hello. i'm eric shawn. time now for "sunday housecall." >> and i'm julie banderas. welcome, everyone. joining us is dr. david samadi, chairman and professor of urology at lennox hill hospital and surgery of robotics surgery. >> and dr. marc geel professor of medicine at langone medical center and author of "the inner pulse, unlocking the secret of sickness and health." >> dock doctors calls it a sharp increase in requesting a double mastectomy, some dubbing it the angelina effect after the famous

actress, as you know, whose own mother died of cancer announced in 2013 that she had undergone a preventive double mastectomy, this after a blood test revealed she had a genetic pre-disposition for breast cancer. dr. samadi, would you agree with the angelina effect? is it safe for women to remove both breasts when cancer only exists in one? >> it's very difficult to answer this question because you have to individualize the care for the patient. in her particular case there was a huge risk factor, family, her aunt, her mom had canser. >> yeah. >> she also had the genetic mutations and had the one and two positive so she was as a very high risk and at the end you sit with your doctor and balance the risk and benefits and make a decision that's good for that particular person. you can't just make it a general discussion, but there's no question that the number of double mastectomies have gone up. we see like less than younger than 45-year-olds, 35% are getting double mastectomy and it's true that there is some

celebrity factor and effect as a result of this. but, also, there's no science and research to back it up. a lot of times these are not necessary, and there's a good study coming from stanford, looking at 190,000 women, and they see that there's no taking the contra lateral, the other breast off. the risk of getting cancer in the other breast is 10% or less. look, this is a discussion. you know, someone may not want to have any mo mris or mammograms and if it makes sense to them they may do it. i don't necessarily agree with it. a couple of things. also federal law is paying for some of these reconstructions and plastic surgery over the years has improved, so it's much bert and with these celebrities coming on board, the numbers rin creasing. >> some insurance companies are covering women to have that second breast removed even though you don't have health concerns or cancer in that particular breast. >> that's right. >> that says something about the

health insurance companies that they are covering this. not just a plastic procedure. this is possibly life saving. >> let me talk about it, covering it to the tune of $30,000 for double mastectomies with reconstruction. it's a lot of money. >> yeah. >> i want to start by saying that saying genetically suspect sucseptible women, women at high risk like angelina jolie is less than 1% of the population, the u.s. population of the women. less than .5% so those women it makes scientific women to consider doing it in the other breast. here's why i think it's occurring. this is my opinion on this. studies have shown from the '90s and after that a lumpectomy with radiation and sometimes with chemo or hormone therapy, all of that has about the same chances of survival, julie, as doing a mastectomy, but women are saying i don't want to take the chance of recurrence, even though you can follow the breast and do mammograms, mris, i don't want a chance of recurrence so more and more women are going for a single mastectomy but then they are saying, wait a minute, the

new breast with the reconstruction as david was mentioning with all the great plastic surgery technique, it feels better and looks better, why don't i have it done on other breast. i am not in favor of that. that's cosmetic surgery and even if one breast looks different than the other i don't believe removing tissue that's not diseased and they may lose some sexual function, in terms of sensitivity. >> the side effects of chemotherapy and radiation and some of the disfiguring things that come as a result of that? >> fair point, a counterargument what i'm saying, don't know the side effects or long-term effects and want to stick to a surgical treatment. as david says with a prostate, i can cure you. that's a big statement. can i cure you. switching to prostate, i'll get the prostate out i can cure you, and we too quickly do go for radiation and chemo, i grant that point. i still don't like the idea of taking out a breast that's not diseased, if it's a very, very low risk >> you mentioned a figure of 10%

of people. >> or less. >> or less? >> yes. >> that's amazing to me because you would think that if you have breast cancer in one breast it could naturally happen in the second. >> it k.eric, it's a discussion women should have with their doctors and find out what the risk for that particular person. do i have the family history? do i have the genetic mutation and then some women they don't want to take any chances and they are willing to go for it knowing the risk of surgery is there. what marc was just talking about is prostate cancer and breast cancer are completely equal, they are the same disease, same number of incidents and same number of deaths, and we're finding out that in men with extremely aggressive, subgroup of patients with prostate cancer with genetic indications, they may have the same markers in both patients. they are not quite there and to say you're going to preemptively remove someone's prostate today doesn't sound good but if someone has me taft seize you may remove.

>> dr. siegel says you shouldn't remove tissue that does not have a disease? >> yes, do i. >> you don't believe a second breast should be removed if it's cancer-free. >> it depends on the risk. >> there's no research really to back it up. >> say you don't have the genetic mutation. >> i wouldn't do it. >> diagnosed with breast cancer in one of your breast, you had a single mastectomy. would you get a second mastectomy. >> i don't think it's a good idea. >> i want to make the point why we think this. genetic susceptibility is the key factor here. you know ire going to get cancer, have a high risk because you have the gene, you might do something in advance. angelina jolie, that's a celebrity factor. everyone says i want -- >> she never was even diagnosed with canser. >> but she has the genetic abnormality. that's totally kettle of fish than some woman that wants to be like her. >> for angelina jolie, made a great statement saying that this was my choice and i don't feel

any less feminine and it makes a lot of sense to her. that takes a powerful woman to say that. >> it's a brave move what she did. >> a brave move, especially if you're in the spotlight and out there, but not every woman should follow what she did and that's what the purpose of this segment is and moving forward, having a discussion. looking at the genetic map, we're looking at the rosetta stone or the language of like who is going to have like a real metastisis or death and that's the beautiful part of precision medicine. >> all right. fascinating and important discussion. >> yeah, definitely. >> disturbing trend. it's summer which means it's vacation time for some of us, so what happens when you get sick? talk about getting sick on your vacation, coming up the doctors will fill us in on some of the most common reasons why you get sick on vacation and how when you go on vacation you can have fun and stay healthy. be right back. americans. we're living longer than ever. as we age, certain nutrients... ...become especially important.

from the makers of one a day fifty-plus. new one a day proactive sixty-five plus. with high potency vitamin b12... ...and more vitamin d. after a dvt blood clot.mind when i got out of the hospital what about my family? my li'l buddy? and what if this happened again? i was given warfarin in the hospital but i wondered if this was the right treatment for me. then my doctor told me about eliquis. eliquis treats dvt and pe blood clots and reduces the risk of them happening again. not only does eliquis treat dvt and pe blood clots, but eliquis also had significantly less major bleeding than the standard treatment. knowing eliquis had both... turned around my thinking. don't stop eliquis unless your doctor tells eliquis can cause serious and in rare cases fatal bleeding. don't take eliquis if you have an artificial heart valve or abnormal bleeding. if you had a spinal injection while on eliquis call your doctor right away if you have tingling, numbness, or muscle weakness. while taking eliquis, you may bruise more easily... and it may take longer than usual for bleeding to stop.

seek immediate medical care for sudden signs of bleeding, like unusual bruising. eliquis may increase your bleeding risk if you take certain medicines. tell your doctor about all planned medical or dental procedures. eliquis treats dvt & pe blood clots. plus had less major bleeding. both made switching to eliquis right for me. ask your doctor if it's right for you.

it's beautiful. >> i say we call it griswold spring. >> it's not nice. >> that's the sulfur, buddy. natural. >> should try to jar this stuff. >> i don't think that's a hot spring. >> everybody out. >> man, that's a clip from the upcoming movie "vacation" and the latest installment of the griswold's adventure. get sick on vacation, ever happen to you? if you want to go on vacation, you want to have fun. don't want to swim in sewage. you think i'm paying money for this hotel room and i'm sick. i might as we will have stayed home. >> your vacation is gone. 12% of travelers get food

poisoning, 12%. >> that's a big number. >> a huge number, only because they are swimming in sewage. it's also because they have raw vegetables to go oversea and if you go to developing countries and even in europe, if you're drinking the water there, you should not. you have bottled water and should have cooked vegetables. if you have to have salads or raw vegetables make sure they are really, really washed. you can pick up in developing countries things like cholera and you get really, really dehydrated and get a fever and then it gets to be very problematic. i also want to caution people out there when you're traveling watch out for sunburns which we talked about last week. that's a huge problem. watch out for dehydration and watch out for boating accidents. people don't realize that driving a boat, and i have one, is just as hard as driving a car is so watch out for that. people are flying around. you don't see them. same with problems with the car. >> david, what should you take with you? >> well, usually when i travel i take very basic things, whether it's going to be some sort of a

cut. take some sort of thing with you. in case you have an energy. i've been hurt before, once i was in a different country doing water skiing with no business to do and next thing you know it grabs and the nearest doctor is 45 minutes away so what you want to do is make sure that your health insurance is covering you, whether you have some sort of a global insurance and also have someone here that you can contact immediately and let them know that you're in trouble and they are able to get you to the nearest hospital, et cetera, but all of these issues, sunburn is a big problem and a lot of times that's what we see so take aloe vera, zinc oxide with you if you have to. we see this also in swimming pools. there's a lot of parasites. kids are not using the bathroom where they should be using them and you can get real poisoning and infection from that. also, like not using the tap water in some of the caribbean islands, problem with real

diarrhea and stomach. >> can you check if there's an english speaking doctor before you go some place? >> check the hotel you're at. very important thing. relating to that. you get off a plane, the first thing you should do is buy a tube of sunscreen because they probably are not letting you take it on the plane because they don't like those tubes. that's what they usually confiscate. >> right, right, right. >> but if you're like me and don't check luggage. >> and you forget, yes. when you travel into some of these countries, us a both know, i just came from south america, i was in colombia and in the hospitals there i thought to myself, oh, my god, if i got sick i do not want to be treated in this hospital. when you're in a foreign country you are at their mercy. what do you do as an american traveling overseas and god forbid you have to be hospitalized. you don't speak the language, in my case i did. >> frightening. >> if you don't speak the language, who do you connecticut tact, who is your advocate? >> what works for you is the

advent of televised manager. >> i had a loved one in the hospital and translated the questions for the doctors there, lucky that you have you as friends. >> the doctor, i have to tell you, he was really, rey good. he was trying very hard and all of the countries are equipped with great, great surgeons and doctors, don't want to put them down. but you're right. if you get stuck in a play, get someone who speaks the language by phone, et cetera, and talk to them, but it's always good to know where is the nearest hospital and in case there's a real crisis where you would go. check on those. most hotels obviously they have ways to get you to where you have to be, but, you know, we've -- we have a center in the dominican republic. we always get the cruise ships that pass by and they will airlift to the big hospitals and save lives so be careful. >> another thing. make sure you check with your doctor before you go about vaccines you may need because there's diseases in other countries that you don't see here, and that includes take

prophylaxis for ma layeria. that includes vaccines for typhoid fever. that includes making sure your hepatitis advantagesines are up to date, that you've had the mmr vaccine, measles, mumps and rubella. polio you've had to have within ten years. all these things when you travel to underdeveloped countries, and then if you get sick, think about the last time a mosquito bit you. again, something like ma layer yeah, you could have picked up from a simple mosquito. >> call dr. siegel if you're sick. got to talk a your doctor beforehand to have coverage for that. >> i think the best choice is to goes to las vegas. >> that's a different choice. >> and you'll have to be treated for a hangover. >> plenty of water, plenty of water. >> coming up, we dissect one viewer's question about the difference between good and bad fats. stay right there.

at ally bank no branches equals great rates. it's a fact. kind of like shopping hungry equals overshopping.

welcome back. now, for should i worry. our weekly segment about everything that worries us. this viewer asks, i like eating avocados and raw coconut. should i worry about natural saturated fat? per day is too m? those sound like pretty healthy foods. >> the key word is the saturated fats. is every saturated fat really bad? and the answer is no. because they all are different. you're talking about for example when you're talking about saturated fat, cheese, butter, beef, animal fat. those are the ones that actually increase the bad cholesterol ldl and lower your good cholesterol which is hdl which leads to heart disease, stroke, all of that stuff. but in the same category of

saturated fat you probably have coconut oil there, that's not necessarily the best thing for you. but it's not as bad as the rest of them. because yes it does increase the bad cholesterol but also increases the good cholesterol. what i want the viewers to know is that moderation is the way to go. on saturated fat are the ones that we love on this program, avocado, walnuts, olive oil. >> monounsaturated foots. >> exactly and trans fat is your biggest enemy that you absolutely want to stay away. when you have carbohydrates which is sugar, that's also another nightmare because it increases triglycerides. try to add some of the unsaturated fats to your diet. >> and actually they showed some fish. that's polyunsaturated. >> i love unsaturated fats. i'm also a huge fan of avocado which has a lot of unsaturated fats. has a lot of fiber. has a lot of vitamin "b." has as much potassium as a banana. what a great food avocado is. and an avocado as an energy source is a great food. it lowers bad cholesterol and

raises good cholesterol. shockingly, coconuts, as david said, have saturated fats in it. oh, my god it has more saturated fats than butter. but the kind of saturated fat it has is something called loreic acid. it's not as bad as butter. it's not animal fat. and the truth is, it's shown to increase all kinds of cholesterol. increases bad cholesterol and increases good cholesterol. so i would say don't have a lot of coconut. if i have to choose for that viewer between a coconut in one hand and an avocado in the other, i'd take avocado. >> what about coconut water? everybody loves to drink coconut water. >> that is fine. >> that's perfectly fine. that has nothing to do with this. >> rah coconut. >> i was waiting for mark to finish his sentence which is very important. it's okay to have some coconut oil because once you say it's good people are going to go out there and it seems like more is merrier. >> it's the mountaintop that's the point. if you have a little coconut it's good. if you have a lot of coconut

it's not great. avocado -- >> could be footening though? >> if you are replacing your milk with coconut you're doing pretty well. just don't have a lot of it. >> okay. >> how about mushrooms? >> how about cocktail in a coconut, is that okay? >> sure. >> won't eat the coconut. >> where are you going to the s seychelles? >> she's going to have a pina colada in a coconut. she's heading to the islands after the show. >> mushrooms. ear going to talk about that in a moment. you're out in your lawn you see mushrooms growing, you don't want to pick them. but some mushrooms in supermarkets can be more dangerous than the ones in the field. the shocking results coming up next. americans. we're living longer than ever.

as we age, certain nutrients... ...become especially important. from the makers of one a day fifty-plus. new one a day proactive sixty-five plus. with high potency vitamin b12... ...and more vitamin d. and we're back now "sunday mouse call." you know you've got to look out for the ones in the wild. but now research shows there's warnings about edible mushrooms like the ones we see in the supermarket. after there's been a spike in the number of people reporting they've become ill. they're in the bin, you think they're fine and the plastic that they've been produced and they're okay. >> first of all let me say that less than 1% of the species of mushrooms, we're talking 10,000 species in the united states are

poisonous. less than 1%. but as dr. banderas here points out before we came on you don't want your mushrooms to be over 77 degrees. and you don't want them in plastic bags. because then the bacteria comes parading in. and then you end up getting sick from them and it can be a very easy thing to get sick from. if you have a fresh mushroom, though, and you didn't get sick and you didn't pick it at 77 degrees in some forest, then it's high in vitamin "d," it's high in vitamin "b." it's got selenium in it. it's low in fats, low in calories. it's a great food. >> we're at the grocery store and picking out mushrooms. is there anything we should be looking out for or just the way you store them? >> a lot of it has to do with the way you store them. they did this study. i don't know why somebody will study these mushrooms, 450 patients, they followed them for about five years and find out that 80% of the poisoning is actually coming from edible mushrooms. the poisonous ones. so the way they collect them and the way you store them is a very critical point for people to pay

attention. don't put them in the plastic bag for a couple of days. because that's when you're going to get very sick. >> don't put them in a plastic bag for more than three hours according to this. >> exactly. the temperature has to be -- >> no more over 77 degrees. >> 77 degrees. >> so definitely when you're packing your lunch in the morning, what do we do with our mushrooms if you pack mushrooms for lunch? >> don't take mushroom to work my advice. it's supposed to be on the pizza and have your mushrooms -- >> you've got to wash them. take a paper towel and make sure -- >> any less dangerous if they're cooked? >> there's no problem with that. >> they can sit there for hours. >> once it's cooked -- >> make sure you go to a good supermarket by the way. don't go to somewhere where they look kind of funky. make sure they look really good -- >> and wash your mushrooms before you eat them. >> i wish we had more time to describe what a funky mushroom looks like. we don't have any more time. >> something extra growing on it. >> if it looks funky don't put it in your mouth. rule of the day. that does it for us.

>> have a great day. >> thanks as always for watching. >> don't put the in your mouth fit looks funky. about an hour from now the senate meets for a rare sunday session. at stake a highway bill lawmakers must pass before july 31st deadline, or it could be a rough road ahead for states and millions of american drivers. however, real fireworks today are likely to be over a couple of amendments. ones that will get a vote, and ones that may not. first a scandal over long wait times for veterans. now lawmakers say the v.a. is hiding a massive budget crisis. can congress make up a more than $2 billion shortfall and keep some hospitals from closing? we'll ask a congressman who is trying to fix the problem. chairman of the house veterans affairs committee jeff miller joins us live. >> p