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HOUSE CALL WITH DR. SANJAY GUPTA
Special Edition: Global Cancer Summit in Dublin, Ireland; Ted Kennedy's Battle Against Brain Cancer; If You Got Cancer Today, What Would It Mean For You?; What Foods Might Help Prevent Cancer
Aired August 29, 2009 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to a very special edition of HOUSE CALL. I'm Dr. Sanjay Gupta, reporting to you from Dublin, Ireland, which is also home of the Global Cancer Summit.
As you might imagine this morning, we are talking about the passing of Senator Edward Kennedy, his courageous battle against brain cancer and what it means for all of us. We're also going to hear from a specialist at the center where Kennedy was treated.
The question for a lot of people this morning: If you were diagnosed with cancer, what does it really mean for you and what might happen as far as your treatment goes?
You're watching HOUSE CALL.
GUPTA: Most of us think of Senator Edward Kennedy as a politician, but we also know that he was dealing with one with of the deadliest forms of brain cancer. The quickness of his progression may carry some lessons for all of us.
GUPTA (voice-over): Senator Ted Kennedy learned his diagnosis in May 2008, a brain tumor called a malignant glioma. It's a deadly cancer that strikes about 10,000 Americans a year. It's a cancer with a survival rate often measured in months, not years.
June 2nd, 2008, the then-76-year-old senator traveled to Duke University Medical Center where he underwent brain surgery. He was awake during the operation. Afterward, the surgeon's statement was read on the Senate floor.
SEN. BARBARA BOXER (D), CALIFORNIA: I am pleased to report that Senator Kennedy's surgery was successful and accomplished our goals.
GUPTA: Kennedy returned to Boston for proton beam radiation and recuperation near the water he loved. Kennedy returned to the Capitol in July, receiving a standing ovation before casting a decisive vote on stalled Medicare legislation.
UNIDENTIFIED MALE: What do your doctors think about when you said, "I want to go down there"?
SEN. TED KENNEDY (D), MASSACHUSETTS: Well, that's another story for another time.
GUPTA: The senator emerged again month later, in his words, defying his illness to deliver a speech at the Democratic National Convention.
KENNEDY: Nothing is going to keep me away from this special gathering tonight!
UNIDENTIFIED MALE: How are you feeling?
KENNEDY: I feel well. Once in a while, I get a little tired, but we're doing well.
GUPTA: Kennedy was in the midst of what he later described as many rounds of chemotherapy. January 20th, 2009, the senator suffered a seizure during his post-inauguration lunch honoring President Barack Obama.
SEN. ORRIN HATCH (R), UTAH: I went down to where he was taken and was with him up until the time they put him in the ambulance. And he apparently had -- I'm not a doctor so I hate to characterize it, but it looked like a seizure. And it was painful to him.
KENNEDY: I'm doing well.
GUPTA: Kennedy was back at work less than three weeks later, just long enough to cast a single vote on the economic stimulus bill.
GUPTA: And arrive to a standing ovation in March at the president's summit on health care reform, which Kennedy called the cause of my life. Days later, a 77th birthday party at the Kennedy Center. In April of this year, almost a year after his diagnosis, Kennedy threw the ceremonial first pitch at the Boston Red Sox seasonal opener against Tampa Bay. Senator Ted Kennedy marked the anniversary of his diagnosis out of the public eye.
UNIDENTIFIED FEMALE: Edward M. Kennedy.
GUPTA: On August 12th, President Obama awarded him the Medal of Freedom, the highest honor a civilian can receive from the U.S. government. But the senator could not attend because of his health. Kennedy's daughter accepted the award on his behalf.
GUPTA: As we now know, Senator Kennedy survived about 15 months with this particular type of brain tumor. And I had a chance to sit down with a specialist at the center where Kennedy was treated, to try and find out why these tumors are so deadly and what possible treatments lie in the future. Henry Friedman is a neuro-oncologist at the Robert Tisch Brain Tumor Center at Duke University.
GUPTA: What makes this tumor so problematic and what I mean by that is for the layperson, I mean, what makes it problematic and what causes death in a patient that has this?
DR. HENRY FRIEDMAN, DUKE UNIVERSITY MEDICAL CENTER: The problem with a glioblastoma multiforme is at a time it's diagnosed, it's all over the brain. You may see a tumor that on an MRI or CT scan breaks the blood brain barrier and you can see the so called contrast getting in the white bowl there. But there's microscopic disease everywhere else, all over the brain.
So you have to do both local therapy to try to treat the tumor where you can see it and you've also got to do therapy to treat the disease where you can't see it, the microscopic disease. Well, it it's your finger, I mean, you can go around being known as four- fingered Henry if you sacrificed that pinkie, which has a cancer. But in the brain, it's a much more difficult proposition.
GUPTA: When you look at glioblastoma overall, people hear of an operation maybe useful, chemotherapy, radiation. But they hear at Duke, there's a lot more weapons in (INAUDIBLE) here. What are some of those weapons? How did they how -- did they come to be?
FRIEDMAN: There are definitely more weapons than just surgery, radiation, and the standard chemotherapy, that would be a drug Temodar. It's been around since probably the late '90s, 1999.
But there's progress being made with the ability to deliver radiotherapeutic isotopes directly into a tumor crater through monoclonal antibody therapy. A company has licensed that approach.
There are vaccines that appear to allow ones own body to stimulate an immune response against the tumor. Companies have licensed that approach.
There is anti-angiogenesis drug called Avastin, which appears to have a profound effect on recurrence of glioblastoma, and will soon be getting its try in a very large national and overseas trial for patients with newly-diagnosed disease.
And then more than that, in the last number of months, both science and nature had papers that looked at 620,000 genes respectively, in glioblastoma, finding patterns of abnormal genes that are either turned on or turned off or missing that give us you clues to really find ways to more precisely target a tumor. And what's going to come in the future -- this will take some time -- if someone has a brain tumor, their tumor is going to be analyzed and then use drugs to target those pathways.
And my personal belief is that targeted, individualized therapy is the wave of the future. And the progress we've made so far is going to be dwarfed by the ability to do that.
GUPTA: Would you describe neuro-oncology the same way it was described to you when you decided to go into this field? FRIEDMAN: I think in the last five years, there has been some substantial advances -- small steps, not giant steps. But there are things that are changing in the field where I can confidently say that there is a fraction of patients, an increasing fraction, but a minority, but still increasing fraction of patients with the worst of the worst, which is the grade four, almost glioblastoma multiforme, who are being cured of their disease.
Most physicians out there would say that that is simply nonsense, that there is no cure for those patients. But we have patients around five, six, seven, eight, 10, 12 years without recurring disease. I think we made our point.
GUPTA: If someone is diagnosed with this type of tumor, a grade four glioma, what would -- what would most doctors tell the patient?
FRIEDMAN: Put their affairs in the letter. You've got six to nine months, maybe a year to live. Live a good life, but put your affairs in order. They would be told that they're incurable and to move on with their life as best they can for whatever small amount of time is left behind.
GUPTA: What made you sort of think differently than what a lot of doctors think in this country?
FRIEDMAN: We're told that many of the things we do are pushing too hard. Just let the patient have what their remaining time is going to be and die with dignity. I don't want my patients to die with dignity. I want them to live with dignity. And I think we can give them therapeutic strategies which minimize an adverse effect in the quality of life and give them a chance to survive.
GUPTA: Straight ahead, I'm going to sit down and talk to the head of the American Cancer Society. If you got cancer today, what would it mean for you?
And also, the United States might be preparing for one of the largest vaccinations in U.S. history. What you need to know.
And finally, what food you might try and eat today that could help prevent cancer. Here is a clue -- antioxidants.
HOUSE CALL is back in 60 seconds.
GUPTA: Welcome back to HOUSE CALL.
A new report out this week talks about the deadly implications of a swine flu outbreak this fall. The presidential advisor committee that released a report saying that there could potentially be up to 90,000 deaths as part of a plausible scenario involving a variety of factors, such as outbreaks in schools and possibly the virus peaking before the vaccine is actually available. They also talked about the fact that the swine flu could lead to one of the largest U.S. vaccinations in history.
Michael Jackson is also back in the news this week. After weeks of speculation, court documents show Michael Jackson overdosed on the powerful drug Propofol, something that we talked about quite a bit on HOUSE CALL. Now, this is a medication that should really never be administered outside a hospital setting. And this document shows that Jackson's own physician, Conrad Murray, did administer this powerful drug.
He also had four other drugs administered, supposedly to help him sleep. Keep in mind these drugs are all sedatives. They can all have drug interactions and can also compound one on the other. When talking about Propofol specifically, this medication is a general anesthetic, and even in small doses can cause respiratory depression, can help make you stop breathing and can also cause death.
This show is a show dedicated to cancer. We'll have much more HOUSE CALL after the break.
GUPTA: And we're back with a very special edition of HOUSE CALL, reporting to you from Dublin, Ireland, home of the Global Cancer Summit. A lot of discussion this week is obviously about cancer. We're going to be joined by CEO of the American Cancer Society.
Thanks so much for joining us. Appreciate it.
You know, you talked a lot about where we are on the war on cancer. It's interesting, because I've done a lot of reporting talking about President Nixon, declaring war on cancer back around 1970. What was the impact, do you think, of Senator Ted Kennedy overall on cancer?
JOHN SEFFRIN, CEO, AMERICAN CANCER SOCIETY: He had a -- it's ironic -- he had a life-saving impact on people's lives with respect to cancer. It's an amazing story that hasn't been told very well. That he was not only one of the main architects of the National Cancer Act of 1971, but he brokered a deal and made it truly bipartisan because Nixon was in the White House and that made sure it got passed. And it's changed the world. Cancer mortality rates started going down in 1991 and they've gone down every year since.
So, he is directly responsible for saving as many as 650,000 lives just in the last 15 years.
GUPTA: Do you think that this sort of measure of progress over the time since the war began on cancer -- how we've been doing?
SEFFRIN: We should be doing better. There's more we have to do, but we're do very, very well. Huge progress is being made. We're saving 273 more lives per day than we were in 1991 when cancer deaths started to go down.
The fact that we have National Cancer Act, we have the comprehensive cancer centers, we're building research, ,we're trying to improve access to health care. So, we're making progress.
The key point is that we can do better, and hopefully, his death will stimulate us to rebuild our efforts, because he wanted us to redouble our efforts.
GUPTA: Sixty-five countries represented here at the Global Cancer Summit. Obviously, a lot of discussion this week is about Ted Kennedy and his passing. Do you think it's going to inspire people to do more?
SEFFRIN: I do. I really do. The key point is, is that we now have enough experience and enough know-how that we can deliver. So, if people will pay attention to this problem, cancer will become the most preventable and the most curable of major life threatening diseases based on human counting (ph).
GUPTA: People, a lot of people have heard of the American Cancer Society obviously. Just tell me a second, what does the society do and what do you do as CEO on a regular basis?
SEFFRIN: Well, I have the good fortune of leading one of the largest voluntary health organizations in the world. We have 3 million volunteers, 8,000 staff, who get up every day and go and try to deliver our cancer control programs.
We do research. We're the largest funder of cancer research in every institution in the world. We deliver programs. We have a 24- hour hotline. You can call us. You can get help on quitting smoking.
So, we try to attract -- attack the problem in multiple ways because we know that most of the people dying from cancer today don't have to die if we get to them soon enough.
GUPTA: You know, one of the things that obviously Senator Kennedy will be known for as well is talking about health reform overall. A lot of people may not know his son Teddy Jr. also had cancer, osteoblastoma, and an amputation of his leg. We talked about this earlier.
What -- how you did he draw the correlation between cancer and health reform?
SEFFRIN: Well, he was one of the most passionate people about cancer and health reform that I've ever met in my life. He told me one day about that experience, that he was at Dana-Farber Hospital and overheard parents with children with the same disease his own son had who had went up to the doctor and said, "Doctor, could we do just half the treatments because that's all we can afford?"
GUPTA: They said they just want to do half.
SEFFRIN: Just half, because that's all we can afford. And he said, "Here I was," he said, "I'm the United States senator and I have health care to cover my son. Everybody should have that kind of quality health care." So, he was very patient about doing something about cancer and he did, and he was very passionate about doing something about quality health care and hopefully we will.
GUPTA: A lot of people don't know that story about Teddy Jr. and how it was a bench mark in informing Senator Kennedy's attitudes towards health care reform. Thank you for joining us.
SEFFRIN: Thank you.
GUPTA: This is going to be discussion topic for a long time to come.
And we are here in Dublin, Ireland -- again, home of the Global Cancer Summit, 65 countries have been here -- represented here over the past several days.
We're going to have much more on cancer and on Ted Kennedy after the break. Stay with HOUSE CALL.
GUPTA: We're back with a very special edition of HOUSE CALL, coming to you from Dublin, Ireland, also home of the Global Cancer Summit.
Senator Ted Kennedy's death from brain cancer came at a time when his passion surrounding health care reform was very much in the spotlight. And as we learned, this passion, like so many others, was informed by his own personal experiences.
GUPTA (voice-over): In 1964, less than a year after his brother, the president, was assassinated, Senator Ted Kennedy had his own brush with death.
UNIDENTIFIED MALE: Senator Edward M. Kennedy was seriously injured when his private plane crashed in the woods.
GUPTA: Kennedy was in the hospital for months.
KAREN TUMULTY, TIME MAGAZINE: This was, I think, the first one of his first experiences of how completely vulnerable and helpless he could be.
GUPTA: And that was just one piece an excruciating family medical chart -- strokes, mental retardation, depression, and substance abuse. And there was cancer. In 1973, the senator's son, Teddy Jr., then 12, was diagnosed with bone cancer. He survived but only after losing a leg to amputation.
JOE TRIPPI, FORMER KENNEDY CAMPAIGN AIDE: He really felt that everybody should have the health care that his son had.
GUPTA: The senator himself recently wrote this, quote, "My family has had the care it needed. Other families have not, simply because they could not afford it."
Daughter Kara fought off cancer as well, beating a lung tumor that was diagnosed in 2002.
TUMULTY: As many things as he had worked on, nothing that struck quite as close to his heart as health care reform. He, one time, said that universal health care was an issue that burned in his soul.
GUPTA: In 1997, he and Republican Orrin Hatch were behind the SCHIP bill, expanding health coverage for children. In 2006, he worked with Republican Governor Mitt Romney to push through a ground- breaking system of universal care in his home state of Massachusetts.
At a crucial point in last year's presidential campaign, the senator threw himself behind Barack Obama and the push for universal health care.
KENNEDY: This is the cause of my life. New hope that we will break the old gridlock and guarantee that every American -- north, south, east, west, young, old -- will have decent, quality health care as a fundamental right and not a privilege.
GUPTA: Whether the fight over health reform turns out to be Senator Kennedy's crowning legacy or a final bitter loss is yet to be seen. But even in death, he's a big part of the debate.
GUPTA: If you've been watching HOUSE CALL, you already know the foods you eat can impact your health. But did you know that some are powerful enough to improve your memory and also ward off cancer? Like I always say, the more color is the better. I'll explain.
Stay with HOUSE CALL.
GUPTA: You know, Senator Kennedy in many ways is an example of a truly "Empowered Patient." In dealing with his own illness and also, he had two children with cancer who taught us many lessons. For example, seeking out the best treatment and not taking "No" for an answer. Elizabeth Cohen explains.
ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Senator Edward Kennedy's passing this week has made us here at the "Empowered Patients" stop to take a look at his life and his life as an empowered patient. Many people don't realize that the senator had not one but two children who had cancer. His son Teddy Jr. had cancer in his bones at the age of 12. His daughter Kara Kennedy had lung cancer in her early 40s.
By all accounts, the senator pulled out all the stops to make sure that his children got the best care. He arranged for specialists to fly in from around the world to see what the best course of action would be and even when sometimes it was a dismal prognosis, the senator did not accept that and he fought to get them care that would save their lives. And today, both of them are healthy and cancer- free.
Now, very few of us have the money or the power of a Kennedy, but in this week's "Empowered Patient," I talk about how you can try to get that level of care without being a Kennedy, how you can summon experts from around the country, how you can educate yourself about your disease. You can read all about it in this week's "Empowered Patient" column which is CNN.com/empoweredpatient -- how to get Kenned-esque health care when you're not a Kennedy.
GUPTA: You know, it's not just about the foods you eat or even how you eat them but how your waist line could affect your cancer risk. We'll have that when HOUSE CALL returns.
GUPTA: Welcome back to HOUSE CALL.
You know, the National Cancer Institute says about one-third of cancers are related to your diet. Think about that for a second. What you eat can truly impact your health. And here's a look at why experts recommend adding color to your plate.
GUPTA (voice-over): We've all seen the headlines, "Green leafy vegetables keeps cancer at bay." "Blueberries a cancer cure." Or how about this one -- "Eating and Drinking Your Cancer Away -- a beer and pizza prevention plan"?
Despite the headlines, new research shows your diet doesn't really impact most cancer that way.
DR. WALTER WILLETT, HARVARD SCHOOL OF PUBLIC HEALTH: There's not really one type of diet or one magic pill or one magic food that's going to prevent cancer.
GUPTA: Dr. Walter Willet is a Harvard nutrition specialist who co-authored the book "Eat, Drink & Weigh Less." He suggests, about 35 percent of cancers in the United States are due to nutritional factors -- most, he says, because so many Americans are obese and so many don't exercise.
Obesity is a proven risk factor for colon, breast, endometrial, esophageal, and kidney cancer.
So, no silver bullet but when it comes to preventing disease -- including cancer -- diet does count. The American Cancer Society recommends changing your diet by focusing on color.
COLLEEN DOYLE, AMERICAN CANCER SOCIETY: Colorful fruits and vegetables like broccoli, like tomato, like carrots, like oranges, have lots of different antioxidants, lots of different phytochemicals. GUPTA: Phytochemicals are naturally occurring plant compounds that could prevent disease. The American Dietetic Association recommends eating green vegetables like broccoli, spinach and romaine that protect eyesight and the immune system.
Red strawberries, cherries, tomatoes, apples improve heart and brain function. Yellows and oranges, like grapefruit, cantaloupe, squash, and carrots also boost the immune system. Blueberries, blackberries, purple grapes, egg plants, and plums may help reduce some cancers and keep your memory sharp.
So, go beyond the headlines. Eat well, eat less. You may just keep cancer away.
GUPTA: Well, unfortunately, that's all the time we have for today. We hope you got a lot out of today's show to try and empower yourself. If you want to try and get some more information, you go to my podcast, CNN.com/podcasting. You can also check out our Web site, CNN.com/HouseCall and Twitter at SanjayGuptaCNN.
Remember, this is the place for the answers to all of your medical questions. I'm Dr. Sanjay Gupta. Stay tuned now for more news now on CNN.