By Yvonne S. Lee
CNN Medical Producer

The late stages of cancer are brutal. I remember an ugly tangle of tubes around my grandmother's body, her desperate, humiliating struggle for each breath, her body slumped over as sweaty white skin hung off the emaciated body of this once-mighty woman.

She was the family matriarch, a woman who had fed three hungry children and a half-dozen nieces and nephews through the worst days of the Korean War. She started smoking because she was hungry. She got her first cigarettes from American soldiers stationed in Korea during the war. She said they helped her feel less ravenous.

Doctors weren't able to save her. Advanced lung cancer was hard to detect and just wasn't curable in the late 1970s. It still isn't. Only 16 percent of cases in the United States are detected in Stage 1, when tumors are still confined to the lung.

It turns out that thousands of patients in the U.S. have to endure what my grandmother did - trying to survive after their cancer is diagnosed at a late stage. But many of those people find out they have advanced cancer because they do not have health insurance - something my grandmother did have - and therefore have limited access to health care and early cancer screening.

A new American Cancer Society study published in the journal Lancet looked at 3.7 million cancer patients - the largest study of its kind - and found that uninsured and underinsured patients are twice as likely to learn about their cancer in its late stages of cancer as people who have private insurance.

When I read this, I thought about all the people who have to watch their loved ones die of cancers that could have been successfully treated had the disease been caught earlier. It seems tragic that if they'd had insurance, perhaps they would have gotten pre-screened for breast, colon and other cancers. Catching these cancers early means you're much more likely to live longer.

If colon cancer is diagnosed in Stage 1, you have a 93 percent chance of surviving five years. This drops to 8 percent if it's found at Stage 4. According to the study, uninsured people were twice as likely get their diagnosis at an advanced stage of colon cancer versus an early stage.

The statistics weren't any better for breast cancer. Women without insurance were nearly three times as likely to learn they have cancer at a later stage rather than an earlier stage. If breast cancer is diagnosed late, your chance of surviving five years goes down by 80 percent.

These are scary numbers when you consider that 47 million Americans don't have health insurance. That's 47 million people who are taking a chance, whether by circumstance or because they have no choice, that they won't become seriously ill; 47 million who may have to rely on emergency rooms if they do; 47 million who don't have the luxury of calling their family doctor to ask about a pain in their chest, or a lump in their breast. They just have to grin and bear it, or hope that it's nothing.

I think about having five more years with my grandmother. I would have asked her what it was like to live during the Japanese colonization of Korea, when she escaped with her family to China, or how she was able to feed her children during the Korean War, with only a sack of rice to get through most weeks.

For me, health insurance is not a political issue, it's a moral issue. Poverty shouldn't mean that you are more likely to die from diseases that we can treat effectively if caught early. It shouldn't mean you get less time with your kids, or grandkids - not in the richest country in the world.

Are you uninsured or on Medicaid? Was your cancer diagnosed at a later stage because you didn't have insurance? Tell us your story.


Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Val Willingham
CNN Medical News producer


When I was a little girl, I wanted to be Julie Andrews. I would run down the hill behind my home, throwing my arms in the air and screaming out the lyrics, "The hills are alive..." And I loved her in "Mary Poppins" -- flying through the air with an umbrella, dancing with penguins, jumping in and out of chalk pictures! To me, she was supercalifragilisticexpialidocious!

But now that I'm older, I have come to admire Ms. Andrews, not only for her acting, but also for her magnificent voice. I even have her as a playlist on my iPod. So it was sad when I heard she had lost it because of a surgical mishap on her vocal cords.

Although they are two of the smallest muscles in the body, vocal cords, which are also called vocal folds, do an awful lot of work. Vibrating up to 400 times a second, they create sound when we breathe through them. Yet as we age, many of us abuse our voices without even knowing it. "The voice is an instrument," says voice therapist Susan Miller. "We need to learn how to play it. Many times we don't warm it up."

The best thing for our vocal cords: Drink lots of water. Vocal cords need to be wet and relaxed to vibrate. As we age we don't produce as much saliva, and keeping our vocal cords hydrated is important. Also, cut down on the caffeine and alcohol. They can dry out your throat. .

Exercising your cords is also a good idea. Vocal folds can lose a little bit of tone -- and then they don't meet together. Try lip vibrations, or hum in the shower for a few minutes before you start your day. That keeps your vocal muscles in shape as you age.

Medication can also affect the cords. Medicines for blood pressure and heart ailments can dry the throat. Health conditions like acid reflux, common in your 40s and 50s, can really affect the voice, causing a raspiness and change in pitch. That's because during the day, acid comes up and can spill over the vocal folds.

And give your voice a rest. Professional singers or speakers, like Julie Andrews, sometimes scar their folds. She actually grew polyps on her vocal cords, requiring the surgery that robbed her of her beautiful soprano voice.

Have you noticed that your voice has changed over time?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Dr. Sanjay Gupta
Chief Medical Correspondent

All week long, we will be talking about the health of the president. This weekend, we will present "The First Patient" a special about this topic.

I am curious to know how important you think it is for the health of the patient to be divulged. It has always seemed amazing to me that we aren't given more information about the physical and mental health of our candidates. It is arguably one of the toughest and most important jobs in the world.

No question, the information we get today is better than in elections past. John F. Kennedy denied he had Addison's disease throughout his campaign, even though he was officially diagnosed and treated for it. Franklin D. Roosevelt was essentially a dying man when he ran for his fourth term, even though most voters didn't realize it at the time. Roosevelt's doctors didn't even tell him he was suffering from congestive heart failure.

In 1992, you may remember that Paul Tsongas was the first cancer survivor to run for office. What was not known at the time was that Tsongas had a recurrence a year before the campaign. His cancer was back again before he would've been inaugurated. So, what do we deserve to know and when should we know it?

Tsongas for his part actually asked then-president Bill Clinton to create a commission that would require all candidates to release all of their medical records. That never happened.

Last month, Sen. John McCain's campaign released a summary of his records. His staff has promised to release his full medical records should he receive the Republican nomination.

That's important because the 71 year old McCain was diagnosed more than once with malignant skin cancer and would be the oldest president in our history.

As governor of Arkansas, Mike Huckabee weighed more than 280 pounds when he was diagnosed with Type 2 diabetes five years ago. Through diet and exercise, the 52-year-old Huckabee is now 110 pounds lighter and symptom free.

Sen. Hillary Clinton is 60. So far, she hasn't reported any health problems.

Sen. Barack Obama, 46, was a smoker, a habit that cuts an average of 11 years off life expectancy. Obama has told us he has quit smoking and he can often be seen chewing Nicorette gum.

Does the health of the candidate matter to you and would you vote differently based on that information?

Programming Note: Watch "The First Patient" Saturday and Sunday at 8 p.m. and 11 p.m. ET

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By A. Chris Gajilan
Senior Medical Producer

I simply hate exercising. There is nothing I dread more than feeling like a trapped rodent at the gym. I have never experienced that mythical "runner's high." I am confounded by people who make time to exercise every day. In truth, I kind of think marathoners and triathletes fall on the freaky side of the spectrum.

Apparently, I'm not alone. In fact, one out of four Americans doesn't exercise at all according to the Centers for Disease Control and Prevention's latest numbers. But a growing body of research is finding the benefits of exercise are even more wide reaching than the already-exhaustive list of collateral good: improved metabolism, lower blood pressure, reduced risk of hypertension, diabetes, heart disease, cancer and osteoporosis, just to name a few.

"Exercise may be as beneficial as antidepressants for patients with moderately severe depression as well as mild depression," says James Blumenthal, a researcher and medical psychologist at Duke University. "Without a doubt, exercise is directly associated with improved quality of life and self-satisfaction."

Blumenthal's team recently published a study in the journal Psychosomatic Medicine comparing the effects of exercise with antidepressants in the treatment of major depressive disorder. The researchers took 202 depressed adults and separated them into four groups: group exercise; home-based exercise; antidepressants alone; or placebo pill. The antidepressant used was the selective serotonin reuptake inhibitor sertraline (brand: Zoloft, Lustral).

The team's findings: Exercise may be just as useful as a pill in some, but not all cases. (It's also noteworthy that those who exercised in a group fared better than those who exercised at home alone.)

Blumenthal emphasizes, "We're not saying to stop taking antidepressants, but you can consider exercise as a viable option."

If you're asking why exercise has such a sweeping effect on depression and health overall, just look at the groundbreaking research in the field of neuroscience. Study after study details how exercise can actually change the structure and function of your brain.

Arthur Kramer, a professor of neuroscience at the University of Illinois at Urbana-Champaign, found a 15 percent improvement in memory and attention in older people who walked just three days a week for six months.

In fact, several studies have shown that fitness is related to increases in the brain's gray matter and white matter. To be clearer, exercise can help you create new brain cells, thereby improving memory at any age. The dramatic effect can be attributed in part to neuroplasticity, the brain's ability to adjust and adapt. "When someone practices something over and over again, the structure of the brain actually changes," says Richard Keefe, a Duke University sport psychologist. "Synapses and neurons connect with one another and brain substances fortify the connection. Neurons that fire together, wire together."

Just in case you're wondering whether I manage to get past my hatred for exercise, I do. Sometimes. I've found that working out with a friend or family member - and adding a little friendly competition works for me. What works for you?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Miriam Falco
Managing Editor Medical News

Ever since the 2008 presidential campaign shifted into high gear last year, CNN Medical News has been taking a closer look at some of the problems in our health-care system. In our documentary "Broken Government: Health Care -- Critical Condition," which made its debut last week, Chief Medical Correspondent Dr. Sanjay Gupta investigated problems with America's health care system. The program will be rebroadcast this weekend, Saturday and Sunday at 6 a.m. ET on CNN in the U.S.

The World Health Organization ranks France as having the No. 1 health-care system in the world. So last month I spent a couple of days in Paris, to catch a glimpse of how French health care works. This certainly doesn't make me an expert. But it was a very interesting experience.

Everybody in France has to have health insurance. If you can't afford it, the government helps you pay for it. If you lose your job, you don't lose your health insurance. (watch video)

I focused on the costs of having a baby in France, as an example of how it's covered by health insurance.

Dr. Laurent Mandelbrot heads the obstetrics department at Louis Mourier Hospital in Colombes, a suburb of Paris. He explained to me that in France, all prenatal care from the fifth month of pregnancy until the baby is 1 month old is free. New moms also stay in the hospital for at least four days, long enough to learn how to take care of their baby, get used to breastfeeding, get some rest. Mandelbrot says this allows doctors to detect problems early, when they might be resolved. "If people don't have access to care and it's too late (to catch a problem), that costs a lot more and it's just a terrible cost in terms of sick babies and maternal complications," Mandelbrot said.

I also met a social worker at the same hospital, Elodie Cadier-Dervaux. Her main job is to help expectant moms navigate the system, to ensure that all her medical costs are taken care of. Another part of her job is to make sure the expectant mom is taking care of herself, getting proper nutrition, vitamins etc.

Knowing that families in the U.S. can fall into serious debt if their baby is very ill at birth and their insurance doesn't cover as much as they thought it would, I wanted to get an idea of how much a family in France might pay in a similar situation.

When I met the director of France's national health insurance organization, Frederic Van Roekeghem, I gave him a hypothetical scenario: Baby is born with a serious problem, perhaps a heart defect. Baby needs surgery and has to spend a month in a neonatal intensive care unit, how much would that cost? Van Roekeghem told me the total costs would be about 30,000 to 40,000 Euros - but the parents would only pay 18 Euros. Even without doing the math (18 Euros = approx. $26), I knew that was a very low amount, but I asked him again because I thought I had misheard his answer. I think it amused him, but he repeated - 18 Euros.

It's hard to imagine that France's system could be duplicated in the U.S. - it's costly and people do pay a lot for it - approximately 21 percent of their salary goes to their version of social security, which includes mandatory health insurance, supplemental health insurance and retirement benefits. But judging by the folks I met in France, having access to health care for everyone is something they don't want to do without.

Do you think our health care system needs to be fixed? Do you think everyone in the U.S. should/must have health insurance?




Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

By Miriam Falco
Managing Editor Medical News

Ever since we learned of Heath Ledger's sudden death on January 22, the question of what killed him loomed large (at least in the news media). Just a couple of days after, New York's Police Commissioner Ray Kelly announced that no illegal drugs had been found in Ledger's apartment, but two unnamed law enforcement officials told the Associated Press that six types of prescription drugs were found.

Yesterday the New York City medical examiner released the final autopsy report. Cause of death: a combination of six prescription drugs. Ledger "died as the result of acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam, and doxylamine."

A spokesperson for the medical examiner tells us that none of these drugs - two sleep medications, two anti-anxiety drugs and two narcotic painkillers - was taken in excess. Still, the ME ruled this accidental death resulted "from the abuse of prescription medications." And sadly, Ledger is only the latest celebrity to die after mixing prescription meds. Tomorrow is the first anniversary of Anna Nicole Smith's death.

But experts from addiction specialists to pathologists point out that prescription abuse is hardly limited to celebrities. In fact, within an hour of the report's release, two acquaintances told me they had some or all of those drugs in their medicine cabinets, left over from previous prescriptions.

Many people may not realize that mixed together, sleep aids, anti-anxiety drugs, antidepressants and narcotic painkillers can be lethal. In Ledger's case, we're told the combination of drugs probably caused his central nervous system to slow down so much that his heart stopped beating and lungs stopped breathing and he never woke up. It's hard to imagine that any doctor would prescribe all six of these drugs to the same patient, but nowadays it's not difficult to obtain prescriptions from several different doctors. Unless you tell your doctor what other drugs you're taking, it's difficult for him or her to anticipate potential complications.

Some use prescription drugs to get high because they are so widely available, and much easier to get than illegal drugs such as cocaine and heroin. And many parents may not know that among teens, prescription drug abuse ranks ahead of all illegal drugs except for marijuana according to a report by the White House Office of National Drug Control Policy released two days after Ledger's death. The agency noted that, "Teens are abusing prescription drugs because many believe the myth that these drugs provide a 'safe' high." That may be a common misconception among the young and the old. Even though a drug may be prescribed by a physician, taking it in the wrong way or in excess can be deadly.

Concern for prescription drug abuse has led the drug control policy agency to participate in a $30 million ad campaign to raise awareness about the problem. The launch was delayed in light of Ledger's death (the White House didn't want to appear to "opportunistic," according to spokeswoman Dana Perino), but if you watched the Super Bowl, you may have seen the commercial showing a drug dealer complaining that he can't compete with kids getting their drugs for free out of their parents' medicine cabinets.

Many, including Ledger's parents, hope that lessons will be learned from this tragedy. In a statement, the family said, "Heath's accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage."

Were you surprised that too many prescription drugs led to Health Ledger's death? Were you aware of the risks of combining multiple prescription drugs?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

Tangia Boyd stands on the balance platform

By Val Willingham
Medical Producer

Tangia Boyd loves high heels. A confessed shoe fanatic, she's the Carrie Bradshaw of Temple University. So when she was asked to participate in a balance study through Temple's Physical Therapy Department, she thought she'd get to wear a new pair of stilettos. Instead she wound up barefoot, standing on a moving platform, wearing 3-D glasses and strapped to a harness. Sounds more like an amusement park ride than an experiment. But Temple is using a virtual environment to see how and why people recover when they're thrown off balance.

Surrounded by moving screens, the Temple lab is set up to see how the central nervous system handles movement in a natural setting. That's because all our senses help keep us balanced. When there's a change, it can knock us off stride. "If you have an impairment in the sensation of your limbs, your balance will become impaired," said Dr. Emily Keshner, director of the project. "If you lose your inner-ear sensors, your balance is impaired."

More than 6 million people in this country suffer from chronic dizziness or imbalance, and those numbers are expected to grow as our population gets older. As we age, our balance can be affected. Minor injuries can play a big role in balance control. Athletes will favor one side of their bodies if they've hurt a foot or leg and begin to lose their stability. Also good posture is crucial in keeping your balance. Yoga and tai chi can help correct balance at any age. Keshner says these methods "are actually good in two ways. One, they'll strengthen you, but two they also make you pay more attention to the input you are getting from your limbs."

As we get older, our senses begin to change. Our hearing isn't as good, our eyesight may need to be corrected, so by keeping senses intact, balance problems can be avoided. And getting plenty of sleep makes a difference. Being alert helps. Keshner says that's because, "A lot of times, there are so many things going around us, we can't always pay attention to everything that is happening. It becomes a processing problem."

With data from this project, Keshner and her researchers hope to develop tools that can help people, especially stroke victims and those with brain disorders, keep their balance even as they age.

As for Tangia Boyd, she stayed upright on the platform, even though it left her "a little dizzy". At age 42 she's still walking a straight line, which makes it easier for her to get around in her new as Jimmy Choos. Do you have a problem with balance? Tell us how you handle it.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.