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SANJAY GUPTA MD
Brain Cancer Vaccine Shows Promise/The Amazing Dr. Q./Mammogram Screening Guidelines/Soldiers' Mental Health Still Undertreated/Super Foods and Your Health
Aired October 9, 2010 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Good morning. I'm Dr. Sanjay Gupta. Welcome to the program.
First up, something we don't get to say too much on this show, a real breakthrough in brain cancer, the deadliest form, a new treatment out there that uses the body's own immune system to try and fight the tumor. I'll explain that to you.
And also, the war in Afghanistan. I've been out there several times and I have seen the enormous toll, both physical and mental. And now PTSD is leading to more hospitalizations than physical injuries. We've got some startling figures to share.
Also, this week's "Medical Mystery." Something we do every night could actually be making us gain weight. I'll tell you about it.
Let's get started.
Doctors may have unlocked a big secret which would help some patients with the deadliest form of brain cancer. It's called glioblastoma. It's also the most common form of cancer in the brain, about 10,000 new cases in the United States every year. It's the same type of cancer that took the life of Senator Ted Kennedy. But there's a vaccine out there, a new vaccine that has nearly doubled the expected survival time for some patients -- doubled. Think about that, extra time. It is what the patient you are about to meet -- every patient, really -- is fighting for.
DR. ALLAN FRIEDMAN, PRESTON ROBERT TISCH BRAIN TUMOR CTR.: Oh, because left untreated, the patient succumbs to the disease very quickly.
GUPTA (voice-over): Even with aggressive treatment, average survival is barely a year.
KAREN VANEMAN, BRAIN CANCER PATIENT: Oh, good to meet you.
GUPTA (on camera): How are you?
VANEMAN: I'm fine, thank you.
GUPTA: Feeling good today? VANEMAN: Yes.
GUPTA (voice-over): But here at the Preston Robert Tisch Brain Tumor Center, Karen found hope, an experimental vaccine. The vaccine has a futuristic name. It's called CDX-110. It uses the body's own immune system to attack tumor cells. It won't work on every GBM patient, just the 40 percent or so whose tumors make one particular protein. In those patients, it goes off like a smart bomb.
Now Karen gets a shot, a painful one, every month. But look at the results. We were able to pay her another visit a full year later. Remember, most patients don't even live that long.
VANEMAN: It's been about a year-and-a-half. As long as the vaccine works, then I'll be getting the monthly shots. And when it doesn't work, then I'm in trouble.
GUPTA: Dr. John Sampson helped develop the experimental treatment.
(on camera): What can we say about this vaccine now? In terms of educating a patient about it, what do you tell them in terms of what it promises?
SAMPSON: We're always careful not to overpromise what somebody can deliver. And this is still in an experimental stage. But patients are living two to three times longer with the vaccine than we would have expected.
GUPTA (voice-over): Preliminary study results made public in June were slightly less dramatic. But still, on average, compared to standard therapy, the vaccine nearly doubled survival time, as much as six years in some cases with no signs of returning cancer.
You know, I want to take just a second to show you how this vaccine works in the brain. What you're looking at here is a glioblastoma in the brain there. And what's so particularly interesting is that in a certain percentage of glioblastomas, they have a protein that is unique to this particular tumor. So you can train the body's immune system, like you see here, to go in, and basically, like a smart bomb, really start to attack this particular type of cancer. Again, you're training your body's own immune system to fight a tumor.
And we're starting to see some incredible results here, as well. For this type of cancer, the average survival 14 months. But with this treatment, closer to two years, which is almost double. Now, only about 18 patients were studied, but the results have been so promising. And some of those patients have been living up five years, some even more than six years. Several are still going strong with no sign of returning cancer.
So these are early studies, to be fair, but there is hope that more studies are going to prove this same point and the treatment's going to become more widely available. Also, it may be something that is available for other cancers down the road, as well.
One of the cancers that a lot of people talk about, breast cancer. And there's new mammography guidelines. They sparked controversy, as you well know. They sparked some confusion. Is it really worth it to get a mammogram, and at what age? I'll answer that viewer question in our "Ask the Doctor" segment. That's next.
Also, you'll meet a man that inspires us all. He's teaching us the strength that comes from within when you really want to succeed. I'll explain that, as well.
GUPTA: And we are back with SGMD. It's Breast Cancer Awareness Month, so no surprise we've got lots of questions about breast cancer screening. I got a question from a CNN blogger says specifically this, "Is it really worth it to get a mammogram?" We've gotten lots of questions just along these lines, and it's a good question because it has been a confusing issue. Most medical experts agree that getting a mammogram can find breast cancer at an early stage.
Now, the earlier you catch cancer, the more likely it can be treated successfully, but this is a screening tool and it has limitations. It's by no means perfect. For example, in a small number of cases, a tumor can be missed. On the other hand, some things that get picked up by a mammogram can lead to a biopsy and then turn out not to be cancer. And that, of course, can cause anxiety.
But the American Cancer Society and a lot of other groups agree that despite these limitations, a mammogram remains an effective screening tool, and women's lives can be saved if their breast cancer is found early and treated early.
There's been a lot of controversy over this, and we've covered some of this over the past year, about when a woman should start getting a mammogram. Now, the ACS and the Comprehensive Cancer Network have been recommending that women get a high-quality screening mammogram annually beginning at age 40. That's the number you should probably tuck away. If you have a history of breast cancer in your family, you may want to get screened earlier.
Again, the confusion. I don't want to overestimate or underestimate this, but there has been confusion about this in the past. And again, there's no question that a better screening test is probably necessary. But I want to make sure you to have the best information that we have right now.
You know, we've got a new series that we're loving. It's called "The Human Factor." We get to introduce you to some pretty remarkable people with stories that I find inspiring and you're going to find inspiring, as well. In learning their stories, we discover some remarkable things about them, including something that we like to call "The Human Factor."
This week, I'm going to introduce you to a fellow neurosurgeon and also tell you about his path to medicine which is different than just about anybody you've ever met.
(voice-over): This is Dr. Alfredo Quinones-Hinojosa -- they call him Dr. Q. -- here taking out a life-threatening brain tumor.
(on camera): This is quite an operating room, right?
DR. ALFREDO QUINONES-HINOJOSA, JOHNS HOPKINS HOSPITAL: Yes.
GUPTA: You got all your scans up. You got an interoperative CT scanner.
(voice-over): We're at Johns Hopkins, one of the finest hospitals in the world.
(on camera): So is this your room? I mean, this is what you --
QUINONES-HINOJOSA: This is my room. This is -- they build this specifically for our service.
GUPTA (voice-over): At 42, Dr. Q. is at the top of his game. But life wasn't always like this. In fact, it's been a long journey from his home town in Mexicali, Mexico. He started working at the age of 5 at his father's gas station. His family was poor, and things got worse when the business collapsed. In 1987, young Quinones headed north to the border.
QUINONES-HINOJOSA: There became one choice that I knew I had to make, and I hopped the fence. I jumped the fence. I climbed the fence between Mexico and the United States at age 19.
GUPTA: His first job, pulling weeds in California's Central Valley.
QUINONES-HINOJOSA: I remember, I tell you, Dr. Gupta, my -- my hands, they're the very same hands that now do brain surgery. Right around that time, they had scars everywhere from pulling weeds. They were bloody.
GUPTA: This trailer was his home. But Quinones knew he could do better. He worked for the railroad. He got a job as a welder. That money paid for night school. He got a scholarship to the University of California-Berkeley, and from there he went to Harvard Medical School.
(on camera): Did you ever think to yourself, You know what? I don't belong here.
QUINONES-HINOJOSA: Yes, many times. But I think that that's also what has kept me on the top of my game. You know, back then, when I was in medical school, I remember thinking, Wow. I look at my classmates. As you know, you had some of them who train at the best prep schools in the country, who came from the most distinguished families in the United States, from traditional education. And there was me, who barely had an education. But I was eager to learn. And I said -- I always knew that I had something that all of the others didn't have, and that was that fire in my belly that keeps me going.
There is my girl, right there!
UNIDENTIFIED FEMALE: Good morning!
GUPTA (voice-over): The fire, it still burns today as Dr. Q. takes out brain tumors and does research that he hopes will lead to better treatments.
(on camera): Do you guys ever sit around, you and your wife, and just pinch yourselves? I mean, your wife has literally seen you go from being a migrant farm worker to being here.
QUINONES-HINOJOSA: Yes. I do. We -- we think about it. But I feel very blessed that every day, when I walk out of the operating room, of this operating room, and I go and give the patients the news that everything well -- went well in surgery, and they hug me -- it's just the most rewarding moment that I can think of.
GUPTA: Just an amazing doctor, an inspiring person, and of course, an amazing story. Dr. Q., thanks for sharing with us, if you're watching.
Next up: War is taking its toll on our troops, and I'm going to tell you about the struggle to keep our troops mentally healthy. We've got that next on SGMD. Stay tuned.
GUPTA: America's longest-running war has taken a severe toll on the physical and mental health of our troops. You know, I spent a lot of time out on the front lines both in Afghanistan and Iraq, and I've seen firsthand the war's devastating effects.
The one thing we've talked a lot about are the suicides when they come back, even when they're overseas, men and women, but there's so much that they're dealing with. That's one thing I've learned. And as the war has progressed, the mental wounds have become one of these things that you simply cannot ignore at any level.
You know, if you take a look at the numbers, I think they're the most striking. May attention to these. For example, in 2009, there were more than U.S. troops hospitalized last year for mental health issues than for physical injuries. Take a look at that. That should say a lot to anybody who looks at those numbers. Mental health conditions are worse for those serving multiple tours. That's intuitive, but listen to this. If you're redeployed, you're two-and- a-half times more likely to develop some of these symptoms. The numbers are making it increasingly clear that this is a problem, and to military officials -- well, they're starting to take notice. So joining me in the discussion this morning is Tom Tarantino. He's an Iraq veteran. He's a legislative associate for Iraq and Afghanistan Veterans of America. Tom, thanks so much for joining us.
TOM TARANTINO, IRAQ AND AFGHANISTAN VETS OF AMERICA: Thanks for having me, Sanjay.
GUPTA: You know, people have referred to it as the elephant in the room, talking about mental health issues and our veterans. I know that for a long time, they thought about mental health issues as a disorder, as opposed to an injury. That thinking is starting to change now. But still, these suicide rates, Tom -- they're so disheartening in some ways. They're creeping above civilian rates.
And why do you think those numbers continue to rise? And do you think it's a problem that can be addressed?
TARANTINO: Well, I think it can be addressed. And it's a symptom of a force that's just breaking. It is a force that is stressed to the point where, you know, things are starting to go wrong. And I think we're starting to see that the top brass at the Pentagon is understanding these issues. And I firmly believe people like Admiral Mullen and Vice Chief of Staff Chiarelli in the Army really understand these issues.
The problem is, is that's not getting down to the sergeants, the lieutenants and the captains who are on the line day to day with their troopers. And if we can bring that type of awareness to those line leaders, then they can help get their troopers the care that the need to get back into the fight.
GUPTA: So when they're not -- it's not filtering down, so to speak, does it result in stigma, do you think? I mean, or is it that people don't want to bring up these issues because the people on the front line, these sergeants, aren't adequately addressing it?
TARANTINO: Right. Well, you mentioned the elephant in the room. And stigma really is the elephant in the room, if we really want to talk about it. You know, people are afraid to seek treatment. Why? Because they're afraid they might look weak to their buddies. They're afraid how it's going to impact their career.
We have to change the culture not just in the military, but in society as a whole --
GUPTA: Yes. Yes.
TARANTINO: -- to look at things like post-traumatic stress and traumatic brain injury as injuries, not disorders. I always tell troopers, Look, if you got shot in the chest, you're not going to walk around with a bullet hole in your chest, right? You're going to go to the doctor. You're going to -- you're expected to go to the doctor, get it treated, heal, and get back into the fight. We have to change that paradigm so people look at mental health injuries like that.
GUPTA: And you're good to bring up that this is obviously -- the stigma is a concern not only among the troops, but also among the civilian population, as well. So what does make that change? How do you change that culture? And I'm a doctor asking you this, and I've, you know, seen this for 20 years, the way it is. How -- do you have any ideas or have you seen anything that works?
TARANTINO: Right. I mean, there are things that we can do within the military community. First of all, it's education, education, education. The Army is starting to train mental health resiliency in its basic training courses and throughout the lifecycle of education for sergeants and officers. And they need to make that a regular part of your professional development as you progress through your career.
IAVA fought last year to get mandatory mental health screenings for everybody returning from Iraq and Afghanistan. We really think that these early and frequent screenings could have saved more lives than all the armored vehicles money can buy.
TARANTINO: But here we are a year later, and they still haven't implemented the program, largely because we can't figure out how to get enough mental health professionals to meet the need.
GUPTA: Yes, the demand is so high. I was reading Ft. Hood, for example, up to 4,000 mental health visits a month. I mean, most big hospitals could not handle that long (ph), and let alone Ft. Hood. You mentioned Mike Mullen and how he's made this a top priority. We've heard this referred to now as an emergency situation, this idea of mental health injuries. And I'm using the word "injury" specifically here. Have you seen, as a result of this increased focus -- have you seen progress being made?
TARANTINO: Yes. I mean, we're -- the reality is, we're in a much better place today than we were two or three years ago. The Defense Center for Excellence for Brain Injury and Mental Health has done an excellent job of really trying to get smart on the issues for the military. These are issues the military frankly ignored for the last 50 years. We have the National Intrepid Center of Excellence.
We have a physical place that is part recovery -- recovery lab and think tank on where we could do the big think on these issues and solve some of these problems not just for this generation, but for the next generation and the generations after that.
GUPTA: You know, you think about what it's going to look like 10, 15 years from now for people who did not receive adequate treatment. This -- you and I are talking about this now in 2010, but this is something that's going to affect people for a long time to come.
Thanks for being a measured and important voice on this. And we're going to keep talking about it, as well. Thanks for joining us.
TARANTINO: Thank you, Sanjay. Appreciate it.
GUPTA: And we'll be right back.
GUPTA: You know, you've probably heard the term "super foods" quite a bit. Sounds like something that's going to promise you a lot. But what can you or what should you expect from these foods? I decided to go take a look for myself.
You've probably seen the lists, the super foods, the 10 foods you should eat every single day. What is it about super foods? What makes them so super? Can they protect you or do they prevent you in some way from getting sick? Let's take a look. Come on.
ANN DUNAWAY TEH, REGISTERED DIETITIAN: Hi. How are you, Sanjay?
GUPTA: Thanks so much for meeting us.
TEH: Thank you for having me.
GUPTA: So I see you're hanging out by the fruit, the berries. If you had to pick one fruit out of all these here, what would you say is sort of the ideal super food, and why?
TEH: Blueberries are definitely the ideal super food, and it's because of their dark, rich color. And that just means it's got a lot more antioxidants in it. And it's really great for memory, also for eye health, and it might also help lower bad cholesterol.
GUPTA: OK. So definitely put berries on the list of super foods. Leafy greens is what we talk about all the time. What about leafy greens?
TEH: The dark green color lets you know, again, it's got a lot of nutrients in it. It's a great source of calcium and fiber.
GUPTA: I mean, there's a lot of foods that are good for you. What makes a food super?
TEH: A super food is what we call a nutrient-dense food, so it's going to do a whole lot more for you with less calories expended.
GUPTA: Can it erase some of my other bad eating habits?
TEH: Well, if you start replacing some of those bad eating habits with more fruits and vegetables, then it can certainly help. But if you're going to be loading it down with other really unhealthy foods, it's probably not the best choice. But at least you've got some on the plate.
GUPTA: Can these foods in some ways act like medicines, in the sense that they can decrease inflammation, decrease your cholesterol, things like that? TEH: Yes, there are some studies that show some of these foods can do that, but it's also part of our lifestyle that we want to get, as well.
GUPTA: Sweet potatoes I know are on your list.
TEH: Yes, sweet potatoes are great. The Center for Science in the Public Interest calls this one of the healthiest vegetables that you can eat. And that's because they're so packed with nutrients. Their deep orange color lets you know there's vitamin A in there, which is really great for our eyes, also vitamin E for our skin.
GUPTA: Fish is, I know, very much on your list.
TEH: The fatty cold-water fish that have the omega 3 fatty acids, which is the good, healthy fat that helps fight inflammation. And those are salmon, halibut, mackerel, tuna, sardines and herring are all great fish that have a lot of omega 3s in them.
GUPTA: Now, hearing all that about super foods, you may think, Great, but I don't have a market that looks like that in my back yard. It's a good point. A lot of people are like you. They don't have that. But you can get a lot of those same foods frozen, still get a lot of benefits. You can get them canned and still get the benefits. Keep in mind, though, you need eat those super foods with a healthy diet in general. And you know what? Even try and get a little exercise every now and then.
Speaking of healthy, this week's "Medical Mystery." If you're trying to lose weight, will your sleeping habits hurt you or help you? That's next.
GUPTA: We're back with SGMD. You may be trying your best to eat right and exercise, but you're still not losing weight, something I hear all the time. Well, that brings us to our "Medical Mystery" of the week. Could it have something to do with your sleep?
Well, a new study out there suggests that lack of sleep could throw off your weight loss goals. And maybe this is something you've already known, but researchers think that they have figured out why. Ten people, small study, they were considered overweight or obese, they were put in a controlled environment for two weeks. They gave them food. They gave them vitamins. And they had them participate in the same activities. Now, six of the dieters got to sleep 8-and-a- half hours and four slept 5-and-a-half hours.
Here's what they found. Dieters who got more sleep, longer, they actually lost 55 percent more body fat than dieters who slept less. So what's the connection? What did researchers sort of stumble upon? They think that people who don't sleep enough may produce more of the hormone ghrelin, also known as the "hunger hormone." Ghrelin makes you hungry. It causes fat retention, as well. So what does this mean for you? If you want to lose weight, make sure you're getting enough sleep. It can be one of the first important steps in your weight loss goals.
If you missed any part of today's show, be sure to check out my podcast. CNN.com/podcasting. Also set your DVR 7:30 AM Eastern. Remember, this is the place for the answers to all of your medical questions.
Thanks for watching. I'm Dr. Sanjay Gupta. More news on CNN starts right now.