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CNN: Special Investigations Unit

Saving Your Life

Aired January 20, 2007 - 15:00   ET


DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Hello and welcome. I'm Doctor Sanjay Gupta. I'm here with Lance Armstrong.

We're in his hometown of Austin, Texas. We're also joined by 200 cancer survivors in this room. Our mission? SAVING YOUR LIFE.

LANCE ARMSTRONG, MARATHON CYCLIST, CANCER SURVIVOR: For the next hour, we'll give you the latest news on ways you can prevent and beat cancer.

GUPTA: You know Lance and I have been talking about this for sometime. We're stunned by the idea with everything that we already know, we can save hundreds of thousands of lives. It is remarkable.

Please join me, join Lance, and our survivors, and a terrific panel of experts as we examine the war on cancer, where we're winning, where we're losing and where we're going.


GUPTA (voice over): Cancer is not one disease, but more than 100 with the potential to strike anywhere in the body. Cancer has been the focus of intense research for more than three decades.

RICHARD NIXON, FMR. PRESIDENT OF THE UNITED STATES: The national commitment for the conquest of cancer, to attempt to find a cure.

GUPTA: Since President Nixon declared a war on cancer, we have made progress.

UNIDENTIFIED FEMALE: I'm going to die. I really thought I was going to die.

GUPTA: About 10 million cancer survivors now live in the United States. Still, more than 1.3 million Americans will be diagnosed with cancer this year.

UNIDENTIFIED FEMALE: It's been hard. It's like a whirlwind, someone coming in and just knocking your world upside down.

GUPTA: And every day, 1500 of our fathers, mothers, husbands, wives, brothers and sisters die of cancer. Many didn't have access to care or didn't have their cancers detected early enough.

UNIDENTIFIED MALE: The most important single thing that we should do in the war against cancer is to apply what we know should be done to all American people.

GUPTA: Hundreds of billions of dollars have gone into this war on cancer since 1971. But it's not just about the money.

UNIDENTIFIED MALE: We need the political will, the moral will, the will to stand up and say, out loud, that fighting cancer, preventing cancer, is a national priority, a priority on the same scale as preventing and fighting terror. And when we come to terms with that, when we say this with our heart and soul, then we will end this war on cancer.


GUPTA: Joining me now are three of our distinguished guests, all have been touched by cancer, are experts on cancer, and all, most importantly, are committed to helping us beat cancer.

Of course, Lance Armstrong, an amazing athlete, a cancer survivor, possibly the best-known advocate in the war on cancer now today. Clifton Leaf, also a cancer survivor, he's executive editor of "Fortune" magazine, where he wrote a groundbreaking story arguing that we might be losing the war on cancer. He's now writing a book, examining whether our efforts against cancer are simply misdirected.

And Doctor Harold Freeman, the associate director of the National Cancer Institute. He's medical director of the Ralph Lauren Center for Cancer Care and Prevention, in New York. He has served on the president's cancer panel, and as president of the American Cancer Society, as well.

What we want to do is look at what medicine can do, what government can do and what each and every one of us can do, as well, to prevent and beat cancer. First of all, thanks for joining us.


GUPTA: Doctor Freeman, it is so interesting, we have spent billions in this war on cancer and a lot of people in this room would say we're not winning the war on cancer. It's not just a money issue. Where is the shortfall?

FREEMAN: The shortfall is that we have fought more of a research war against cancer than we have applied what we know. In other words, there's a disconnect between discovery and delivery.

We've done wonderful things in the last 30 years, since the National Cancer Act was signed by the president. But we're not applying to what we know to all American people. If we close that gap, that would be the biggest thing we could do to improve the results for cancer. Apply what we know to all American people, irrespective of their ability to pay.

GUPTA: That's something that, Lance, you talk a lot about, as well. And something else you've told me. The headline one day everyone was waiting for is we got it. We found the cure for cancer. ARMSTRONG: Right.

GUPTA: We're not there yet, but we can make a lot of progress short of that. You just said that, what do you mean by that?

ARMSTRONG: I'm sitting here today, a 10-year cancer survivor, having won seven Tours, meanwhile down the street, we're going to lose a 42-year-old mother to breast cancer. It's not fair. But if you just took roughly 600,000 deaths a year, and as Doctor Freeman just said, you just applied what we already know, you don't have to go out and do anything else, we don't have to research anything -- we just have to deliver it to the people that need it the most, you save 200,000 of those lives. That's 1/3 directly right off the top.

Then you get into other things. This is, to me, easy fundamental stuff. And I know, Dr. Freeman and I talk a lot about this, I've been to his clinic in Harlem. Listen, I'm a kid from Texas. I was diagnosed right here in this city. I had the best care at my fingertips.

But visiting Harlem, you see where the problem is, when you talk about these 200,000 people. They will never know. They'll be diagnosed late. They won't receive the proper care. They may not believe in the system. They never have a chance. They die needlessly. That's, to me, as an American, and again, coming from literally another land -- unacceptable.

GUPTA: Both of you brought this -- in some ways an access issue, an access to care -- which we're going to talk a lot about, Lance. Because I know it's something you've talked about it as you travel around the country.

Clifton, you've made this, in part, your life's work. Talking about how we might be losing the war on cancer. Listening to what they just said, who do we hold accountable for this? Where do we go? Lance wants to help solve this problem today. Who are we holding accountable?

CLIFTON LEAF, EXECUTIVE EDITOR, "FORTUNE": As if I'm not in enough trouble.


I think in some ways, you know, we're all complicit, at least in two mind-sets. I think Dr. Freeman and Lance just touched on one of the mind sets; which is this need to have a breakthrough come and save us. You know, nobody wants to eat your spinach, you know, the hard work of prevention. What we want is another breakthrough.

If you look, this is a great exercise for everyone. Do a Google search for the term, "cancer breakthrough" in quotation marks. It's something like 58,000. We expect that every discovery out of the lab is going to be, you know, the next great cure for cancer and we can't be so willing to dismiss the things that we do know, as Dr. Freeman and Lance said.

And I think the second mind-set is that we have to get out of this notion that cancer is an event that strikes. It's really a process. You know, most people think when they feel a lump, or they go to the doctor, and they see this lesion on their MRI, oh, my god, I have cancer and it changes their life right then and there.

The truth is, it's a multi-step process that took decades, perhaps, to get there. And we have to intervene before that. So we're all guilty of that mindset, both of those mind sets.

GUPTA: There's a woman here -- that's tonight -- with us that you're going to want to meet. It's remarkable. She may actually drive us to get one of the most dreaded diagnostic tests out there. Her story will help us save 50,000 lives. That's next.


GUPTA: Do nothing? Lose everything. I'd like you to really think about what's at stake here -- your life. Testing to detect cancer early on can help you beat it. You can't get treatment unless you've been diagnosed, and the longer you wait, the more deadly the cancer becomes.

Now, we can all come up with reasons to put off getting screened for cancer. You're too busy, you feel fine, you're afraid, you're not sure where to go for certain tests, you might be worried it's too expensive. It's not sexy to talk about cancer, but we are in the fight of our lives. If we do nothing, we could lose everything.



GUPTA: Grace Miller and Jane Stoutenburrow are foot soldiers in the war against cancer.

UNIDENTIFIED FEMALE: Have you had a pap smear lately?

UNIDENTIFIED FEMALE: No, I've never had that.

UNIDENTIFIED FEMALE: The people are so spread out around here.

GUPTA: Every week, Jane and Grace drive the dusty and desolate back roads of Baker County in southwest Georgia. Cotton, peanuts and poverty have long defined this region, which has one of the highest cancer rates in the United States.

UNIDENTIFIED FEMALE: Do you have health insurance?


UNIDENTIFIED FEMALE: Oh, good. There's somebody I want to talk to.

GUPTA: Jane and Grace's message is simple. A cancer screening could save your life.

UNIDENTIFIED FEMALE: Hello, don't go. We want to talk to ya'll.

GUPTA: But convincing people to do it can be tough.

UNIDENTIFIED FEMALE: They don't seek early detection because they don't have coverage to pay for their screenings.

UNIDENTIFIED FEMALE: And I'll tell you another thing, too. They're afraid. They hear talk of so much that when people have surgery, they open them up, they die.

GUPTA: Fear, financial limitations and a growing obesity problem contributes to the problem in southwest Georgia. Colon cancer is of particular concern.

UNIDENTIFIED FEMALE: She was my sister, but she was my friend and my buddy.

GUPTA: Erliene Burns (ph) lost her sister, Bernice, to colon cancer in 2005.

UNIDENTIFIED FEMALE: No symptoms at all.

GUPTA: And that's part of the challenge of colon cancer. Often, there are no symptoms until it's too late.

UNIDENTIFIED FEMALE: We're going to put seven of them in like that.

GUPTA: It was almost too late for Sally. She lives just up the road in Terrell County, which has the highest mortality rate for colon cancer in the country. In the spring, Sally went in for her yearly check up. Since she's over 60 Sally's doctor insisted she get screened for colon cancer. At first, she resisted.

UNIDENTIFIED FEMALE: I was against having this colonoscopy.

GUPTA: Sally thought it would be a waste of time. She had no symptoms and was feeling great. But doctors found cancer, dangerously close to spreading.

UNIDENTIFIED FEMALE: I'm going to die. I really thought I was going to die.

GUPTA: After taking chemotherapy and radiation, Sally is now cancer free. She credits early detection with saving her life. The American Cancer Society says nine and 10 colon cancer patients survive, if the cancer is caught early, but early diagnosis happens less than 40 percent of the time. The survival rate for more cancers increases dramatically if they are detected early.

For example, with cervical cancer, early detection of abnormal cell with a PAP test results in a survival rate of almost 100 percent. With breast cancer, when it's caught early, the five-year survival rate is almost 98 percent.

DR. JIM HOTZ, ALBANY (GA) AREA PRIMARY HEALTH CARE CTRS.: How was your breast cancer picked up initially?

UNIDENTIFIED FEMALE: Through a mammogram.

GUPTA: Dr. Jim Hotz has practiced medicine for nearly 30 years. He's considered one of the leading experts on rural health care in the country. At Hotz clinic, the first page of each patient's chart has all of their cancer screening information, a system that Hotz and his colleagues hope will save lives.

HOTZ: If you look at the greatest populations at risk and who will get screened the least, it's poor people.

GUPTA: Dr. Hotz, Jane Stoutenburrow, Grace Miller, and others in Baker County are trying to change that. Through private donations and public funds, monthly free cancer screenings and treatments are available for people without insurance in Baker County. Along with saving lives, investing in early detection, says Dr. Hotz just makes good business sense.

HOTZ: Early detection of cancer, colon cancer, specifically, costs probably around $2,000 if it's detected early, but that can save us over $250,000 in treatment costs.

GUPTA: But saving money is only one part of the equation.

HOTZ: People shouldn't die from cancer if there's a way of screening for it and picking it up early.

GUPTA: Picking it up early to increase the odds of surviving into old age.


GUPTA: This is Sally Hammond from Georgia. Thanks for joining us.

SALLY HAMMOND, CANCER SURVIVOR: Thank you for inviting me.

GUPTA: Sally, by your own admission, you waited too long.

HAMMOND: That's correct. I didn't think there was any need to have a colonoscopy. I was healthy, active, had no symptoms, couldn't see any reason. I went to a doctor just for my general physical. And he insisted I have a colonoscopy because I had had a PAP smear and a mammogram. I allowed him to go ahead and make the appointment.

GUPTA: From what we learned, there's a good chance that you wouldn't be sitting here today as far advanced as what this cancer was.

HAMMOND: That's correct. I had what they call a T-3 colon -- tumor in my colon. If it had gone to another stage, it would have metastasized and I wouldn't be sitting here probably.

GUPTA: So didn't think you needed the test. You get the test, the doctor tells you, you had this advanced colon cancer. What's going through your mind?

HAMMOND: I thought for sure I was going to die. I really did.

GUPTA: When you talk to your friends now, your family, about colonoscopy, colon cancer, because I'm sure you talked to them about that, what do you tell them specifically about screening?

HAMMOND: I tell them definitely. I know it's a terrible test to go through, but it is well worth it. If I had not had that test, I would not sit here today.

GUPTA: Dr. Hotz, they say -- doctors say no one should have to die from colon cancer. We are that good at taking care of colon cancer. How do we go from the number two cancer killer in the country to no one dying from it?

HOTZ: We have a test, the colonoscopy, that is extraordinarily effective at picking up this disease and eradicating it. One of the great problems we have is that there is ignorance about it. There was a study about four years ago, looking at what people knew about screening. And two-thirds didn't even know they were even supposed to be screened.

Then we have problems in paying for it. It is an expensive study and there's a certain percentage of the population who, which is only about 3 percent of the population, if we paid for these screenings could get these things done.

So that's really the major barriers. And then we have to remember to do it. The reminder sheet that you saw on that chart down in Baker County is the same reminder that her doctor used to pick up her cancer. And a lot of times it's an opportunity and we have to tell people to do it.

We did a study and we found out that within one month alone, 20 percent of our people got a colonoscopy just because we reminded them, told them, and they did it.

GUPTA: And you know, Lance, I mean, -- you're superman.


GUPTA: But it brings up an important point. What finally drove you to go to the doctor?

ARMSTRONG: There's so much stigma around certain types of cancer. Like colon cancer, back 20 years ago, when women were afraid to talk about it, or they had a phobia about talking about breast cancer. Thank God, they came along and said, you know, it's OK to talk about that.

Ten years ago I was a 25-year-old kid in Texas that thought perhaps he had testicular cancer. And he's like -- oh, no. How am I going to -- how does that work? Do you go to the doctor, and what happens then? Basically, at that point, the symptoms were so bad, it had gone beyond just traditional or normal swelling and soreness, to blurry vision, extreme headaches, coughing up of blood, a general just bad feeling. I mean, I -- you might say that I was superman, but I was extremely hardheaded more than anything is what I was.

GUPTA: One of the things that comes up a lot, and it puzzles me to some extent is could your health be in danger because of where you live, or how much you earn? You have talked about this. What can we do right now so that all of us has an equal shot at beating cancer? That's coming up next.

Also, my top ten tips for saving your life, and the Lance Armstrong challenge. Stay with us.


GUPTA: First, here is what you need to know about early detention. Depending on your overall health and gender, starting at age 20, you should consider getting screened for cancers of the thyroid, skin, lymph nodes, testes and ovaries.

For breast cancer, yearly mammograms are recommended for women starting at age 40. However, if you have a family history of breast cancer, talk with your doctor about starting mammograms earlier.

When it comes to colon and rectal cancer, both men and women should begin at 50. You should get colonoscopies every 10 years and fecal occult blood tests yearly.

For cervical cancer, here's the rule: All women should start screening three years after they begin having intercourse, or at 21. And 50 is the age men should consider getting early tests for prostate cancer. African-American men and men with a history of prostate cancer should think about getting tested at 45, or earlier.



GUPTA (voice over): There's something in the eyes of a woman with breast cancer. Harlem Surgeon Harold Freeman knows the look. Early on, half the women who came to him were in late stages of the disease, incurable.

FREEMAN: It was very devastating for me to come to Harlem and see people presenting for the first visit sometimes, with a breast that was replaced by cancer and you couldn't see the breast at all.

GUPTA: Freeman set out to disentangle race and poverty and cancer. To understand why black women are less likely than white women to get breast cancer, but twice as likely to die from it. His research found that poverty is the real problem, the lack of access, education, and resources.

FREEMAN: It is not acceptable that people that are poor should die because they're poor.

GUPTA: Freeman was just 13 when his own father died of testicular cancer, leaving his mother to raise three kids alone.

FREEMAN: I lost my father to this devastating disease, at a point where I really needed to have a father. I hated cancer because it had killed my father.

GUPTA: The great-great grandson of a slave, who bought his own freedom, Freeman, the surgeon's desire to beat the cancer propelled Dr. Freeman to become president of the American Cancer Society, and the chairman of the United States President's Cancer Panel.

Then in 2000, a turning point. Targeting breast cancer was in vogue. As Ralph Lauren launched his Pink Pony Campaign. And Freeman had found himself an ally to build a cancer center in Harlem.

FREEMAN: People were dying at a high rate because they were poor and black. He asked me, he said, what are the solutions? Mr. Lauren stood up, dressed immaculately, of course, and he simply said, Dr. Freeman, I will help you.

GUPTA: Jerona Smith (ph) is a single mom who now comes to the Ralph Lauren Cancer Center for, since being diagnosed with aggressive stage of breast cancer at 29, it's been one shock after another. First losing her job, and then her health insurance.

JERONA SMITH, CANCER PATIENT: It's a lot to bear. I'm not working at this point in time because of chemotherapy, and it's a bit hard, but I got the help here.

UNIDENTIFIED FEMALE: We gathered all of the documentations for Medicaid.

GUPTA: And that's one of Dr. Freeman's other innovations, the Patient Navigation Program, conceived in 1990 and signed into law last year, the federally funded program awarded about $25 million in grants.

Navigators are familiar with the health care system, and help women with everything from insurance to medications, makeup and wigs. Giving them access to a system that might otherwise ignore them.

MAUD COLAS, RALPH LAUREN CANCER CENTER: Patients actually come here and they're faced with so many barriers. Our job, as navigators is to assist them. We always find a way.

FREEMAN: The five-year survival rate in breast cancer, at the Harlem Hospital, which was initially 39 percent, before navigation and screening, is now in the range of 70 percent.

GUPTA: Jerona knows the chemo and radiation ahead will tax her energy. But the fact is she, and women like her, now have a better chance at beating breast cancer.

(END VIDEOTAPE) GUPTA: Dr. Freeman joins us now. It's striking. African- Americans, less likely to be diagnosed, more likely to die. You've made an impact on this in Harlem. You're sitting here with Lance Armstrong. Is this something that you could take and go national with?

FREEMAN: There's no doubt about it. What we know is that black and white Americans, who have the same treatment at the same stage of the disease have the same outcome. So it's a matter of providing the same treatment, and the same early diagnosis.

So this is a challenge that we can meet. We shouldn't accept the fact that there's a 10 or 15 percent difference in survival of black and white Americans. And between poor and middle class Americans, as well. We have the resources in America to fix this problem. It's a matter of educating the public in a language that they can understand, culturally sensitive language, to prevent cancers.

Don't smoke cigarettes, have the right diet, exercise. But also to create screening for all American people irrespective of whether they can pay for mammography, colonoscopy, prostate examinations, prostate examinations, PAP smears. To provide it to all Americans, and when people have a problem on the screening test, the important thing is to resolve the case.

GUPTA: To follow up?

FREEMAN: To treat them, if they have cancer, in high quality and rapidly. That's a navigation solution.

GUPTA: Lance, you talk a lot about access. You talked about that at the beginning of this show. You know, the thing that strikes me is you've made it something that people care about again, cancer, but there's so much going on in the world, Lance. You know, you've got a war. You have things going on everyday. How do you get people to think about cancer?

ARMSTRONG: You build an army of people. You get a group of people that hopefully to the tune of several million people that say this is our issue. This is what we care about. I was affected personally, or my mom, or my sister, or somebody that I love was affected. And I'm not going to stand for what we see today, which is -- for the first time ever, a cut in the federal budget at the National Cancer Institute, totally and completely unacceptable.

Meanwhile, listen, I understand there's a lot going on, things are expensive, money is tight, everybody is fighting for money. But boy, how about the disease that's quickly approaching the number one killer status in this country? I think it deserves some attention.

So my job -- or all of our jobs -- is to stand up and say, OK, no, it's not acceptable that the budget shrinks, it's not acceptable that we hear this stuff from Dr. Freeman.

And just let me say something about that real quick, when it comes to screening. Screening is one of the first things that they cut. Let's save a dime today, so we can spend a dollar in two years. That doesn't make financial sense. I mean, if you just considered the financial disaster here. It's unacceptable.

GUPTA: And that may make the argument better than anything else in some ways. We cannot have this discussion in so many ways without talking about children, as well. What can be done for children? And there's also one type of cancer that kills the most but gets less than one percent of research money and that has some people outraged, plus the Lance Armstrong challenge, all that's ahead as we continue SAVING YOUR LIFE.


GUPTA: Welcome back. We are sitting here with more than 200 cancer survivors. Our goal right now, SAVING YOUR LIFE. Saving your child's life. I want to give you the knowledge and power to beat cancer.

So for an inside look at childhood cancer, experimental drugs and clinical trials, I'd like you to meet the Benjamin family.


GUPTA (voice-over): Sunset in Castle Rock, Colorado. This is where the boys play after school. Just up the street, eight-year-old Cole Benjamin spends most of his time indoors, keeping away from dangerous germs that could threaten his life.

COLE BENJAMIN, CANCER SUFFERER: I used to like to play football and me and my dad used to wrestle a lot. And now I can't play with my friends on the monkey bars.

GUPTA: Cole was diagnosed with Ewing's Sarcoma, a rare type of bone cancer in August. Parents, Randy and Kim, moved fast. Cole began chemotherapy just days after being diagnosed.

The whole family spends a lot of time now at the Children's Hospital in Denver. The doctor delivers good news on this day. Cole's white blood count is back up, so he can toss the coin at the big game.

Castle Rock has rallied around Cole. The county high school football team adopted him and joined his young teammates to save their heads in support during a benefit for the Benjamin family.

Childhood cancer is considered a rare disease. The American Cancer Society estimates that in 2006, 9,500 new cases will be diagnosed in children 14 and younger. Fifteen hundred children will die. The American Cancer Society reports that survival rates have gone way up since 1975. But M.D. Anderson's head of pediatrics, says we need to do more.

DR. EUGENIE KLEINERMAN, M.D. ANDERSON CANCER CENTER: Cancer will kill more children in the United States than any other disease.

GUPTA: The problem is that drug companies can lose money developing medicines for rare diseases because only a few will buy them. In 1993, the Food and Drug Administration created the Orphan Drug Act, giving financial considerations to companies willing to take on the challenge, but it doesn't always work.

Kleinerman is holding a clinical trial on an experimental drug called Inther (ph) designed to treat the same cancer Cole has. Despite help from the FDA, the small biotech company that made it bailed out because it says it couldn't make a profit. Kleinerman was holding all the remaining Inther in the world, just enough for her trial.

KLEINERMAN: There are drugs out there right now that may help us save lives in children with cancer. And because they are under 18, we can't enroll them on a clinical trial.

GUPTA: Sometimes children get caught in the middle. Too young for experiments, too rare to support medical research. The director of the FDA's orphan drug development plan says children with cancer are neglected, but stresses the law does not need changing.

DR. MARLENE HAFFNER, FDA: We need to improve our knowledge about the science of developing drugs and we'll be able to move more quickly and companies will be able to move more quickly.

GUPTA: Kleinerman sees Inther as a lifesaver that may have uses beyond Ewing's Sarcoma.

KLEINERMAN: My hope is that we've complete the trial and show that it's efficacious and someone will be interested in picking it up.

GUPTA: Kleinerman also says let parents make the decision on whether to use experimental drugs. Randy and Kim Benjamin were spared that decision since Cole's cancer was found early.

The next step is surgery to have the tumor removed. The Benjamin family is hopeful that by Cole's ninth birthday, he'll be back on the playing field.


GUPTA: And this is Randy Benjamin, Cole's dad. Thanks for joining us.

RANDY BENJAMIN, SON HAS CANCER: Thanks for having me.

GUPTA: I saw you watching that and obviously it's very emotional for you.

R. BENJAMIN: It was very emotional. I was just hoping to get through it without crying.

GUPTA: How is Cole doing?

R. BENJAMIN: He's doing pretty well. The reason he couldn't be here today is he's actually getting chemo this week, so he couldn't make it, but he's doing pretty well. You know, he has a great attitude, his spirits are up, but the chemo really makes him very, very sick. GUPTA: We're also joined by Dr. Mary Relling from St. Jude's Medical Center in Memphis. It's interesting. For a child, you heard a lot of what Dr. Kleinerman was saying there. A child gets sick with cancer, they have surgery, they have radiation, they have chemo as options, are there other new things, are there other things being developed specifically for children?

DR. MARY RELLING, ST. JUDE CHILDREN'S RESEARCH CENTER: There are some, but it's a real challenge because as was alluded to, the market is so small. We could cure every child with cancer in this United States and it's still not a big enough market to make it profitable for most companies. So we're doing things by individualizing therapy based on genetics to try to use existing drugs in a smarter way, but again, it's all going to lead to something that we need as a society to come to grips with, and that is as we get better at individualizing cancer therapy, or any therapy, the markets gets smaller, it gets less profitable for companies to maintain those medicines. We have to figure out, as a society, how to make sure we can provide those medicines, even though few patients will benefit from them.

GUPTA: As you hear that, Randy, are you confident? Do you feel comfortable in believing that modern medicine, the way the structure is right now, will save your son?

R. BENJAMIN: You know, I think it's coming a long way, it has got a long way to go. You know, years ago, what my son has would have been an amputation. With what we have today, that certainly isn't the case. The survival rate for Ewing's is 70 percent.

And Cole, unfortunately, had heard that through conversation. He asked me one night, dad, do I really only have a 70 percent chance to live. And when your kid starts questioning his own mortality, those are things that you never really want to face and say that it's only 70 percent. We certainly would like to get that percentage much, much higher.

GUPTA: Yeah. I mean, as a relatively new father, I can't even imagine having to think about that or having to make those decisions. Dr. Relling, if someone is watching right now and they're in a situation similar to Cole, how do they work? How do they get to meet you? How do they get to a clinical trial?

RELLING: Of course, luckily, now there's a lot of resources so easily available on the Web. The National Cancer Institute can be a trusted source of information for anyone.. Completely nonprofit. It's supported by our tax dollars. The best science gets summarized there. So I would start with resources through the National Cancer Institute or through NCI sponsored cancer centers.

We started off with the war on cancer that Nixon declared. One of the good things from all of that was that we established a national center of funding cancer centers and there are 60 or 70 of those centers throughout the United States and people can be assured that that's a place to go initially to get very good advice on the latest therapy. GUPTA: Lance, you made this your life's work in so many ways. Connecting people is a large part of that. How does the foundation work, your foundation terms of actually getting people who might find themselves in this unfortunately situation with the people that can help them?

ARMSTRONG: Knowledge and information is so critical. I mean, as we all know, back when I was diagnosed 10 years ago, I think I had a primitive sort of Internet system. I didn't -- we weren't really able to go online. You couldn't Google testicular cancer and what are your odds and where do you go? So it was rough. You're then left with talking to friends or going down to the bookstore.

Think about that, going down to the bookstore and buying a book. So we've come a long ways in 10 years. Just as the doctor said, obviously, the Web site, the National Cancer Institute is great. The Internet has really changed a lot for a lot of us. Just at the foundation, we have, or a program called Survivor Care where people can call up and talk to a person. It's not an automated voice on the other end.

GUPTA: You can talk to a human being.

ARMSTRONG: You can talk to a human being, ask questions, see how they - obviously, just after diagnosis it's complete panic mode for everybody in the family and everybody in the community. So we encourage people to call and ask the hard questions and, of course, the feedback is what we know but also encouraging them to ask hard questions for themselves, be involved in the process and, you know, have a great attitude, obviously, too.

GUPTA: Attitude is everything, as you like to say. Thank you very much for being here. I really appreciate that.

My top 10 tips for beating cancer is coming up and it's the deadliest cancer, some say it's also the most ignored. Lance Armstrong battled it and what can we learn about it when we come back? Stay with us.


GUPTA: Metastasis, it's a dreaded word among cancer patients. It means the cancer has spread and metastatic cancer kills at an alarming rate, yet there is very little being done about it.



GUPTA (voice-over): Randy Lopez thought he had beaten cancer. He was 34, young and healthy when doctors found a golf ball sized tumor in his colon. Surgery and chemotherapy wiped out the tumor and Randy was cancer free for several months. And then, bad news.

LOPEZ: They found it again. They found another piece in my liver, another tumor. I was angry, I was so mad that I had already gone through chemo. I am like, my God, what more.

GUPTA: His cancer had metastasized, or spread from his colon to his liver. For cancer patients like Randy, metastasis is the dreaded word, the one that usually spells the end.

DR. LARRY NORTON, SLOAN-KETTERING CANCER CENTER: If the cancer stayed in the organ where it started, it would rarely cause any big problems. It's the ability of the cells to spread to other parts of the body that really is dangerous.

GUPTA: It's also the most complex part of cancer research and the least studied. Clifton Leaf, a senior editor of "Fortune" magazine is writing a book about the war on cancer. What he finding is sobering.

CLINTON LEAF, "FORTUNE" MAGAZINE: I started to look at the measures of our success of our progress and I was shocked to discover that we're not really making much progress at all. I don't want to say no progress, but we're not making much progress.

GUPTA: But why? After pouring over how the nearly $5 billion annual cancer budget was being spent, Leaf thought he found an answer. He says less than one percent of research money is given for studies that focus on the things that kills, metastasis.

LEAF: To think that just one percent of the study is at least even intentionally focused on this process when this is truly the heart and soul of death from cancer, that, to me, is a little frightening.

GUPTA: Medical researchers we've talked to agree that more funding is needed for metastasis research. In fact all cancer research. But they want to remain anonymous because many of them get funding from the National Cancer Institute and other agencies.

Recent data from NCI indicates that of more than 10,000 grant proposals funded by the NCI and other federal agencies, only 556 even mention the word metastasis. Using that measure, only five percent of research would seem to be expressly targeted at metastasis.

The NCI says those figures don't tell the whole story, that the thousands of other projects funded through the agency contribute to our body of knowledge about metastasis.

DR. JOHN NIEDERHUBER, DIRECTOR, NCI: I think that, in fact, all of what we do is in one way or another focused on metastasis.

GUPTA: It's more that just a disagreement between the NCI and its critics. It trickles down into the lives of patients, like Randy Lopez. For his part, Lopez hopes that talk about budget and research might someday impact the lives of others with metastasis and change its all too frequent status as a death sentence.

LOPEZ: We just tell people that the way to survive is to treat it, to hit it with everything you can. You have to be angry about it. You can't just accept it. Just because you have cancer doesn't mean your going to die.


GUPTA: And everyone knows Lance Armstrong won the Tour de France seven times in a row. Most people here know that he had cancer. Fewer people knew that cancer had spread.

When you were told that the cancer had actually spread to your lungs, to your brain, as well, what was going to your mind, how did those words hit you?

ARMSTRONG: Well, that was sort of the way that my neurologist delivered the news. He said, Lance, you have testicular cancer. And I said, Are you sure? And then he showed me a chest x-ray which showed a whole collection of tumors all over the lungs and I thought, wow, I guess you're pretty sure.

The news of the lesions on the brain came some weeks later which explains all the side effects and symptoms I was having, the blurry vision, the headaches. But at that point, I was almost -- I sort of drew the map of my body and I thought, OK, it started here and here and here. OK. Good. That's enough of the bad news. There's nowhere north of there. I guess not. For me, it's almost a relief. It's all on the table. Now let's get busy trying to fix it.

GUPTA: Did you think you were going to die? Were you immediately thinking I'm beating this?

ARMSTRONG: You have moments, for sure, moments of weakness where you think, I'm going to die or perhaps I'm going to die. But those were, I have to say, those were few and far between. I was totally committed, totally focused and I had complete faith in my doctors, in the medicine, in the procedures. And I looked and searched long and hard and with a whole team of friends and family to find the best people and the people that made me feel the most confident. And essentially, you're turning your life over to them and say, OK, guys, here it is. Go for it. So, I had a lot of faith.

GUPTA: Cliff, you talk a lot about this, as well, you write a lot about this, you hear Lance. Lance, the superman. Most people, they hear metastasis. Most people hear it spread and they think they're going to die. And part of that is not true and Lance is a shining example of that.

There are a lot of people in this room today that are shining examples of cancer that spread and they're still here today. Yet it doesn't seem like pay much attention to it at many levels, the scientific level, the governmental level, the funding level. I sense a sense of rage when I read your articles. Tell me about it.

LEAF: I guess it's hard to keep the rage in because -- and yet, it is tempered with a lot of hope because I have spent the last two and half years studying this and talking to people in the community and every aspect of that community from the treatment side to the research side. There isn't anybody I found that wouldn't give their home and their careers to solve the cancer problem. So I am encouraged by that.

The problem is that our system is incentivized to do all the wrong things. Take metastasis. The reason we're having trouble with it is it's a hard problem. It involves some many different systems, overlapping systems, interlocking systems of biology. And our system is incentivized to study easy things, to study the things we already know the answers to, even. That was probably the most frightening message that I got from talking to researchers around the country.

GUPTA: That's pretty remarkable. And we know how to take care of several different types of cancers, but once it's spread, even if you talk to a doctor, if you talk to a lay person they're going to think, well, that's really bad. That's something we haven't really made much progress in.

LEAF: Yeah. But I think we ought to play to our strength. Because if our strength is in early stage cancer and precancers, then that's what we ought to treat and that brings us back to the issue of exemption and preemption. This is our strong card. This is how we're going to win the war on cancer is by playing to that strength. We don't have to necessarily have a strategy designed for that game of treating metastasized cancer. We can't ignore those people, but we have to rethink this strategy.

GUPTA: That's a good point. So if we get really good at the prevention game, maybe metastasis isn't something we have to talk about as much anymore.

LEAF: Absolutely.

GUPTA: We're about to show you something never before seen by the public but I think it might help us all learn something from Lance about how to beat cancer.

The Lance Armstrong Challenge also, coming up next. Stay with us.


GUPTA (voice-over): Here are my top ten tips for avoiding cancer. Number one, number two and number three on my list, do not smoke. If you're one of the more than 40 million American smokers, you need to stop. Smoking is linked to at least three in 10 cancer deaths according to the American Cancer Society.

That's more than 165,000 deaths year. Number four, stay active. Inactivity and obesity are linked to cancer. Half an hour exercise a day will significantly help your odds.

Number five, if you want to reduce your chances of getting cancer, eat plenty of fruits and vegetables. The American Cancer Society recommends at least five a day. In general, the most colorful fruits and vegetables have the most nutrients.

Number 6, limit the amount of red meat and processed meats in your diet and make sure the meat you eat is lean. Number seven, avoid deep fat frying. Instead, use low fat cooking methods like roasting, baking, broiling, steaming or poaching. Also choose low fat or nonfat milk and yogurt.

Number eight, limit your alcohol consumption or avoid alcohol altogether. Number nine, protect yourself in the sun. Wear sunscreen to limit your exposure to damaging ultraviolet rays.

Number 10, girls should get the HPV vaccine before they're sexually active to help prevent cervical cancer.


GUPTA: Welcome back.

Lance, we've obviously talked a lot about your cancer. I want to show some images of what was really happening inside your brain at the time this was all going on. I don't even know if you've seen some of these images. These actually are an MRI scan of your brain. Just to get people a sense of what they're looking at. These are your eyes so you're looking forward. This is the right side of your brain, the left side of your brain and circled there is the tumor.

ARMSTRONG: That explains the headaches and blurry vision.

GUPTA: It's pretty remarkable, you had a tumor, and I think there was another scan now, as well, here you go, another tumor. So you had at least two tumors in your brain.

ARMSTRONG: Two on the top -- One in the top and one in the back. Correct.

GUPTA: So you had to have operations for both of those?

ARMSTRONG: It was basically one procedure, but yeah, two separate cuts.

GUPTA: And you have the scars, still, I know because you've shown me the scars.

ARMSTRONG: Constantly a reminder.

GUPTA: Your hand is sort of always up there feeling those scars.

ARMSTRONG: It's nice to feel a reminder.

GUPTA: It's a reminder that you beat this.

ARMSTRONG: Yeah. Exactly.

GUPTA: We have talked a lot about cancer. And you and I always say we shouldn't just talk about these things. We should actually do something. What's next?

ARMSTRONG: 2008 is a very interesting year politically speaking. If I could just sum it up in one phrase, I would say make cancer a national priority. Engage the leaders of this country, both the ones we have in place now and also the future leaders and just remind them if it's me saying it or if it's all the way down to a local level or grassroots level, people saying, I care about this disease, a disease that's quickly becoming the number one killer in this country, we have to focus on it, we have to refocus and, of course, 35, 36 years later after Nixon declares war, people become complacent. But we have to again reenergize, refocus and restart the war.

GUPTA: I think with you helping lead the charge, we're going to get there, Lance. Thank you so much for your efforts.

ARMSTRONG: Thank you.

GUPTA: Really appreciate it. And we said it before, we'll say it again. Our goal is to save hundreds of thousands of lives. I'm more optimistic than ever before that with all of your help, we can win this fight our lives.

I'm Dr. Sanjay Gupta with Lance Armstrong. Thanks a lot.