kind of like mute buttons equal danger. ...that sound good? not being on this phone call sounds good. it's not muted. was that you jason? it was geoffrey! it was jason. it could've been brenda. i'm arthel neville. time now for "sunday housecall." >> and i'm eric shawn. joining us as always dr. marc siegel of langone medical center and author of "inner pulse," unlocking the secret code of sickness and held" >> >> and dr. david samadi chief of robotics at lenox hill hospital. good to see you. >> good to see you. >> we start with poignant news you might have heard b.former president jimmy carter has been diagnosed with cancer. the 39th president made that announcement a week after he had a small mass removed from his

liver, and he says the cancer has spread to multiple parts of his body. the diagnosis though also shines light on cancer treatments in elderly patients so dr. siegel, first of all, our heart obviously goes out and prayers to the former president, roslyn and his family. what happens next when you make that type of announcement and doctors have discovered not just potentially one mass but when it spreads? ed. >> key word you said to start with is 90 years old, and everyone out there should know the game is changing and this is very shocking and very positive way, we're offering things we never offered before we talked about them a lot on the show and it isn't what it used to be and president comforter is very active and with it mentally and doing all kinds of international peace efforts and we factor that in. if someone comes to my office, even 90, widespread cancer, i want to know where it originates and he has a family history of pancreatic cancer. don't know if that's what he has but it's a possibility. spread to the liver and other places.

interest to figure out what type it is because when they figure that out that aids treatment. we use targeted therapies where we look at the mutation on the cancer and figure out exactly how to cut off its blood supply. we do things that have less side effects and they are advisized or personalized approaches that enable us to say one patient responds to one thing and another patient to another and, again, means less side effects. david, i want to address something to david on this because david does the same thing with surgery. he offers a kind of prostate cancer surgery that's much less invasive than what they used to do which means an older patient can now get it. >> let me jump in because i want to stay no netly on prostate cancer at the moment but wanted to ask you specifically dr. samadi because dr. siegel pointed out the advantages of treating elderly patients with cancer what. are the complications involved? >> the big question is should we actually treat him or not, and most doctors when they see 590-year-old, the first question that may come to their mind, the silent question that you don't necessarily discuss with the

family is what exactly are we doing here, and are we going to treat this and have the side effects overtake the quality of life and that debate should be going in any doctor's mind, but this particular type of patient, we're going to see more and more. for two reasons. one is the population, the elderly population in america is growing, and we're going to see by 2060, we're going to double that whole group 6 patients and we're going to see 80-year-olds, 90-year-olds coming into our office. going back to what you were saying is you have to individualize the patient and the key word is performance status. is he functional? is he really mobile? does he have comment yeah, the psyche and emotion has taken over, or is to hill going to the library and signing books and traveling so all that have plays a big role. then comes, okay, what is the treatment we're going to give. stage 4 means it's metastasized meaning the bird is outside the cage. that is poor prognosis. whether it's colorectal, pros

kate cancer or paining atic. everything goes through the liver which is a big filter and that's where the highway is. if you're going to get chemotherapy, arthel, what are the side effects and what's the primary disease? what's the size of the primary disease, and are we going to extend his life or not? these are the questions we should always answer. >> what do you tell your patients. you have an elderly patient. when do you decide whether to have chemotherapy or go under the knife or in some cases prostate cancer. >> it's a discussion with the family. as a doctor, and i'll let marc answer, that he goes through this all the time as a doctor balancing the pro and cons. >> if you're an elderly man with pros kate cancer, and some say it grows very slowly so don't do anything. >> you're both reaching to this. the first thing is what kind of cancer does a person have? they may be able to find from his liver looking at it the under a microscope to figure out where it originates. where it originates will help us decide how to treat it. something like bank attic much harder to treat.

colon that spreads to the live, a little more response i have to treatment. you mentioned chemotherapy. i want to clarify something here. the exciting state of the art treatments right now are immunotherapy meaning we're trying to get the body's immune system to rev up and fight the cancer, to targeted some mutations on the surface of the cancer. when we succeed at, that there's much less side effects than the old way because, eric, chemotherapy means poisoning the cancer and hopefully poisoning the cancer more than you poison the body. there's more side effects with chemo. >> can you get the immunotherapy now? >> absolutely. >> and if you're 90 years old and does that help? >> you can get it now. it's in the doctors' offices. we're developing new research all the time but, yes, you can get it now. >> eric, i think going back to what you were saying is as an oncologist and what we deal with in cancer centers all the time. just because you can give a treatment, should you be giving that treatment? does it really work?

if we're going to give you immunotherapy and marc is absolutely right about this, if we give the immunotherapy and it only works in 14% of the patients but he's going to be sick in his stomach, have nausea, vomiting, weights loss and everything else, it's a debate and discussion with the family and more importantlied with the patient's quality. two things going on. as patients are getting older we'll see the cancer. if you live long enough you'll get cancer, number one. number two, diabetes is going tonight biggest risk factor along with obesity over smoking over the next few decades. as obesity and diabetes will come, and we'll get older, now you're going to see cancer coming in. you know why? because he's doing a good job saving the heart attacks. they are not dying from heart attack which used to take them away at 65. by the way, this is the reason why medicare is bankrupt, and i don't mean to sound like donald trump. i can take care of it, okay? but medicare is not going to catch up with the elderly population. i figure that's cute. >> that is cute. >> nobody can do it better than

me. >> that's what i do. >> go on. >> one final point you may decide in anner did iler person to give one shot at at all. patient may come in and say i want to try it. the more you try different treatments and the less they work the more you'll say a more realistic conversation going on but hope should not be taken away at the beginning, that's my experience. >> we pray for his health and recovery. >> absolutely. no doubt about that. >> what a stalwart. >> yes. >> here's something else we're going to talk about. stroke survivors and their families face a whole lot of challenges as they adjust to the new normal, but now there's a new way to build hope. we're going to explain that next. ♪ [music] jackie's heart attack didn't come with a warning. today her doctor has her on a bayer aspirin regimen to help reduce the risk of another one. if you've had a heart attack be sure to talk to your doctor before you begin an aspirin regimen.

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the lives of stroke victims are changed forever, but it's not only the patients who are affected. their families are as well and now stroke survivors and their caregivers can build hope and gain strength from each other at retreat camps across the country. dr. samadi, i want to find out what sorts of therapy are these patients receiving at these retreat camps, and then also i know you want to break it down because i don't think we all know the difference between a stroke versus a tia. >> yeah. these camps are absolutely important and mostly not only for the patients but for the patients' family. strokes can change the patient's life forever and it's really an attack on brain, just like we have heart attack and you have blood flow that stops hitting the muscles and the heart. you have the same thing cold brain attack which is called a stroke and you have your husband, your wife that's functioning quite well and next thing you know they collapse and they can't speak and it's horrendous so these camps are i think a healing process.

they have gains. they are getting together and seeing they are not alone and suddenly there is hope. it's certainly important. how do we prevent stroke? this is what you want to know what. are the risk factors? many different types of strokes, hemorrhagic, meaning something bleeds in your brain and that's from high blood pressure or you may have an aneurysm. you may have arterial venous malfunction. >> can you feel that? >> you can have tlobing headaches and one of the symptoms you should be aware of and not saying i have stress. 80%, 90% are kind of aschemic stroke meaning the blood doesn't get there. what are the risk factors, diabetes, high blood pressure, smoking, all the things we talked about. i always talk about the new jerseyic f.a.s.t. facial drooping, put your arms together, that's another one, weakness and slurred speech and time is an essence.

time loss is brain loss and that's when you come. the question to mark is how do you distinguish between stroke and tia? >> what's the difference. >> time is brain is the key new jerseyic. what's happening if you get a blood clot to one of the arteries that's block blocking the brain, you may have trouble speaking or weakness on one side or the other or problems with blurry thinking and get 911 right away and if you get to the hospital right away we may be able to give you a clot dissolver and reopen it within three hours or have a denies now that goes in and sucks out the clot, prevent the stroke but to answer your question, eric, what's a tia, it's a trance yet aschemic attack meaning you have the symptoms of a stroke but it reverses because the clot opens up. if it doesn't open up and you get the permanent damage. stroke is permanent and tia temporary but it's a warning sign, a tia that a stroke could

be next. >> quickly it's the carotid arteries that your doctor should do both of them. my father had a stroke, tia on the bus and one of the carotid arteries totally blocked and fell down to the floor, like oh, my god. >> your doctor, we point that out about taking a pulse last week. a doctor can literally listen to these arteries for a squishing sound. that's a sound of a blockage or send you for a crotied doppler and tell you there's a blockaged and surgically can fix it. >> how do you know if you've had "x" number of tia experiences, how do you know that the next one could be the big one? is is there a certain number? >> you really don't know and if you have had or are being diagnosed with tia you should be under the care of neurologists and doctors. as marc mentioned, if you have any kind of thrombosis or cloth or atherosclerosis in the artery surgely treat it and sometimes even after surgery sometimes can send an emboli or blood clot to

the brain so these are things that you should not ignore and treat it as -- >> david is 100% right. i would add a $3 month a drug to this, aspirin a miracle drug of preventing a tia from becoming a stroke. your doctor has to be involved. i'm not asking anyone to go out. >> a big booster of baby aspirin. >> for something like that. stroke prevention and treatment. >> dr. samadi talked about diabetes. do you know there are two types of diabetes. coming up, we'll detail type i and type ii, what they are, how you get them and how you treat them to make sure you stay healthy. "sunday housecall" rolls along with this sunday.

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welcome back to "sunday house call." >> i am an active 75-year-old female with a recent change of diagnosis from type 2 diabetes to type i. should i worry? >> the first thing i want to

know is who told her that because most of the final type i diabetes, i'll tell you what it is, type i is diagnosed around the age of 14. i would immediately go for a second opinion. type i is when the body makes antibodies and destroys part of the pancreas that doesn't make insulin. you have to be dependent on insulin otherwise you go into a coma and make ketones. type 2, you don't make enough n insulin for what you need. you make insulin but not enough to overcome the body not using it properly. what's the treatment for that? lose weight, that helps you, we give you insulin or oral medication helps you. it's not the same thing. you don't have the body

attacking the pancreas. >> which one is worse? >> they're both bad. type i is probably worse. >> we don't see a lot of type i because 80 to 90% are type 2. type 2 diabetes it's all from industrial countries. it's from food. fast food and obesity is the reason why we have diabetes the poor kid who has basal cell disease, not much you can do. this is very interesting concept. as we get older and we talk about obesity, your body and pancreas is pumping insulin. you don't care. you're having the fatty food, gaining weight. now your insulin is becoming resistant. it doesn't work anymore. a lot of sugar is floating in your body. over time your pancreas is going to get exhausted. this guy doesn't listen to me. active. she said she's active. >> just because she said active -- >> what should you do?

>> there is a chance that now your pancreas is not producing enough insulin, you're going almost from type 2 to type i. that's when the oral medication doesn't work, you have to start giving insulin. >> can you get diabetes from drinking too many sodas? >> you're prone to it. type 2 is genetic. if you want to ward off diabetes, exercise, have fiber not soda pop, not cookies, not cakes, lose weight. if you do that, you'll be on the right diet. to your other question, sometimes you can get type 2 diabetes even if you're not overweight. that runs in families. >> type i is worse of the two. how do you treat it? >> type one, you have to give insulin. your pancreas has had an autoimmune disease. it just doesn't make it.

juvenile diabetes, really see it in children. the other phenomenon is even among younger children we are seeing type 2 diabetes. get a second opinion, start losing weight. if your sugar is not controlled after all of this, oral medication, you may need this. >> you know what i've learned on the show? >> oatmeal and blueberries. >> thank you. >> i want to add in modern technology, by the way. if you get stuck with a diabetes diagnosis, at least we have more and more medications to treat you and better and better varieties of insulin to treat you than before. >> that's the technology. >> always get your hemoglobin a 1 c. blood test you can get to look at the last three months what is out of your sugar and blood. >> you get that automatically? >> they should. >> you get that whole list. >> write it down, eric. eric, write it down. you always forget.

>> "house call" list. >> well, listen, from chiropractors to massage chairs, you probably tried it all to relief your back pain, but the solution could be as simple as sitting or standing up straight. when you're living with diabetes, steady is exciting. only glucerna has carbsteady, clinically proven to help minimize blood sugar spikes. so you stay steady ahead.

♪ [music] jackie's heart attack didn't come with a warning. today her doctor has her on a bayer aspirin regimen to help reduce the risk of another one. if you've had a heart attack be sure to talk to your doctor before you begin an aspirin regimen.

your mom always told you, practice good posture. it can help relieve your back pain. even sitting the wrong way can cause tension and muscle tightness. easy exercises can also help ease the ache. dr. somadi, what do you say? >> we were talking during the break that we're spending more time sitting and not mofk like we used to. unfortunately with all of the technology and computers, this is heading the wrong direction. not only it can affect heart and overall 4ehealth but good postu. sit straight and make sure all the very at ttebras are aligned. swimming, yoga, absolutely. finally, invest in a good mattress. that's a good thing. >> don't slump your shoulders.

>> stretch like this. stretch like this. stretch your neck get an ergonomically sound chair. get up and exercise and lose weight. that's the main ching. >> very good. >> weight loss. >> he's eric shawn. they're the docs. thanks for joining us. brand new polls are out on all the candidates running to be your next president including who you think won the republican deba debate. we'll break it down. meanwhile, hillary clinton can't get away from her e-mail troubles on the campaign trail. plus, new questions about her home server and if it compromised national security. >> i wish she had done this in march, we would be further down the road. she swore she would turn the server over. it wasn't turned other, it was taken. >> we'll talk with congressman john micah on the house oversight committee. >> brand new details on the indonesia plane crash in one of the most