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DR. DREW

Tomorrow: Sandusky Sentenced; Horrifying 911 Call

Aired October 8, 2012 - 21:00   ET

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


(BEGIN VIDEO CLIP)

DISPATCHER: 911, where is your emergency?

JAKE EVANS, 17-YEAR-OLD: My house.

DISPATCHER: OK, what`s the emergency?

EVANS: I just killed my mom and my sister.

DISPATCHER: You just killed your mother and your sister? How did you do that?

EVANS: I shot them with a .22 revolver.

DR. DREW PINSKY, HOST (voice-over): Three days ago, a 17-year-old boy shot and killed his sister and then his mother in cold blood. Then he called 911 and confessed to everything.

People who knew the family say he was a good kid. So, what went so wrong?

And later, young women facing what could be a life or death decision, having their breasts cut off before they have cancer. What would you do? We`re going hear from a woman who is struggling with this choice right now.

Let`s get started.

(END VIDEO CLIP)

PINSKY: OK. That shocking 911 tape, Breast Cancer Awareness month. Thus, the pink tie. We`ve got a lot to get to tonight.

Do not -- you want to stay with us through this entire show.

First off, we`re getting to Jerry Sandusky. He`s going to be sentenced tomorrow for sexually abusing young boys. This scandal destroyed tons of lives, impacted an entire university system.

The former Penn State football coach just made a statement from jail to Penn State ComMedia Radio here he maintains he is innocent. Take a listen.

(BEGIN AUDIO CLIP, PENN STATE COMMEDIA RADIO)

JERRY SANDUSKY, CONVICTED SEX OFFENDER: I would cherish the opportunity to become a candle for others as they have been a light for me. They can take away my life. They can make me out as a monster. They can treat me as a monster, but they can`t take away my heart. In my heart, I know I did not do these alleged disgusting acts.

(END VIDEO CLIP)

PINSKY: All right. Well, joining us to discuss these alleged disgusting acts, criminal defense attorney Mark Geragos and clinical psychologist Ramani Durvasula.

Mark, would you let someone get on the radio before sentencing and say stuff like this?

MARK GERAGOS, CRIMINAL DEFENSE ATTORNEY: Look, your advice is always is the knee-jerk as a criminal defense lawyers. You don`t let the client say anything and want him being contrite. In a case like this, it doesn`t matter because the mandatory minimums on this case are off the charts. The number of years he`s going to get and that judge has to give him is in effect a life sentence.

So if he believes he`s innocent, I -- it always strikes me is why do the guys go quietly when they get sentenced anyway. I`ve always wondered why defendants don`t get up and give the one armed salute to the judge.

PINSKY: Do you think there`s any chance he is innocent?

GERAGOS: You don`t be -- look, I sat in the courtroom a week and a half ago with Chris Brown. And Chris -- while Chris and I were waiting in that courtroom, (INAUDIBLE) I watched the Judge Schnegg release a guy who had been in custody for 19 years in that courtroom, released him immediately because somebody had lied at his trial 19 years ago and this young man -- not so young anymore -- was convicted and spent 19 years in jail.

So, there`s the 300th person who was just released and exonerated by DNA. A lot of times that happens with faulty eyewitness identification.

PINSKY: Is it shocking to you this happens?

GERAGOS: No. I think the system is made up of humans, and I think that there`s errors all the time. No, it`s not shocking.

Do I know if he`s innocent? I didn`t sit in that courtroom, so I couldn`t tell you. But there is a quality to the kind of feeding frenzy of the witch hunt and the money lawyers out there trying to get it --

PINSKY: What do you mean lawyers? What does that mean?

GERAGOS: Lawyers who were there insinuating themselves into the case for the purpose of a lawsuit, shaking down Penn State and the whole bit. That always to me is distasteful when you`re talking about a criminal case.

PINSKY: So those attorneys don`t care whether he`s innocent or proven guilty. But they just want the money from the university system.

GERAGOS: Well, understand what happens. If you`re a civil lawyer and you get a criminal conviction, case over on civil, because you`ve -- beyond a reasonable doubt, you`ve only had to get beyond the preponderance for a civil case, you`ve got a conviction, that`s a done deal.

Penn State opens up the coffers. At that point, you`ve made a pretty penny.

PINSKY: So, Ramani, he was in the shower. One thing we know is he was in this Sandusky, was in the shower with a kid.

RAMANI DURVASULA, PH.D., CLINICAL PSYCHOLOGIST: Yes.

PINSKY: Mark, we`ve said this before. Your son, my son, we`re going to take the law into our own hands.

GERAGOS: Any of our kids. Doesn`t have to be a son, daughter, it doesn`t matter.

PINSKY: Thank you. Trust me. That`s right. Well, I think it would be -- I don`t want to go down that path.

GERAGOS: Either way it`s going to be an offensive notion. And that`s part of the reason this was such an uphill battle for him. Even if he was completely innocent, he was totally guilty of inappropriate behavior.

PINSKY: Right. And, Ramani, isn`t that enough?

DURVASULA: And that is enough, because what`s infuriating to me -- infuriating about this statement is that these young men were likely traumatized, and this absolutely denial to be re-traumatized. The courage it takes to show up and talk about this happening to them. And then have it put back in your face and having to listen to this.

This is why people don`t come up and try to use the justice system to correct this. And that`s why these people get to do it for years. One more time, here we go. It`s traumatic.

PINSKY: Too traumatic to the victims.

Go to a caller. Deborah in Texas.

Deborah, you got something?

DEBORAH, CALLER FROM TEXAS: Yes, Dr. Drew. I`m a retired deputy and I arrested a pedophile with nine counts of indecency with a child. And when I was patting him down, he told me, "Little deputy, I`ll be out of this jail long before you get done with your report". The arrogance is the same thing that Sandusky has. Both of them are evil.

PINSKY: Mark?

GERAGOS: Well, there is a -- quite a bit of theory and you see it in practice that you`re never going to have somebody admit to one of these things. It`s completely -- there`s always this justification. There`s always -- the closest they ever get to admitting anything like this is, well, they came on to me. They enticed me, that kind of thing.

So, I understand that. What bothers me in cases and I defended cases and had them where I thought it was a false allegation. So it does happen, and a lot of times it happens -- it didn`t happen in this case obviously. But in divorce situations, custody is manipulated by the allegation of molestation.

So let`s not paint the entire -- everybody the accusation is made against as guilty.

PINSKY: Does he have an appeal? Sandusky?

GERAGOS: Yes, he does have an appeal. And he`s got a basis upon which he was not granted a continuance. He was behind the eight ball. The commonwealth had three years ahead to put this case together. And then he gets charged and then (INAUDIBLE) go, you have to try to get out from this avalanche of evidence.

PINSKY: All right.

GERAGOS: So, there`s an arguable color appeal.

PINSKY: So, we`re going to be hearing about this case. We`re going to hear about it tomorrow when he gets sentenced. There`s going to be appeals in the future. This thing ain`t going away.

GERAGOS: It`s not going anywhere.

PINSKY: All right.

Now, next up -- by the way, Mark, thanks for joining us. (INAUDIBLE) running around today.

At the beginning of the show, you heard that shocking 911 tape of a 17-year-old boy who shot and killed his mother. We`re going to get into that deep after this break. Don`t go away.

(COMMERCIAL BREAK)

PINSKY: A 911 call from a 17-year-old boy telling the operator that he had just shot his mother and sister not once but multiple times and then in cold blood systemically killed them. This all took place in the family mansion located in a posh suburb of Fort Worth, Texas.

Now, before we get into this and ask why and what happened here, I need you to hear part of this chilling 911 call from Jake Evans. He`s the 17-year-old. Now, be warned, this is graphic material. It may be shocking to some.

Here is this 911 tape.

(BEGIN AUDIO CLIP)

DISPATCHER: 911, where is your emergency?

EVANS: My house.

DISPATCHER: OK, what`s the emergency?

EVANS: I just killed my mom and my sister.

DISPATCHER: You just killed your mother and your sister? How did you do that?

EVANS: I shot them with a .22 revolver.

DISPATCHER: Are you sure they`re dead?

EVANS: Yes.

DISPATCHER: OK. I want you to stay on the phone with me, OK? Are you all right?

EVANS: Yes, I`m fine.

DISPATCHER: OK. Where is the gun?

EVANS: It`s on the kitchen counter.

DISPATCHER: Is there any reason that you were so angry at your mother and your sister?

EVANS: I don`t know. I wasn`t -- it`s weird. I wasn`t even really angry with them. It just kind of happened. I`ve been kind of planning on killing for awhile now.

DISPATCHER: The two of them or just anybody?

EVANS: Pretty much anybody.

DISPATCHER: Why?

EVANS: I don`t know. I don`t really like people`s kind of attitude.

DISPATCHER: Right.

EVANS: I think they`re very, like, you know, emotion -- I don`t know. Verbally rude to each other and stuff like that.

DISPATCHER: Right.

EVANS: I don`t know.

DISPATCHER: It`s OK.

EVANS: My family -- I don`t know. They just really kind of really -- I guess this is really selfish to say, but to me they -- I felt like they were just really suffocating me in a way. I don`t know. Obviously, I`m pretty, I guess evil. But that`s -- whatever. I`m sorry.

DISPATCHER: OK. No, don`t be sorry.

(END AUDIO CLIP)

PINSKY: Everyone who listens to that has got to get the same chilling feeling that I get. In sort of that cold, unemotional, I`m evil.

He`s not on drugs. He`s not manic. He`s not psychotic. There`s no evidence of him responding to stimuli or bizarre thoughts. It`s all methodical and extremely difficult to understand.

I want you to listen to another portion of this call -- again, very graphic. Here is Jake telling the 911 operator how he killed his sister and mother. Take a listen.

(BEGIN AUDIO CLIP)

DISPATCHER: I`m listening. OK. You have my undivided attention.

EVANS: This is really going to mess me up, you know, in the future. See, my sister, I told my sister that my mom needed her. She was in her room. And she came out of her room and I shot her. And she rolled down the stairs and I shot her again. Then I went down and I shot my mom maybe three or four times.

But I`ll never forget this. My sister, she came down the stairs and she was screaming and I was telling her that I`m sorry but to just hold still. That, you know, I was just going to make it go away. But she just kept on freaking out. But finally she fell down and I shot her in the head about probably three times.

DISPATCHER: So they`re both downstairs?

EVANS: Yes.

DISPATCHER: OK. Where are you?

EVANS: In the kitchen.

DISPATCHER: OK. You`re not sitting by the gun are you?

EVANS: No. It`s about 10 or 15 feet away from me.

DISPATCHER: All right. Where`s your dad?

EVANS: He`s out of town.

DISPATCHER: Do you know where out of town?

EVANS: Washington, D.C. and for I guess future reference, I don`t really want to see any of my family members, you know? Like in visiting or whatever. I don`t know how it works or anything. But I just don`t want any type of visitors.

(END AUDIO LCIP)

PINSKY: Unbelievable. Joining me to discuss this is clinical psychologist Ramani Durvasula. What is your take? This is a bizarre, unusual -- you know what I thought when I first heard this, I thought to myself, oh, my God. People think somebody who is killing is angry and aggressive and hateful.

DURVASULA: Right. Yes.

PINSKY: But there`s a spectrum of people that kill, and this is a certain thing.

DURVASULA: Yes.

PINSKY: What do you think?

DURVASULA: The absolute absence of emotion and even sort of the labeling himself, I did something wrong, I did something evil, but there`s a complete detachment o from emotion --

PINSKY: But he doesn`t seem disassociated.

DURVASULA: He doesn`t seem disassociated. That`s the thing.

PINSKY: It`s almost like my sister was suffering. So, I -- hold still while I make you not suffer.

DURVASULA: Coming up with odd rationales. The first place I want to go -- first place I want to know what`s going on in this kid`s brain in terms of -- if what we call an organic cause.

PINSKY: Yes.

DURVASULA: Meaning like does he have a tumor? Has something change in his brain? That workup is the first place I would go.

PINSKY: It`s funny you would say, that was my first thought too. If people remember, there was a famous incident at the University of Texas- Austin where a guy with a frontal lobe tumor went into the clock tower and started shooting people randomly.

This I think may well be one of those circumstances. At least that`s the first thing to make sure it isn`t.

DURVASULA: Yes, it is.

PINSKY: Joining us on the phone is Sheriff Larry Fowler.

I also want to remind the callers, please call and talk about this case, 855-373-7395.

Larry Fowler, Parker County, Texas. He has spent time with Jake the killer since the shooting.

Sheriff, can you help shed any light on this?

SHERIFF LARRY FOWLER, PARKER COUNTY, TX (via telephone): Well, I really wish I could. You heard the tape -- just as I have. And for two hours after this incident occurred out there, after we had this young man down in the sheriff`s office and he was interviewed at length for two hours by our local Texas ranger here, and we heard just about the same thing that we were hearing on this tape. He just rambles around.

Now, in this young man`s background and I think you mentioned it before, there`s no drug history. There`s no alcohol history. There`s no family violence history. There is no history.

PINSKY: There`s no misbehavior? He was a good student.

But I did hear something -- I listened to a longer version of a tape and he was complaining of headaches and going to see an allergist recently because of these so-called sinus headaches. It`s there a plan to do a CAT scan on this kid to make sure -- I`m not making excuses for his behavior but we have two mental health people here saying, get a brain scan to make sure this is something like the University of Texas incident.

FOWLER: Well, he now has an attorney. And I`m sure all we`ll (INAUDIBLE) as this case goes forward.

But, seriously -- I mean, in 50 years in this business that I`ve been in this business, I have never seen anything like this. I mean, it -- the officers when they arrived on the scene out there, it was the same when he came out of the house and they took him into custody, it was the same flat monotone, nothing exciting. They asked him where his mother and sister were. He told them where the two deceased persons were.

And his demeanor and everything has not changed since that phone call.

PINSKY: It`s incredible. It really is something to try to sort out. We`re going to get further into this. Sheriff, please stay with us. Dr. Durvasula, please as well.

Now, later on, again, I`m wearing a pink tie. We`re going to talk about breast cancer awareness and a breast cancer gene that you might have and you need to know about. Be right back.

(COMMERCIAL BREAK)

PINSKY: We`re discussing 17-year-old Jake Evans who admitted to shooting and killing his sister and mother on a 911 tape just days ago. HLN did try to reach the family and their lawyer for a comment. As of air tonight, we have not heard back from anyone.

The sheriff who took this kid into custody is still with us. He`s on the record saying he`s never seen anything like it.

Ramani Durvasula is here with me. And we`re trying to make sense of this. It`s difficult.

I want to go to a caller. I believe we got Brian on the line. Brian, what do you got for me? Brian?

BRIAN, CALLER FROM TEXAS: Ramani, it said earlier on the segment that this boy didn`t show any signs, that he was a well-liked kid. But are there signs we should have been looking for? Did he snap? It`s a little frightening.

PINSKY: It`s all frightening. We were trying to figure this out during the break, no.

DURVASULA: No, there`s not. I mean, again, we did come back to this idea that this social isolation piece. I definitely would want them to work up, whether this is sort of the early onset of schizophrenia in this child. I mean, this is the first angle.

First, I want to understand what`s going on in his brain, whether it`s a tumor or something else happening, and then really work up on the schizophrenia angle, because again, the social isolation withdrawal is a piece of that. And we were seeing some of that in his case, and really sort of frustration about people coming in to his social space.

PINSKY: And, Sheriff, here we are, the clinicians, trying to figure this out. What`s your hunch? You said you`ve never seen anything like this before. Do you have any way of understanding it?

FOWLER (via telephone): Well, no. That`s the tragic part of this whole thing. I mean, it`s because everyone is searching for a motive. And of course as you can well imagine, I`ve had the media all over the place, and I don`t have an answer.

And I watched he interview, talked to this young man, reviewed everything and I can`t -- I mean, I just can`t get a handle on it. I don`t understand it.

PINSKY: How is the community reaction? You said the media`s all the over this. Is your community at large there pulling together? Is it pulling them apart? How are people reacting?

FOWLER: Well, the way I read it here is the community is rallying around the family. This is a well-respected family in this community here.

PINSKY: Yes. I got to tell you, sheriff. When we hear that over and over about how great the family is, how great the kid was, it makes a psychological explanation unattainable. It just makes you wonder what organic is going on.

Tina in Virginia. Tina, you got something for us?

TINA, CALLER FROM VIRGINIA: Yes. I was wondering if he and his mother had gotten into some kind of altercation before and if he was on any psyche medications, and I`d like to say hi to my sister-in-law, Bella Johnson (ph).

PINSKY: OK, Tina.

Sheriff, what do you say to that?

FOWLER: The only medication that has come to our attention in this whole thing is for an allergy. And the night when all this occurred, we executed a search warrant on the residence. There was no indication of drugs, you know, there was just nothing. The only thing that has come to light as far as in the medical arena is, I believe it was an allergy he was being treated for.

PINSKY: Sheriff, I heard that the kid was actually describing it in a longer 911 tape he was taking xerotic and allergy medication. He was taking Sudafed.

FOWLER: Right.

PINSKY: But he did hint he was having headaches. And that`s again further evidence of something organic that might be going on here. They might have been going down the wrong path with the allergies and missed a neurological problem.

And -- oh, Sheriff, go ahead, please.

FOWLER: Well, it`s going to take somebody a whole lot smarter than I am to figure this out, because -- it`s one thing when somebody walks into a convenience store and shoots somebody and takes off with the money. We know how to deal with that.

But I can assure you, I have no idea and I wish to heaven I did, but I have no idea what prompted this young man to do this.

PINSKY: And, Sheriff, this is so -- we got to point out this is so sad. Whatever the reason, this is just a devastating tragedy. I guess we just have to send our best thoughts out to the community. I want to thank you for joining us.

Please keep us abreast to this. Let us know how the community pulls together. This is a deeply troubling and sad situation.

FOWLER: It certainly is. Thank you very much.

PINSKY: Thanks, Sheriff.

And, Ramani, thanks for helping me discuss this thing. It`s -- this is the wildest, craziest thing. I`m sure -- one way or another there will be an explanation. We`ll stay on top of that.

Breast cancer awareness month, ladies and gentlemen, that`s why the pink tie here. Three women we`re going to talk to who are faced with a terrible decision -- who have been faced or may be faced with a decision of being tested for a genetic marker for breast cancer. Do they have their breasts taken off or not? And should you be tested? And what do you do if you`re positive.

Stay with us.

(COMMERCIAL BREAK)

PINSKY: In 2012, 39,510 women will die from breast cancer and 63,300 new cases of non-invasive cancer will be diagnosed. It is breast cancer awareness month, folks. Did you know there is a test that can predict whether a man or a woman, both, can predict whether you might get breast cancer? It`s also predictive of ovarian and colon cancer. And many people who test positive are choosing to have their breasts removed preventatively -- a prophylactic mastectomy, just in case.

Joining me are two women who have been through this experience. Jackie Morgan MacDougall and one of our own here at DR. DREW, our producer, Wendy Brokaw. Also, we have 35-year-old Catherine Duda who has tested positive for what we`re calling this breast cancer gene and has elected so far not to have surgery. Jackie, tell us about your story. Why were you tested? What did you think when you first found out? Let`s go there.

JACKIE MORGAN MACDOUGALL, HAD PREVENTIVE DOUBLE MASTECTOMY: OK. So, I was tested because when I was three years old, my mom, who is the mother of 11 kids died of breast cancer, and she was 39 years old.

PINSKY: Wow.

MACDOUGALL: So that was just -- I mean, growing up with that, that was kind of defined our family. And so, when I was older, I was in my 20s, my sister who is -- a few sisters, but one of them who is 14 years older than I am was tested and tested positive. The others were negative.

And so, I like a lot of people even today who might be watching think they`re not effected, you know? Even after my mom had passed away felt like, well, I don`t have to worry about that. I`m young and I`m -- I`ve got my whole life ahead of me.

PINSKY: How old were you when you were tested?

MACDOUGALL: So, I was 34 when I was tested.

PINSKY: And what`d you think?

MACDOUGALL: It`s amazing how it changed. You know, I got tested after I had two children. And, my whole life I -- my sister had preventative surgery. It all started to make sense. You know? And instead of thinking she was crazy, I saw her for the strong woman that she was. And I wanted to be -- I couldn`t imagine and refused to not be here for my children like my mother wasn`t here.

PINSKY: So, you had both breasts removed?

MACDOUGALL: I was -- I had a lump and so they weren`t sure if I had cancer or not. So, I made the choice before even finding out to have both breasts removed.

PINSKY: And Wendy, it sounds very similar to your story.

WENDY BROKAW, PRODUCER, HLN`S `DR. DREW`: Yes. I mean, for myself, I felt a little removed. My mother didn`t pass away. My grandmother died and I never knew her. And my aunt had -- and she died from ovarian cancer. My aunt, my mother`s sister, had breast cancer and is a survivor.

PINSKY: All right. So, let`s remind people that breast cancer and ovarian cancer are linked through these particular genes.

MACDOUGALL: Correct.

PINSKY: And so, when they find positive and you elect to have a mastectomy, meaning the breast taken of, you also have to have oophorectomy, the ovaries removed.

MACDOUGALL: Right. They recommend before 40 to have the ovaries removed. And, it was a lot easier of a decision to make when I had my children and I know the same for Wendy.

PINSKY: You were tested. What`d you think?

BROKAW: Well, so -- I mean, it wasn`t a question mark for me. I have two girls. I had already had -- you know, I had my children. And my mother had a hysterectomy. And I didn`t think twice about it. I knew I was going to do that. the tougher decision for me was removing my breast, but I`m not the kind of person that will leave anything to chance.

PINSKY: But Wendy, you`re saying it very positively. I imagine it was -- you must have shed a few tears over this.

BROKAW: You know, honestly, I`m very proactive and --

PINSKY: You didn`t freak out and cry and didn`t worry about it?

BROKAW: I didn`t. I mean, I had one moment right before surgery where I, like, literally had the ugly cry. I mean, no question about it. But, I`m just somebody that looks at the upsides. And you know, I mean, there`s definite perks.

PINSKY: What would you have done if you hadn`t had kids yet or say you`re a lot younger?

BROKAW: That would have been an absolutely -- totally different decision for me. I mean, I struggle with this because I think about my two girls and them finding out. I mean, really struggle with it.

PINSKY: And so, Catherine, who we have here, Catherine Duda is in a similar situation. Catherine, you have not had kids yet, is that right? And you`re choosing active surveillance.

CATHERINE DUDA, HAS GENE FOR INCREASED CANCER RISK: Correct. I have not had children, and I`ve been having every six months mammograms and MRIs for the breasts and every three months ovarian ultrasounds for ovarian screening.

PINSKY: And tell us why you decided to do regular surveillance rather than have the surgeries and be done with it?

DUDA: Well, you know, I was diagnosed with the gene when I was 29. I actually have a unique experience of working not only in radiology but in cancer research for an extended period of time, and I`m now in hospital administration.

And, I felt like if I was very active with the screening and I kept up with the regimen that I could actually do a good job at preventing any serious cancer. So, I`ve been feeling like having my breasts and ovaries removed as a bit radical for me.

PINSKY: Let`s take a call and see what other people have to say about this. Kathy in Texas.

KATHY, TEXAS: Hi, Dr. Drew.

PINSKY: Kathy.

KATHY: Yes. When I was 17, I had radiation for Hodgkin`s. And when I was 20, relapse. And they told me when I was 22, oh, by the way, you`re going to have breast cancer because of the radiation we gave you. At 40 years old, I wanted a child. So, I waited (INAUDIBLE). At 40 years old, the breast cancer came.

They said we think we got it all with biopsy. I said no, do it. (INAUDIBLE) for 20 years. Take them off. It`s done. Do it. They did it and found out I had more types of cancer in one and the second one was right behind it. If I hadn`t insisted then, they would have had to do it the next --

PINSKY: These are very, very personal choices. And I could understand being very aggressive. You`re smirking when you hear that story.

BROKAW: Well, because I respect everyone`s decision to do whatever they think is right for themselves. But I definitely -- I mean, Catherine`s decision not to do it strikes me as something I could never do, because who wants to -- I mean, I`m a provider. I have this important information that I had an 87 percent risk of getting breast cancer. When you have that knowledge, I just don`t know how anyone can leave that to chance.

PINSKY: What will you tell your kids?

BROKAW: Well, I`m hoping that by the time, you know, they have to get tested, that there`ll be -- science will have advanced to a different place. I`m conflicted. I`m conflicted, because knowledge is power. As much as I think that having knowledge is great, it also alter, you know, your path in life.

Had I known at a younger age, I absolutely would have made different decisions. I probably would have married someone different -- yes, Because I would have had that information and probably the boyfriend I had before my husband, I would have --

PINSKY: And what a terrible decision that would have made.

(CROSSTALK)

BROKAW: He`s a great guy.

(LAUGHTER)

MACDOUGALL: But you know, surgery is not for everybody.

PINSKY: Yes.

MACDOUGALL: Surgery is not -- and I --

PINSKY: Hold that thought. We`re going to talk to a surgeon in just a sec. This is a complicated area. The same thing is erupting -- we`re talking about breast cancer, but interesting, similar stuffs erupting in prostate cancer as well. It is breast cancer awareness month. I`ve got a physician who also he, himself, has this gene and the decision he faces and what his patients have faced. Stay with us.

(COMMERCIAL BREAK)

PINSKY: One in eight chance that any woman will get an invasive breast cancer in her lifetime. One in 36 chance that a woman will die from breast cancer. Welcome back. Reminder, this is breast cancer awareness month. Everybody get your pink ties on. Thanks y to Catherine Duda who shared her story with us.

We are now adding Dr. Ian Taras, an OB-GYN who also he, himself, positive for the BRCA gene, this breast cancer. You may be surprised to learn that about 2,000 men are diagnosed with breast cancer annually and about 450 of them die. So, what are we going to do, doctor? Are you going to have radical mastectomies to prevent this or are you getting some sort of screening procedure?

DR. IAN TARAS, OB/GYN: I`m -- you know, although male breast cancer has certainly increased in people who have the BRCA gene, I think still it`s pretty (INAUDIBLE) small. My sister who`s also a BRCA positive is also concerned about me, but I`m just still more concerned about the women in my life both before and afterwards.

PINSKY: And you must have seen plenty of patients being referred for mastectomy because of this genetic. How do we help the population at large to understand who should be tested and what they should do with this information?

TARAS: You know, every patient who comes in to my office says an OB- GYN -- she comes in for an annual visit, and I am definitely giving them a screening questionnaire trying to catch those people who might just fall through the cracks. They don`t realize that they need to be tested and how easy the testing. It`s just a saliva test.

PINSKY: And who are those women that should be tested? First relatives (ph) with ovarian or breast cancer or is it more?

TARAS: There certainly are groups of people, (INAUDIBLE). There`s also population in Louisiana occasion. And,if you combine that but also women of color. But yes, you`re looking first at the primary, the first- degree relatives, the lineage, is it more of the age also.

Are you talking about somebody who`s getting breast cancer in their 30s, 40s, or maybe even early 50s, pre-menopausally. That`s the tip off or ovarian in their 40s, 50s, maybe early 60s. Definitely somebody needs to be tested.

PINSKY: During the break, I was saying, you know, it`s very easy in the society to think, oh, operation (ph) no big deal, be done with it. Operations are dangerous. There`s risk of anesthesia, the infection. You`ve never seen lymphedema in somebody`s arm whether arm swells up like elephantiasis and they walk around with that the rest of their lives because of a radical mastectomy or in fact, chest wall pain, all sorts of misadventures.

So, the question is, did you think about that before you ran in to have surgery? It`s easy to say, but Catherine Duda was saying I don`t want to put myself at that risk. Is that unreasonable?

BROKAW: Well, I mean, for me I did a lot of research and actually Jackie and I went through this process together. And, we both did a lot of research. And, for myself, I felt comfortable with the doctors that I met with that I was going to be in the best of hands. We`re lucky that we`re in that position. I know not everybody is in that position.

PINSKY: Yes. People don`t have health care. They can`t be tested --

MACDOUGALL: I feel equally as strongly that this is not for everyone. Surgery is not for everyone preventatively. I mean, if you don`t have the support at home or you feel a certain way about your body. I mean, there - - I think that there`s a lot of psychological things to consider and a lot of support that you need to go through it.

PINSKY: I got to say if I were a female with this and it was a high risk genetic profile, I`m with you guys. Kelsey in California -- Kelsey.

KELSEY, CALIFORNIA: Hi.

PINSKY: Kelsey, go ahead.

KELSEY: Hi, Dr. Drew. Yes, I`m Kelsey and I`m BRCA I positive. I`m a 34-year-old African-American woman that just found out less than two years ago that I have it. And I went ahead and made the decision to do my ovaries removed, but I have not chosen to do the double mastectomy.

You know, it`s a very hard decision because I`m a single woman never married with a daughter. And you know, it`s a lot of surgery for a young woman to go through.

PINSKY: Yes. Dr. Ian, how would you advise her if she walked in?

TARAS: She took the first best step. She got tested. Removing the ovaries significantly reduces the risk, also with breast cancer, but certainly have ovarian cancer. There`s a debate about which to go first, the breasts or the ovaries. When you take the ovaries out, you send the person into menopause right away. However, the physical -- the physical --

PINSKY: Deformities.

TARAS: Well, no, the recovery, excuse me, is very quick with the physical. The emotional is more difficult.

PINSKY: Right.

TARAS: I think she`s doing the right thing depending on her age -- I`m sorry I didn`t catch that. She needs to make that decision. But, she needs to have certainly surveillance, MRIs, ultrasounds, mammograms.

(CROSSTALK)

PINSKY: Wendy, your reaction?

BROKAW: Yes. I just want to say that, you know, I think people have this impression that the physicality of it is deformation. And it does not -- Kelsey, it does not have to be that way. Mine came out quite beautifully.

PINSKY: With reconstruction.

BROKAW: Yes.

PINSKY: But you have to pay for that out of pocket, right?

MACDOUGALL: Right.

BROKAW: You do.

PINSKY: And a lot of people can`t afford that.

BROKAW: Well, insurance does cover --

(CROSSTALK)

PINSKY: Listen, insurances are extremely restrictive. I have trouble getting them to pay for sonograms and things when people are positive. It is an issue for people these days. We`ve got to keep that in mind, too. It`s plastic surgery to have the reconstructions.

TARAS: May I interject two things?

PINSKY: Yes.

TARAS: Number one is, a lot of people are worried about discrimination, genetic discrimination for health insurance, life insurance. There was an act passed by Congress, federal act, called the Gina Act, a couple of -- three years ago. So, that`s been covered. Number one.

Number two is there is an organization for this young lady called force, FacingOurRisk.org. And they`re the only ones out there that are doing genetic breast and ovarian cancer research and grants. And she should reach out to them to see if they can help her.

PINSKY: There you go. And Wendy, you had a website that was very helpful for you as well.

BROKAW: Well, it is. It`s actually FacingOurRisk.org. Jackie and I, that`s how we met initially is through that website. It`s a wonderful -- it really is a --

PINSKY: It`s really important to get support from other women going through this so you can make a decision.

MACDOUGALL: Absolutely. I can`t imagine -- I mean, we sit here six years later. You know, I can`t imagine going through what we went through not having force and not having --

PINSKY: What are you crying about?

BROKAW: No, no. I`m just -- I get -- you know, -- this is something I`m emotional about. And I just really want to get the point across to the viewers that they don`t have to be afraid of the surgery, because this really is life saving for someone like myself. I`m so grateful that I had this knowledge ahead of time. I mean, I really fee like --

(CROSSTALK)

PINSKY: I`m playing devil`s advocate today, but I`m on your squad. More on breast cancer awareness month when we come back and information, more information, that could save your life.

(COMMERCIAL BREAK)

PINSKY: We`re back, and we`re talking about the BRCA genes, the genes that can predict whether you might have breast, ovarian, and colon cancer, all three. But breast cancer, primarily is what we`ve been p talking about. USC genetic counselor, Charite Ricker is here. Charite, what is the main difference between the BRCA I and the BRCA II genes.

CHARITE RICKER, GENETIC COUNSELOR, USC: So, when we think about the risk for developing breast and ovarian cancer, they both have a very highly elevated risk. The risk in BRCA II is slightly lower and the average age of diagnosis a little bit older. But in general, for both genes, the screening and management is very similar.

PINSKY: When should Wendy be testing her children or daughters?

RICKER: In general, when we talk about genetic testing, we talk about testing at a time when it will make a difference for an individual`s management. So, for a young woman that usually means consideration of MRI and mammograms starting at age 25. So, by age 25 to have tested to find out if a young woman is positive or negative.

PINSKY: Wendy, you take a sigh just thinking about that.

BROKAW: Yes. That, I mean, I would say that in this overall experience for myself, the consideration of my girls is the thing that weighs heaviest on me. So, I would prefer because I don`t want the direction of their life to take a turn. I want it to be as it was meant to be. And I`d rather just treat them as the if they have it until, you know, after they have children or married.

Because as I said, I do think it would have changed the course of my life. I would have been in a bigger rush to get it all done.

PINSKY: Charite.

RICKER: And I think the important thing is exactly what Wendy just said, that until the point in time when we know that a woman carries the mutation that`s running in her family, she should be screened as if she was a BRCA carrier.

PINSKY: Lorri, you got something for us?

LORRI, BRITISH COLUMBIA: I do. I have the BRCA II mutation. I`m about to have my first surgery, ovarian surgery next week. And, that should be followed up by the mastectomy surgery next year.

PINSKY: How long do you have to wait for that in the Canadian system?

LORRI: Actually, just a few months ago, they gave me the option and I was shocked at how quickly it happened.

PINSKY: Shocked that things moved along. Wendy, you`re still upset.

BROKAW: No, no. I`m all good. I want to wish Lorri luck, and that was the path that I took. I had my -- I had a hysterectomy and then I had the double mastectomy sooner after.

PINSKY: Charite, who should be tested? Should be everybody be tested? I think not, right?

RICKER: No.

PINSKY: -- not predictive result.

RICKER: Exactly.

PINSKY: So, who are the people that need to be tested?

RICKER: So, I think the most important key points to take into account are what your family history is and what personal history is. So, for example, any young woman with breast cancer, young meaning pre- menopausal or very broadly under age 50 should consider talking to somebody about genetic testing.

And then, there`s other factors which might be taken into account like the type of breast cancer she`s developed, like certain characteristics like being triple negativity which is a feature of the tumor itself might indicate a testing even if a woman isn`t terribly young and knowing your family history.

So, perhaps, for women who do not have cancer themselves, but have a very strong family history if it`s a young woman with breast and/or ovarian cancer to consider talking to somebody about the risks and benefits of testing.

PINSKY: OK. Take a quick break. More of your calls, more of this, when we come back.

(COMMERCIAL BREAK)

PINSKY: Breast cancer awareness month. Talking about the BRCA gene. Going straight out your calls. Annie in California.

ANNIE, CALIFORNIA: Yes. This is Annie.

PINSKY: Hi, Annie.

ANNIE: Hello.

PINSKY: Go right ahead.

ANNIE: I don`t know if I have the BRCA gene. My mom had breast cancer, my sister had breast cancer and it killed her. Now, her breasts were almost completely microcalcified and she -- but I still have just assumed we don`t have the gene.

PINSKY: How old are you now?

ANNIE: I`m 58 and my breasts are -- you can just see right through the tissue because they`re not young women`s and I just got a mammogram and I was fine.

PINSKY: Charite, what she should do? Should she be tested?

RICKER: So, Annie, I don`t know if your mother is still living. Has she passed?

ANNIE: She died, but she died of emphysema.

RICKER: OK.

ANNIE: My mom was an x-ray technician for 50 years. And that`s what I kind of thought it might have been, because they were doing surveys on that, how many x-ray technicians --

PINSKY: At very minimum, I would make sure you get your colonoscopies on a very regular basis.

(CROSSTALK)

ANNIE: I never knew they went together, because I just had a colonoscopy and the --

PINSKY: I think the big point I want people to take away from here is that ovary, colon, and breast are manageable and potentially preventable cancers and certainly could be picked up early if properly screened. Charite, would that be a reasonable takeaway?

RICKER: Yes, I believe also. I also think it`s important just as a point in that, Annie, it would be reasonable to talk about genetic testing. Your chance of having something in your family is probably relatively low because your mother and sister were diagnosed under 50, but just based on that alone, you have a slightly higher risk for breast cancer and that should be addressed.

PINSKY: Robin, quickly, in Wisconsin. Robin, you have something for us?

ROBIN, WISCONSIN: Yes. I`m a six-month survivor. I chose the lumpectomy as my mother chose the mastectomy and died because it came back from the chest wall, but I still think it`s a woman`s choice and just to be proactive.

PINSKY: It is a -- again, we`re coming all the way full circle here. That`s somebody with breast cancer and you guys are people that have prevented breast cancer.

BROKAW: Yes.

PINSKY: It`s still -- in all these circumstances, very individually a personal choice. Just using the information the best way possible for you. That`s the message tonight?

MACDOUGALL: Absolutely. Absolutely. And being pro-active. Asking the questions, knowing what your risk is, knowing what the risks of having surgery is, knowing all of it and then making the right choice for you exactly.

PINSKY: Wendy take me home. I got about 15 seconds.

BROKAW: Well, I just think that, again, this is life saving information. And if people have a family history of breast and/or ovarian cancer, this is something that people should at least explore and talk to their doctors or OBs.

PINSKY: Thank you, Charite, Wendy. Thank you, Jackie. I appreciate you guys for telling your story. Thank you all for calling. Thank you, of course, for watching. We`re going to keep (INAUDIBLE) that gentleman that young boy out there with the 911 call. We`ll have more on that. Nancy Grace starts right now.

END