banking. loyalty. analytics. synchrony financial. enagage with us. hello. i'm arthel neville. time now for "sunday housecall." >> hi, everyone. i'm eric shawn and welcome. joining us, dr. marc siegel. >> and dr. david samadi. chairman and professor of urology and chief of robotic surgery. good to see you. >> we start with a very important issue. this happens to be a new study on colon cancer. turns out the number of cases in people older than 50 is dropping. but they say more young people

are coming down with the disease and it's so easily preventable. how come it's decreasing for the older folks, but sadly increasing for the younger ones? >> this is out of a place called m.d. anderson. they looked at a huge database from 1990s up to 2008. they found that there's a 3% decrease in colon cancer over the age of 50. i think the reason why is colonoscopy. we're finding poll will you pleases before they turn into cancer. as with prostate cancer, the younger people who get the cancer, they get a very aggressive form. so they found an increase of almost the same percent, about 2% in people 20 to 34. that doesn't mean that i'm telling 25-year-olds to get

colonoscopies out there. what i am saying is we need to be on the lookout. age 50, colonoscopy. before age 50, no colon no, sos. what are your risk factors, what's your diet, how obese are you, do you smoke? your risk of colon cancer goes up. >> when should you get a colonoscopy. i have it in my family. when do you get it? how often should you get it and what age? >> i think what marc is trying to say is a guidelines is coming from a lot of these agencies and they're too stiff. you have to individualize medicine. if you have family history of colon cancer, perhaps we should do it early on. as we just heard, 142,000 americans are getting colon cancer. it's the third common cause of cancer in this country. 50,000 die from this.

so family history. what kind of diet do you have, if you're having a lot of fried food, processed meat, you're not taking a lot of fruits and vegetables. even smoking. we know smoking is also a big risk factor for colon cancer. you know, maybe we should do a baseline colonoscopy on you at the age of 40. if you find pollups, you can take care of it and that would be the end of it. we're finding out young men with very lethal and aggressive cancers. >> what if you don't have it as part of your family history? what do you do then? >> the key here is to look at the individual patient and look at a trend. the thing i look for most is what we call a change in bowel

habits. 42, change in bowel habit, suddenly not feeling well, having abdominal discomfort. maybe has a family history, get that screening. you want to know. >> i think the best thing to watch out for is if you see blood in the stool, this is a first mark of this. the doctors may just pass it on saying it could be hemhorroids and other things, pay attention to these things. crohn's disease. in our field, i'm always concerned about men that get radiation for pro state cancer. we know it can effect the rectum. on those patients, you want to be a little more aggressive. in the hands of experienced doctors, this colonoscopy is fairly safe and we can check it. >> to david's point about

that -- >> what's -- >> i give the stool cards out to you and i say -- >> you put that on the shelf and you forget that. >> don't forget that. >> i lose it. it's like this big. >> three days in a row. you can even mail it to your doctor and i'll check it for you. we can do that in advance. >> what's this called again? >> there's the yearly rectal exam. we can check for blood then. on top of that, ask your doctor. do three of them in a row. either bring them back or mail them in. we should be screening for blood. if we find blood, we do a colonoscopy. >> we know that inactivity increases the risk. add fruits and vegetables and get rid of a lot of these processed meats and red meats. >> let's say you're 25 years old, how do you know if you potentially have this? >> if you lose sudden weight

loss, if you're having abdominal pain, you see blood in the stool. first-degree relatives have colon cancer, if you have some sort of irritated bowels, go to your doctor. don't worry about the guidelines. those are for mass screenings. they're for the whole population, right? i just operate on a 38-year-old with very aggressive prostate cancer. >> how did you know he had it? >> he went for life insurance. the psa was high. that's how he found out about this. >> if you have red blood or blood in your stool, you want to see your doctor. i may tell you it's the beets you ate last night. >> you mentioned having spicy food, which can sometimes cause problems when you're having a moment. maybe that's just temporary. if it persists -- >> but i can do an exam right

then and tell you if it's really broad or not. we can do the stool cards. get to your doctor. if you see a change in the color of your tool. >> or the size. >> any kind of change in bowel habits. >> when you have colon cancer, the stool comes in at a very small -- narrow diameter. >> very helpful. so it is the largest family planning event in the world, world vasectomy day. who started this and why do we need such a day? "sunday housecall" returns. out i didn't think i'd have a heart attack. but i did. i'm mike, and i'm very much alive. now my doctor recommends a bayer aspirin regimen to help prevent another heart attack. be sure to talk to your doctor before you begin an aspirin regimen. so i can reach ally bank 24/7, but there are24/7branches?

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getting men involved in the conversation about family

planni planning. friday marked world vasectomy today. what has this accomplished? first of all, if you could tell us what a vast sect my is and are there risks involved. >> it's basically a very basic male sterilizatiosterilization. i had no idea but i learned myself, it's called the national vasectomy today. they are encouraging all other the world. they're doing this because there was a picture of a father who had 26 children. in order to control this, they're doing this. so it's a minor procedure. it's done in our office. you take a piece of the tube that carries the sperm to the outside world. by taking a piece out and putting sutures at the end of it, you prevent any kind of

sperm. now just because you get a vasectomy, it doesn't mean that you have no sperm. you have to go back after couple months and get a he has to tell you on the microscope that there are no sperms. this is an important point. people get it and may end up having another child. so that's really important. people are worried about the risks and benefits of this. it's fairly minor. in the hands of experienced doctors it's about 10, 15 minutes. most insurance accept this. some data suggest, and this is not a cause, there is some study that came out this year that when you get vasectomy, you have a very small chance of developing very aggressive prostate cancer. i don't want people to be worried. this is a very small chance. some suggest they are also the ones go for psas.

>> is it reversible? >> that's a very good point. you can reverse it. when you get a vasectomy, you should think of this as a permanent solution. that's the way it is. if you reverse it in the first three years after, you have a much better chance than when it's over ten years. experience mattered. you have 50% chance of having a child by reversal. >> the way you're describing it, snipping down there is making me feel really uncomfortable. does it hurt? >> it can be painful for the first couple of days afterwards. there's ways to do it where they don't even use a scalpel. risks of bleeding and infection are the key thing. and 50% reversible within ten years. you have to compare that to what we offer women. we're snipping the tubes in between the ovary and uterus. there, though, we're now going

to the lap row scope. before, it used to be done open which had more complication rates. obviously i'm going to vote for a vasectomy if i can make a choice because it's less invasive. studidies have been showing a decrease in breast cancer. but as david just said, with men, maybe it's just an association. we don't know. it's a more complicated procedure for women to have to have it because the tubes are buried in much deeper. there again reversible in about 50% of cases. >> you were pointing out that fist of all none of these procedures are without risk so you shouldn't just casually get them. you mention that having a vasectomy does not prevent the possibility of getting stds. >> that's a very important point. a lot of times men use condoms in order to prevent this and

also stds. just because you have vasectomy now you're not protected against stds. i don't want people to worry about sexual function. it doesn't interfere with testosterone function. think of it as irreversible when you go and do it. and of course we leave it up to men to save the world and we have to go through the painful experience. >> versus -- >> women save the world. we know this. >> credit for just that painful experience down there. >> versus the medical risks and costs -- >> but unwanted pregnancies is what we're trying to avoid here. that's the key thing. >> all right. keep your letters coming folks. we talk about water. drink eight glasses of water a day. eight? who really does that. coming up, your question on on

dehydration. >> the surprising facts you need to know from the doctors on how much we should drink. that next on "sunday housecall." want to know how hard it can be... ...to breathe with copd? it can feel like this. copd includes chronic bronchitis and emphysema. spiriva is a once-daily inhaled... ...copd maintenance treatment... ...that helps open my airways for a full 24 hours. you know, spiriva helps me breathe easier. spiriva handihaler tiotropium bromide inhalation powder does not replace rescue inhalers for sudden symptoms. tell your doctor if you have kidney problems, glaucoma, trouble urinating, or an enlarged prostate. these may worsen with spiriva. discuss all medicines you take, even eye drops. stop taking spiriva and seek immediate medical help if your breathing suddenly worsens, your throat or tongue swells,... you can get hives, vision changes or eye pain, or problems passing urine. other side effects include dry mouth and constipation. nothing can reverse copd. spiriva helps me breathe better. sfx: blowing sound.

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back to "sunday housecall." our weekly segment "should i worry." one viewer writes, i drink a couple cups of coffee and three-quarters a gallon of water each day and was recently diagnosed with dehydration. how can they be? how do you get dehydration? >> this is a very good question. i'd say you should worry a little. the amount of coffee and green tea you're having, i don't think that's the cause of this.

we love coffee on this show. you have to have 500 milligrams of caffeine to get a significant amount of fluid that amount of water is not a ton. we probably want people to drink more than that, but i'm suspicious that the dehydration could be from something else. are you in hot climate? do you exercise a lot? could you have -- what about diabetes? if your sugar is elevated, that could cause it. i want this patient to be che checked for that. a sign of diabetes or kidney problems. but especially diabetes in this country. i would get checked. >> so how much should we be drinking? >> i think it depends on what you're doing. if you're a runner and in arizona and hot weather, humid, running all the time, you should be drinking more than we are over here because we're not perspiring as much. everyone has to be treated differently. i'm concerned about this

patient. i hate to act like a a medical doctor. something called diabetes, someone who basically is drinking a lot but is also urinating a lot because the hormone that absorbs all the fluids is not there. or there's a problem with the kidney. so you drink a lot but you also are not holding on to it. so talk about adreeal disease. you lose your salt and the water follows. so going to doctors, looking at the 24/7 urine test, you'll find out what kind of lek ro lites you have in the urine. >> if we get to the medical advice, i wanted to ask something simple before you get to the complication. should we have the drinks with the electrolytes? >> especially if you're exercising, absolutely.

when i go mountain biking, we have jelly beans loaded with to it is a sum. a simple blood test looking at electrolytes will rule out diabetes inaccept diz, the kind of things he's talking about. you could have a sodium that's way low. that would explain the water being lost. >> jelly beans have potassium. >> special jelly beans for exercise. >> i like jelly beans. >> not the usual. those have sugar. >> in general if you drink a lot of coffee, always for one cup of coffee have two cups of water to support that. that's a basic rule. don't add sugar or milk. that's basically it. >> thank you. >> that viewer had a great question. if you have any questions, you can e-mail these guys. they will potentially answer it on the air. all names and e-mail addresses

will be kept completely confidential and never send you a bill. >> and the co-pays are $100. >> it goes to charity. it's november which can only mean one thing, men with mustaches. we're going to discuss why they are letting it all grow out. out

i didn't think i'd have a heart attack. but i did. i'm mike, and i'm very much alive. now my doctor recommends a bayer aspirin regimen to help prevent another heart attack. be sure to talk to your doctor before you begin an aspirin regimen.

welcome back. hey, look who it is. you recognize this handle devil. you may see a lot of men with the same look this month. that's because it's monthvembar. why do we have this focus so much. >> because men don't like to go to doctors. they live five years less than women. and partly because either they are too busy, they don't want to deal with it or it's embarrassing for them. and it's a no-shave november and really becoming more and more popular. and growing mustache, i tried, i hope you enjoy and will show a

picture i made. but this is -- >> nice. >> blue is the color of men's health. you should go and get your psa checked and your testosterone checked. look at mental health, everything else that can help you live longer. this is important. you know we are launching a big event in new york city. women for prostate health, which if you go to our facebook page, a lot of information about how men can make themselves have their best month. so this is the best shot i could give to growing a mustache. >> i need you to match the color of the mustache with your hair. >> you got to give me credit for it. >> we think we don't go to the are doctors, we think everything is okay. >> that's one thing, denial.

the other thing i want to talk about is testosterone. women have estrogen that protects from heart disease. testosterone can increase cholesterol, increase risk of heart disease. another one is testicular kacanr in young men. there are 9,000 cases a year. when you are young, you have that testosterone storm. there's issues of motor vehicle accidents. they are more likely to die in adolescence than women. check them for testicular cancer and check mood and testosterone rate. >> the foundation does a lot of work. >> anything that happens to men indirectly affects women. that's part of the reason why women are jumping on. enlarged prostate, prostate cancer, all of those effect

women. that's why it's time to go out and get tested and it can save your life. >> excellent. thank you, doctors. >> enjoy your cupcakes. >> they look good. a u.s.-led coalition makes a bold statement in iraq targeting isis from the top down. this as president obama sends more troops to the middle east. is. >> we need ground troops, iraqi grond troops that can start pushing them back. what we will not be doing is having our troops do the fighting. >> election fallout, the people have spoken putting the gop in charge at capitol hill. can lawmakers from both sides of the aisle work together? you'll hear from bob casey, a democrat, and senator jerry maran. plus they remember the fallen e