten people died. In Cameroon, 20 are killed. Unable to afford basic supplies, people increasingly turn to the forest for food.

June 2008, deep in a remote region of Cameroon, two hunters stalk their prey. Their names are Patrice and Petit. They're searching for bush meat, forest animals they can kill to feed their families.

(on camera): Patrice and Petit set out most days to go hunting in the forests around their homes. They have a series of traps, of snares that they've set up. They'll catch wild pigs, snakes, monkeys, rodents, anything they can really.

(voice-over): Patrice and Petit have been out for hours, but found nothing. The animals are simply gone. Not too far away, Dr. Sanjay Gupta is with another hunter. But he, too, is finding his traps empty.

GUPTA: We've been trekking for about an hour now. It really gives you an idea of just how hard it is to actually get even a little bit of food. Biddy, who's trying to provide enough food for nine people tonight, doesn't care what he gets at this point as long as he gets something. And I can tell you, we still got a long ways to go. It is hot. It is humid. It is a lot of work.

COOPER: Hunters have to keep going deeper into the forest, but that is where hidden danger lurks. Forest animals are a reservoir of viruses, microscopic pathogens living in the animal's blood. Some are harmless, but some are potentially deadly when passed to humans. There's nothing new about these viruses but what is new is the frequency of our contact with them and how easily they can now be spread around the world.

NATHAN WOLF, DR.: Individuals have been infected with these viruses forever. What's changed, though, is in the past you had smaller human populations. Viruses would infect them and possibly go extinct. Viruses actually need population density as fuel.

COOPER: Dr. Nathan Wolf is a world renowned epidemiologist, a virus hunter. He works in these forests tracking what are called zoanautic (ph) viruses, ones that can jump from animals to humans. It's the zoanautic (ph) viruses that scientists think could trigger the next pandemic.

WOLF: When I look around in this forest, part of what I'm thinking is what's the diversity of viruses out there?

COOPER: It may sound farfetched, but it's already happened. HIV is the deadliest example.

(on camera): It was in a forest not too far from here in southern Cameroon that scientists now believe HIV was born. They say it started with a chimpanzee infected by several strains of viruses from eating smaller monkeys.

An infected chimp's blood then must have come in contact with a human being, most likely, say scientists, a hunter or someone cutting up the chimp for cooking. That simple seemingly insignificant transmission set off a global epidemic, a pandemic that so far has killed tens of millions of people.

(voice-over): Scientists now believe HIV crossed into humans in the early 1900s. But it wasn't until air travel increased that it spread and became a global epidemic in the 1980s. Is it inevitable that there will be another pandemic of some virus like HIV?

WOLF: Yes. The human population is going to have pandemics. That's just the nature of how we operate now. We are so profoundly interconnected that it will be the case that things will enter into the human population and they'll spread globally.

(END VIDEOTAPE)

GUPTA: Now, as virus hunters continue tracking down future diseases, others are diligently working to find cures for existing ones. And early results for experimental malaria vaccine offers some sign of progress.

Researchers tested a trial vaccine on young children in two African nations and found it was more than 50 percent effective in preventing the disease. Again, the results are preliminary and more tests are scheduled. But scientists say this hopeful beginning could one day help prevent the 350 million infections and more than 1 million deaths caused by malaria every single year. Now, you want to save some money in these tough times? Well, start with your health benefits. One catch, you got to do it before December 31st. We got the details just ahead.

And they say where there's a will, there's a way. We'll have tips to help you hold onto your willpower and stick to your diet as well over the holidays. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Well, the end of the year is quickly approaching, but Christmas gifts shouldn't be the only item on your shopping list. It's also time to shop around for ways to use those last-minute health benefits. After all, if you don't use them, you lose them. So to help make sure your hard earned money doesn't go to waste, Elizabeth Cohen joins us with some tips.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Sanjay, in these difficult economic times, the last thing you want to do is lose money, because of something you forgot to do. That's right. There are certain things that if you forget to do them by the end of the year, you could lose money. I'm talking about some health care costs.

Let's take a look at three things that you need to do by the end of the year so you don't lose your hard-earned cash. First of all, spend down your flexible spending account. The way that that works is you put money aside at the beginning of 2008. Well, you've got to spend it by the end of the year or else the government basically -- they just take it away from you. You don't get that money back.

Now, some people have until early 2009 to spend their 2008 dollars, but a lot of people have got to spend it by the end of the year or that money disappears. Use it or lose it.

The second thing is get elective surgery if you've been putting it off, if you've already paid your deductible. If you paid your deductible for 2008, get that surgery now so that you don't have to repay that deductible in 2009.

The same thing holds true for prescription drugs. If there are some prescriptions that you know you're going to need, and you know you're going to need them into the next year, you've already paid your deductible, you might as well get them now so that you don't have to pay that deductible again next year.

And also, Sanjay, I want to tell you about a couple things that you should not do. And that is don't get annual exams twice in one calendar year because your insurance might not pay for them. So for example, if someone had a mammogram in January of 2008, thinks, oh, December, we're almost up to a year, I'll have it now, well you know what? Your insurance might not pay for two annual mammograms in one calendar year. So you want to check with your insurance company and see what their rules are on that.

All of these things are to help you save money before the end of the year. Act now before you lose that money -- Sanjay?

(END VIDEOTAPE)

GUPTA: All right, Elizabeth. Thanks. Great advice as always. Be sure to check out the rest of Elizabeth's tips by visiting cnn.com/empoweredpatient.

It's time for our segment "Ask the Doctor". Let's get right to it. Our first question comes from Tori in Jacksonville, Florida who asks this. "I suspect my 16-year-old daughter may suffer from bipolar disorder. How does one know whether to seek a psychologist or psychiatrist?"

Well, Tori, that's a great question, an important one as well. Psychiatrists are medical doctors and considered the best people to treat bipolar disorder. They can use psychotherapy and treatment, but can also prescribe medications.

Now, many patients with bipolar disorder do require medication. And psychiatrists are well qualified to identify which drugs might work best for a specific patient.

Now, a major part of any therapy for this disorder is considered psychotherapy. And that can be provided by psychologists and other mental health professionals as well. Talk therapy can help you develop coping mechanisms and may help you keep you on your medications.

Bottom line, psychiatrists prescribe medications. Psychologists do not do that.

Our next question comes from a blogger. Marie writes this. "I suffer from severe anxiety/panic attacks and I would like to know if they could eventually do damage to my heart?"

Well, Marie, this is an amazing area. I'm very fascinated by this, this idea that issues typically thought of as psychological ones affecting our bodies. In fact, a study just last year found that older women who reported at least one full blown panic attack during a six-month period were three times more likely to have a heart attack or stroke over the next five years than women who did not of a panic attack.

Now, one of the many culprits here could be stress hormones, which could cause direct damage to the heart and affect heart rate, heart rhythm, and blood flow. If you're concerned, of course, talk with your health care provider, talk to your doctor about medications, and/or therapy which could help limit your anxiety.

Well, turkey pies, buffets, lots of alcohol, the holiday season is here, folks. It's in full swing. That means a big test to your palate and to your willpower. We're going to have some tips on how to control your appetite and how not to overeat.

And later in the show, cutting back on sugar or taking it away completely. Wait until you hear this school's success story and what they do daily to keep their kids on track. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: You know, the holiday season is all about temptation, so what should you do? Judy Fortin has some great ways to resist the urge to overeat.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN MEDICAL CORRESPONDENT: During the holidays, there are so many tempting foods and so many calories, it's hard to have willpower.

PATRICE HARRIS, DR., PSYCHIATRIST: I'm not even sure what willpower is.

FORTIN: Experts like psychiatrist Patrice Harris understand it's difficult to resist a holiday spread, especially when relatives are pressuring you to eat up. She says it's important to have a plan to help resist the urge to overeat.

HARRIS: Sort of do a tasting menu. Taste a little bit of everything.

FORTIN: Nutritionist Julie Schwartz suggests instead of being bombarded at the buffet table, survey what's being offered first and then go for the healthiest items.

JULIE SCHWARTZ, REGISTERED DIETITIAN: Have vegetables, have fruits. It gives you a lot of bulk, a lot of nutrients. The other thing it gives you is that you feel good tomorrow.

FORTIN: Speaking of feeling good tomorrow, she recommends watching your alcohol consumption.

SCHWARTZ: When we drink, sometimes our resolve is also diminished. So, it may be having something like 16 to 20 ounces of water in between every alcoholic beverage to help stay hydrated, but also to help slow down the rate of consumption.

FORTIN: At the very least, it may help boost your willpower.

Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Judy, thanks.

Up next, meet a principal who decided to take matters in her own hands, targeting sugar in the schools and making it her number one priority. Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Exercising, eating right, getting regular checkups. Of course, they're all crucial to your health, but what do you do when your kids are exposed to so much sugar even when they're at school? We'll take a look at a school where targeting obesity is a major goal. Do these programs really work? You decide.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Dr. Yvonne Sanders Butler is principal here at Browns Mill Elementary School in Lithonia, Georgia, a place where preventing obesity is as important as reading, writing, and arithmetic.

YVONNE SANDERS BUTLER, DR., PRINCIPAL BROWNS MILL ELEMENTARY: Our children get 60 minutes of physical activity each and every day. We start the school day dancing.

GUPTA: Ten years ago, before it was the popular thing to do, she even got rid of soda machines and banned birthday cupcakes.

BUTLER: One of the first things that I heard from some of my peers that if you go and change the menu, that you're probably going to lose your job. And I'm saying that if we don't do something, that we're talking about children that are probably going to lose their life.

GUPTA: Ten years later, she's still employed and her school wide program has shown results.

BUTLER: The amount of discipline that we were seeing referred by teachers, it went down by 23 percent. And the first year that we did standardized test scores, they went up 15 percent.

GUPTA: And her local solution is getting some international attention. Dr. Butler's program was honored at a global diabetes summit in Belgium just last month.

KEN MORITSUGU, DR., ACTING SURGEON GENERAL: Here is a great example of how a person in the local community saw the issue, saw the problem and said, I'm going to help be part of the solution.

GUPTA: Dr. Butler says she wouldn't have it any other way.

BUTLER: Childhood obesity, it's our tsunami. It's our Katrina. It's Wall Street today. And so, if we are really thinking about the best interests of the young people that we deal with each and every day, then we will take a stand.

(END VIDEOTAPE)

GUPTA: All right, 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, HOUSE CALL is the place for the answers to all your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.

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