that a change in the definition of cancer, they might want to do that in the hopes that patients with nonlife threatening diseases would avoid being overdiagnosed and subject to needless radiation and testing and treatment. i wanted to start with you, dr. sama samadi. >> actually this article came out of jama. we've had a lot of discussion about overdiagnosis and overtreatment. the truth is look at some of the facts. screening we know in the last two or three decades has reduced the number offal mortality. when you screen and overdiagnosis, of course, if you look for them, you're going to find them. the truth is -- >> that doesn't make any sense to me. >> if you start screening for cancer, you're going to find more and more of these diseases. then the question is, which one really are life threatening and which ones are really indolent. which is a bad cancer and which is a good cancer. we never used to use the words good and cancer in the same

sentence. now what we're looking is to really distinguish. let's say you see five guys that come up with prostate cancer. three of them may die from prostate cancer. two of them may go on forever without having any problem. that's what we're discussing over here. my issue with this whole thing is that at the same time the panel also recommended getting a cat scan for lung cancer. they are actually advocating more screening. they're looking at like if you treat precancerous lesion in cervix and colon you reduce the number of cancers. mammograms are not great tests. biopsies we do for prostate are random. my attitude is we're sending wrong messages to patients. not every low risk prostate cancer is low risk. you really have to dig in and talk more about this. >> i'm still confused. dr. siegel, it seems to me finding things early would be of a benefit. what is the difference what you call it? >> look, here's what's going on. the national cancer institute

has this panel. dr. esiman is the head of it. she's saying as cancer is progressing more and more we're changing what kpacancer is. we used to call it one thing. now there's a lot more to it. there's early cancers that are never going to progress. there are cancers so aggressive even if you find them you can't treat them. the others are cancers you find and get rid of quickly like david op raperates on. it's often hard to know. it's in the reverse of what we do as doctors and have done in this program. we want to know. the doctor needs to know. if there's a million bad doctors overreacting to a cancer diagnosis does that mean we shouldn't know? i think if we polled every viewer we have out there they would want to know whether they have cancer or not. dr. otis brawly, head of the american cancer society, said something interesting. he said cancer is a fear term. so the problem with some of these indolent cancers is you

tell someone they have ductal carcinoma, a precancer in the breast, they're going to worry about it for the rest of their life. panic, want it out, go for radiation. we've also thought there's bad treatments for prostate cancer. stuff we don't agree with. certain kinds of radiation. you see you have it. you rush to get the treatment. bottom line is -- this is david's field more than mine. psa. prostate specific anojen. i can follow a trend. send the patient to a urologist. why wouldn't you want to know? >> even though there's a call to change the definition, it's still a bit controversial. we'll talk about this one again. >> it's also scare tactic in terms of the costs. >> right. the truth is that real tests, ways to find out which is lethal and which is not, overtreating if you have good

outcome may save lives. this discussion goes much further than what we're talking about. >> there's also something else coming out right now. a brand-new study linking anemia to dementia. researchers are finding that people who have been diagnosed have a nearly 41% higher risk for developing dementia than those who are not. dr. siegel, what about this? >> kelly, this is from san francisco. it was published in a reputable journal called "neurology" this past week. they looked at over 2,000 patients between 70 and 79. they found over 11 years the ones that were anemic were the ones that were more likely, 40% more likely to get dementia. what is anemia? not enough blood flow. not enough hoemoglobin. it's the molecule on the blood cell that carries oxygen. if you're not getting enough oxygen and you're anemic the study is saying you're chances are greater you're not going to get enough blood flow to the brain, areas of the brain. i'll tell you why i believe that even though this isn't proof.

it's just association. we already know that about the heart. if someone is prone to heart disease and you have their blood counts very low, they're not getting enough blood or oxygen to the heart, they're more likely to have a heart attack or angina. with the brain there's something called watershed areas. areas of the brain where you don't get enough blood flow. already where you don't get enough oxygen. as you get older you're more and more prone to what we call mini strokes. i can't prove that's what this study is about but i think it is. i think when you're anemic -- anemia can come from blood loss, destroying blood cells which we sometimes do in the body or it can come from not producing enough blood cells. those are the three reasons you have anemia. if you're anemic i think as you get older the chances are greater you're going to have problems with thinking. >> what to you do about it? what do you do to prevent getting to that point of being anemic to begin with? >> the worst thing you can do is take a prescription for iron without knowing exactly what the underlying disease is. anemia can come from having some bone marrow problems. maybe you're not making enough red blood cells. or you may have a kidney

disease. cells that make the red blood cells. i want a lot of people to know, because there's so many vegan and vegetarian people out there that may be low vitamin b12. sometimes low vitamin b12 can lead to dementia. you have to dig in and find out what the underlying is. to add to a little bit of what marc said, anemia also could be an overall picture of poor health of the person. if somebody's not taking care of themselves. and about 25% of americans over the age of 65 have low anemic or low blood count without knowing it. that can lead to dementia. whether it's a low blood flow as a result of high cholesterol, high blood pressure, and you have blockage in your artery or you may have good blood flow but since your blood count is lower, you don't get enough oxygen. i think we don't have the answer today. but i want people over the age of 65 to check with their doctors, check your blood test, check your level of vitamin b12, find out if you have any kidney disease and get to the bottom of it.

then maybe one of the treatments would be iron supplement. >> is that part of the standard blood panel? >> i think it should be. >> it's not? >> i think it should be. studying for anemia, checking for b12 deficiencies. this ties into the first topic because this is an example of why we do need to screen our patients. it's what we do with the information. anemia is something very important to find. >> especially in older americans it sounds like. thank you so much, doctors. we've got a lot more, though. we've all been there. every once in a while your throat goes dry. gets you hoarse. maybe you lose your voice altogether. why does that happen? how should you treat it when it does? plus, a prescription for produce. a new plan for doctors to prescribe a healthy meal. >> sometimes they don't tell you, you don't know what exactly is good for the kids. sometimes the doctor told you it's very, very good. they have to take it more

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back to "sunday housecall." a new approach to getting kids to eat healthy. doctors are actually writing a prescription for fruits and vegetables. new york city is just the latest to join the program, which is being seen nationwide. dr. siegel, you can bring a horse to water. you can't make kids eat fruits and vegetables, can you? >> that's absolutely right. this is a program that -- for children and pregnant women. it started in 2011. organization called wholesome wave. a nonprofit organization gets together with local government and raises money. here in new york it's the lori tish illumination fund. they have sites all around the country. they've actually found that by

getting doctors to prescribe a specific diet with a nutritionist involved, fruits and vegetables of a certain kind per patient. it's a one on one thing. they've actually had a tremendous positive result from this. let's watch. >> it addresses the need. it not only provides a prescription, but it provides things that are traditionally beyond traditional health care. food. good nutrition. it gives people the wherewithal to get that if they can't afford it. >> we've seen bmis decrease for patients in 37% of patients. we've also seen that 94% of patients reported an increase in fruit and vegetable consumption. also that farmers reported an increase in revenue. we've really seen across the board there's satisfaction and there's improvement and the community level, the farmer's market level, on the patient side as well. >> the patients get a voucher for $2 or about $1 per month per family member. they go to the local

supermarket, the local growers right outside the hospital or clinic where they are. i spoke to dr. stema at lincoln hospital. she's the head of the pediatric clinic. she works directly with the patients and their families. amazing there's a 30% decrease in weight of these kids. this is over two years. but the early results look really well. it's not what we usually think of with a prescription. it's what we do on this show, too. we broaden our horizons. what is a prescription? we always think of it as medication. in this case it's a change in diet. half of the poor people in the bronx eat no fruit and vegetables in the day. in this program they've increased the amount they eat up to 90%. >> and supporting the growers supports jobs, too. >> absolutely. i like the fact this program is fun. eating fruits and vegetables for kids is not a fun thing. we used to sell an apple a day keeps the doctor away. now fruits and vegetables may keep the doctor away. it's fun.

it involves a nutritionist. it also gives access to low income families. instead of having all the fast food and sew das, it brings them on board to have some of this. cooking classes. a dollar a day per family. they to this for four months. i'm sure we're going to see good results as a result of this. >> can we take this one step further? if you're eating poor and you're from a poor family chances are you're not going to perform well socially, particularly in school. >> one of the things that has happened is the fact we have a real epidemic obesity among our children. and when you think about obesity, it's not a single disease. it's not a heart disease you take care of. it's a spectrum of everything. heart disease, high blood pressure, diabetes. and we need to crack this down early on. it's becoming a cultural problem. as marc mentioned, about a third of our children are suffering from this. this is serious problem. you're right. >> it's cultural. it's a great point. dr. ross wilson, medical director of health and hospitals corporation told me they're going to move on to exercise as

well. so start with diet. then exercise. overall lifestyle change. >> just so everyone knows we try to practice what our doctors preach, this is what kelly and i will be snacking on during the break. >> i'll give you one of those prescriptions for a tldollar. there are millions of americans living with gallstones. most don't know they're there. the doctors are back with what you need to know about that. also, we are monitoring the breaking developments this morning on the potential al qaeda terror threat that's prompted a global travel alert and the closure of nearly two dozen of our embassies and consulates. it's to be taken very seriously. we'll have a live report and much more coming up. she's still the one for you - you know it even after all these years. but your erectile dysfunction - you know,that could be a question of blood flow. cialis tadalafil for daily use helps you be ready anytime the moment's right. you can be more confident in your ability to be ready. and the same cialis is the only daily ed tablet

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and welcome back. about 20 million people in the united states have gallstones, and the majority are unaware of the disease and show no symptoms at all. dr. samadi, what are these gallstone, how can people detect them, and what do they do about it? >> 20 million people? >> this is what kept me up in the middle of the night. people would come in with pain on the right side.

right lower quadrant is the appendix, right upper side is gallstones. a lot of times there are no symptoms. it's incidentally found through ultrasound and cat scan. when it starts to move around it can block the gallbladder. by the way, it has nothing to do with bladder. it's just the name of it. it can cause problems like pain, nausea, pain radiating to the back. it can cause jaundice. laparoscopically we remove this. it's a very safe operation in the hand of a skilled surgeon. takes about a half hour to an hour, but the gallstone, really, besides trauma rn, this is one

the things that would keep us up in the middle of the night, especially after eating fatty foods. the gallbladder pushes to work on the fat and then they're in pain. >> when you're in the emergency room you don't know what it is. it could be gas, it could be angi angina. >> that's a very good point. that's why when you have symptoms, you need to see your physician. of those 20 million people out there, many are carrying it and don't know about it. the laparoscope -- you can take it out with a scope now -- is so much better than they used to have with open procedure. same with robotic surgery. it's much easier to do this. but here's the problem. people weigh too much. being overweight is a huge problem. diabetics. half of the diabetics out there are carrying gallstones. again, you can live for years without having a problem but if

you start having pain especially after a fatty meal and it wraps around in the back and it's in the right upper quadrant, grow to your doctor and they do an ultrasound and see if there's sludge, a widening of the duct where you actually get fever, nausea, sick, then you might cool the gallbladder and take it out acutely. >> hopefully laparoscopically. >> if you can. >> i think what marc just mentioned is important. anything that slows down the gallbladder that pushes it out, certainly diabetes and obesity -- this is important. people who lose a lot of weight too quick, they're susceptible to gallstones, pregnant women and those using hormonal therapy for a long time. anything that will slow down the gallbladder from getting it out can sit there as gallstones. you want to be careful.

>> one final point. you don't need to live with your gallstone. your liver will help you. >> i'm thinking, oh, my gosh, take it, please. >> wrong side. >> stay away from high fat food. >> there's a lot of good messages in that topic. at one point or another, you even been there. your voice becomes hoarse, you lose it altogether. how do you make it go away. we have the tips straight ahead. stay with us. [ male announcer ] this is betsy. her long day of pick ups and drop offs begins with arthritis pain... and a choice. take up to 6 tylenol in a day or just 2 aleve for all day relief. all aboard. ♪

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welcome back, everybody. have you ever gotten hoarse or lost your voice and you don't have a cold, you don't know what it is? well, dr. seelgle iegel knows w might be. >> you know what? it's your vocal cords. most of the time it's from an upper respiratory infection or cold. it will go away in a few days. if it persists, i'd start to thing about reflux, heart bubur. you could be sitting at the bar smoking and drinking. you're going go hoarse, i guarantee it.

watch out for smoking, allergies, reflux. if it doesn't go away, seek treatment. >> what about old-fashioned treatments? tea, lemon? does that do anything? >> absolutely. your throat needs to be moist. there's drainage in the back of the throat that can do this. yes, reflux can do this. that's why you don't aeat a big portion of food before you go to bed. there's also lesions and nodules that doctors can find. also you don't want to ignore and abandon this. if it goes on for three weeks to a month. make sure you get it checked out

because thyroid cancer, lung cancer can cause this but for the most part i think tea and also vapor can take care of it. >> moisture tur. >> i heard my grandmother telling us that. thank you, doctor. great advice. we hope you will take this to heart and the doctors will be back next sunday. we'll start this hour with a fox news alert. the u.s. issues an extraordinary global travel alert for all americans. they've nearly closed two dozen embassies and consulates in the northeast, africa, and asia. sources telling fox that the terrorist chatter that the u.s. intelligence has picked up over the last two weeks, take notes, folks, exceeds anything witnessed in the last decade. heavily armed military surrounding the u.s. embassy in