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Rep. John Lewis Diagnosed with Pancreatic Cancer; Iran Warns of Consequences after U.S. Strikes; Nine International Stories of 2019; Auto Plant Closures May Be Linked to Rise of Opioid Overdoes. Aired 3:30-4p ET

Aired December 30, 2019 - 15:30   ET

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

[15:30:00]

RYAN NOBLES, CNN HOST: Maeve Reston, thank you so much for that report, live from Iowa.

MAEVE RESTON, CNN NATIONAL POLITICAL REPORTER: Thank you.

NOBLES: Next, I'll be joined live by a doctor who can tell us what's ahead for Congressman John Lewis. Here how the civil rights legend is dealing with his pancreatic cancer diagnosis.

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[15:35:00]

NOBLES: Legendary civil rights icon and Congressman John Lewis is sharing with the world that he's been diagnosed with stage 4 pancreatic cancer. The 79-year-old said he's in the biggest battle of his life and will undergo treatment.

Former President's Barack Obama and Bill Clinton along with countless others have shared their prayers and support. Joining me now is Doctor Roshini Raj. She's the Associate Professor of Medicine at NYU and a contributing medical editor for "Health" magazine. So Doctor Raj, cancer rates, cancer death, pancreatic cancer in particular that's the third leading cause of death in cancer in the United States. Congressman Lewis is 79 years old, from your perspective, what is his prognosis?

DR. ROSHINI RAJ, ASSOCIATE PROFESSOR OF MEDICINE AT NYU LANGONE HEALTH: Well, unfortunately, with stage 4 pancreatic cancer, the prognosis is not good. And the problem with pancreatic cancer is we often do not diagnose it until it's quite a late stage. Because of the location of the pancreas it doesn't cause symptoms until it's quite large and possibly has spread and that's what stage 4 implies. That it's spread usually to the liver or the lungs, sometimes even the bone.

So at this point it's not really about curing. There is no cure for stage 4 pancreatic cancer, it's about treatment which will hopefully prolong his life by -- we're talking about months usually, not years.

NOBLES: Is there a lesson to be learned here? Is it possible to catch it early through routine examinations or what can you do?

RAJ: Well, I mean, we should all be aware of the symptoms, and the symptoms of pancreatic cancer include, loss of appetite, weight loss, fatigue. When it gets more advanced you might get yellowing of the skin or eyes, we call that jaundice or itchiness of the skin because of buildup of bile.

But again these are not symptoms that usually occur early on for pancreatic cancer and there are no routine screening tests for this type of cancer. Now I will say as much as we're talking about how terrible the prognosis is, those are the statistics. When you talk about an individual person that could be different. I personally have had patients who have lasted over a year with stage 4, so everyone's different, every case is different. Trying to get into a clinical trial is also one way to really try to beat it.

NOBLES: Right. OK, so let's talk more about the medical advances that this type of cancer has made it at least somewhat treatable in some cases. Talk about that.

RAJ: Right, so treatment involves chemotherapy usually. When we're talking about stage 4, sometimes with radiation as well. Sometimes surgery is used if there's obstruction that needs to be relieved. But those are the mainstays.

Actually just today a new treatment for pancreatic cancer was released by AstraZeneca and Merck, so there are develops coming out, it's still not unfortunately a cure. But hopefully things that could prolong someone's life by several months.

NOBLES: All right, terrific insight. Dr. Rohini Raj, thank you for being here, we appreciate it.

RAJ: Thank you.

NOBLES: Still to come, the hero who stopped a gunman in a Texas church is speaking out. Here what he says happened in the moments leading up to the deadly shooting.

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NOBLES: Iran is warning of consequences today after the U.S. launched air strikes against an Iran backed militia group in Iraq and Syria. U.S. officials say Sunday's strikes which killed at least 25 people were in retaliation for attacks by the militia groups that injured American military personnel. It's the latest act in a series of escalating tensions with Iran. And the entire year has been filled with tumultuous situations around the globe.

CNN's Clarissa Ward takes a look back at the top 9 international stories of 2019.

(BEGIN VIDEOTAPE) CLARISSA WARD, CNN INTERNATIONAL CORRESPONDENT: As the decade comes to a close, so does another tumultuous year. 2019 was marked by global protests, brutal terrorist attacks and political instability. And CNN was there as it all happened.

Number 9.

THERESA MAY, FORMER BRITISH PRIME MINISTER: I will shortly leave the job that has been the honor of my life to hold.

WARD (voice-over): Theresa May stepped down as British Prime Minister after failing to security Brexit, the U.K.'s withdrawal from the European Union. She was replaced by Boris Johnson, who called for an early election in December hoping to break the Brexit impasse.

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WOLF BLITZER, CNN HOST: We've got a major victory for British Prime Minister Boris Johnson.

BORIS JOHNSON, BRITISH PRIME MINISTER: And, yes, they will have an overwhelming mandate from this election to get Brexit done.

ROBYN CURNOW, CNN ANCHOR: Many MPs who lost their seats have blamed Jeremy Corbyn saying people decided that he wasn't the kind of leader they want.

WARD: Boris Johnson vowing to get Brexit done by the end of January.

Number 8. China ramps up its persecution of Uyghur Muslims.

UNIDENTIFIED MALE: China doesn't want you to know the secret behind these walls. Men, women, children. Sometimes entire families separated from each other, cut off from the outside world. The U.S. State Department says they live in prison like conditions. Locked up not for what they did, but who they are. Members of Muslim minority groups from Xinjiang province in China's far west.

WARD (voice over): Human rights groups allege that 2 million members of the ethnic minority are being detained in sprawling secret camps. The Chinese government denies this. It says the Uyghurs are voluntarily enrolled in, quote, vocational training center.

Number 7. A holy day meant for rest and worship turns deadly in Sri Lanka.

UNIDENTIFIED MALE: An entire country shaken after hundreds of people are killed in a wave of bombings. This is Sri Lanka, more than 200 people are dead, hundreds more wounded in three separate cities.

WARD: Ten days before the massacre an intelligence memo warned of a possible attack. Raising questions about whether more could have been done to prevent the bloodshed. Two of the suicide bombers were brothers. Members of a prominent wealthy Muslim family, ISIS claimed responsibility for the attack.

Number 6. Power in numbers. Citizens from almost every continent flood their city centers and demand systemic change.

UNIDENTIFIED MALE: The mass protests against income inequality have gone on for two weeks. 20 people have been killed.

WARD (voice over): Some protesters paid the highest price, but their movements forced dictators out of power.

UNIDENTIFIED MALE: This morning a military transitional council announced the end of Omar Al Bashir's 30-year reign, a dictatorship known for its brutality against its own citizen.

WARD: Confronting economic inequality, fought for democracy and reaffirmed the underestimated power of a people united.

Number 5. The world's most wanted terrorist cornered and killed.

JAKE TAPPER, CNN ANCHOR: As we are getting some major news out of the Middle East, ISIS leader Abu Bakr al Baghdadi is believed to have been killed.

WARD: President Trump announces U.S. Special Forces conducted an overnight raid in Syria. Al Baghdadi detonated a suicide vest, killing himself and three children when he was cornered in a tunnel.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: He died like a dog. He died like a coward. The world is now a much safer place.

UNIDENTIFIED MALE: U.S. Special Forces were in the compound for about 2 hours. And were able to gather what's described as highly sensitive material on ISIS before pulling out and flying back to Iraq.

WARD: Days later ISIS announces a new leader the Califate. Baghdadi's death symbolizes the destruction of the Islamic state, but not the end of its violent ideology.

Number 4. The deadliest terror attack in New Zealand's modern history.

UNIDENTIFIED MALE: Police say these were the actions of a lone gunman. Whose rampage began with the attack on the Al Noor Mosque and subsequently the Linwood Mosque.

WARD: The massacre claims the lives of 51 people and wounds 49.

UNIDENTIFIED MALE: We ended up having to lift the bodies over top of other bodies onto our stretchers. There was no -- and those people were bleeding, and there was a lot of blood.

WARD: The gunman, a 28-year-old, self-described white supremacist armed with military style weapons and live streaming the massacre from a helmet cam. He posts an 87-page manifesto on social media just hours before the attack. New Zealand Prime Minister Jacinda Ardern vows to take action on gun violence.

JACINDA ARDERN, PRIME MINISTER, NEW ZEALAND: Today I am announcing that New Zealand will ban all military style semiautomatic weapons. We will also ban all assault rifles.

WARD: Number 3. A power struggle in Venezuela ushers in an era of violence and poverty.

BROOKE BALDWIN, CNN ANCHOR: The breaking news straight out of Venezuela, Juan Guaido the country's self-declared interim President and opposition leader urging the military today to join him, to take to the streets to force out the President Nicolas Maduro.

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WARD: After what critics described as an illegitimate inauguration of Maduro, Guaido challenged Maduro's claim to the presidency. President Trump recognizes Guaido as the legitimate president. Maduro accuses the United States of backing an attempted coup and expels U.S. diplomats from the country.

UNIDENTIFIED FEMALE: The world watches as a stark message was sent to protesters. Maduro's forces would not tolerate dissent. Human rights activists say they are being backed up by an unprecedented police crackdown.

WARD: The United States sanctions Venezuela's government owned oil company. But almost a full year later Maduro remains in power, more resilient than his opponents expected. As for the Venezuelans, Guaido once inspired, they continue to suffer from government corruption, inflation and hunger. Losing faith that much will change.

Number 2, abandoning a commitment creating a vacuum.

JIM SCIUTTO, CNN CHIEF NATIONAL SECURITY REPORTER: An invasion is underway in northern Syria. Turkey's President Erdogan said the military offensive there has begun.

TRUMP: And our soldiers have been coming back over that period of time.

WARD: Days earlier, President Trump makes an abrupt announcement that he is withdrawing U.S. troops from northern Syria. Clearing the way for Turkey to launch an offensive. The move essentially abandons Kurdish fighters who have fought alongside American forces to defeat ISIS. Ceding power to Turkey, cementing Bashar al-Assad's grip on Syria and benefiting the regional ambitions of Russia and Iran.

At number 1, a pro-democracy movement fights for autonomy.

UNIDENTIFIED FEMALE: Breaking overnight from Hong Kong, protesters flooding the streets, clashing with police as Hong Kong marks 22 years since it was formally returned to China.

WARD: Frustrations were ignited with the proposal of a controversial extradition bill that would see mainland China's authority over the semiautonomous region grow. At its peak organizers estimated as many as 2 million took to the streets. The extradition bill was suspended. But as the violent and property damage grew so did the protesters demands. They wanted an independent investigation into police actions, the release of all those arrested. Conditions that proved unpalatable to authorities.

UNIDENTIFIED MALE: And there is no end in sight to these sharp political divisions and this crisis that has plunged Hong Kong into economic recession. The worst crisis this city has seen in a generation.

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NOBLES: Well, here in the United States, many communities have been rocked this year by the opioid crisis. And now a new study may have found a link between overdose deaths and auto plant closures. We'll explain next.

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NOBLES: The past year has seen a number of headlines about auto plants closing across the United States. And a new study takes a closer look at the consequences of those closures. Specifically, how they impact opioid overdoses in these communities.

Jacqueline Howard, the CNN health reporter joins me to talk more about this. So Jacqueline, what does the research say happens after these plants close?

JACQUELINE HOWARD, CNN HEALTH REPORTER: Well it's really fascinating research, Ryan. What it found in particular is that five years after an auto plant closed in a county, that county then saw in about 85 percent higher rate of opioid overdose deaths in its community.

The reason why this is so important is that's equivalent to about eight to nine additional deaths for every a hundred thousand people in that community. And it just goes to show how the economy or any economic burden really can have links to our overall health. It is really fascinating.

NOBLES: Wow. So tell me more about the demographics of this trend. Who is primarily impacted by this?

HOWARD: Well, the study looking at manufacturing counties across the country but they were primarily distributed in the Midwest and in the South, so that is a regional demographic to keep in mind. And then when they looked specifically at this link between plant closures and opioid overdose deaths, they saw the link to be stronger among white men who are of working age. So that is about 18 to age 65. So that was interesting as well.

But overall, Ryan, we've known about this link between the economy and your health, and when it comes to opioid overdose deaths in particular, they're part of a group of deaths that researchers call deaths of despair.

Deaths of despair also include alcohol-related deaths and suicides. And we know that deaths of despair have a link with economic burden. And so this study just adds to our understanding of that link and specifically deaths of despair as well.

NOBLES: Yes, so how does this fit in term of the overall epidemic across the country?

HOWARD: The overall epidemic as you know is a large and complex problem and this study is just one small piece of that larger puzzle. What we do know in general in the United States is that about 130 people die every day related to opioid overdose so that's important to keep in mind.

In recent years we have seen a decline in those deaths. We have seen a decline in opioid prescriptions. But overall this is a very large and complex problem, and we still have much to learn and this study is helping us to learn and better understand that problem as well.

NOBLES: All right, Jacqueline Howard, we'll leave it there. Thank you so much, we appreciate it.

HOWARD: Thank you.

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