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HOUSE CALL WITH DR. SANJAY GUPTA
Aired August 13, 2005 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, HOST: Welcome to HOUSE CALL. I'm Dr. Sanjay Gupta.
This morning, we're looking at the real stories and people behind the fight against cancer. CNN traveled to the renowned M.D. Anderson Cancer Center and got unprecedented access to the doctors, nurses, researchers, patients and families on the front lines. What we found were amazing stories of strength, hope, and life-saving cutting-edge treatments.
UNIDENTIFIED MALE: I know where Bob is going to be sitting. Bobby will be sitting to my left, to the congregation's right. And he will be approximately eight to nine rows back. He is always there.
SANJAY GUPTA, HOST (voice-over): By all odds, Bobby Yoakum should not be alive. A Baptist church deacon, he prays each day his stage IV lung cancer won't take him.
BOBBY YOAKUM, CANCER PATIENT: If you have cancer, don't worry. That's not going to solve it. Don't worry. You pray about it. You trust God. You have faith. Have faith in God.
GUPTA: Bobby spends his days receiving chemotherapy, sometimes radiation and one experimental drug after another. Dr. Roy Herbst is Bobby's doctor, a pioneer in new therapies to beat back lung cancer.
DR. ROY HERBST, M.D. ANDERSON CENTER: More and more, I'm developing a group of patients who are long-term survivors of this disease.
GUPTA: Dr. Herbst first ordered Bobby a foul-tasting mystery drink. He wanted to know if pure shark cartilage worked on lung cancer.
YOAKUM: I knew it would taste terrible. But anything that he suggested, if Dr. Herbst said it, I was willing to try it. I have nothing to lose.
GUPTA: And in the beginning, Plan A was a hit.
HERBST: And you can see the main mass has pretty much disappeared.
GUPTA: But after 15 months of remission, the cancer began spreading. Bobby moved on to Plan B, more chemo and a new experimental drug. But like almost all clinical trials, Plan B soon flopped.
HERBST: His tumor grew by more than 20 percent. So he had to come off the study.
GUPTA: Bobby was disappointed, but hopes that his participation may have a larger purpose.
YOAKUM: Thank you, sir. Thank you.
It's not just going to benefit me. What they find out is going to benefit the public. And that's why I was willing to do this.
GUPTA: Clearly, a single drug will not magically cure Bobby Yoakum and the more than 175,000 Americans living with lung cancer.
GUPTA: And since we shot this story, a new drug studied at M.D. Anderson received FDA approval. Tarciva is a once a day pill, a targeted therapy, that's been shown to prolong the lives of lung cancer patients.
Unfortunately, none of these drugs were enough to save the life of anchorman Peter Jennings, who died four months after announcing he had cancer.
Now we hear about Dana Reeve. She's the widow of Christopher Reeve, and has been also diagnosed with this deadly disease.
So here's what we know about lung cancer. It strikes more men than women. It kills more people than colon, prostate, and breast cancer combined. And about 60 percent of people died this year within just with one year of being diagnosed. Those are the statistics.
And here to give us an inside look in the battle against cancer is Dr. Martin Raber. He's a cancer specialist, a medical oncologist at M.D. Anderson Cancer Center in Houston.
DR. MARTIN RABER, CANCER SPECIALIST: Hi, Sanjay.
GUPTA: Let's talk a bit about the two big lung cancer stories this week, both of which have been raising a lot of questions for our viewers. Dana Reeve, diagnosed with lung cancer, a non-smoker, young, 44-years old. A lot of people are asking, how does that happen?
RABER: Well, I think that we know a certain percentage of patients who have lung cancer never smoked. And we don't understand well why they get lung cancer. In some cases, it may be passive smoke that they've been exposed to, or other carcinogens that they've been exposed to. Or maybe -- and it's probably likely -- that there's some kind of genetic susceptibility that we haven't completely figured out yet.
GUPTA: And let's keep on topic here. You know, Peter Jennings was a smoker, but stopped years ago. He still got lung cancer. And that has a lot of reformed smokers worried, like Kha in New Jersey, who writes this.
"I smoked cigarettes for nine years, then quit. I started smoking again five years ago, but am quitting for good. How much damage have my lungs suffered? And how long will it take for them to recover fully to the point where it's like people who never smoked?"
Can that happen, Dr. Raber?
RABER: It can happen. I've got to say, the big thing in that letter is he says he's quitting for good. If that's true, things are looking up for him.
I think about the risk of smoking related to cigarettes is every cigarette increases your risk. Every year that you smoke increases your risk. Every cigarette per day increases your risk.
But after you stop, your risk begins to go down. And when you get out about 10 or 15 years from your last cigarette, your risk is approaching -- it may not exactly be the same, but it's approaching the risk of the non-smoker.
Now I've got to tell you, if you're a heavy smoker, your chance of getting lung cancer compared to someone who never smoked is 25 times greater.
RABER: That is an awesome number. Ten years of non-smoking is going to bring that number down probably under 10 times. It's going to more or less halve your chance of getting cancer.
GUPTA: We are going to talk about that more and more. We're going inside the cancer ward when HOUSE CALL returns.
(BEGIN VIDEO CLIP)
RABER: I couldn't decide if I was the patient or the doctor.
(END VIDEO CLIP)
ANNOUNCER: Dr. Raber tells us what it's like to go from doctor to cancer patient.
Plus, a miracle drug for some, a bad investment for others.
(BEGIN VIDEO CLIP)
GUPTA: This really does keep you up, doesn't it?
DR. EUGENIE KLEINERMAN, CHIEF, PEDIATRIC DIVISION: Oh, yes, of course.
(END VIDEO CLIP)
ANNOUNCER: Find out what's keeping this doctor up at night.
GUPTA: We're back talk about cancer. Our guest is cancer specialist Dr. Martin Raber. He was chief of physicians at M.D. Anderson Cancer Center. Ten years ago, he spent his days fighting for his patient survival. And then one day, life changed and the fight became personal.
GUPTA (voice-over): When someone of your educational level and your experience, you know, is told by the radiologist, I see something there, what is going through your mind? Are you thinking the radiologist got it wrong?
RABER: Definitely not.
GUPTA: You knew he got it right?
RABER: I knew he got it right.
GUPTA: Dr. Raber had lymphoma, a rare cancer of the blood. His prognosis? Poor. At home, four children and a frightened wife.
UNIDENTIFIED FEMALE: It was very scary because, of course, his disease does not have a cure rate.
RABER: And I took Interferon for two years, which is not a drug that I would particularly wish on people. And I reoriented my career away from patient care. I had big-time doctor/patient confusion. And when I was sick, I said to myself, what's most important to me is being well, being alive, alive for my family.
GUPTA: At one point, staying alive meant days in Anderson's ICU. Dr. Raber's recovery uncertain. It was...
RABER: Close, close, close, close. I was deathly ill. I was going to get better or I was going to die.
GUPTA: Wow. And getting better took five years. Dr. Raber is with us. And he's also seeing patients again. This time, he says with a different perspective.
And Dr. Raber, you've told us that this fight against cancer is a marathon, not a dash. Where are you in this race? And is a marathon better?
RABER: A marathon is definitely better. You know, used to be you got cancer, you had surgery, and you were cured or you died. It was a dash. You got to make the decisions quickly, and it was all over in a matter of months.
That's not the way it is now. For so many patients, cancer is a chronic illness. You take therapy. You get better. You have relapses. You take other therapy. Maybe you get better, maybe you get worse. It's a marathon.
You got to conserve your energy for it. You've got to focus on it. You have to try and make good decisions. And you have to realize that it's not going be over in a day or a week. You're going to be fighting cancer for a long time. And that's the good news.
RABER: That's the good news.
GUPTA: Well, I hope a lot of people are listening, because it is good news. And a lot of people have heard your story as well, Dr. Raber, and have e-mails about that.
Let's get to one now. Ron in Oregon writes this. "Please explain the latest treatments for non-Hodgkin's lymphoma." And doctor, anything new?
RABER: A number of new drugs have come along that are what we call monoclonal antibodies. They're biologic drugs aimed at a specific abnormality in the cancer cell.
One of them, Rotoxin, has made a tremendous difference in about 80 percent of patients with non-Hodgkins lymphoma. So I would say new drugs are coming out for non-Hodgkin's lymphoma at a pretty good clip.
GUPTA: We are talking to Dr. Martin Raber. Really important stuff here. We've got to take quick break now, but stick around. Allie's story is one you're going to want to miss.
(BEGIN VIDEO CLIP)
SANDRA KROWSKI, ALLIE'S MOM: I'm losing my child and she's dying in front of me.
(END VIDEO CLIP)
ANNOUNCER: A little girl's fight against cancer and the drug that saved her. Why isn't that drug being made anymore? Find out, coming up.
But first, this week's medical headlines in "The Pulse."
CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Non-melanoma skin cancer is on the rise in young men and women, according to a study published in "The Journal of the American Medical Association." This is the most common and least deadly type of skin cancer.
Researchers found rates of the two different types of non- melanoma cancer have risen dramatically in people under 40 since the late 1970s, especially women. Doctors believe the increase is due to several factors, primarily prolonged exposure to UV rays. And a new study shows improvements in breast cancer survival rates are mostly due to smaller tumor size. The research in the journal "Cancer" doesn't explain why tumors were smaller on the average, but it seems to suggest early detection may be leading to better breast cancer survival rates.
Christy Feig, CNN.
GUPTA: Welcome back to HOUSE CALL. We often think of cancer as an adult disease, but nearly 10,000 children were diagnosed last year.
Imagine it for a moment. A child complains of pain. It could be anything, just a bruise, but then they can't move their legs. They're paralyzed. And then, they find the tumor.
GUPTA (voice-over): Alexandra is the only child of Sandra and Ed Krowski. While on vacation, she suddenly blurts out, "My back hurts."
S. KROWSKI: You have that little voice saying something's wrong.
GUPTA: For weeks, doctors think otherwise. They point to a new tricycle or a playground injury as the probable cause of the pain. Then suddenly, little Allie can't walk.
KROWSKI: She was telling the doctors, my legs are stuck. She had no movement from her waist down. She was completely paralyzed. It was just a horrible situation where you're -- I said to my husband that I'm losing my child and she's dying in front of me.
GUPTA: An emergency MRI reveals a tumor on Allie's spine. She has a rare, often fatal cancer called Ewing's Sarcoma.
S. KROWSKI: Allie's physician, Dr. Cynthia Herzog, came in and told me that there was a clinical trial for Allie's type of cancer. I said I don't need to think about it. I've already thought about it. And you can bring me the papers and I'll sign right now.
GUPTA: Weeks of very aggressive chemotherapy and radiation had left Allie weak, nearly dead. Then she began a year-long treatment with ImmTher, an experimental drug. After six months, a change.
S. KROWSKI: I knew that it was working. I just had that feeling. Once she started the trial, like she just seemed to -- I could see, you know, in her face, she was getting more energetic.
UNIDENTIFIED FEMALE: Put your head straight.
GUPTA: Now almost 6, Allie is cancer free, but must be monitored carefully. UNIDENTIFIED FEMALE: Just hold your breath. Do not breathe and do not move.
GUPTA: ImmTher, the drug that apparently saved her life, is still available as part of Dr. Kleinerman's ongoing clinical trial. But after that, it disappears. So there was a drug out there that, as far as you could tell, at least seemed to be working?
GUPTA: And then you got a phone call saying that they weren't going to manufacture the drug anymore?
KLEINERMAN: Correct. Basically, I was getting the message that our marketing people had done research and were never going to be able to recoup our research and development costs. And it doesn't matter who we're going to help or who we're not going to help. The marketing people have made the decision that we're not putting any more resources in this.
GUPTA: And the outcome?
KLEINERMAN: The outcome is, we still have only a certain amount of the drug.
GUPTA: Just enough to treat 60 kids, or about one-third of the kids that get Ewing's Sarcoma each year.
This isn't the kind of story people want to hear. If the drug works, why wouldn't they make more of it?
KLEINERMAN: Because sarcomas are a very rare tumor. And you have to understand that drug companies, pharmaceutical companies, have to report to their stockholders. And they're interested in their financials. And this will never be a money maker.
GUPTA: This really does keep you up, doesn't it?
KLEINERMAN: Oh, yes, of course. Of course.
GUPTA: Keeps you awake at night?
KLEINERMAN: Of course.
GUPTA: A really amazing story. And Allie is doing well -- remains cancer-free. But her amazing story is just one of many that we saw at M.D. Anderson's Cancer Center.
And we're talking about some of these stories with cancer specialist Dr. Martin Raber, who works at that center. You know, and Dr. Raber, as we were working on this documentary, stumbled upon the story of drugs being not available is just sort of a fact of life, I guess, but it's hard to deal with. How do you deal with that?
RABER: Sanjay, that's a hard story for me to watch. And I've heard it a number of times before.
How do I deal with patients who want or should have drugs that aren't readily available? If there's a drug for one of my patients at another center, or an operation that they -- another center can do that we can't, that's where I send the patient.
If there's a drug that a company has that I think a patient should have, I'm going to call the company and ask them to send me the drug.
And sometimes they will, and sometimes they won't. But the fact is, I can only work with what's available to me. And I try to make the best decisions I can, given the drugs that are available.
And it's not unusual for a promising drug to be available only in a clinical trial for a period of time. And hundreds or thousands of patients who might benefit from that drug not be able to get it while that drug is undergoing the approval process or being tested. And that's just a reality that every cancer doctor has to live with.
GUPTA: Really amazing story.
RABER: It's tough.
GUPTA: Dr. Raber, I want to thank you for sharing your personal story, also for getting up early with us this morning. We all wish you very well in your fight against cancer and wish you well in all the work that you continue to do at M.D. Anderson. Thank you very much.
RABER: Thanks so much.
GUPTA: Stay where you are, everybody at home. We're heading to camp when HOUSE CALL continues.
(BEGIN VIDEO CLIP)
SHAWNA RUBBECK, OVERWEIGHT TEEN: People would call me cupcake as a joke. And I would just sort of laugh about it.
ANNOUNCER: A last-ditch effort to lose weight. We head to camp with two desperate kids.
NATHAN RUFFIN, OVERWEIGHT TEEN: Definitely starting to hurt.
ANNOUNCER: We've got more coming up.
(END VIDEO CLIP)
GUPTA: It's time to get going in the fight against childhood obesity. Lots of kids headed to camp this summer. And for some, weight loss -- not making new friends -- was the goal.
Elizabeth Cohen headed to one such camp and found out fighting fat is only half the battle. (BEGIN VIDEOTAPE)
ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): She's not crazy about exercising this early, but Shawna will do anything to lose weight because she's scared. Scared of getting diabetes, scared that since she's been heavy all of her 14 years, she'll be heavy the rest of her life, and scared that the teasing will never end.
RUBBECK: People would call me cupcake as a joke. And I would just sort of laugh about it because, you know, I knew I couldn't do anything about it.
COHEN: When Shawna reached 250 pounds, she realized she needed help.
RUBBECK: I went online. And I was looking up weight loss camps for kids, summer weight loss camps.
COHEN: She found them, plenty of them. But the price tag, around $4,000 a month, was way more than her family could afford. Then her mother heard about a scholarship program, 22 kids competing for just eight spaces.
RUBBECK: She told me that I had been one of the first chosen, and I was -- had gotten the scholarship. And I was almost in tears.
Too bad I'm leaving someday.
COHEN: Will she be able to meet her goal of losing 40 pounds? This one month may be her best shot ever.
Unlike Shawna, Nathan Ruffin was thin throughout childhood. In fact, he started out life a two pound preemie. Then in sixth grade, bullies started to tease him mercilessly.
RUFFIN: To be in a crossing and someone's talking about you, you feel like you're kind of an outcast. And no one really likes you or knows you basically.
COHEN: On one particularly bad day, Nathan found a new refuge.
RUFFIN: And I ate two packs of noodles, hot dogs, and chips and dinner. So it was a lot to eat that day.
COHEN: Why do you think you ate so much?
RUFFIN: I was really stressed out maybe.
COHEN: Nathan gained 70 pounds in two years. Now 13, he weighs 200 pounds. Like Shawna, he started going to the gym, but it wasn't enough.
RUFFIN: Definitely starting to hurt.
COHEN: His mother heard about weight loss camp, but since she supports five children on her own, she couldn't afford it. Then Nathan heard about the scholarship program.
RUFFIN: I was like speechless. I didn't talk.
COHEN: A lot is riding on these next four weeks. Not just the 30 pounds Nathan intends to lose, but his pride in making his mom happy.
Elizabeth Cohen, CNN.
GUPTA: Wow, Elizabeth, thanks. Tune in next week. Shawna is struggling with her confidence And Nathan pleads to leave camp. More HOUSE CALL coming up after the break.
COHEN (voice-over): It's just before 7:00 a.m., but John Dowhy is still asleep. John has to be at work by 8:00, but he just went to bed a few hours ago.
JOHN DOWHY, NIGHT OWL: I've always been a night owl, ever since I was a little kid.
COHEN: A recent study finds that night owls are less likely to stick to routines, putting them at greater risk for conditions like high blood pressure, obesity and depression.
So John decided it was time to get some help.
RUSSELL ROSENBERG, PHD, SLEEP SPECIALIST: All right, so John, here's what I want you to do is to think about getting into a better routine first. Choose activities that are relaxing for you. You start winding yourself down.
COHEN: Rosenberg suggests things like reading, listening to music, or watching TV, but keep the TV outside the bedroom. He also recommends staying away from caffeinated beverages in the afternoons and staying away from alcohol for the three hours leading up to bedtime.
Elizabeth Cohen, CNN.
GUPTA: For the majority of our show today, we've talked about cancer. You can see the whole special, including updates on the stories you saw here, tune in Sunday night at 8:00 p.m. Eastern for CNN PRESENTS: TAMING THE BEAST, INSIDE THE WAR ON CANCER. Really important, really uplifting stories as well.
Thanks for watching today. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.
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