housecall." joining us is dr. david samadi, chairman of yourology in new york and chief of robotic surgery. >> good morning. >> and dr. marc siegel is here,

associate professor of medicine, also author of "unlocking the secret code of sickness and health." good to see both of you. we're going to begin with this alarming new research question, which women should get mammograms and whether screenings at a young age could help save lives. a new study has found a majority of deaths resulting from breast cancer occur in younger women who do not have regular mammograms. dr. samadi, what do you say? >> we have gone around the whole circle in the last five years. if you recall a segment from 2009 when u.s. task forces came in and said no, ma'amgrams between the ages of 40 and 50 because we were finding deadly cancers start at the age of 50. do every other year mammograms and you're fine. i'm very pro screening, whether it's psa for prostate or for mammogram, and these two diseases are identical.

same number among men and women. they go parallel. anything we say about mammogram is true for psa tests. we said early diagnosis doesn't have to mean overtreatment. you need that information. now a harvard medical school study comes in looking at about 7 tho 7,000 breast cancer patients and a lot didn't have mammograms and a lot were younger than 50, so this is not good news for us. i think we're going to at the end of the segment, go back to the same recommendation we did, start the mammogram at the age of 40 and get it every year, especially if you have a family history and strong genetics. we saw angelina jolie, she found the gene and went on and got a ma mastectomy. it may be a little radical, but we want people to go ahead and get their tests and screening and act on it. >> do you agree with this, dr. marc? >> completely. the tests in 2009 said no

screening from 40 to 50. the american cancer society and the national cancer institute still say screening over the age of 40. this study out of harvard looking over 7,000 women with breast cancer is very dramatic. 50% of the deaths occurred in women between 40 and 50. 65% of the women in the study weren't screened that ended up dying. you know why? when you get breast cancer at a young age, the chances are you'll get a much more aggressive type. david is dealing with the same issuecancer. if it's very aggressive, it can kill you. we want to know if you have that breast cancer. the issue isn't what we're going to do about it. that's a doctor by doctor basis. a patient and a doctor. the art of medicine. let's not look at whether biopsies should be done or shouldn't be done, what the side effects are. let's look at the doctors who are doing them and whether they're doing them appropriately. patients want to know, i guarantee every patient out there would want to know if they have breast cancer, especially if they're young. >> what do you tell your

patient? >> tell them to get screens. what i tell them is 1969 when the mass screening started, we see that there's a survival benefit, that people are dying less from this kind of disease. screening helps. the problem, and the people who are skeptical about screening, is that you're going to find 30% of cancers that are not going to be deadly or they're going to overtreat or hurt people. and the answer is overdiagnosis doesn't mean overtreatment. you need to speak to a doctor, individualalize the care, and find out who should go for treatment or not. now with genetic testing, you have this that can get cells and send it for diagnosis. we have many ways to narrow down as to who should get treatment and who should not. >> 40 is the number? >> 40 and every year. >> here is something that is alarming, frightening. you take antibiotics. millions of us are getting resistant to antibiotics and the cdc will issue a groundbreaking report on

this tomorrow. you're going to get sick and take antibiotics and they ain't going to work. >> "sunday housecall" is getting an early look at it. we got a look at it this week. the story is not breaking on it untim tomorrow. it's embargoed until then, but they're letting us talk about a certain amount of this. very important, the first time the centers for disease control have issued a report about antibiotic resistant. it looks at the reasons, the worst culprits. what are the reasons? we're overprescribing an antibiotics. 50% of the antibiotics you're getting are unnecessary, and we're not careful in hospitals. i have been in david's hospital. it's sterile and well organized. not all hospitals are like that. and then antibiotics are used without careful thought. the economic costs, the clinical

problems, how we can track resistant bacteria, developing new biotics will be the keys to the report tomorrow, and the bacteria we're going to look at, we have talked about on this program before. c-diffis a bacteria that gets into the gut, especially in people who are immuno compromised, who have chronic illness, who are run down, who are in hospitals. it can be avoided if you carefully track beige patients don't overuse antibayotics, another one we have talked about on the show which is resistant to our most prominent antibiotic. >> how do you know if you have it? gone ria, yeah, but how about the first two? >> when you talk about c-dif, that's a kind of infection you're going to get in your bowels that gives you severe diarrhea, abdominal pain, and

that can get into your system and kill people. but the news is worse than we think. over 100,000 people have died from the hospital-acquired infections. over $10 billion we're spending on taking care of these kind of infections. i think the reason why we're here today is because since 1927 when alexander fleming discovered penicillin unl till now, for many years we were doing well. antibiotics were defeating these bugs. then we kind of fell asleep, and the bugs are very smart. they have genetic mutations. they talk to each other. when one dies, a gene can go to someone else. resistance builds up, and meanwhile, our companies did not invent new antibiotics. it takes a lot of money and years. >> what should i tell my doctor? >> how do you go to your doctor and say you're overprescribing? >> you have to be sensitive with doctors. don't attack your doctors.

>> don't put me on it, i want to wait? >> are we treating bacterias or are we treating a virus? that's a big thing. when you go to the hospital, you have to wash your hands. if the doctor comes in and goes from patient to patient, do you mind washing your hands? look what goes on in the hospitals. a lot of it has to do with our ventilation. catheters and blood born, and we have to be moomore cautious. >> i want to emphasis about c-defand other bacteria. we're wiping out the good bacteria. you think you're targeting the bad bacteria, but you're wiping out the good bacteria that's keeping away the c-dif or other bacterias. everything in medicine is a cost and benefit. the cost is you can allow bad bacteria to grow. we're in trouble because the drug companies do not have the incentive to make new antibiotics. >> so you say to your doctor, do i really need this? >> 90% of infections are viral.

>> and take your probiotics. >> both of these doctors are good about not overprescribing. >> when we come back, we're going to talk about this. our knees can be fragile. if they suffer a major injury, what are the best options for fixing them? our doctors weigh in on that. >> and the latest on the devastation in colorado. helicopt eer crews planning to expand their search and rescue missions in the flood-ravaged area. they're even going to horses. but will mother nature help or hurt? we'll have the latest on what's going on in colorado with these devastating, horrible floods straight ahead. is really made of cheese? [ crisp crunches ] whoo-hoo-hoo! guess it was. [ male announcer ] pringles, bursting with more flavor. investors could lose tens of thousands of dollars on their 401(k) to hidden fees. is that what you're looking for,

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his day of coaching begins with knee pain, when... [ man ] hey, brad, want to trade the all-day relief of two aleve for six tylenol? what's the catch? there's no catch. you want me to give up my two aleve for six tylenol? no. for my knee pain, nothing beats my aleve. welcome back. anxiety is a normal human emotion that everyone experiences at times, however, anxiety disorders are different.

dr. siegel, tell us about that. >> the 19 million americans suffering from anxiety, i think it's the number one reason that patients see internists like me, not psychiatrists. we're going to have a woody allen moment where david is going to say everything i say about anxiety applies to me, but i also wrote it in my books. i wanted to say it before he said it. anxiety. >> let me tell you what internists see. people come to me because they can't sleep. they come to me because they're worried all the time. i called it in one of my books the cycle of worry. you had panic attacks, you think you're having a heart attack. you're probably not, but i have to make sure you're not. i have to make sure there's no medical reason underneath it, but anxiety can take a lot of forms. if it's not triggered, meaning there's nothing happening to go wrong, it's a general anxiety problem. if you had a traumatic event like you were in some type of terrible situation, you could have symptoms of post traumatic

stress for a long time, that could be flashbacks, heart wraet going up, sweaty palms, panic. the thing i worry about the most is can we break the cycle? can we replace the anxious activities with things that make you feel good? >> can we? >> first, you have to recognize the symptoms. you have to understand all of us have stress in our lives so we have some anxiety disorder. that's not what we're talking about. we're talking about generalized anxiety disorder. people who go on and the symptoms are chronic. they can't sleep. they have sweaty palms. it interferes with their work life, with their interaction with other people. they have social phobias. they have obsessive compulsive. this is a real anxiety disorder. first, you need to recognize and go to doctors that will do it. now, what do the doctors do? a lot of times unfortunately, they take the prescription pad and say here's xanax, here's valium, good luck. i think that's a mistake. there's a lot of relaxation

techniques, yoga, but i know that everybody loves the herbals that we recommend. the best one out there is really kava. you have heard about kava tea. >> kava is the best one. it calms you down, it can make you sleep well, and the other is passion flow er tea. you should try the herbals before you jump in. a lot of the medications are addictive. they can stay with you and you get used to it. >> i want to add valerian which david has mentioned before. valerian tea helps at night. >> xanax and valium -- >> those should be the last resort. i think accepting the symptoms, finding the right person and sundaying and doing something about it is the right way to go. >> that's why i like these guys, all about the natural stuff first. i like that. >> david has calmed me down. >> it's working. >> somebody calm me down. >> next, the now calm marc

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back with the doctors on "sunday house call." now for viewer e-mail. barbara writes my hub is in need of total knee replacement. i would like to know what your thoughts are on having a total knee replacement robotically or conventionally. dr. samadi, they say once you got it, it changes your life. >> absolutely. i think osteoarthritis, the wear and knee on the knees because people are living longer, obesity is on the rise, that weight on the knee also affects some of these joints. we're going to see more and more of these. now, a lot of times when you look at the knee, there are multiple compartments. there's a medial, lateral one and the wear and tear starts from the medial one. you may be walking and see someone limping and have pain. limiting your activity or getting some steroids or court costa

costeroids is the first step. you can inject it is the second one. then it is the major operation. but now we have the robotic surgery coming in for knee replacement. and the partial knee replacement, part of it is the fact when the cartilage is gone and the bone is not fit well, you do the resurfacing with the robot. didn't y when you do it manually, it works well. with the robot, it's a little more precise. you basically just through the ct imaging, you can see where you have to resurface. it works really well so i would go with the robotic surgery. >> dr. siegel, there are people that have the knee replacement surgery and they're not all fantastic. they're having side effects and problems with those new knees. >> over 600,000 of these are done every year and the biggest

problem is alignment afterwards. now with the total knee replacement with the robot as well, the alignment is dloclose 100% because the computer and robot is lining it up. another problem is infection. almost a liter of blood is lost during a regular and total knee replacement. i worry about that and anesthesia. if i'm going to clear someone for knee replacement and they're older, is their heart in good shape, is their lung in good shape. with the robot, it may be that there's less of a medical risk. and in addition, and i want david to comment on this, one of the reasons i like the robot for the prostate and david has shown me that personally is he's operating in areas where you can't see without that robot. you can't get in there and there's blood everywhere. what about with the knee? >> well, first of all, it's a very good question and i want to comment about the conventional surgeons who are watching this. in the hands of great conventional surgeons, the

outcome is excellent. if somebody is going to use the robot without having the skill, they can do more harm than go with the conventional one. but ike the robot has added benefit of precision, working in a narrow space, low blood and patients go home the next day. >> we talk about eating breakfast as the key to losing weight. is it true? we'll look at the facts and the myths coming up next. [ male announcer ] this is pam. her busy saturday begins with back pain, when... hey pam, you should take advil. why? you can take four advil for all day relief. so i should give up my two aleve for more pills with advil? you're joking right? for my back pain, i want my aleve.

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breakfast, you're probably eating it right now. the most important meal of the day, right? helps you reenergize and is said to help prevent weight gain but there's a new study claiming that's not all true. research finds the idea that eating breakfast helps you lose weight stems largely from misconstrued studies. dr. siegel, what? >> i'm not buying that and i'll tell you why. i think breakfast is good for a lot of reasons. one study shows after you eat breakfast, you're more likely to exercise. guess what, that's part of a lifestyle that helps you lose weight. 80% of the people who had lost weight went on to eat breakfast. i think the question here is not whether to eat breakfast, which i think everyone should do, but what you eat for breakfast. we like fiber. we've talked about it on the show a lot. we like fruit. we like oatmeal. we like things that are good for

you. if you eat a bacon whatever it is, bacon and eggs and all that for breakfast, you're not going to do well. you have to eat the right things. >> the right fuel. >> well, the critics are people that would say if you have breakfast you may or may not lose weight, they're saying most of these are observational studies. they're not good studies. but the truth is you starve your body throughout the night so you go seven or eight hours without water or food. if you're not going to have a complete breakfast then later on your sugar will drop and you'll starve more and eat more carbohydrate and more fatty foods and gain more. start with oatmeal. i'm a big fan of coffee. make sure you start your day with good hydration, good water and all the antioxidants from berries and fruits and vegetables. enjoy your day. >> when you get up at 4:00 in the morning you know what the secret is? chocolate milk. >> i thought you were going to say low fat yogurt.

>> chocolate milk early. doctors, thank you very much. they'll both be back at 12:00 and we'll have an exclusive on oklahoma city bombing. stick around for "media buzz." coming up right now. on the buzz beater this sunday, president obama back on network television this morning continuing his media campaign on syria after reaching a deal with russia. days after making his case to six openly skeptical anchors. and members of congress are saying we'll concept wal because we don't think the administration has a strategy for day two, day three, day four. >> i have to say that's not the case. >> you talk about limited, targeted military action but the fact is you don't know what happens after you order a strike. >> actually we know what the capabilities are. >> and the press turns thumbs down on his east room speech. did the tv blitz fail? while bashar assad was delivering his