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Bob Schieffer And Bladder Cancer: A Survivor’s Story

Bob Schieffer is broadcast journalism’s most experienced Washington reporter. He has covered Washington for CBS News for more than 30 years, and has been the anchor for Face The Nation (one of the longest-running news programs in the history of television) since 1991. I had the privilege of interviewing him about his bladder cancer at the CBS studios today. It is Bob’s sincere hope that his story will inspire others to seek medical help at the first sign of bladder cancer, and also gain comfort from knowing that they are not alone.

This is part two of our interview series. Click here for part one.

Dr. Val: Do you have any advice for patients facing bladder cancer?

Schieffer: Bladder cancer is a very insidious disease, you can have it for a long time without knowing that you have it. At the first sign of blood in the urine, you need to go to the doctor. I think men are often reluctant to go to the doctor, and their tendency may be to attribute blood in their urine to a muscle strain of some kind. But waiting is a dangerous proposition. When I think of my own situation, I realize that even waiting another week or two could have put me into a whole different risk category and I might not be where I am today.

Cancer research is such an evolving field – that if you can keep yourself alive today, there may be a cure tomorrow. That’s the good news about this. The bad news is that we spend about as much on cancer research in a year as we do on one day in Iraq. I don’t know anyone in the cancer community who doesn’t believe that if we invested enough money in it we’d find cures.

Dr. Val: Was it hard for you to speak publicly about your cancer?

Schieffer: Tony Snow and I became really good friends, and we both felt that we had an obligation to talk about our conditions in order to promote cancer awareness. Hamilton Jordan was also a good friend of mine, and he devoted his life to raising awareness. He survived 5 cancers though the 6th one got him. I was a very private person before all this started, and when Hamilton found out I had cancer he called me and said that I really needed to get out and talk about it because I have the opportunity to have an impact on so many people.

As it turned out, I went on Don Imus’ radio show one morning and talked about it, and soon afterwards Wolf Blitzer asked me to be on his show on CNN. I must have received 600 emails from people thanking me for talking about my situation – some were glad to know how to recognize potential bladder cancer, and others told me they no longer felt alone in their cancer experience because they knew that I was going through it too. At that point, I thought to myself that speaking out about my cancer might have been the most important thing I’ve done so far as a journalist. If one person goes to see their doctor when they first notice blood in their urine, then I may have had a part in saving a life.

Bladder cancer is a “below the belt” disease and people are reluctant to talk about it. I think it’s really important to help people get past this barrier. It is nothing to be ashamed of, there’s nothing wrong with you as a person – it’s just that a certain percent of us are going to get bladder cancer.

Dr. Val: How do people get plugged in to the cancer community to get the help they need?

Schieffer: What I’ve noticed is that when you get cancer, you become acqainted with everyone else who has it. There’s a kind of natural networking that occurs when you participate in meetings and events. However, I’d encourage people affected by bladder cancer to go to the Bladder Cancer Advocacy Network. The founder, Diane Quale, left her job as an attorney to create the advocacy group after her husband was diagnosed with bladder cancer. She has raised hundreds of thousands of dollars for the cause, although sadly her husband lost his battle with bladder cancer a few weeks ago.

Hamilton Jordan told me this, “You have to take control of your disease. Nobody is going to be more interested in it than you. It’s your life, so you’re the one who has the most invested in this. Just Google ‘bladder cancer’ and learn as much as you can about it.”

When you go to a doctor, especially with cancer, it’s invaluable to get a second opinion. I got a second opinion from a wonderful physician at Johns Hopkins, Dr. Mark Schoenberg. And Dr. Schoenberg told me this: “A doctor is like a good craftsman. A good craftsman is always happy to show his work to other craftsmen. It’s the guy who isn’t really sure what he’s doing who doesn’t want to discuss his work with somebody else in the field.”

Dr. Val: What’s your bottom line about cancer?

Schieffer: Cancer is not something to be embarrassed about. It’s something that happens to us and needs to be dealt with. When the doctor tells you that you have cancer, it is not the death sentence that it once was. Cancer research is advancing every day and we’re finding new ways to fight the disease. There’s no need to say, “I have cancer — this is it” but rather, “I have cancer and what do I need to do about it?” And then you have to do it.

*Visit the bladder cancer center at Revolution Health*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

The AARP: Online Trends, Health IT, and Fixing US Healthcare

I had the chance to speak with John Rother, Executive Vice President of Policy and Strategy for the AARP about the intersection of online health, information technology (IT), and the baby boomer generation. Find out what America’s most powerful boomer organization thinks about the future of healthcare in this country.

*Listen to the podcast*

Dr. Val: Recent studies suggest that Americans age 50 and older are more Internet savvy than ever before. How are AARP members using the Internet to manage their health?

Rother: People over the age of 50 are the fastest growing set of online users, and healthcare is the major reason why they’re going online. They’re looking for health related news, help with diagnosis, and finding appropriate healthcare providers.

Dr. Val: What role can online community play in encouraging people to engage in healthy lifestyles that may prevent chronic disease?

Rother: Our experience is that online communities can be extremely helpful in several ways. First, it provides emotional support for people who have a shared experience, whether it’s as a caregiver, or being recently diagnosed with a disease or condition. Second, people seem to feel more comfortable asking questions of others with their condition than they do their own physicians. And third, online communities can reinforce needed behavior change. Whether it’s weight loss, exercise, or quitting smoking – online communities can be just as effective in encouraging behavior change as a face-to-face community.

Dr. Val: Tell me a little bit about the communities on the AARP website.

Rother: Currently our communities are organized around medical topics, but in the future I think the communities will become more geographical. An online community designed to serve the needs of people in a given location can facilitate information sharing about how to navigate a particular hospital system, for example, instead of just general information about coping with a disease or condition.

Dr. Val: Intel just announced that it has FDA approval for its “Intel Health Guide.” The unit enables caregivers to provide their patients with more-personalized care at home, while also empowering patients to take a more-active role in their own care. What do you think of this technology?

Rother: I think information technology is going to have all kinds of beneficial applications for people with health challenges. Personal health records and this Intel Health Guide are very well suited to the needs of individuals with chronic health conditions, and I expect to see more Internet based tools developed to help people to make appropriate decisions and change their behavior.

General information is helpful, but personalized information is the key. The more these technologies allow you to have your own individual information at your fingertips and allow that to be the basis for recommendations and decision support, the more powerful it’s going to be. This is all very promising technology – the next question is, can people afford it and will the people who need it be able to use it?

Dr. Val: In your opinion, what role does health IT have in reducing healthcare costs and improving access to care?

Rother: Health IT can support almost every aspect of healthcare. It can decrease costs by reducing duplication. Many people with chronic conditions see different doctors – and if you have to go through the same set of X-rays or CT scans every time you see a different doctor, that can get very expensive. A good, common medical record system is critical in reducing costs and improving care.

IT can also reduce the cost of health insurance, in the way that online car insurance has reduced car insurance premiums. If we reform our health insurance market, this could offer substantial savings to individuals.

People often use the Emergency Department inappropriately – for minor issues instead of true emergencies. A good decision support system that helps people to figure out when they need to go the ER could be helpful in reducing costs.

Dr. Val: What are the AARP’s major health-oriented initiatives?

Rother: The AARP is very focused on healthcare because our members tell us that it’s their top priority. The cost, quality, safety and accessibility of healthcare are important to us, so we are involved in a broad spectrum of initiatives.

First of all, extending coverage to all Americans, regardless of their age or health condition, is a top priority for the AARP. Second, In terms of health quality, it varies quite broadly among hospitals in the US. If we could get everyone to copy the best hospital practices, we’d have a much more manageable problem.

Dr. Val: What needs to happen to America’s healthcare system in order for it to serve the needs of baby boomers on its limited budget?

Rother: We spend almost 2.5 trillion dollars for healthcare in the United States, so I don’t think of it as a limited budget, but quite an expansive budget. There is enough money in the system to fully respond to the needs of the population. It’s just that we’re not organized very well and the system has become fragmented.

The healthcare system needs to be organized in a more person-centered way, and we need it to shift from a focus on acute care to a chronic care model. We need a different system of health delivery – one that relies more on nurses and other physician extenders. People need to join support groups to modify their behaviors and risk factors and rely on IT to help them make appropriate decisions.

So you put that all together and you have a pretty big agenda for change. I don’t know if we can achieve this all at once, or if it will occupy us for several years. The upcoming election gives us the opportunity to do this at the Federal level, though there are many private sector initiatives that are currently making important contributions.

Dr. Val: Can you give me an example of someone in the private sector who’s making an important contribution to improving healthcare?

Rother: The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system – and with improved outcomes. We asked them about their secret to success.

Mayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there’s no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.

If Mayo can do it, why can’t everyone else? The AARP believes that the potential is there for most communities to have excellent care – we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It’s a big job and will take some investment, but we have many opportunities to do a better job than we’re doing today.

*Listen to the podcast*

*Learn more about preventing chronic disease*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Not "Lost To Follow Up"

My caller ID displayed an unfamiliar number and I answered the phone hesitantly. Background noise and static nearly drowned out the caller’s determined intent to introduce himself. “This is Dr…. [couldn’t quite make it out]. Is this Val Jones?”

“Dr. Who?” I asked, trying to recognize the voice.

“Dr. Anderson. Is this the Val Jones I know?”

My mind raced through its physician contact list, without finding a match.

“Doctor… Anderson?” I said, trying so hard not to betray my lack of name recognition.

“Yes, yes, that’s right. I was your pediatrician. Remember me?”

Suddenly it all came back to me – this dear gentleman did indeed take care of me when I was young. I remembered him as a tall, fit man with white hair and kind eyes. He had stitched my face after I was bitten by a dog, put my shoulder back in its socket, and diagnosed fractured ribs after I fell out of a tree house. I guess I went to see him pretty regularly growing up, though I hadn’t thought of him in decades.

“Wow! Of course! Dr. Anderson I… I’m so surprised to hear from you after all these years. My goodness. How did you find my cell phone number?”

“Well, it wasn’t easy. Your parents have moved off the farm, and your university didn’t have any recent records. I finally found someone you used to work with and they found you on the Internet and got me in touch with Revolution Health…”

“Gosh, I’m sorry you had to go through all that to find me. What was it that you needed to talk to me about?”

“Well, I’m 90 years old now, and I’ve been thinking about my former patients. I was going through my records and I found your file a few years ago. My wife and I have been praying for all the kids I used to treat, and we started praying for you a while back. You were such a bright little girl – I always knew you’d do great things in this world. I guess I was just curious how you’d turned out and what you were doing in life. This is kind of like a follow up visit I guess.”

I was stunned. I became misty-eyed as I imagined this 90 year old man and his 91 year old wife praying for his former patients, remembering them fondly and even going out of their way to contact them for follow up, for no other reason than to know how they were making out in life, and wishing them well.

I spent about half an hour telling my pediatrician about my life and catching up with his. His wife had undergone biltareral knee replacements after her 90th birthday and was walking around with the help of a cane. He had 5 grand children that were doctors, was actively involved in his church, and still traveled extensively.

“Gee, Dr. Anderson – I’m so glad you’re doing so well. It was so nice of you to call.”

“I’m so glad I got to hear your voice, Val. Nothing makes me happier than to know you’ve grown up to be a doctor. Now take good care of your patients, ok? Keep track of them, and make sure they’re doing alright.”

As I said goodbye I thought to myself, “Those are some pretty big shoes to fill. But it sure feels good to be a patient who was NOT ‘lost to follow up.'”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Video of the Week: The Onion Spoofs Children’s Healthcare

This news video is really funny. It’s called, “Most Children Strongly Opposed To Children’s Healthcare.”

Thanks to the Scut Report blog for the tip.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Autism in Babies: Early Detection By Tracking Eye Movements?

The Wall Street Journal recently described some interesting new research related to the early detection of autism. Some scientists suggest that babies at risk for developing autism have different facial-scanning eye movement patterns. In other words, babies tend to focus on the eyes and mouth of faces in their direct line of sight. Babies at risk for developing autism have difficulty recognizing faces and their eyes may tend to wander. Although this test is not a diagnostic tool, it could be used to predict risk as early as 9 months – which could allow parents to get their children into early intervention programs sooner than they do now.

Researchers at Canada’s McMaster University recently announced that they had developed a computerized test using eye-movement sensors that aims to predict the risk of autism in children as young as 9 months. The system, which administers five eye-tracking tests over 10 minutes, measures the direction and fixation of a child’s eyes when confronted with computerized images, including human faces.

“Children with autism in general have difficulty extracting affective information from faces, and also difficulty in recognizing faces,” says Katarzyna Chawarska, director of the Yale clinic. By tracking eye movements, “we can begin to understand what interests them, how they examine objects they select for processing, and what motivates them intrinsically,” she says.

But eye-tracking won’t pick out all children with autism. That’s because the disorder can manifest itself in a variety of ways at different ages, such as a child not responding when called or failing to exhibit normal body gestures. Some children also won’t cooperate with the eye-tracking equipment.

I think it’s too early to know how valuable this tool will be in the evaluation of children at risk for autism spectrum disorders, but it’s certainly an interesting idea.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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