and start planning your own. hello. welcome to "sunday housecall." >> joining us is dr. david samadi, chairman and professor of urology and chief of robotic surgery. >> and dr. marc siegel professor of medicine who is also the author of "the inner pulse: unlocking the secret code of sickness and health." doctors? >> good to see you. >> thank you. >> we are going to begin today with breast cancer. october is breast cancer awareness month t. is a disease that touches 200,000 families each year. dr. samadi, i want to start with you. if you could tell us some of the

breakthroughs in research and testing. >> this is an important month because october the whole world turns pink. and congratulations for wearing the right color. 230,000 women get breast cancer and 30,000 still die from this disease. now, we have made huge progress. if you look at the five year survival for breast cancer in this country, today it's about 90% at five years. in 1970, it was only 75%. why is this happening? and it keeps going back to early screening. and i just interviewed a lady this morning on my radio show who said, look, 20 years ago i took it into my decision to go ahead and get my mammogram and i'm standing today cancer-free. so screening plays a big role and of course women are very aggressive when it comes to this. but also we have angelina jolie factor. there's a study that just came out that 20% increase in awareness of as a result of what she did. get to know your janetgenetic t. the big message is, if you're under 50 and you have a family

history and have had a history of ovarian cancer, get that test. >> do you have to request the test? it's not automatic? >> it's not automatic. excellent question. there are a lot of guidelines coming to the doctors and they may or may not recommend this. you should be in charge of your health and you say, i want to know my genetic tests are. you know why? because if you're positive for that, you have very high risk of breast cancer, 80% chance of owe villanuevian cancer. what she did, went public and talked about this is extremely important. but another factor very important to both of you that people need to know this, we are becoming smarter. wre using our genetic testing to find out. 21 genetic tests to find out whether somebody needs chemotherapy or not. based on this study, 10,000 women looked at this genetic test, 16% of them did not need any chemotherapy. that's huge. so we're selecting the right people. we're doing the right procedure. know what your risk factors are

and the awareness this month is very helpful. >> how often should you get tested? what should women do? and also self-examination. >> first of all, i get this question every day because there's a lot of conflicting information out there on this. and i agree with david that earlier is better. here's another statistic to throw at you. mammograms are 90% effective at diagnosing breast cancer early. here's another thing. between the ages of 45 and 55, the number one cause of death in the united states for women is breast cancer. so i say start getting your mammograms at the age of 40. >> hang on. i know someone who has breast cancer, serious aggressive breast cancer, early 30s. >> that can happen. again, david's point, you have to know the family history. >> no family history. >> we're getting better and better at finding out genetic predispositio predispositions. also careful breast exam. i'm not saying breast examine stead of mammogram. here's another thing, when

you're younger you have more dense breasts. the mammogram may not be the answer. you may need an ultrasound or mri. if it seems lyle abnormal. all gynecologists and internists should be paying attention to the point you just made. sometimes it can be even earlier than 40. we want to get this early, before it escapes the breast. because then limited procedures can be done, lumpectomy. now reconstruction on the breast has made great advances so your breasts can look and feel the way they did before. and one more thing. if you god forbid have breast cancer that escapes the breast, research now is looking at what mutations are occurring, why your breast cancer isn't responding to the chemotherapy or treatment. what else can we offer you? there are vaccines coming out now. there's immunotherapy, things that look at the dna of the cell of the breast cancer and say, this is abnormal. what can we do to target it? >> so first of all because you have younger women and celebrities as you pointed out,

when we talk about this and there's no longer -- it should not have been the stigma of having reconstruction surgery if needed after breast cancer. we're talking about it. that in and of itself is great. clearly there's better research. but why isn't there a cure yet? >> look, i think the research is ongoing and we're getting better and better. and the answer to your question is that, you know, we learned that the breasts are not what make women feminine. if this thing is going to spread and really jeopardize your life, you will go on angelina jolie is going to still be beautiful. but the big message is, if you catch it early, yes, it's a very radical procedure but she's standing free. that's high risk genetic mutation is extremely important. we're also finding out that if you have, for example, ees estr positive receptors, now we have medications that can work. and finally going back to what marc just mentioned, there are

three-dimensional mammograms. there are breast tissue that's are very dense and they're fibrous and more glands. they're at higher risk. so individualized care, precision medicine. tailored screenings. >> how does a woman know if she has dense breasts and what do you do? >> well, your gynecologist should be able to tell you that. a great question. >> what if your breasts have civic cysts normally? that's related to coffee drinking. if you drink a lot of coffee, you could cysts. that makes it harder to interpret a mammogram or exams. but sequential mammograms and whether we're talking about screening the prostate or the breast, early screening is important because then we have something to follow. i look at last year's mammogram and compare it to this year's. >> so one year or every five years. >> it depends on the patient.

i can't give a prescription on the air here. one year in a lot of patients. some every year and a half. one more point i want to make. early detection leads to less side effects whatever your treatment is. i like to talk about quality of life because scientists are always saying the death rate is the same. death rates are only one thing. what about quality of life? if i have to put you on chemo, if i have to put you on radiation, it's not the same thing as a surgical cure. >> and the dense breast issue, if you could just address that, you should have more tests? >> a lot of women who are listening and saying, guys, come on, what are we talking about? annual mammogram. that's what they're saying now. so get tested. it's good to know. now, should everybody go out and start doing mastectomies? of course not. but while we're on the topic let me just mention also that alcohol consumption increases the risk of breast cancer. overweight can change your hormones. >> absolutely. >> cigarette smoking. please, if you're not smoking, don't start. these are all risk factors for breast cancer. that's really, really important.

>> those are usually important points. and lifestyle and exercise key. to emphasize your point, the denser the breasts, the harder it is to make a determination. and in younger women you're going to probably have to use ultrasounds rather than mammograms or a special kind of mammograms that's three dimensional. it's more of a challenge but we're up to it. >> big lesson to a lot of men out there. these two diseases, prostate and breast cancer identical. women we salute you. men, go get tested. both diseases are identical stats, rate of diagnosis. certainly starting with pink, sunday housecall is going pink as other programs are. >> breast cancer in men, too, by the way. >> absolutely. >> doctors, thank you. you ever go to the doctor and you come back and you have the list that has 7.321, 5.925? you don't know what that means. those are the codes. they just came out with new codes. what does it mean?

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just book any flight you want then use your miles to cover the cost. now, that's more like it. what's in your wallet? . we're back now with "sunday housecall." the world health organization releasing its annual icd report, international classification of disease. all those mumbo jumbo numbers, dr. siegel, i can't figure this out. what does it mean to doctors? >> if you came in to see me and i said you had some diagnosis, that would be your disease. international classification of disease means i put down some diagnosis. this is expanding my options by about 50,000. what it means is, say diabetes, for example. it used to be three or four codes. i looked it up this morning. over 100 codes for diabetes. diabetes involving the retina,

diabetes involving the left ankle with kidney disease. it gives me a way to be more specific. >> is this better? >> this takes more time. it's going to lead to a lot of delays and it's going to lead to delays in payment theoretically if you got it right, if you had time to get it right, it should lead to higher reimbursements. i'm dubious and worried. cms is saying that we have a year to get it right. we need more than a year. >> what's ems? >> medicare and medicaid services. we have at least a year to get this right. it's going to take more than a year. i've got a couple of codes to read to you you're going to like. problem with in-laws is a new code. >> seriously? >> seriously. fear of thunderstorms. that applies to the entire american public over the last week. here's one. helicopter parenting. that's me for sure. and sucked into a jet engine. i saw david on a jet plane there's a picture of him on the internet. i don't think he was sucked into the engine, though. it gives you an idea how expansive this is. it's really wild and it's going

to take a long time -- doctors that are already overburdened with record keeping are going to have a problem with this. people in private practices. hospitals have been gearing up for a couple of years on this already. billers are ready. they're ready. those of us in small practice -- >> are insurance companies ready, though? >> the reason why we're doing this segment is october 1st, after years for preparation for icd 10 we if finally got hit. the hospitals are getting ready. the tunes have to tune in. it's a big change for us. the super bills have to change, the computer software has to change. it's a major delay in getting paid for the procedures that you do. and it's going to affect you. so when you come to your doctor's office and you're going to wait a little longer and see less time with the doctor, it's because some of the changes. purpose of the change is to be having more specific codes. >> that sounds good. >> for example, for fracture you have 700 codes in icd 9. now you have over 1,000. for erectile dysfunction, you have one code.

now there's a million different ones. >> can't you just put it into the computer? >> no. you have to learn it, know it. >> the statistics show that 25% of doctors are not prepared. that will put them out of business. that's one concern. and 75% of us are only using about 10% of the codes. we like easy stuff. we're going from 14,000 codes in icd 9 to 68,000. more complex. what does it mean for all of us? when you come, the billers have to gear up. i think long term this may work because it's going to have better outcomes, more specific outcomes. the government can look, who is doing a quality job? that's the purpose of this. we have to stick together and be patient. >> you know what's going to happen? you're going to go to the doctor and give it to the insurance and then you're going to get a letter like a month later saying it's the wrong code. >> exactly. >> they don't know what the hell they're talking about. >> a lot of denial. >> absolutely. the good news is, there's going to be about 500 codes that will end up being the big eighties. we'll have to figure them out. this is a game with the

insurance companies. >> you'll end up paying out of your pocket. >> i'm going to -- call them. >> let's revisit in six months. >> send me the bill and i will take care of it for you. >> all right. not just me. everybody else. >> yeah. >> absolutely. >> may i? >> yes. do tall people have a higher risk of cancer? that is a new claim from a brand-new study. so what's behind this new finding?

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a brand-new study finding taller people have a higher risk to certain cancers. dr. samadi, is this true and why and what sort of cancers are we talking about? >> breast cancer and skin cancer, melanoma. this study got a lot of attention it comes from sweden. 5.5 million people participated in this study. one of the longest and largest studies out there, that shows that for every four inches your risk of cancer goes up among women 18% and among men 11%. what is interesting about this, it doesn't mean if you're taller, there is a cause or you would get cancer. there is some association. what is the take home message

for me? i think that if you're tall, because there is more surface area to cover, you're eating more probably, more cells in that particular person, that may be push you to a higher risk. so certainly whether you have to do screening, we talked about breast cancer or staying away from the sun that's what i would do. doesn't mean short people don't get cancer, just be aware. that's all. >> two things to add to this. obviously it is a wake-up call for people through the that you're in the sun. every part of your body can be -- is a risk of skin cancer. not just what we show on tv, your back or neck. melanoma can occur anywhere. the more surface area you have, as david said, the more of a risk for cancer, the more cells you have. here is something else that needs to be studied. what about growth factors? what about the growth factor that caused you to be tall? is having more of that growth hormone increase your risk of cancer given that cancer is growing out of control. we do not know that. this study, because it was in so

many people, means that has to be looked at. >> a lot of theories behind this. even food, if you're taller, you'll be consuming more food and maybe that causes more inflammation. we don't know the answer yet. it is a good study to talk about and just make sure you do your screening as we talk about, especially if you're taller. >> even in winter. david is 6'1". even in the winter, watch out for skin cancer. that's another thing. fall and winter. not just a summer problem. have to watch out. wear sunscreen when you're exposed in the weather no matter what time of year it is. >> good idea. from tall and short to losing weight, are you having trouble? most of us do. there is a new study that says you're not alone. coming up, why researchers say it is, it is getting harder to shed those extra pounds.

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increased the amount of exercise by 120% over my generation, so you would expect them to weigh less. couple of theories. preservatives in our diet. we lay around when we're not exercising, too sedentary, wear watching tv. my former boss at nyu think it is antibiotics. antibiotics interfere with the bacteria in your gut and we absorb your food differently and end up gaining weight. finally, anti-depressants, we're talking more than we used to and antidepressants -- >> it makes you lazy and can't move or what? >> no, they cause weight gain by having the -- >> oh, i see. >> i think there is a lot of other factors. how many people are out there are doing the right exercises, all the stuff we said, drinking your water, drinking green tea, coffee and say hey i still can't lose the weight. what do i do over here? i want you to look at -- it is true. so a lot of studies shows that

low vitamin d can be one thing that can lead to obesity. check your vitamin d. the truth is you may have a low thyroid, hypothyroid is one of those things that can lead to obesity. now, everybody knows about stress. who is not stressed? especially in the new york area? stress is one of those factors, kushing syndrome is a disease you may not know you have it but your level could be high and polycystic ovarian disease. there are so many medical issues, may not have any symptoms, but check with your doctor and find out if you have them and i promise you -- >> two more quick points. diabetes epidemic and lack of sleep. lack of sleep leads to weight gain. >> they are sleeping more, drinking the water. this is for people who do everything right and still can't get it right. >> i'm going to post it on our facebook. come to dr. david samadi facebook and we'll post it out

there. >> vitamin d. >> get your thyroid checked. your sugar levels checked. sleep when you're supposed to do. decrease stress and exercise. >> excellent. >> thanks. this is a fox news alert. u.s. coast guard now revealing brand-new information in that massive search for a missing cargo ship off the bahamas. welcome. i'm shannon bream. >> i'm leland vittert. the ship vanished thursday as it sailed into the path of hurricane joaquin with 28 americans on board. brian is following the search for us. what do you hear from the coast guard in. >> the u.s. coast guard says they found some items in and around the last location of the missing cargo ship. two life rings have been spotted in the water as well as a