Is organic better for your health? A look at milk, meat, eggs, produce and fish. - Washington Post

By Tamar Haspel,

Organic or conventional? It’s a choice many grocery shoppers are faced with, over and over. The price difference is easy to see; it’s right there on the product. The quality difference is much harder. Is the organic milk better for your kids? Is the conventional lettuce more likely to carry pathogens?

Leave aside for the moment whether organic agriculture is better for the planet and whether organic livestock have better lives, although there’s a strong case for both of those arguments. Leave aside flavor, too, because it’s subjective and variable. What motivates many organic buyers, particularly the parents of small children, is health benefits, and there are two questions: Do organics do us more good (in the form of better nutrition), and do they do us less harm (in the form of fewer contaminants and pathogens)?

Because the risks and the benefits vary by product — meat is different from produce — it’s important to look at each category separately. While every category has the potential to harbor pathogens (such as E. coli in produce and salmonella in chicken), there are some product-specific concerns, including pesticide residue in produce and hormones in milk.

Here’s a rundown of the evidence on nutrition and contamination levels for organic and conventional products in five categories — milk, produce, meat, eggs and fish — to help you decide whether to buy organic or stick with conventional.

Milk

Nutrition: Compared with conventional milk, organic milk has higher levels of omega-3 fats, which protect against heart disease and may decrease the risk of depression, stroke, cancer and other diseases, but the quantities are too small to be very meaningful. (It takes 11 quarts of organic milk to equal the omega-3s in four ounces of salmon.) Milk’s omega-3 content is a function of the cow’s diet, and higher levels reflect more grass. (A few other nutritional differences between organic and conventional milk have been studied, but there isn’t enough research to draw conclusions.)

Contamination: Neither organic nor conventional milk contains antibiotics. By law, every truckload of milk, organic and conventional, is tested for veterinary drugs, including antibiotics, by trained dairy workers. Any load that tests positive is pulled out of the food supply. In 2012, that was one in 6,000 loads. Organic cows aren’t given antibiotics, and conventional ones are given them only for illness, and their milk isn’t used until after a withdrawal period.

The U.S. Department of Agriculture tests for pesticide levels and has found them to be “very low.” The main culprit is DDE, a remnant of the agricultural pesticide DDT.

DDT was banned years ago, but the USDA said it “is very persisten[t] and remains in many cropland soils. It is also in the body fat of all Americans and most farm animals and wildlife. Conventional and organic farmers can do little to avoid the DDE residues in milk. Over the next thirty to fifty years these residues will gradually decline below limits of detection.”

Pasteurization fails some of the time, allowing milk contaminated with bacteria to get into the food supply, but there are no reports comparing illnesses caused by organic vs. conventional milk.

Hormones: The issue with milk is that many conventionally raised dairy cows, unlike organic ones, are injected with bovine growth hormone (BGH, the synthetic version of which is called either recombinant bovine growth hormone, rBGH, or recombinant bovine somatotropin, rBST) to increase their milk production. The problem isn’t the hormone itself — it’s unlikely to survive pasteurization or human digestion and, even if it did, its mechanism doesn’t work in humans — but rather a compound called insulin-like growth factor (IGF-I).

Both organic and conventional cows have IGF-I in their milk, but cows that get hormone treatment may have more of it. Humans also produce IGF-I, and a recent review of many studies concluded that milk drinkers generally have higher IGF-I levels. But it may not be because of IGF-I in milk. Eating animal and soy protein can also increase IGF-I levels in our bodies. It’s not the IGF-I in foods, but how the body responds to other compounds, that increases human levels.

Some research has linked IGF-I to cancer. The American Cancer Society found that “some early studies found a relationship between blood levels of IGF-I and the development of prostate, breast, colorectal and other cancers, but later studies have failed to confirm these reports or have found weaker relationships.” The organization concluded in 2011 that “the evidence for potential harm to humans is inconclusive.” A 2009 FDA report says that IGF-I levels in rBGH milk are safe

The use of rBGH has fueled concerns among some parents about giving milk to children, but the FDA report concluded that “consumption by infants and children of milk and edible products from rBGH-treated cows is safe.”

Bottom line: Organic milk has higher omega-3 fat levels, but probably not enough to make a difference. Exposure to pesticides, contaminants or hormones is not a significant risk in either organic or conventional milk.

Produce

Nutrition: Many studies have compared the vitamins, minerals, macronutrients and other compounds in organic and conventional produce, and a 2012 review concluded that the results were all over the map. The one exception was that the phosphorus content of organic produce is higher, although the review, done by Stanford University scientists, calls that finding “not clinically significant.” Along with calcium, phosphorus helps build strong bones and teeth.

Contamination: There are two issues for foods that grow in the ground: pesticides and pathogens. There is widespread agreement that organic produce, while not pesticide-free, has lower residue levels and fewer pesticides. A study using USDA data found that 73 percent of conventional produce sampled had residue from at least one pesticide, compared with 23 percent of organic, though that study is more than 10 years old. There also isn’t agreement about whether that’s meaningful for human consumption.

Carl Winter, a toxicologist at the University of California at Davis, says that the Environmental Protection Agency, working from animal research and factoring in the special sensitivities of human subgroups such as babies and children, has found that lifetime risk of adverse health effects due to low-level exposure to pesticide residue through consumption of produce is “far below even minimal health concerns, even over a lifetime.”

Dana Barr, a research professor at Emory University’s Rollins School of Public Health, has less faith in the EPA standards. She points to one particular pesticide class, organophosphates, and notes evidence — including a 2013 review she co-authored — correlating exposure to possible neurological problems such as ADHD and lower IQ in children, which she says the EPA standards don’t adequately consider.

But another review last year by a different group of scientists found “the epidemiologic studies did not strongly implicate any particular pesticide as being causally related to adverse neurodevelopmental outcomes in infants and children.” As of December 2013, the position of the Centers for Disease Control and Prevention was that high levels of organophosphate exposure were associated with some neurobehavioral problems in farm communities with exposure higher than that in the general population.

An American Academy of Pediatrics 2012 report noted the correlation between organophosphate exposure and neurological issues that had been found in some studies but concluded that it was still “unclear” that reducing exposure by eating organic would be “clinically relevant.”

The EPA expects to have a new assessment of organophosphates in 2016. In the meantime, the agency has determined that certain foods —snap beans, watermelon, tomatoes and potatoes — are likely to have higher residues of the pesticide than other produce. If you’re pregnant or feeding small children, you may want to consider organic versions of those foods.

As for pathogens, the 2012 Stanford review found that E. coli contamination is slightly more likely in organic than conventional produce.

The best strategy to reduce risk from produce isn’t to buy either organic or conventional. Rather, it’s to cook your food. A CDC review notes that leafy vegetables, led by lettuce and spinach, are the No. 1 cause of food-borne illnesses, responsible for 22 percent of food-borne illnesses.

Bottom line: While there may be no significant nutritional difference between organic and conventional produce, organic does have lower levels of pesticide residue. However, there isn’t universal agreement on the risk those residues pose.

Meat

Nutrition: As with milk, the main issue here is omega-3 fats. Some organic meat and poultry have more of them than conventional products do. The reason is diet: Animals that eat more grass have lower fat levels overall and higher omega-3 levels than animals fed more grain.

Although measurements of omega-3 fats in beef vary, the numbers are low and substantially below what can be found in a serving of salmon.

Contaminants: The USDA randomly tests carcasses for residues of pesticides, contaminants and veterinary drugs including antibiotics. In 2011, it screened for 128 chemicals, and 99 percent of the tested carcasses were free of all of them.

It found a few with residue violations and a similar small number with residue within legal limits (mostly of arsenic and antibiotics). Although the USDA doesn’t report organic and conventional separately, contaminant risk overall is extremely low.

The bigger concern is pathogens. Studies of bacterial contamination levels of organic and conventional meat show widely varying results. These findings suggest that organic meat may be slightly more likely to be contaminated, possibly because no antibiotics are used. But conventional meat is more likely to be contaminated with antibiotic-resistant bacteria. The 2012 Stanford review found that slightly more organic chicken samples were contaminated with Campylobacter than conventional samples and that organic pork was more likely than conventional to harbor E. coli. But the risk in meat overall was essentially the same. And whether meat is conventional or organic, the solution is adequate cooking.

Bottom line: There doesn’t seem to be much difference, health-wise, between organic or conventional meats. Grass-fed beef has a slight edge over grain-fed because of higher omega-3 levels, but the amounts are probably too small to affect human health.

Eggs

Nutrition: As with milk and meat, the omega-3 levels of eggs are affected by the hens’ diet and can be increased by pasturing or diet supplementation for either organic or conventional hens. Eggs high in omega-3s are generally labeled.

Contaminants: There’s very little research on contaminants in eggs. The USDA’s 2011 National Residue Program tested 497 egg samples and found no residues of pesticides, contaminants or veterinary drugs, including antibiotics. This isn’t surprising because, according to Pat Curtis, a poultry scientist at Auburn University, laying hens aren’t routinely given antibiotics, and there is a mandated withdrawal period after they do get the drugs (to treat illness) before their eggs can be sold. The 2012 Stanford review concluded that there is “no difference” in contamination risk between conventional and organic eggs.

Bottom line: There are no significant differences affecting health between organic and conventional eggs.

Fish

The USDA has not issued any organic standards for farmed fish or shellfish, but several overseas organizations have. (Because there’s no way to control the diet of wild fish, “organic” doesn’t apply.) Canadian standards prohibit antibiotics and hormones, restrict pesticides and set criteria for acceptable feed. There’s not enough research comparing organic and conventional fish to draw any conclusions about their health benefits.

Haspel writes regularly for The Post’s health and food sections. Follow her on Twitter: @TamarHaspel.

More from The Washington Post: 10 nutrients that can lift your spirits Benefits of organic milk may be an oversell Hydroponic is not the same as organic Access to unpasteurized milk is increasing. So are illnesses.

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One way to pay for health-care costs in retirement - Washington Post

A couple of weeks ago, I posted on the vast gap between the savings we’ll actually need for health-care in retirement and the amount most people think they’ll need. Here’s a bit of good news on health savings accounts, an under-utilized way to  accumulate those funds for people enrolled in high-deductible health-care plans. –Lenny Bernstein

There is quite a bit of research that highlights the danger of financial shortfalls in retirement faced  by many Americans. Although some people accrue enough savings to meet their basic needs, health costs – which tend to rise after retirement – remain a major concern. A recent MarketWatch analysis found that most retirees will spend an average of $250,000 on out-of-pocket health costs during their retirement years, an amount that can quickly cut into their savings.

Health savings accounts (HSAs) offer consumers a way to save for these costs now and into retirement years. But many consumers view them only as spending accounts for managing in-year expenses.  Employers and HSA providers who help workers understand the full potential of  HSAs will give them a valuable option and will benefit themselves..

Health savings accounts were introduced just over 10 years ago, many years after flexible spending accounts (FSAs), which you use to pay medical bills each year. Many consumers confuse their features. FSAs were designed as a way to manage predictable health-care expenses within a given year. HSAs are designed to be a powerful short and long term savings vehicle.

Employee Benefit Research Institute estimate of out-of-pocket health care costs in retirement.

HSAs are individual accounts, owned by the consumer, just like personal checking and savings accounts.  As such, they are portable – the account and the contributions in it remain the property of the account holder, even if he or she changes jobs or   enrolls in a different health insurance plan.  Consumers can continue to contribute up to the allowable IRS limit, as long as they are enrolled in qualifying high deductible health plans. The funds roll over from year to year with no expiration.

Best of all, HSA contributions are triple-tax-advantaged.  Contributions are tax free. Once HSA account balances reach a minimum threshold, funds can be invested, with interest and earnings on investments tax free.  And HSA account holders do not pay income tax on funds when they withdraw the money for qualified health-care expenses, as they do with the money in their 401Ks.

All of these features make HSAs an attractive way of managing near term health-care spending and saving for health-care costs through retirement.

Employers also benefit when their employees understand the full value of HSAs.  Employers realize an immediate tax benefit when more workers adopt HSAs and contribute to them. HSAs augment benefit programs, which are typically designed with the intent of attracting and retaining talent. Forward-thinking employers may want to offer integrated retirement planning strategies that take into account potential future health needs by offering to match contributions to HSAs, as they do for 401Ks.

HSAs are growing as more people come to understand them. According to a recent report, assets in HSAs exceeded $20 billion  as of January 2014.  Growth is stable. And HSA investment assets have now reached $2.3 billion, meaning that more than 10 percent of HSA deposits are currently invested in mutual funds or other long-term growth vehicles.  These trends are expected to continue as the popularity of HSAs grows and consumers increasingly look to HSAs as a complement to their retirement savings.

Tom Torre is chief executive  of Alegeus Technologies, which provides benefit and payment solutions for employers.

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Girl with cancer who befriended Michigan State basketball star dies - CBS News

Adreian Payne, No. 5 of the Michigan State Spartans, walks on the floor for Senior Night with Lacey Holsworth, a 8-year-old who is battling cancer, after defeating the Iowa Hawkeyes 86-76 at the Jack T. Breslin Student Events Center on Feb. 6, 2014, in East Lansing, Mich.

EAST LANSING , Mich. - Lacey Holsworth, the 8-year-old who battled cancer and became friends with Michigan State University basketball star Adreian Payne, has died, CBS Detroit reported.

Lacey's dad, Matt Holsworth, said the girl died at their St. Johns, Mich., home late Tuesday "with her mommy and daddy holding her in their arms."

Princess Lacey has achieved the ultimate victory. She now dances among angels.... The world is a... http://t.co/SAXeJ4D4zH

— Princess Lacey (@adorablelacey) April 9, 2014

The cancer-stricken girl became friends with Payne when she met him during one of her hospital stays two years ago.

"They communicate and hang out like a brother and sister," Holsworth told The Associated Press last month. "It's a unique and special bond."

When it was Payne's turn to be honored during the Spartans' Senior Night ceremony last month, the 6-foot-10 center scooped up Lacey and carried her around the court.

"She was tired that day," Payne recalled in an interview with the AP. "I just figured I'd pick her up instead of having her walk."

He scooped her up again, taking her toward the top of a ladder as Michigan State celebrated winning the Big Ten tournament by cutting down the nets in Indianapolis. He even included her in his recent shot at the college dunk contest.

Lacey watched Michigan State's NCAA tournament run from the stands. After Payne scored a career-high 41 points to help Michigan State beat Delaware in one tournament game, Payne talked as much about what his performance meant to Lacey as it did to the Spartans.

"It's like having a family member who's really sick," he said. "The only thing you can do is play basketball. You can't be there with them. Just knowing that when I play well, it makes her happy. It feels like I'm doing something, in a way, to make her feel better."

The little girl affectionately known as "Princess Lacey," had neuroblastoma, a fetal-nerve cell cancer. She wore a long, blond wig because chemotherapy took her hair.

Back pain while dancing in 2011 led to the discovery of a football-sized tumor that had engulfed her kidney. After another tumor wrapped around her spine, her father had to carry her into a hospital on Dec. 28, 2011. She lost feeling below her belly button and couldn't walk on her own for several months, a long stretch that included the first of many visits from Payne.

While Lacey had some victories in her battle, the cancer kept coming back and eventually spread to her neck, head and pelvic region.

"She loved unconditionally and without hesitation," Holsworth said. "Spreading her smile and love throughout the world."

© 2014 CBS Interactive Inc. All Rights Reserved.

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Cancer quests - The Economist (blog)

HOW can playing on an app generate scientific meaning? It’s a question that Cancer Research UK may have just answered at a favourable time: the use of mobile games increased by 66% last year. The charity enlisted the help of gaming experts at tech startup Guerilla Tea, as well as the Dundee agency, Amazon Web Services and many others in the creation of “Genes in Space”.  

Released two months ago, the spaceship exploration game is centred on the hunt to harvest the fanciful element alpha by charting a course and steering a ship accordingly through outer space. Its premise is nothing revolutionary in the gaming world, but its true purpose is. Everyone who plays “Genes in Space” aids in a quest—not to find element alpha, but instead the gene mutations that cause breast cancer. Hannah Keartland, citizen science programme manager at Cancer Research UK, believes the mobile game is the first of its kind.

The game was created from the DNA microarray data found in a breast cancer trial by Carlos Calda for Cancer Research UK’s Cambridge Institute. They appear to the player by way of clusters of dots on the route mapping graph and purple clouds of element alpha in space.

By taking part in both game elements, the player locates genetic data that veer from the standard pattern—which could indicate genetic faults that cause cancer. The results are then sent as data files to scientists, which direct them to the areas that need further investigation.“The human eye is very good at spotting patterns and anomalies—much better than computers,” explains Ms Keartland.

The app was created after Cancer Research UK’s resounding success two years ago with their first attempt to crowd-source data: “Cell Slider”. This interactive website taught players basic pathology before guiding them through an investigation of real tumour samples. It helped to analyse data six-times faster than scientists could working alone.

“Genes in Space” has had encouraging results too. Since its release, it has been played for more than 53,000 hours—equivalent to more than six months of cancer research. Four weeks after it appeared, the charity reported that its players had made 1.5m classifications—the analysis of a length of DNA that spans the English Channel twice. (By contrast, it took scientists working alone more than a decade for faulty BRAF genes to be declared responsible for many Melanoma skin cancers.)

Entertaining elements suffered as a result of the game’s role in aiding cancer research according to CEO of Guerilla Tea, Mark Hastings. But with countless game apps available today, having this hook will likely mean that “Genes in Space” maintains a following for longer than apps without helpful outcomes.  

But when using untrained and unknown individuals to do scientific work, there is always the possibility of error, which is why each sample in the game is analysed by many players—slowing down the process a bit. This also suggests why there is a limit to the types of research projects that people can help with through a game format.

According to Mr Hastings, there are likely other types of data analysis within research that could benefit from games that crowd-source real-life data. “But until scientists come forward to tell us that, I’m afraid there’s not a huge amount we can do about it,” he admits. Fortunately though, "Genes in Space" has already allowed breast cancer research to be taken light-years ahead.

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Prostate cancer screening may be improved with new test - Fox News

Men who have elevated levels of prostate specific antigen (PSA) during prostate cancer screening often turn out not to have cancer, but a new set of markers in the blood may improve the ability of the test to distinguish men who have cancer from those who don't, a new study suggests.

In the study, a blood test that looked for three markers in the blood, in addition to PSA, was much better than PSA alone at distinguishing men with prostate cancer from those with high PSA levels who did not have cancer.

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Moreover, the percentage of men who were misdiagnosed as a result of their PSA test (i.e., they were suspected to have cancer when they did not, or they were not suspected to have cancer and did) was reduced from about 32 percent to 9 percent when their blood was tested for just one of the markers in addition to the PSA test. [10 Dos and Donts to Reduce Your Risk of Cancer]

PSA is a protein in the blood that is sometimes increased in men with prostate cancer. Although the PSA test has been used for nearly 25 years as a way to screen for prostate cancer, it has come under scrutiny in recent years, because it is not very selective for men who have prostate cancer, said Kailash Chadha, of the Roswell Park Cancer Institute in Buffalo, N.Y, who presented the findings April 6 at the meeting of the American Association for Cancer Research.

Some studies show that 70 percent of men who have high PSA levels do not have cancer.

This is a drawback, Chadha said, because men with high PSA levels may have a biopsy they do not need, leading to patient discomfort and extra health care costs.

Another criticism of PSA testing is that it finds cancers that would never go on to cause health problems, leading patients to undergo unnecessary treatments.

The new study also found that the same three blood markers were better than PSA alone at distinguishing localized prostate cancer (which remains in the prostate gland) from high-risk cancer that is likely to spread to other parts of the body.

While the findings need to be confirmed in future studies, "it's very encouraging at this point" that this set of blood markers seems to address the two main drawbacks of PSA testing, Chadha said.

"What we really needis something that will reduce the number of men getting unnecessary biopsies, and also better distinguish those who should get treated compared to those who don't need to be treated," said study researcher Dr. Willie Underwood III, a urologist and associate professor of surgical oncology at the Roswell Park Cancer Institute. "Right now, with our current tools, we can't adequately do that."

The three markers are proteins in the blood called cytokines, specifically IL-8, TNF-alpha and sTNFR1.

The new study was small; it included 46 men, and nearly all of them were white. Future studies looking at these markers will need to be larger and more racially diverse, Underwood said.

Copyright 2014 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Health Goal Met, White House Reviews Missteps - New York Times

WASHINGTON — Days after hitting their target of signing up more than seven million people for health insurance, Denis R. McDonough, the White House chief of staff, and other top aides to President Obama gathered last week on the patio just outside Mr. McDonough’s West Wing office.

In an hourlong interview they requested, the officials said one of their biggest mistakes in the disastrous health care rollout last fall was worrying about the wrong thing. They said they focused too much on their ultimately unfounded fear that not enough insurance companies would participate in the health marketplaces and that premium prices would be too high. In turn, they said, they ignored what became the real problem, a website that was virtually inaccessible in its opening days.

“It wasn’t for lack of time; it was for lack of time on the right variables,” Mr. McDonough said.

Like all White House aides who have endured withering criticism and survived a political crisis, Mr. McDonough and the others sought to cast their actions in the best possible light. Not surprisingly, their conversation was filled with high praise for Mr. Obama and satisfaction that they had at last fixed the website and met their enrollment goals.

They also offered a new look into the high levels of anxiety inside the West Wing last fall, their nightmare scenarios and the future, as they see it, of the Affordable Care Act.

Mr. McDonough was joined in the discussion by Phil Schiliro, a former congressional liaison who rejoined the White House team in December to help manage the health care program; Jeffrey D. Zients, director of the National Economic Council, who helped salvage the website; Kristie Canegallo, a top aide to Mr. McDonough on health care; Jennifer Palmieri, the White House communications director; Tara McGuinness, an outreach leader for the health care effort; and Marlon Marshall, the deputy director of the Office of Public Engagement.

Here are excerpts from that conversation:

Q: Is there something you can say about what wasn’t working at the White House that caused the struggles on health care?

MR. MCDONOUGH: The work in setting up the individual marketplaces actually was sound and good. One of the lessons learned, I’ll be candid with you, is we spent a lot of time on the issues in setting up and insufficient time, in retrospect, in the tools that will allow the transaction to then be completed.

Q: Did you focus on getting the competition and pricing right because you anticipated the opposition would jump on that issue?

MS. PALMIERI: We thought that was the hard part. The big questions at the time, among policy people and the press, was: Were you going to be able to put these marketplaces together? Were they going to have competition? Were the premiums going to be affordable?

Q: [To Mr. McDonough] There was a moment in early February where you freaked out and said: We’re not on track to meet our enrollment targets, and I’m not going to be the one to walk into the Oval Office on March 31 and tell the president we didn’t get there.

MR. MCDONOUGH: Yeah, I was quite hot.

Q: Because at that point, you felt like your staff was preparing to take it easy?

MR. MCDONOUGH: I feared that may be the case.

MS. CANEGALLO: I remember you saying something to the effect of like, which is a very McDonough-ism thing to say: Leave everything on the field. At the end of this, we don’t want it to be April 1st and feel like we didn’t throw everything that we could against the wall.

Q: Give me an example of what you were doing to prepare for contingencies when the law went into effect on Jan. 1.MR. SCHILIRO: Kristie put together a comprehensive book that anticipated everything that could go wrong.

MS. CANEGALLO: A “break glass” book. [A three-ring binder, named for the boxes that read “In Case of Emergency, Break Glass,” provided White House officials a resource for responding to a variety of potential crises.]

MR. SCHILIRO: It was pretty scary. Think of it this way... it’s preparing for Y2K in health care. You just don’t know what could go wrong. Every hospital in the country had our 800 number because we set up a special 800 number for anybody who had a problem. So you know when you go to a hospital and you get to that little admitting desk, that 800 number was right there. The hospitals helped. The pharmacies helped. The insurers helped. MS. PALMIERI: We followed Twitter to see if anyone was tweeting that they had a problem.

Q: Who was doing that? Denis wasn’t watching Twitter?

MR. MCDONOUGH: I don’t know how to get it.

Q: So, lessons learned?

MR. ZIENTS: We need to expand bringing in the best I.T. folks in the country into the government, and then procurement and contracting and making sure the very best companies, with the very best people, are bidding on government contracting.

Q: Be realistic. Isn’t that a 10-year project?

MR. ZIENTS: I think you can make a lot of progress fast. Particularly when the president of the United States is holding you accountable.

Q: Think at the 60,000-foot level about the way history books talk about presidential administrations and how they have problems and confront them. Are there lessons about the mistakes made?

MR. MCDONOUGH: Look, I’m a person with a very active conscience. But I’m not going to bare that to you today. I’ve done a lot of thinking about that.

The first thing is you’ve got to keep the team together and keep them focused on the right target. And that’s true no matter what you’re going through. We’re all in this together, and all you’ve got is each other, basically. The second is to hear your early warning. Congress was a good early warning for us. They are back in their districts every week. They come back with very actionable intelligence.

The third is something I’ve been saying ever since October 1, which is the strength is in the planning, not in the plan. There’s never a plan that you run in the government, and I don’t know, maybe the private sector, that survives first contact.

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Simple Blood Test To Spot Early Lung Cancer Getting Closer - NPR (blog)

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hide captionAn artist's illustration shows lung cancer cells lurking among healthy air sacs.

David Mack/Science Source

One of these days there could well be a simple blood test that can help diagnose and track cancers. We aren't there yet, but a burst of research in this area shows we are getting a lot closer.

In the latest of these studies, scientists have used blood samples to identify people with lung cancer.

At the Stanford School of Medicine, Dr. Maximilian Diehn spends some of his time as a radiation oncologist treating patients with cancer, and some of his time delving into the world of DNA. In particular, he's been working on ways to detect DNA that has been shed from a tumor and ends up in a patient's blood.

"The problem has been that there's a very small amount of the DNA there, usually, so it's very hard to detect," Diehn says.

" If there is cancer DNA in the body left, that suggests there are still cancer cells left, so that patient is probably not cured.

- Maximillian Diehn

But new technologies allow him to find tiny amounts of DNA and scan large parts of it to look for mutations that come from tumors. And that opens up all sorts of possibilities.

"The initial impetus was having something I could use in my own patients ... as a blood test that would let us both detect the presence of cancer as well as monitor how a patient's cancer responds to various treatments," he says.

Right now, doctors often just wait and hope. And it can take months or even years to see whether a cancer treatment has worked.

But Diehn and his colleagues say they've developed an exquisitely sensitive DNA test that can tell them right away whether there is tumor left in a patient.

"If there is cancer DNA in the body left, that suggests there are still cancer cells left, so that patient is probably not cured," he says, "whereas if the cancer DNA is gone, that suggests the patient is likely to be cured."

And if the cancer is still there, they can try other treatments.

Their new experimental test is specific for lung cancers – non-small-cell lung cancers, to be precise. They report in Nature Medicine that they were able to detect tumor DNA in every patient they studied who had a more advanced cancers (Stage 2 or higher). And, more remarkably, they have been able to detect very early, Stage 1 lung cancer, about half the time (with a test they're still working to perfect).

"Now, since we can already detect half of them with the current assay, we're very hopeful that the majority of cases will have detectable DNA," Diehn says.

Researchers at Stanford are not only working to improve the lung-cancer test, they're developing tests for other cancers — including lymphomas, cancers of the breast, esophagus and pancreas.

"But the ultimate holy grail would be to move this to the early detection of cancer," says Dr. Ash Alizadeh at Stanford. "The early detection of cancer could save many lives by being amenable to being treated."

They aren't the only lab on that quest. Dr. Luis Diaz and colleagues at the Johns Hopkins School of Medicine recently reported a blood DNA test targeting 14 different tumor types. The team at the Hopkins Kimmel Cancer Center also found about half the early-stage cancers in their volunteers. Diaz says even a test that only finds early stage cancer half the time is still a big step forward.

"When you have a Stage 1 tumor, the patients feel healthy," Diaz says. "They're still going to the gym, they're still performing all their activities of daily living without any sort of feeling that something's wrong. This blood test will detect the cancer at a very early stage — albeit only in 50 percent of cases."

The researchers are optimistic they can improve the test so it will catch many more cases, but they don't yet know whether that's a matter of better technology or if some tumor DNA will simply always remain hidden. And it's not entirely clear yet how many false alarms might turn up. But even now, this emerging DNA technology has many uses.

"For me this is very exciting because there is momentum building in this field," Diaz says. Many skilled and capable research groups are diving into this field, so "what we're going to see is really cool questions answered that we couldn't have answered in any other way."

And while new medical technologies often drive up the cost of care, these researchers hope that a few years from now, a cancer blood test will be available for a few hundred dollars. Using it could help patients avoid costly scans – and avoid late-stage diagnoses, when cancer is often more difficult and more expensive to treat.

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Guarded Optimism After Breast Cancer Drug Shows Promising Results - New York Times

SAN DIEGO — Researchers say that a new type of drug can help prevent advanced breast cancer from worsening, potentially providing an important new treatment option for women and a blockbuster product for Pfizer.

In a clinical trial, the drug cut in half the risk that cancer would worsen, or progress, researchers said here on Sunday. The median time before the disease progressed or the women died was 20.2 months for those who received the drug, compared with 10.2 months for the control group.

“The magnitude of benefit we are seeing is not something commonly seen in cancer medicine studies,” Dr. Richard S. Finn, a principal investigator in the study, said in an interview. Dr. Finn, an oncologist at the University of California, Los Angeles, called the results “quite groundbreaking.”

The drug, known as palbociclib, also appeared to prolong survival but not by a statistically significant amount. Those who received the drug lived a median of 37.5 months compared with 33.3 months for those in the control group.

The results from the Phase 2, or midstage, study were presented here at the annual meeting of the American Association for Cancer Research. They are being closely watched on Wall Street, because palbociclib is considered a jewel in Pfizer’s product pipeline, with analysts predicting annual sales of billions of dollars. Amgen is entitled to an 8 percent royalty on sales of the drug.

As strong as the results were, it is possible they will be a bit of a letdown to some investors.

That is partly because they were not quite as good as interim results presented about halfway through the trial. At that point, the difference in median progression-free survival was 26.1 months for palbociclib versus 7.5 months for the control group.

The lack of a statistically significant survival benefit could also give investors pause.

Dr. Finn said, however, that a statistically significant survival benefit should not have been expected at this point because only 61 of the 165 patients in the trial had died. Also, patients can use other drugs after leaving the trial, which can dilute any effect of palbociclib.

Palbociclib slows the runaway proliferation of cancer cells by inhibiting the activity of two related enzymes involved in cell division — cyclin-dependent kinases 4 and 6.

While Pfizer is in the lead to bring this new class of drugs to market, Novartis has begun late-stage testing of its own CDK 4/6 inhibitor. Eli Lilly is at an earlier stage, with some results for its drug presented here. While breast cancer is the initial focus, the drugs are being tested for other cancers.

Breast cancer specialists not involved in the study were encouraged but somewhat cautious. “These results are strikingly positive and with a large potential impact to patients,” Dr. José Baselga said in a speech at the conference discussing the results.

But Dr. Baselga, the physician in chief at the Memorial Sloan-Kettering Cancer Center, said the results might have been biased because the study investigators, who determined whether tumors had progressed, knew which patients were getting palbociclib.

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said larger studies were still needed.

“This is a small Phase 2 trial — not tiny, but not the kind of study that would typically lead to a change in practice,” he said.

The study, sponsored by Pfizer, involved 165 post-menopausal women receiving their initial treatment for recurring or metastatic breast cancer. The cancers were estrogen receptor-positive, meaning their growth was fueled by that hormone, but negative for Her2, a different protein.

About 60 to 65 percent of breast cancers fit that description, according to Dr. Dennis J. Slamon of U.C.L.A., another investigator in the study. Analysts at the ISI Group, an investment research firm, estimate that about 50,000 American women a year would be eligible for palbociclib.

All the women in the trial took letrozole, a drug that blocks the synthesis of estrogen. Such drugs are standard initial therapy for this type of breast cancer. About half the women also received palbociclib, which was taken orally once a day for three out of every four weeks.

The biggest side effect, experienced by about three quarters of patients, was a decreased white blood cell count. But that did not lead to infections as it usually does, according to Dr. Finn, who said that the drug was generally well tolerated.

Still, many patients had their doses reduced because of side effects, and 13 percent of patients who received palbociclib dropped out of the study because of side effects, compared with 2 percent in the control group.

A big question is whether Pfizer will be able to win approval of the drug based on this study. The Food and Drug Administration normally requires larger Phase 3 studies, but sometimes makes exceptions for drugs for cancers and other life-threatening illnesses.

If Pfizer can get early approval, the drug could probably reach the market next year. If the company must complete a Phase 3 study, which is already underway, approval might be delayed a couple of years, according to the ISI Group.

Garry Nicholson, president of Pfizer’s oncology division, told analysts on Sunday that the company “can envision the possibility” that the data from the Phase 2 trial would be sufficient for approval. He said the company had not gotten far enough in its discussions with the F.D.A. to be able to decide whether to seek approval now, however.

In 2008, the F.D.A. granted accelerated approval to Genentech’s Avastin as a treatment for breast cancer based on a single trial in which the drug delayed disease progression by about five and a half months.

But the women who got Avastin did not live significantly longer, and subsequent studies showed a smaller effect in delaying progression. In 2011, the F.D.A. revoked approval of Avastin for breast cancer treatment.

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People across the US take a dive for young cancer patient - New York Daily News

Orlin Wagner/AP Kansas City Chiefs fan Ty Rowton, known as XFactor, participates in the “Plunge for Landon” fundraiser Friday. Orlin Wagner/AP The event raised money for 5-month-old Landon Shaw who was diagnosed with cancer. Orlin Wagner/AP Hundreds of people across the country joined in by jumping into various bodies of water.

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KANSAS CITY, Mo. — Being told to “go jump in a lake” is usually a snarky kiss-off. But it’s become a heartwarming call-to-action for a Missouri community whose effort to help the family of a 5-month-old boy with cancer has inspired thousands across the country to submerge themselves in cold bodies of water.

Organizers of the Facebook-based Plunge for Landon fundraiser said they have lost count of how many people have posted videos of themselves taking a dive for Landon Shaw, a Tarkio infant who was diagnosed in late February with a rare form of cancer. People are jumping in, from chilly farm ponds north of Kansas City to the Gulf of Mexico and the Potomac River in Washington, D.C.

“I can’t believe how viral this is going,” said Alyssa Shaw, Landon’s mom. “My son has been such an inspiration to everybody and opened up people’s eyes that you can’t take life for granted.”

Before they jump into the water, participants record themselves challenging three other people to do the same, with monetary pledges for each person who completes the challenge. The effort had raised more than $30,000 by Friday evening, only five days after notice of the fundraiser was first posted on the popular social networking site.

Entire schools, police departments and businesses around the region have posted videos of participants taking the plunge.

Landon was 4 months old on Feb. 23 when his parents took him to Children’s Mercy Hospital in Kansas City to find out why he was vomiting and losing weight. Doctors found a tumor on his left kidney, which they removed, and later discovered a large mass on his brain.

Landon’s heart stopped during an operation to remove the brain tumor, his mother said, and he lost so much blood that doctors gave the family little hope their baby would survive.

My son has been such an inspiration to everybody and opened up people’s eyes that you can’t take life for granted.

“The surgeons came into the room and said they would be surprised if he made it through the night,” Shaw said.

Landon did make it through, and his condition improved enough that on April 1, Shaw and her husband, Brandon, were able to bring their baby home.

But the child still has a long road ahead, with chemotherapy sessions, MRIs and CT scans. And the family is on Medicaid, Shaw said, which isn’t nearly enough to cover medical bills that are just starting to arrive.

The plunge group’s Facebook page had more than 11,700 members Friday, seven times the number of people who live in the small farming community of Tarkio, two hours north of Kansas City.

Lydia Hurst, who helps maintain the group’s page, said participants include a soldier in Afghanistan, and people in Germany, South Korea, Spain and Ireland.

Ty Rowton, also known as the red tight-wearing Kansas City Chiefs super fan “X-Factor,” dove into a pond near Bonner Springs, Kan., on Friday after being challenged by several people he didn’t know. In turn, he challenged the Royals, Chiefs and all their fans to also chip in to help baby Landon.

My legs got numb faster than I thought they would. It was shocking. I went home and showered and didn’t get warm until about noon that day.

Hurst took her own plunge Tuesday morning in sub-freezing temperatures. Like most people she knows who did their own plunges, she said she never would have jumped into a frigid farm pond had it not been for the thought of the little boy.

“My legs got numb faster than I thought they would,” she said. “It was shocking. I went home and showered and didn’t get warm until about noon that day.”

Residents of the former college town of roughly 1,600 also have been holding bake sales and fundraising suppers — popular affairs in rural Bible Belt communities — to help the family pay for travel and other expenses. But the plunge drive has brought in the bulk of donations.

A YouTube video shows U.S. Rep. Sam Graves, a lifelong Tarkio resident, in a suit and tie as he dove head-first into the Potomac in Washington on Wednesday. He challenged several Republican leaders, both nationally and in Missouri, to take the plunge.

Lora Cummins, a former Tarkio resident who is an ordained minister and beach body coach in Port Aransas, Texas, accepted the challenge of some of her ex-classmates in the town and jumped into the Gulf of Mexico on Wednesday.

“All of us are so fortunate to have grown up there and forged lifelong bonds,” she said. “Facebook has brought us all back together.”

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Hay Fever Cures: Five Natural Remedies - MyDaily UK

The warmer weather and lighter evenings are a welcome change after winter,but the start of spring has its downside. When the pollen count is high, a fifth of the UK population will suffer from hay fever and although there are conventional remedies readily available at the pharmacy, many of these are linked with drowsiness and health concerns.

So - what else can be done to ease hay fever symptoms? The experts at Neal's Yard Remedies spoke to us about alternative remedies that are worth looking into.

"Whilst there is no magic bullet from natural health alternatives for hay fever, there is encouraging research in some areas," Neal's Yard said.

"In a clinical trial, taking nettle leaf did lead to a slight reduction in symptoms of hay fever-including sneezing and itchy eyes."

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Aromatherapists also recommend using inhalations as a way of helping the congestion and inflammation that comes with hay fever. Two of the best essential oils? Frankincense and eucalyptus.

"Try adding a couple of drops of each to a bowl of hot water and inhale the steam to relieve the symptoms of congestion and itchy eyes," Neal's Yard told us.

Want to try an alternative hay fever remedy? Here's five more natural solutions...

Eyebright
This herb is specific for treating allergic inflammation of the mucous membranes, especially itching or watery eyes. It is useful for clearing, drying nasal catarrh and for infectious or allergic conditions of the eyes, sinuses and nasal passages. It enhances the blood supply to the eyes and has soothing, cooling properties.

Peppermint leaf
It is a carminative, antispasmodic, anti-emetic and hepatic herb that relaxes the digestive system and stimulates digestive juices. It has a refreshing taste, which makes it popular as an after-dinner pick-me-up.

Elderflower
This anticatarrhal and anti-inflammatory herb is excellent for symptoms of colds and flu such as coughs, catarrh and fever. The diaphoretic action promotes gentle sweating and therefore helps reduce any fever. Elderflower is a drying herb so it helps reduce the build-up of mucus. It also reduces inflammation in the lungs, which leads to improved breathing.

Nettle
Rich in minerals and vitamins, this is one of nature's finest spring tonics (the new green shoots especially). Excellent for anaemia, it will slough off the clogging foods of winter and revive the system. It is cleansing, detoxifying and strengthens the whole body, increasing natural resistance. It can be eaten as food either in soups, as a vegetable, or try making a nettle tea. Make an infusion of dried nettle by adding a heaped teaspoonful of leaves to a cupful of boiling water and stand for 10 minutes (drink a cupful three times a day if you're really suffering.)

Liquorice root
A multi-purpose herb that addresses weaknesses in most major body systems. In the respiratory tract, it is anti-inflammatory and expectorant, so helps to reduce catarrh and coughing. This anti-inflammatory action also helps improve arthritic and rheumatic conditions.

Neal's Yard Remedies

Neal's Yard's top tip? The brand's Summer Tea is great for hay fever and includes all five of the ingredients listed above. Keep the used tea bags in the fridge and place over irritated eyes to help soothe and depuff.

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Eczema Home Remedies: 6 Natural Treatments To Alleviate Red, Itchy Skin - Medical Daily

Living with eczema at any stage in life, whether during childhood or adulthood, can evolve into a severely troublesome skin problem that can take a toll on your physical and mental health. Recurring itchy, dry skin can turn to damaged, red, and raised patches that can lead to agony and embarrassment. Eczema patients can begin to heal themselves from the inside out without the use of harmful chemical creams, however, with these six at-home natural remedies to treat mild to severe eczema in kids and adults.

1. Go On a 30-Day Diet

Typically, skin conditions such as eczema have to do with poor dieting. Eczema food triggers such as eggs, fish, peanuts, and soy are known to help reduce flare-ups, but this can vary from person to person. These foods may also exacerbate eczema because many people cannot properly digest the proteins, which causes an allergic reaction. Eczema patients can go on an allergy-elimination diet for 30 days, says MindBodyGreen, by removing these food triggers that contain gluten and casein (wheat and dairy). Also during this 30-day healing phase, it’s advised to get rid of toxic cleaning products and cosmetics with harmful chemical irritants.

2. Change Up Your Wardrobe

Switching your wardrobe doesn’t mean you have to spend a fortune on new clothes. Eczema patients can avoid scratchy fibers for softer ones like bamboo, cotton, or silk, which are gentler on the skin. Opting to buy organic fibers can also be a wise, healthy, and eco-friendly alternative. Overall, avoid wearing clothing that is tight, rough, scratchy, or made from wool, to avoid irritation. Dr. David E. Bank, a dermatologist, founder and director of the Center for Dermatology, Cosmetic, and Laser Surgery in Mount Kisco, N.Y., suggests eczema sufferers to first start with switching the products they use for laundry. “Consider switching your laundry detergent to one free of added chemicals and scents,” he told Medical Daily in an email.

3. Take a Magnesium Bath

Red and itchy skin can be alleviated with simple hydration. Bathing allows moisture to enter the skin. After every shower or bath, it is best to use moisturizer in order to seal the moisture in the skin. However, for some eczema sufferers, soaking in water could actually make their condition worst. It is best to be aware of how your skin reacts. The University of Maryland Medical Center advises eczema sufferers to avoid hot baths or showers, and to opt for lukewarm water.

A magnesium bath could not only soothe your skin, but also help eczema patients feel more relaxed. According to a Wellness Mama blog post, simply adding a cup of Epsom salts or magnesium flakes, and a few tablespoons of Himalayan salt can be helpful in skin healing.

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The Wellness Mama magnesium bath recipe is:

1-2 cups of epsom salts or magnesium flakes (magnesium flakes are absorbed much more easily)

1/2 cup Himalayan or Sea Salt

1/2 tsp of natural vanilla extract

10-15 drops of essential oil of choice (I love lavender and mint)

4. Apply Coconut Oil

Coconut oil has gained even more popularity for its use in oil pulling, but it has multiple uses such as an eczema natural remedy. “Coconut oil is a wonderful topical solution for itching or mild pain caused by eczema,” Banks said. “It's natural, gentle and can be commonly found at your local health food store.” Simply applying two to three tablespoons of coconut oil daily, especially on the eczema patches, can yield good results. Also, replacing vegetable oil with cold pressed, organic, extra virgin coconut oil in cooking can not only help your skin, but also help you develop better healthy eating habits.

5. Apply Turmeric

The turmeric herb has been used extensively in the treatment of skin disorders. Curcumin — the active ingredient present in turmeric — contains anti-inflammatory and bactericidal properties, says Turmeric for Health. Eczema patients can simply mix turmeric powder with water to cleanse the area infected by the skin condition.

6. Manage Your Stress

People with eczema must cope with the stress and the lack of sleep associated with itchiness during nighttime. However, stress can make the condition worse, so it is best to monitor stress levels to reduce the number of eczema flare-ups. Stress-reducing exercises such as deep breathing, basic yoga exercises, or meditation can help you manage your stress and lessen your need for creams and ointments.

Dr. Jennifer C. Franklin, a psychologist in Durham, N.C., told Medical Daily in an email “the nervous system is highly linked with a variety of skin disorders, including eczema,” which emphasizes the need to manage stress. “In other words, by resolving or even just bringing awareness to a psychological issue that may not be fully conscious or addressed, you can minimize or alleviate all kinds of physiological symptoms, assuming they are more, mostly, or completely psychosomatic in origin,” she said.

Begin to heal eczema from the inside out, and practice these six at-home remedies to reduce flare-ups and breakouts on your skin.

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How Public Health Advocates Are Trying To Reach Non-Vaccinators - NPR (blog)

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hide captionA school nurse prepares a vaccine against whooping cough before giving it to students at Mark Twain Middle School in Los Angeles.

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Whooping cough made a comeback in California last year, which researchers have linked to vaccine refusals. And with new measles outbreaks in Southern California, New York and British Columbia, the debate over vaccination is also spreading.

Forty-eight states allow parents to sign a vaccine exemption form — only West Virginia and Mississippi don't. California now requires a doctor's signature on the school form, but parents are still able to find doctors who will sign.

It can be a touchy subject, and even some physicians are unsure of how to approach parents who don't want to vaccinate their children. Still, health professionals and pro-vaccine parents are trying new ways to share their message.

Matt Willis, a public health officer for Marin County, says that if pediatricians know why parents aren't vaccinating, then they can come up with responses to try to change parents' minds.

He helped design a survey to figure out what parents are worried about. They canvassed parents in Marin County, just north of San Francisco, the site of the whooping cough cases.

"Some of the themes that came out of the survey [were] ... preference for natural immunity over immunity conferred by vaccines; children perceived as low risk for some vaccine-preventable diseases; and lack of trust for the health care system or pharmaceutical industry," he says.

Doctors' Approach

Physicians use that kind of information in different ways. Michael Yamaguchi, attending a presentation by Willis, says he gives parents articles from scientific journals.

"I hand them the article and I say, 'Look, if you're going to disbelieve this, you have to say these eight authors [and] the entire editorial board are all in somehow collusion to create some sort of data that's untrue," he says.

Other doctors say changing minds is not easy.

"I think there are those parents that come in with their mind made up, and there's nothing you can say to sway them," says Lisa Leavitt.

A study at Dartmouth College supports that theory. Political scientists surveyed nearly 1,800 parents about the vaccine for measles, mumps and rubella (MMR). What they found was that the more skeptical parents are about vaccines, the less likely they are to listen to public service ads or to their pediatricians.

Marin County pediatrician Nelson Branco hasn't given up on convincing non-vaccinators. He gave parents an ultimatum in 2012: Vaccinate your toddler against measles, mumps and rubella by the time the kid is 2 years old or find a new pediatrician.

And for some people, it worked.

"There were many families who were on the fence about vaccines who chose to get the MMR vaccine and stayed in our practice," he says. "There were very few families that left our practice."

Fewer than 20 families left, and about 150 families chose to vaccinate.

A Mom's Plea

Mother Sonia Green has also taken up the cause of convincing parents to vaccinate. Her three boys have an immune disorder called XLA. Ten-year-old Holden and his two brothers are basically "walking around with half their immune system missing," Green says.

hide captionThe Green family: (clockwise from top-left) Colby, Harrison, Sonia, Davis, Langford and Holden. Holden, Harrison and Davis have an immune disorder that affects the bodies ability to fight infections.

Courtesy of Sonia Green

Because of their condition, the boys can't be vaccinated. If they were, Green says, the best case scenario would be that the vaccination would do nothing. The other scenario is that they wouldn't develop the immune response from the vaccine and would instead become very sick.

If enough people in a community are vaccinated, then even those who didn't get vaccines are likely to be protected. If other children aren't vaccinated, kids like the Green brothers are at greater risk.

Last spring, Holden was exposed to something that for another kid might not have been a problem, Green says. But for Holden, it caused a skin infection that required him to be in the hospital for about a week.

Green wrote a blog post explaining why vaccinations are important to families like hers. And she says she's talked to other parents about the issue, and says some decided to vaccinate after hearing her story.

Part of what keeps Holden and his brothers healthy, Green says, is that she lives in a community where most people are vaccinated. But she says she's ready to pull her kids from a school or situation where she knows most people around her kids are not vaccinated.

"To me, they're gambling with my kids' lives when they don't vaccinate their kids," she says.

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On the road with the Health Wagon - CBS News

This week, 60 Minutes boarded the Health Wagon, a mobile health clinic in a beat-up Winnebago. It's run by Teresa Gardner and Paula Meade, two nurse practitioners who navigate the hills and hollows of Appalachia, providing free medical care to the working poor.

But, as 60 Minutes Overtime discovered, this week's story isn't the first time Scott Pelley and 60 Minutes producer Henry Schuster stepped foot on the Health Wagon.

For more information on the Health Wagon, visit their website or call 877-432-4466

Six years ago, the team encountered that same Winnebago while reporting another 60 Minutes story called "Lifeline" about a charity that air drops weekend-long health clinics into remote, needy areas of the country.

"To see hundreds of people line up before dawn just because they have a chance to see a doctor about something that's probably been bedeviling them for years-- it's enormously moving," says Pelley.

Working among the health care volunteers during the weekend 60 Minutes shot the 2008 story was nurse practitioner Teresa Gardner. During some pre-interview chit-chat with Pelley and Schuster, she told them about her almost daily treks through Appalachia to deliver free health care to her struggling community. Pelley and Schuster even shot footage of the Health Wagon, which was there to help out for the weekend. The footage never made air, but the story of the Winnebago stuck with the 60 Minutes team.

"There's a feel when you're in the Health Wagon that it took me a long time to put my finger on, and it's the feel of a country doctor," Schuster says. "They don't just rush 'em in and out, they talk to them. It's old-fashioned medicine in a lot of ways. You get a feel there that they're treating the patient and not just the symptoms."

"We were so moved and inspired by what they were doing," Pelley tells 60 Minutes Overtime. "Henry has, for years, wanted to go back and revisit that story."

"You see this little bitty ol' Teresa and she's driving this big old Winnebago through the mountains," says Schuster, "and your producer brain is going, 'That's gotta be a story.'"

And it certainly was-- starting with the Winnebago itself.

"There's not many more than 50,000 miles on it, but those are really hard miles," Schuster says. "Those are, like, dog years when they go up and down those hills."

But even more compelling is what happens inside the Health Wagon nearly every day when it's parked next to gas stations and convenience stores. Like old-fashioned country doctors, Gardner and Meade see patients with all types of serious medical problems -- everything from stroke symptoms to diabetes to depression-- at no charge.

For the working poor with no health insurance in Appalachia, the Health Wagon is often their only option for medical care.

"Obamacare was supposed to change all of this," says Pelley. "These folks, many of whom work full time at minimum wage, make too much money in those states to qualify for Medicaid, but they don't make enough money even to buy insurance on the health care exchanges. So at least five million Americans now fall through this gap. And they're in the same place they always were, without health insurance and unable to buy it."

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Fort Hood shooting renews attention to mental health - MSNBC

While an Army official said Friday that Specialist Ivan Lopez’ possible mental health problems were not the “direct precipitating factor” in Wednesday’s shooting at Fort Hood that killed three people and wounded 16 others, his struggles nonetheless shone a light on mental health in the U.S. military. That spotlight revealed a problem still unsolved.

Lopez, 34, was apparently involved in an altercation with other soldiers that escalated. He had been undergoing treatment for depression and anxiety and had been assessed for post-traumatic stress disorder despite having completed a tour of duty in Iraq that did not take him onto the battlefield. The tragedy at Fort Hood might be an anomaly, but Lopez’s mental health situation was not so unusual: after a decade of war, a huge number of men and women who have served in the U.S. military are suffering from injuries both mental and physical – and not all of them are the result of combat.

A poll conducted by The Washington Post and the Kaiser Family Foundation found that more than half of the 2.6 million men and women who fought in Iraq and Afghanistan struggle with mental or physical injuries and feel that the government is not meeting their needs. There are myriad programs aimed at increasing employment and reducing homelessness among veterans, but mental illness can play a part in both. Experts say a more holistic approach to treating veterans is needed.

Loree Sutton, a psychiatrist and retired Army Brigadier General, told msnbc that drawing a line between combat and non-combat injuries obscures the reality of military conflict and its effects. “Whether an individual actually engages in combat, whether it’s shooting or being shot at, just to be deployed on a forward operating base, the entire time you’re there you’re exposed to fear and death. You’re witnessing it,” she said. “There’s an impact there.”

Just because there are resources available for servicemembers and veterans who need mental health treatment doesn’t mean that they’re taking advantage of it. Despite pervasive dissatisfaction and widespread suffering reported in the poll, mental health resources are already stretched thin. A Department of Veterans Affairs survey from November found that a full third of new mental health patients seeking care through the VA were not seen within two weeks. For psychiatry appointments, the average wait was longer than a month.

In Lopez’s case, Lt. Gen. Mark Milley, the commander in charge at Fort Hood, told NBC News Thursday that Lopez had been “undergoing a diagnosis process” for post-traumatic stress disorder. Military officials also told NBC News that there was no record that Lopez saw combat while he was deployed in Iraq, nor were there any records that medically confirm a brain injury Lopez claimed he suffered from.

Sutton stressed that the even if the shooting at Fort Hood were related to Spc Lopez’ health issues, that says nothing about other individuals. “The vast majority of service members would never commit an act of violence like this, just like the vast majority of people with mental illness wouldn’t do this,” she said.

Iraq and Afghanistan Veterans of America (IAVA) founder and CEO Paul Rieckhoff cautioned against any rush to judgment.

“In moments like this, there is a tendency by some to paint a broad brush across the entire veterans community and it’s important to guard against that mistake,” Rieckhoff said in a statement Thursday. “We encourage everyone – especially those in the media and political positions – to be thoughtful and responsible in their reactions and to remember that correlation does not imply causation.”

He added, “At the same time we recognize that the vast majority of our military and vets are not in crisis, we must all acknowledge that there are indeed problems with the way mental health care and transitional support is managed and available to our service members and veterans.”

IAVA members spent last week meeting with lawmakers and administration officials about suicide and increasing access to mental health care. Of those who have served in the military since 9/11, the Kaiser poll found one in two people report knowing a fellow service member who has either attempted or committed suicide.

Pre-existing mental health issues would not be unusual; a paper published in March as part of a landmark study into mental health among military personnel found that nearly one in five soldiers had a psychiatric disorder before they enlisted. Those problems could be made worse by deployment to war zones.

Greg Jacob, policy director of Service Women’s Action Network, told msnbc that while combat trauma is the leading cause of PTSD for men, for women it is sexual assault and harassment. With medical records available for use in courts martial, many victims of sexual assault forego treatment out of fear that their mental health care records will be used to discredit their testimony.

“The huge thing about mental health treatement and mental health care is that you’re encouraged to suck things up and deal with stuff,” Jacob told msnbc. “There’s a lot of attention on injury of physical problems, but when they’re invisible wounds or mental health issues, then it’s a personal issue.”

The military has fought for years against the stigma of seeking mental health treatment. A 2008 study found that while around a fifth of soldiers returning from Iraq and Afghanistan reported major mental health problems, only half sought help. Doctors and veterans are already concerned that the shooting at Fort Hood will cause people to view PTSD as a precursor to violence and make it harder to reintegrate into society after leaving the service.

Sutton told msnbc that as in all other areas of military life, military leaders must set an example for their troops when it comes to mental health care. Leaders in the armed forces, Sutton said, must “view mental health as a force multiplier” and treat it as “on par with physical health.” Outside the military, communities must become involved if veterans are going to feel more comfortable reentering civilian life.

“We don’t return to the Pentagon, we return to communities,” Sutton said. “As troops re-enter civilian life, they need communities that can serve as safety nets as well as springboards.”

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