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The war in Iraq: It is real

I have been in Iraq only two days and this is my first visit, so my impressions can only be those of a new set of eyes looking at a very well-examined place and situation. 

Still, two things stand out to me immediately: One is that at the hospital in the Green Zone where the 28th Combat Support Hospital (CASH in military speak) receives massive numbers of wounded soldiers, there is a sense of it all being so routine. And it is not just the medical staff that does such a sensational job; the troops I spoke with who woke up with missing limbs and other severe injuries seemed so stoic and calm. It is as though they know that their patrols here have such a high chance of encountering life-threatening trouble that they almost expect it to happen. 

People can talk about bravery and dedication, but when a young woman who just lost her leg tells me she is still glad to just see the sun rise and be in the Army, I'm so moved I start to cry.  Another impression: the Green Zone -- the international American-guarded sector -- Saddam's old palaces, where massively armed U.S. soldiers and a few Iraqis walk around in a calm atmosphere. One can see and feel huge explosions only hundreds of yards away, but it seems thoroughly incongruous. But today, seeing the mangled soldiers in the Green Zone made me know -- it is real.

Editor's note: If you missed Robert's report on Tuesday's broadcast, click here to watch.

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Alzheimer's warning signs

Whenever we discuss a story about Alzheimer's, a lot of people around the room ask whether their forgetfulness is the beginning of this horrible disease. This is especially true concerning our story tonight, which is about younger people with the disease, and features a man who was diagnosed at age 45.

There is no simple answer to the question, but the Alzheimer's Association does offer a guide to the warning signs. The association's report on the prevalence of the disease in younger people can be seen here. In fact, the association's general Web site is an enormously helpful resource as is the Web site of the National Institute on Aging.

Editor's note: We also have an extensive collection of Alzheimer's coverage on MSNBC.com, including a special look at "Maintaining your Memory" as you age.

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Better understanding SIDS

Tonight we report on the discovery of what may be the biological basis for sudden infant death syndrome, or SIDS. Researchers at Children's Hospital in Boston have found that the brain receptors for serotonin are greatly reduced in children who die of SIDS. You can read an abstract of the research here.

This is nowhere near a cure. But someday it could become a means of identifying the children who are at high risk from dying and intervening to reduce the chances of death.  SIDS, which is as old as humanity, has a long, sad history of parents being blamed -- and at times even charged as murderers -- for the deaths of infants six months and under. 

Researchers say SIDS requires three conditions: a child six months or younger, an environmental factor such as a lack of oxygen from a bad infection or from a child sleeping face down, and a change in the brain. This research is a giant step because it identifies that brain abnormality and shows there is a biological basis for the condition. We'll tell you more on tonight's broadcast.

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A melanoma cure for dogs

Tonight we report on an amazing movement of research -- not from animals to humans but the other way around. 

Researchers at Memorial Sloan Kettering Cancer Center in New York City had been working on a vaccine to lessen the chances of melanoma recurring after surgical removal. Down the street at the Animal Medical Center, veterinarians heard of the studies and asked if they could try it in dogs. It turns out dogs naturally get melanoma and it can be fatal to them just as it can be for humans. In many of the dogs the vaccine actually cured the cancer, and the vaccine is about to be licensed. But for now, all this work remains experimental.

We'll tell you all about it on tonight's broadcast.

In the meantime, you can find more information on the dog studies at the Animal Medical Center Web site. You can make an appointment at the Animal Medical Center by calling (212) 838-7053. For information on the human trials led by Dr. Jed Wolchok at Memorial Sloan Kettering in New York, call 1-800-525-2225 or visit their Web site.

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Potential advance in treating lung cancer

Tonight we report on a potential advance in the treatment of lung cancer — a test to see who can benefit from chemotherapy immediately after surgery to remove early stage lung cancer. I say potential advance because this is about a test that is not yet on the market. It requires a large trial to prove its true worth, and that won’t be finished for a few years. You can read an abstract of the actual research from the New England Journal of Medicine.

We chose to publicize this early finding because lung cancer is by far the leading cancer killer and treatment advances have lagged far behind other cancers. This is about to change. A screening test that finds cancer at its earliest stages has just completed a 10-year trial. Those results have not been published, but many experts widely expect they will show that former and current smokers can benefit from screening to find early, small cancers that can be removed easily with surgery. 

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Health problems of cancer survivors

As we will report tonight, a recent study of more than 10,000 adult survivors of childhood cancer found that three-quarters have a chronic health condition. And in more than 40 percent, the  conditions can be disabling or life threating.

It's a tough life as one woman we'll talk to can attest. But, as she quickly points out, it's better than the alternative.

You can learn more by viewing PDFs from the New England Journal of Medicine article: Study.pdf | Perspective.pdf

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The remarkable Dr. Blackburn

In tonight's "Making a Difference" segment we profile an amazing woman, Dr. Elizabeth Blackburn, a native of Tasmania, Australia, who is now a professor at the University of California, San Francisco. Today she shared with two others the Lasker Award, America’s premier recognition for biomedical science. Dr. Blackburn’s research focuses on an enzyme called telomerase that helps determine how long cells live and whether or not they become cancerous. It is basic, but it has enormous potential to lead to new cancer drugs as well as diseases associated with aging and stress. You can read a lot more about her, the other winners and the science behind the discoveries on the Lasker Foundation’s Web site.

I would especially recommend the introduction by Dr. Joseph Goldstein, the chairman of the jury and one of the most witty and erudite scientists I know.

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LINKS FOR YOUR HEALTH

We are reporting on medical stories tonight and as always when possible we want to provide you the original sources so you can study them in detail if you wish.

The first is the discovery of two chemicals that appear in a pregnant woman’s body months before the condition called preeclampsia, or toxemia, sets in. The condition is a major cause of premature births and the finding should soon give doctors a test so they can initiate treatment as early as possible. You can read the study here.

We also make reference to what is called the "Annual Report to the Nation on the Status of Cancer." This is a joint effort of the American Cancer Society and the federal government to show the trends in the incidence and death rates for all sorts of cancer. The big news this year is that the breast cancer rate, which has been increasing steadily, seems to have leveled off. There is an enormous amount of data in this report. You can read summaries and find links to the full report and related sites here.

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Prostate cancer study

Tonight, we report on the latest study of what has become one of the most complex choices many men face: what to do after a prostate cancer diagnosis. Because of the widespread use of the PSA blood test, 234,000 men in the U.S. will be diagnosed this year with prostate cancer. Huge numbers get surgery or radiation even though most leading doctors in the field think a lot of them can get by with either no treatment (so called “watchful waiting”) or hormone therapy whose side effects, unlike surgery or radiation, are reversible. 

You can see a summary of the study we report on. 

For men and their loved ones facing the wrenching decisions involved with prostate cancer there are now a wealth of support groups. I think one of the best is Us Too.   

I would also point to the American Cancer Society’s information section on the disease.

Prostate cancer is clearly an area where many men and their families, armed with the best information, have to make their own decisions.

Read Robert's complete report and find more helpful links here.

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Breakthrough in lung cancer treatment

Tonight we report  on a potential advance in the treatment of lung cancer — a test to see who can benefit from chemotherapy immediately after surgery to remove early stage lung cancer. I say potential advance because this is about a test that is not yet on the market. It requires a large trial to prove its true worth, and that won’t be finished for a few years. You can read an abstract of the actual research. 

We chose to publicize this early finding because lung cancer is by far the major cancer killer and treatment advances have lagged far behind other cancers. This is about to change. A screening test that finds cancer at its earliest stages has just completed a 10 year trial. Those results have not been published, but many experts widely expect they will show that former and current smokers can benefit from screening  to find early, small cancer that can be removed easily with surgery. 

But even when a tiny tumor is removed there is still a big problem. In half of the patients the cancer will still recur, threatening the patients' life. The new test based on an analysis of 2,100 genes distinguished between the tumors that are cured by surgery alone and those that require preventative or so-called adjuvant chemotherapy. The scientists estimate the test has the potential to save tens of thousands of lives a year.

This is the latest discovery in what is called “personalized medicine” –- using tests to individualize therapy so that only those who need the treatment get it while others can be spared the cost and side effects

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