over. i hope you enjoyed it and learning more for a healthy you. ♪ ♪ ♪ ♪ >> i'm arthelneville. time now for "sunday house call i'm i'm. >> joining us everybody sunday is dr. mark siegel, professor of medicine at nyu medical center and author of "the inner pulse" unlocking the seek red code of sickness and health and chairman and professor of neurology and chief of robotic surgery. good to see you, doc. >> we'll start with something that is called a sound disease because it can strike people too quickly and that is pancreatic cancer. pancreatic cancer claims the lives of 30,000 americans each year and now there's a new type

of treatment that got the green light from the fda. dr. siegel, it is so troubling because it is so hard to detect and people don't know you have it until sometimes it's too late. >> if you've been asking us about this and first of all, 45,000 cases a year and 35,000 deaths gives you an idea of what we're dealing with here. it's a number one killer of solid tumors meaning the five-year survival rate is very tough. it's deep in the body of the pancreas and has blood vessels around it and it's by silent jaundice, meaning someone comes in looking yellow. there's no pain and you don't know it any other way, it's hard to screen for it unless you're looking for it, which you can go for it. >> can you go to the doctor and say i want a pancreatic cancer test? >> we got proteins and genetic testing that's in the works. >> cat scan can pick it up, but

by the time you decide a ct scan it's often too late. there are genetic clusters and people with genes that predispose to it. smokers, 30% of pancreatic cancers come from smokes, drinkers, alcoholics and all of these people we have to start looking at pancreatic cancer and again, when we find it we're often faced with what do we do with it and crs 207 has double the survival rate with people that have advanced disease. it's still only six months that we're talking about here and it's not approved by fda and they're fast tracking and in a stage two trial. usually what we try to do is something called a surgery and i want to leave that to david and that's oftentimes unsuccessful. >> i would like to know, first of all, dr. somati can women -- are froen get it as much as men and also dr. siegel talked about the main causes and i want to talk about prevention.

you usually tell us about things to eat and know to eat. >> that's a good point. men are more prone to getting pancreatic cancer and you have seen a lot of famous faces and you saw the picture of steve jobs in his jeans as he was losing a lot of weight and weight loss is in one of the symptoms, and you see patrick swayze and this disease brought him down and also pavarotti and we've seen a lot of famous people with pancreatic cancer and it's alsos color of pancreatic cancer is purple and that's one of the reasons i'm wearing this tie. smoking is one of the same reasons and long-term diabetes is a long-term risk factor and obesity is one of the reasons why we have diabetes in this country, lose weight, stop smoking and pancreatitis which is the inflammation of pancreas either directly or a result of,

if you have someone in your family you may want to ask for a cat scan. if you have bloating or weight loss. jaundice is basically, the the way the pancreas is set up. s six to eight inches of organ that sits under the stomach and at the tail of it has a split. on the other side is the small intestine. it's in a hidden area that nobody knows about this organ, extremely important and vital to our life because it secretes digestic enzymes. when you have the fatty food and burgers, the fat comes in and the pafrj ras has to pump this, you know what other hormone is extremely important? insulin. the insulin comes from pancreas and that's very person. what happens with ripples and the first line of treatment is surgery and the story you'll find, the better the outcome. >> can i get back to that finding it because it has struck in the past a friend. didn't know. it's just amazing to me. isn't there a way to try to find out if you have any type of

pain? what do you do? >> it's based on the signs and symptoms you have. if you have some abdominal pain, maldigestion, weight loss, we don't have a real marker for this that's why they call it a silent killer and it's a lethal disease. by the time they get to you is too late and we remove the head of the pancreas. if the cancer is still organ-confined and you removed the pancreas look with the part of the small intestine. >> you remove the entire cancer as much as you can, followed by radiation and keep on therapy. this particular study that just came on which is immunotherapy is basically adding maybe two more months. so we're not about some revolutionary point over here. should you get ultrasound if you have stomach pain? >> i know you've been asking about this, it's because it's deep in the body.

we don't have a macker for it, that's why we call about the psa, we have a marker for that, we have malm on grams that we can do for breast cancer and for lungs we can do a cat scan of the chest for smokers. we don't have a good screening test for pancreas yet. if we're suspicious we do a ct scan. ultrasound won't tell us in time. i want to talk about the cr207 because it could be the the cusp of something great. i agree with david and maybe at this point, two or three months of long-term survival, not a lot, but what i like about it is the idea of immunotherapy and you provoke the body's own immune system to attack that tumor and that's probably where we'll go with treatments and we're not there yet with pancreas. they're combining, keep on therapy, radiation and these immunotherapies. we don't have the holy grail yet, we're just beginning. >> my orange concern with what we heard and mark's point is

well taken is that we have the same immunotherapy that came in with prostate cancer. prostate cancer that doesn't respond to hormones business and aggressive that midweet aft sizo bone and i don't want people to have a false hope, yes, it may have soma added benefit, but the benefit is only two to three months. given the expense of this immunotherapy, we'll see if the government will sponsor some of the expenses because these are hundred of thousands of dollars for only about a couple of months. >> this is only the beginning and i agree with that. i think it's limited at best and it means it will probably be approved over the next year, eric and you always ask that question. it's maybe a grandfather of a treatment. the biggest thing with the pancreas is out how to diagnose it early. we need to get from teens or genetic markers that something that tells us that you have it.

with the big supply around it escapes it too early. >> is there anything we can do? can we stop eating more. >> stop smoking and stop drinking. >> if you have family history of pancreatic cancer, make sure you go for screening and see your doctors early on in your early 20s. >> really? >> if you haven't started smoke, don't. if you're not drinking alcohol, stay away from this, but family history and diabetes are big tickets. >> one-third of all pancreatic cancer, one third is due to smoking. >> i'm glad you're bringing the awareness. >> very fascinating. so millions of americans suffering from serious back pain on a daily basis. is there anything out there that can help? our doctors weigh in on that plus we'll ask them for their reaction on a new study that claims a popular over-the-counter medicine may not be as effective in treating back pain as once thought. stick around. not be as effective in treating back pain as once thought. back pain as once thought. [ female announcer ] we help make secure financial tomorrows a reality for over 19 million people.

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♪ ♪ for millions of americans it is the go-to over-the-counter medicine that is going to help treat their back pain, but a new claim, a new study out there is saying that acetaminophen may not be as effective in this regard as once thought. dr. somati, everyone thought you go to tylenol if you have back pain, but you're saying a new study says otherwise. tell us more. >> it's a good study and that's why i'm going to post it on my personal facebook. i want people to read about this. australians studied, 1600 patients and followed them for long enough time and they randomized them in one group, they gave them acetaminophen, every day, 500 mill on grams, six pills and they took it all of the time. second group took it only when they had the pain, or as needed

or prn. and they got a placebo. what they found was that at end of study there was no difference between the sugar pill or placebo versus tylenol. what does this mean for people when like to take tylenol and other medication that has acetaminophen. if you have high fever, if you're post-surgery, i don't mind for you to take a couple of days of tylenol or any acetaminophen products, but for back pain and millions and millions of people and two-thirds of americans are taking pills as if it's nothing. it's not helping you except the fact be that you may have the added side effects of this medication. when should you be worried about it? when you step over three grams a day, eric, this is a good time to start taking notes, when you go over 30 grams a day and if you have a cough in the morning and take koufr medicine followed by tylenol and you get some alcohol and that's when you will get your liver and kidneys into trouble. it doesn't help you for back

pain. >> what do you take instead and the doctor mention onned those side effects. >> i have a slightly different take on this, but not that different. >> i would like to hear. >> first of all, in australia they call it partisomol. when they don't see acetaminophen, that's the same thing, tylenol and acetaminophen. a good neurologist never actually turns to tylenol will for back pain and you know why? because back pain is caused by inflammation. it's caused by the bones and the muscles and the nerves being a very tight compartment and that inflammation or muscle spasm can only be treated by a few different things. heat, an anti-inflammatory like advil, like aleve and nap ross inor a muscle relaxer, something like nexterol. >> and all of the people studied and i agree with david that this was an extremely well done stud e all of them whether they got

placebo or this, all got better in 17 days and you know what that dells you? back pain goes away and i'm concerned about people who rush to percocet or rush to surgery. put heat on it. physical therapy, in the old days and they used to do bed rest and argel, it's not bed rest and get up and around and put heat on it, anti-inflammatories and/or muscle relaxers and see your physicians. >> you have to strengthen your stomach muscles. >> that's under the guidance of a physical therapy. >> but having said that, i think a lot of people out there will not go through back pain to neurologists and they go through many other doctors before they do this. what i want people to know is also there are back pains that need to see the doctor immediately. if you have back pain and also have fever and that could be a kidney infection. if you have bloating with it, it could be pancreatic cancer that we just talked about that is

basically referring to the bad. >> what if you have tingling with it. >> if you have a herniated disk and if you have some sort of spinal sten oisis, any kind of spinal. you need to see orthopedics and not to get massage and heat and make it much worse by the time you get to the doctor you may need this. so certain back pains, aneurism of the aorta. >> the bottom line of all of this is don't treat it yourself and i agree you don't always see aure inologist and orthopedist and i see a ton of people with back pain. heat, sometimes anti-inflammatories and sometimes muscle relaxants, but the main thing is not to rush into aggressive treatments and acetaminophen, never has been a treatment. >> and that's the big point over here, taking too much acetaminophen is not going help. placebo is as good. don't touch it, and the addaed benefit, when you add a lot of them together it's going to hurt your liver.

>> can i get a massage, at least, for the back? >> not now. >> not you. >> even massage, there is a new study that shows massage, it's got to be under the guidance of your physician. call your doctor. >> absolutely. absolutely. well taken. >> it you thought about this, there have been three commercial airline crashes just in the last week and a half including the shootdown of malaysia flight 17. some people getting on planes, thinking twice about it? well, that anxiety is not good for you. doctors are explaining what to do before you get on the next flight and how to deal with any possible fear of flying. ♪ don't miss a step... ♪ nothing's missed with tenatwist ♪ ♪ don't miss a beat...

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>> back now with our segment "should i worry," our segment about everything that worries us. someone asks "i am preparing to my and i am taking about taking a valium because i am so nervous. should i worry." we have seen what has happened. is this overblown? >> by far the safest way to travel. i am calling this irrational but it is real. i am not dismissing it. i wrote about knit my book "false alarm." after 9/11 there were 40,000 deaths from traffic accidents and twice as many peoples usual took to the roads so there were a lot more deaths from people driving after 9/11 than would have died in plane accidented entire 40 years of commercial flying. that is how dramatic this is. people who avoid flying and take another mid-of transportation put themselves at greater risk.

why did it happen? because of fear. fear is hard wire into our brain. we have a fear mechanism that overrides everything else. we personalized risk. we think it will happen to us. there are ways to treat it. flying is a perfect storm for fear at 30,000 feet, you lose control, you fear lying. when you lose criminal fear hits. what do you do? desense station, overcoming the phobia, getting into the plane, taking the valium, if necessary. i actually have fear of flying myself. because of having to go on the road here, guys, i had to fly tices in one day to pittsburgh and back and to western to texas in a small plane. >> what did you take? >> i held the hand of producer. after that i was able to do it again. if you do it, you will over come it. get back on the horse. >> one i gave him the

hankerchief he is over it. >> this is a legitimate fear, it is the second most common fear in our life after public speak ing. 25 million people suffer from it. the worst years was 1972, 2,200 deaths as a result and this year we idea what 700. i was supposed to fly myself and i canceled. is it irrational? absolutely. i don't want to jeopardize my life. people will say the risk of dying lop is one in ten in and the risk of a car crash is 172 per person. i don't buy it. there are issues with turbulence and the take off and landing. how do you deal with it? you have to know exactly what your fear is. this is an app called "turb cast." >> we have to take a break. >> stick around. to break. to break. >> more on

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so moving is easier. celebrex can be taken with or without food. and it's not a narcotic. you and your doctor should balance the benefits with the risks. all prescription nsaids, like celebrex, ibuprofen, naproxen and meloxicam have the same cardiovascular warning. they all may increase the chance of heart attack or stroke, which can lead to death. this chance increases if you have heart disease or risk factors such as high blood pressure or when nsaids are taken for long periods. nsaids, like celebrex, increase the chance of serious skin or allergic reactions, or stomach and intestine problems, such as bleeding and ulcers, which can occur without warning and may cause death. patients also taking aspirin and the elderly are at increased risk for stomach bleeding and ulcers. don't take celebrex if you have bleeding in the stomach or intestine, or had an asthma attack, hives, other allergies to aspirin, nsaids or sulfonamides. get help right away if you have swelling of the face or throat, or trouble breathing. tell your doctor your medical history. and find an arthritis treatment for you. visit celebrex.com and ask your doctor about celebrex. for a body in motion.

we will bring back the doctors. dr. samadi you said why we have the fear of flying and you were going to address how we address that. >> aerophobia is the real deal. psychiatrists will tell you, move on, don't worry. that is not the right way did deal with this.

you have to find out exactly what is the cause of the fear. is it take off? the turbulence? the landing? what triggers this? maybe you had an accident when you were younger. there is turb cast, anial that gives you the turbulence while you are traveling. you will know what to expect. if you have that fact it will put you at ease. most of the fear is because of the "what if." what if something happens? what if something goes on. learning about the facts helps. when you travel to a place that and pleasant, you can put a picture of that on your laptop, look at the ocean in cancun, the sun, giving you a prize at end of the trip is great therapy. finally, stay away from coffee and alcohol. that can induce anxiety and dehydration if the plane. valium should be the last thing to touch if you want herbal, take st. wort's that will cam you down.

valium has side effect. >> stay away from alcohol? what about downing the small bottles? >> people think it hips. here is the biggest ticket item and i have counseled people on this. the issue is, anticipating the anxiety you will feel. you anticipating the plane flight. david going to russia. me going to western texas. you have to identify what it is that worries you the most. for me i is the turbulence. i feel myself going up-and-down i feel the next thing we are going to start bottoming out. read the information. in addition to desensization going through something that stipulates it, fuel yourself with information, read about turbulence and what the worst-case-scenario is, landing, how safe is landing? >> sit back, relax, watch your

movie. >> while did you focus on other thing. >> cognitive behavioral therapy. remember that. >> that does it for us. on the "buzz beater," with casualties mounting in the middle east the media is a major battlefield. are they playing into the hands of hamas by bringing israel? or is it going too far in favor of israel? >> the palestinians are experts at the p.r. flight and put little kids in front of weapons so when israel strikes back they can put the images on the cover of newspaper and say look how bad israel is. >> the image most americans are seeing, by and large, are images of the destruction in gaza. all these people are talking about how the israelis are losing the media war. >> is social media changing the landscape by spreading gruesome images of war?