July 16th, 2008 by Dr. Val Jones in Celebrity Interviews, Patient Interviews
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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.
June 20th, 2008 by Dr. Val Jones in Announcements
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I recently met with Tim Turnham, CEO for the Colon Cancer Alliance, to find out what’s been going on in his neck of the woods. He presented me with one of the best non-profit marketing pitches I’ve seen in a long time. His team is organizing a series of races designed to raise support and awareness for colon cancer. The theme? Running the race in your boxer shorts. The title:
The UNDY 5000: A Brief Run To Fight Colon Cancer (see image of Indy 5000 flags made of boxer shorts)
Become an UNDY 5000 sponsor today… because time is short.
I love it.
If you or your organization would like to sponsor a race, check out this website or contact Fran Campion Watson, Director of Events at the Colon Cancer Alliance. Phone: 202-731-0122.
I hope that proceeds will go towards research that will help friends like mine who are battling colon cancer.
For more information about colon cancer (from one of the nation’s prominent researchers) check out Dr. Heinz Josef Lenz’s colon cancer curriculum at Revolution Health.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 17th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
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Ken Thorpe, Ph.D., is the Executive Director of the Partnership to Fight Chronic Disease, and is admired and respected by many of the “movers and shakers” in Washington. The outpouring of appreciation for his work was quite evident during the recent half day-conference entitled, “Fighting Chronic Disease: The Missing Link In Health Reform.” I had the chance to speak with Ken to get his thoughts on chronic disease and health reform.
Dr. Val: What are the most important things that the general public needs to know about chronic disease?
Dr. Thorpe: Two things. First of all, they need to know whether or not they have a chronic disease. For example, about a third of diabetics in the country don’t know they have diabetes. So Americans need to be screened appropriately for potential chronic diseases like cancer and diabetes.
Second, if you do have a chronic disease, there are simple ways to manage it. Management needs to be coordinated through a primary care physician. Basic things like blood pressure and blood sugar need to be monitored on a regular basis. Diet and exercise are also a critical compenent of chronic disease management. The good news is that most chronic illnesses are manageable, but patients need to be actively engaged in their health. Medication compliance and consistent lifestyle modification under the care of a PCP is the way to go.
Dr. Val: What should people know about the Partnership to Fight Chronic Disease?
Dr. Thorpe: We want to get patients (or “consumers”) involved as a voice for healthcare reform. Patients are the key to making our healthcare system simpler, less-expensive, and less administratively complex. We believe that health reform is possible. We must not become frustrated with our inability to fix everything today, but if we start with the right set of issues and really work collaboratively to solve them, we really can make life better for patients and physicians.
The patient community should go to our website and learn the facts about chronic disease and help to educate their local politicians and community leaders about it. I would encourage them to spearhead community-based interventions to promote weight loss and prevent obesity. We just released a book about “best practices” for achieving healthy behavior modifications. It is full of local program ideas to help prevent chronic disease – and it’s all based on initiatives that have a proven track record of success. Our best practices book is an ideal guide to community-based interventions that can make a difference.
Dr. Val: You say that we need a different delivery model to treat chronic disease. Can you explain that?
Dr. Thorpe: Chronic disease management requires a team-based model. Nurses, social workers, and mental health providers should work with patients at home. We need a more proactive model where we engage patients in managing their disease so that we can prevent unnecessary flare ups. For example, with diabetes, if you don’t control your blood sugars on a daily basis, you’re far more likely to go on to require a limb amputation. Our current delivery system does not allow this type of management – interacting with nurses at home, for example – because nobody pays for it. So we need a different payment model and a different delivery model.
Dr. Val: Do you think that online health websites can make a difference?
Dr. Thorpe: I think that online programs should engage people in education – so that they can understand the connection between weight, diet, exercise, smoking, and chronic illness. Only 15% of the population understands the gravity of these issues and how it affects the cost of their health insurance.
Online sites that allow people to track their progress (and chart how they’re managing their disease) may also help people to become more actively engaged in their healthcare.
Dr. Val: How can we encourage people to adopt healthy behaviors?
Dr. Thorpe: Incentives always work. We have to give better tools to people who want to change their behaviors. We have to make it easier for them to manage their health at their places of work. For example, some employers conduct health risk appraisals with their employees and then put together care plans and even have a nurse practitioner available at the work place to check on progress. That way the employees don’t have to take time off work to see the physician after hours.
We can also make a difference in schools – we need consumer advocates to continue to demand healthier school lunch programs and increased physical activity for kids. Consumer advocacy at the community level is critical to our success in the prevention and management of chronic disease.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 7th, 2008 by Dr. Val Jones in Health Policy
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I recently attended a half day conference, “Fighting Chronic Disease: The Missing Link In Health Care Reform” sponsored by Emory University and the Partnership to Fight Chronic Disease (PFCD). It was an extremely well run event with an all-star political cast: Tom Daschle, Dick Gephardt, Dr. Mark McClellan, and Nancy Johnson were present. The key medical players included Dr. Nancy Nielson, president-elect of the AMA, and Dr. Otis Brawley, CMO of the American Cancer Society.
The purpose of the conference was to raise awareness about the cost of chronic disease – it accounts for at least 75% of healthcare spending, and 80% of that could be avoided with lifestyle interventions. Shocking, isn’t it? Any discussion of reducing medical costs needs to begin at ground zero – getting Americans to adopt healthy diet and exercise habits.
One of the most entertaining panelists was Chris Viehbacher, the president of North American Pharmaceuticals at GlaxoSmithKline (GSK). Chris is a gifted speaker with a charming Canadian accent – and could probably be the head of a debate team. We had the chance to speak about lobster fishing in Nova Scotia during one of the breaks since we share a common Maritime heritage. He offered some amusing analogies about our healthcare system, and made some points that bear repeating here:
“Half of the people in the US have some sort of chronic illness. Health insurance is like having car insurance when 50% of people are having accidents. Of course nobody can afford it.”
“We need to keep employer-based healthcare because when employers have ‘skin in the game’ they have the incentive to promote healthy behavior at a local level. Monolithic government programs aren’t good at influencing people at the individual level. Employers know each of their employees by name, they are invested in their lives, they provide childcare services and other benefits to them, and each employee’s health affects their bottom line. Employers are a critical force for promoting and facilitating healthy behaviors.”
“Alternative energy sources aren’t that interesting when gas is $1/gallon. But when gas hits $4/gallon suddenly everyone is very interested in alternative energy. The same goes for healthcare. It takes a cost crisis to bring it to everyone’s attention. And now the audience is listening.”
I’ll be cherry picking some other interesting tidbits from the conference in my next few blog posts. I hope they bring you some good food for thought.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 28th, 2008 by Dr. Val Jones in Expert Interviews
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Dr. Val: Dr. Carmona, I recently met you at the Partnership to Fight Chronic Disease conference in Washington, D.C., and now you’re here with the STOP Obesity Alliance. You are certainly one busy guy. What are you doing with your life these days?
Dr. Carmona: My life is certainly very full and very fulfilling. After completing my four-year term as surgeon general, many good people in the private sector offered me opportunities to continue my life’s work. All of my endeavors are geared toward improving the public’s health —that is, the health, safety and security of a person, a population, a nation —and sometimes even globally through partners that we work with.
As I surveyed the various opportunities to engage in public health service, I wanted to choose initiatives that gave me the biggest bang for my buck. In other words, I wanted to support programs that would have maximal impact in improving the lives of Americans. The chronic disease burden caused by a preventable condition —obesity — seemed like a really logical place to start.
We have to figure out how to reverse obesity in more than 9 million children, and we need to help the two out of three adults who are overweight or obese. Obesity has a huge impact on diseases across the board —asthma, cardiovascular disease, diabetes, cancers and a whole host of chronic diseases. Obesity either causes or is a comorbid [simultaneous and independent] factor in each of these.
In addition to my involvement in the Partnership to Fight Chronic Disease and in the STOP Obesity Alliance, I am involved in the National Foundation for Infectious Diseases, where I chair the Childhood Influenza Immunization Coalition — which endeavors to ensure that our children get their full complement of vaccines.
In a country where we spend more on health care than any other nation in the world, our metrics put us somewhere between 25th and 40th in terms of life expectancy, childhood vaccinations, maternal child mortality and things like that. We have to step back and ask: “Where are we missing the boat here?” I think part of the answer is that many of our children don’t complete their immunization series. In Arizona just recently, we had a measles outbreak. That shouldn’t happen in this country.
When I was a child, every mom worried about her son or daughter getting polio. We don’t have to worry about that any more because of vaccines. In a global economy where people move freely across geopolitical borders, vaccination has never been more important —both here in the U.S. and internationally.
Dr. Val: Tell me a little bit about what you’re doing at Canyon Ranch. People may have some misperceptions about the population that Canyon Ranch exists to serve (i.e., wealthy spa-goers). But I know there’s a lot more to it than that.
Dr. Carmona: I’m the vice chairman and CEO of Canyon Ranch [resorts in Arizona, Massachusetts and Florida], and I am always looking for opportunities for the organization to contribute to health policy issues. Our goal is to help the people who come to us to find a path to optimal health and wellness through prevention strategies based on a true integration of the mind, body and spirit.
The Canyon Ranch Institute is the nonprofit arm of our organization that takes our best practices at Canyon Ranch and translates them to underserved populations around the country. So we serve the upper echelons of society, but we also have a strong social responsibility to “give back” to underserved communities and to help eliminate health disparities. Through the institute, we partner with [for example] the Urban Health Plan in the South Bronx [in New York City] — which is in one of the poorest congressional districts in the United States. We’ve committed to helping some of the poorest Hispanic people in America because they struggle with disproportionate disease burden as a group.
Essentially, we’re building a Canyon Ranch Institute Life Enhancement Program in a federally qualified community health center to change the health metrics of that population. And we’re going to focus on disease prevention and an integrative approach to health and wellness. We’re going to measure our impact scientifically. We do everything in peer partnership in a way that honors the culture of the community, and we respect what they’re already doing to serve their population. With everything we do, we plan and act as consultants to the local community leaders. In this case, we took the local community physician and other health leaders and brought them to Canyon Ranch on a scholarship program. We trained them and then sent them back to the Bronx with a small team of staff to help them put together a life enhancement program. And now, we’re building a curriculum with them.
Dr. David Satcher and I are discussing a new initiative in Atlanta, perhaps through his institute — the Satcher Health Leadership Institute. We also have a partnership with the Lance Armstrong Foundation, in which we’ve come together with other surgeons general to bring forth a collective call to action on cancer prevention and survivorship — which we’ll announce this summer here at the National Press Club. This is the first initiative to include all the past surgeons general, so it’s really exciting.
We’re doing many innovative and entrepreneurial things that we can initiate quickly with a lot of smart and willing people. You can move a little more nimbly in the private sector than you can in the federal government, so it’s a joy to be able to pull all these people together to address the unmet needs of various populations at all levels of society.
Dr. Val: How do you incorporate the “mind, body, and spirit” approach to health without getting too far afield from science?
Dr. Carmona: At Canyon Ranch and the Canyon Ranch Institute, we believe that achieving optimal wellness involves taking an integrative and holistic approach to the many dimensions of health and well-being —enhancing the physical, mental, emotional, social, spiritual and environmental aspects. We’re also helping to translate this integrative approach to underserved communities through the Canyon Ranch Institute.
I have a small group of integrative health doctors and other health professionals who meet on a regular basis at Canyon Ranch. Their job is to read their scientific literature and meet periodically with me to present the new and emerging science in health and wellness. Then we review the science together and ask ourselves if there’s anything applicable that we could use as a product to improve the health of those we serve at Canyon Ranch or through the Canyon Ranch Institute’s nonprofit efforts.
So, for example, we’ve been taking a close look at the brain fitness movement in order to see what we could apply to older adults. When you and I went to medical school, we were taught that when you hit 60 or 70, you couldn’t really learn anything new and you need to be put out to pasture. The fact of the matter is that the science is now very clear that not only can you learn, but you can grow your knowledge and ability in many areas — even when you’re into your 90s and 100s. So at Canyon Ranch, we combine physical fitness with brain fitness, and we have holistic programs to develop cognitive skills through nutrition and mind exercises to increase intellectual capacity.
We have also been investigating whether or not touch can be healing. I believe it’s a gray area — some of it may be hocus-pocus, but some may also have scientific merit. So we’re working with Gary Schwartz, Ph.D., an expert in energy medicine, to take a closer look at this and to conduct some trials to see what works. I know this is pushing the envelope, but it’s not implausible that the comfort and stress reduction one experiences from gentle touch might improve immunity.
I recognize that holistic medicine is a very dynamic and challenging field to be in, but we vet everything and make sure that we have some scientific validity before we move forward with anything as a product. We try to stay open-minded as we study these so-called complementary and alternative medicine practices to see what works. And if we find a benefit, we incorporate it. If not, we reject it and move on.
Dr. Val: And do you practice what you preach? How are you taking care of yourself?
Dr. Carmona: I get about an hour to an hour and 15 minutes of exercise five to six times a week. I even have staff meetings while working out at the gym sometimes. I’ll say: “I have 24 hours a day, and you guys get 23. But I need one for exercise. If it’s so important that you need to see me during that hour, then you have to work out with me. We can swim or walk, and you can debrief me while we’re doing that.” Sometimes they’ll take me up on it, but not always. Last night we didn’t finish our business dinner until 11 pm. Everybody went to bed, but I went to the gym.
I do a lot of cross-training. I don’t run that much anymore because my knees are getting sore. I use elliptical machines and the StairMaster. I swim, and then I do a weight training circuit every other day.
Just keep moving. I think that’s the important thing.
Dr. Val: And what do you do nutritionally?
Dr. Carmona: I’m careful about what I eat. I eat a little bit of beef, but not much. I do eat a lot of chicken. I have fish allergies so, unfortunately, I can’t eat seafood. I eat a lot of whole grains, nuts and fruits, and I control my portions. My typical breakfast is oatmeal, fruit and a glass of skim milk. For lunch, I have a sandwich and some salad, and then I have a full but portion-controlled dinner. I allow myself some vices. I used to joke with my staff all the time about not being able to pass a Baskin-Robbins without stopping in to get a vanilla ice-cream cone.
Dr. Val: Baskin-Robbins has 31 flavors … and you pick vanilla?
Dr. Carmona: That’s right. I told them they’re wasting their time on the other 30. There’s only one flavor that I need: vanilla. Every once in a while, I’m really risqué and I’ll try French vanilla.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
