Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Meet Obama's Defense Secretary Nominee

President Obama nominated former Senator Chuck Hagel as the next U.S. secretary of defense. To those who haven't followed the Senate closely in the past decade, he's probably not a household name.

Hagel is a former GOP senator from Nebraska and Purple-Heart-decorated Vietnam veteran, but he wouldn't necessarily be a popular pick with Republicans in Congress.

At age 21, Hagel and his brother Tom became the next in the family to serve in the United States Army. They joined the masses of Americans fighting an unfamiliar enemy in Vietnam.

In his book, he describes finding himself "pinned down by Viet Cong rifle fire, badly burned, with my wounded brother in my arms."

"Mr. President, I'm grateful for this opportunity to serve our country again," Hagel said after Obama announced his nomination Monday.

In 1971, Hagel took his first job in politics as chief of staff to Congressman John Y. McCollister, a position he held for six years. After that, he moved to Washington for the first time, where he went on to work for a tire company's government affairs office, the 1982 World's Fair and in 1981, as Ronald Reagan's Deputy Administrator of the Veterans Administration.

Obama Taps Sen. Chuck Hagel for Defense Secretary Watch Video

Sen. Chuck Hagel's Defense Nomination Draws Criticism Watch Video

Obama's Defense Nominee Chuck Hagel Stirs Washington Lawmakers Watch Video

He worked in the private sector for most of the 80s and 90s before his first election to the Senate in 1997.
Since the turn of the century, Hagel has followed a curvy path of political alliances that puts his endorsements all over the map. Hagel's record of picking politically unpopular positions could be a large part of why Obama is naming him for the job, as Slate's Fred Kaplan surmises the next Defense secretary will be faced with tough choices.

In 2000, he was one of few Republican senators to back Sen. John McCain over then-presidential-candidate George W. Bush.

After that election, Hagel fiercely criticized Bush for adding 30,000 surge troops to Iraq, in place of the bipartisan Iraq Study Group's proposal of a draw-down and regional diplomacy, which Hagel preferred. When Bush instead announced that more troops would go to Iraq, Hagel co-sponsored a nonbinding resolution to oppose it, along with then-Sen. Joe Biden, D-Del.

"The president says, 'I don't care.' He's not accountable anymore," Hagel told Esquire in June 2007. "He's not accountable anymore, which isn't totally true. You can impeach him, and before this is over, you might see calls for his impeachment. I don't know. It depends how this goes."

Hagel's fierce opposition to America's involvement in Iraq – he called it one of the five monumental blunders of history, on par with the Trojan War – will be of substantial importance as the Obama administration charts our course out of Afghanistan, deciding how to withdraw the last of the troops in 2014 and how much of a presence to leave behind.

Hagel's support for McCain, which was substantial in his competition against Bush, disappeared in the 2008 election. Hagel toured Iraq and Afghanistan with Obama during his first campaign for the presidency.

In October 2008, Hagel's wife, Lillibet, announced her support for the Obama team, after the Washington Post reported on her donations to his campaign. She donated again in 2012.

Before the 2008 election, Hagel wrote: "The next president of the United States will face one of the most difficult national security decisions of modern times: what to do about an Iran that may be at the threshold of acquiring nuclear weapons."

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Activists wary as India rushes to justice after gang rape

NEW DELHI (Reuters) - It's no surprise the Indian street wants faster, harsher justice for sexual crimes after a horrific gang rape that rocked the nation, but some activists worry the government will trample fundamental rights in its rush to be in tune with popular rage.

Last month's rape of a physiotherapy student on a moving bus and her death on December 28 in hospital triggered a national debate about how to better protect women in India, where official data shows one rape is reported on average every 20 minutes.

Many women's rights groups are cautiously hopeful the protests and outrage that followed the crime can be channeled into real change - fast-track courts for sexual offences and a plan to hire 2,500 new women police in Delhi are measures already in the works.

But legal experts and some feminists are worried that calls to make rape punishable with death and other draconian penalties will cramp civil liberties and are unconstitutional. They say India needs better policing and prosecutions, not new laws.

"If there are not enough convictions, it is not because of an insufficiency of law, but it is the insufficiency of material to base the conviction on," said retired Delhi High Court judge R.S. Sodhi.

Five men have been charged with the student's rape and murder and will appear before a New Delhi court later on Monday. They are due to be tried in a newly formed fast-track court in the next few weeks. A teenager also accused will likely be tried in a juvenile court.

Ahead of Monday's court appearance the five still had no defense lawyers - despite extensive interrogations by the police, who have said they have recorded confessions - after members of the bar association in the South Delhi district where the case is being heard vowed not to represent them.

GROUNDS FOR APPEAL

The men will be assigned lawyers by the court before the trial begins, but their lack of representation so far could give grounds for appeal later should they be found guilty - similar cases have resulted in acquittals years after convictions.

"The accused has a right to a lawyer from point of arrest - the investigations are going on, statements being taken, it is totally illegal," said Colin Gonsalves, a senior Supreme Court advocate and director of Delhi's Human Rights Law Network.

Senior leaders of most states on Friday came out in support of a plan to lower to 16 the age that minors can be tried as adults - in response to fury that the maximum penalty the accused youth could face is three years detention.

A government panel is considering suggestions to make the death penalty mandatory for rape and introducing forms of chemical castration for the guilty. It is due to make its recommendations by January 23.

"The more you strengthen the powers of the state against the people, the more the possibility you create a draconian regime," said Sehjo Singh, Programme and Policy Director with ActionAid in India and an expert on Indian women's social movements.

"We want to raise the bar of human rights in India, we want to raise the standards, not lower them."

The Indian Express newspaper warned against "knee-jerk" reaction and said any change to the juvenile law "must come after rigorous and considered debate. It cannot be a reaction to a fraught moment".

Courts are swamped with a backlog of cases in the country of 1.2 billion people and trials often take more than five years to complete, so the launch by Chief Justice Altamas Kabir of six fast-track courts in the capital to deal with sexual offences was widely greeted as a welcome move.

Several other states including Tamil Nadu and Maharashtra are now looking at following Delhi's example.

But Gonsalves says while the courts are a good idea on paper, similar tribunals in the past delivered dubious verdicts and put financial pressure on the rest of the justice system.

FAST TRACK COURTS

India set up 1,700 fast-track courts in 2004, but stopped funding them last year because they turned out to be costly. The courts typically work six days a week and try to reduce adjournments that lead to long delays in cases.

"The record of the fast-track courts is mixed," Gonsalves said. Conviction rates rose, he said, but due process was sometimes rushed, leading to convictions being overturned.

"Fast-track courts were in many ways were fast-track injustice," he said.

The real problem lie with bad policing and a shortage of judges, Gonsalves said. India has about a fifth of the number of judges per capita that the United States has.

Indian police are often poorly trained and underpaid, and have sometimes been implicated in organized crime. Rights groups complain the mostly male officers are insensitive to victims of sexual crimes.

Resources for, and expertise in, forensic science is limited in most of the country's police forces and confessions are often extracted under duress. The judiciary complains it is hard to convict offenders because of faulty evidence.

Human Rights Watch said reforms to laws and procedures covering rape and other sexual crimes should focus on protection of witnesses and modernizing support for victims at police stations and hospitals.

The rights organization has documented the continued use of archaic practices such as the "finger test" used by some doctors on rape victims to allegedly determine if they had regular sex.

"Reforms in the rape laws - these are needed. But not in terms of enhancing punishment," said Meenakshi Ganguly, South Asia Director of Human Rights Watch.

"Why they are not investigated, why there are not enough convictions, those are the things that need to be addressed."

(Additional reporting by Satarupa Bhattacharjya, Shashank Chouhan and Annie Banerji; Editing by Alex Richardson)

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Japan says China ships off disputed isles

TOKYO: Four Chinese government ships entered territorial waters around Japan-controlled islands at the centre of a dispute Monday, the Japanese coastguard said.

The four marine surveillance ships were seen moving within 12 nautical miles of the islands, known as the Senkakus in Japan and the Diaoyus in China, just before midday, the coastguard said in a statement.

It was the first time since December 31 -- and the 21st time since Japan nationalised the islands in September -- that any state-owned Chinese ship has been seen in the archipelago's waters, which lie in the East China Sea.

A state-owned Chinese plane flew through airspace over the islands early last month. Tokyo responded by scrambling fighter jets and said it was the first time Beijing had breached its airspace since at least 1958.

On Saturday, another Chinese state-owned plane approached the islands without entering the airspace, prompting another Japanese fighter jet dispatch.

-AFP/ac

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Pak soldier killed, India says fired in retaliation

SRINAGAR: Pakistani troops violated ceasefire on Sunday by firing mortar shells towards Indian army posts at Hajipir area in Uri sector near the Line of Control.

"They started firing mortar shells towards our posts in Uri sector around 3.15am," an army spokesman said. He said that some shells landed close to civilian habitation though no damage was done.

The spokesman added that Indian troops responded with light weapons which stopped the Pakistani shelling.

On the other hand, Pakistan's army has accused India of crossing the LoC and raiding its check post in Bagh area on Sunday. It said Indian troops raided a military post in the Hajipir sector of Bagh area, killing a soldier and injuring another.

(With inputs from Omer Farooq from Islamabad)

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Your medical chart could include exercise minutes

CHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you are active or getting exercise.

Wait, what?

If the last item isn't part of the usual drill at your doctor's office, a movement is afoot to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation's largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit, and some other medical systems are doing it, too.

Here's how it works: During any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it's among the first things the doctor sees.

"All we ask our physicians to do is to make a comment on it, like, 'Hey, good job,' or 'I noticed today that your blood pressure is too high and you're not doing any exercise. There's a connection there. We really need to start you walking 30 minutes a day,'" said Dr. Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.

He said Kaiser doctors generally prescribe exercise first, instead of medication, and for many patients who follow through that's often all it takes.

It's a challenge to make progress. A study looking at the first year of Kaiser's effort showed more than a third of patients said they never exercise.

Sallis said some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who routinely exercise live longer than others, even if they're overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely measuring it, she "really didn't take it seriously."

She was obese, and in a family of diabetics, had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenuous.

Solano, 34, decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon — and ran that 13-mile race in May in less than three hours. She formed a running club with co-workers and now runs several miles a week. She also started eating smaller portions and buying more fruits and vegetables.

She is still overweight but has lost 30 pounds and her blood sugar is normal.

Her doctor praised the improvement at her last physical in June and Solano says the routine exercise checks are "a great reminder."

Kaiser began the program about three years ago after 2008 government guidelines recommended at least 2 1/2 hours of moderately vigorous exercise each week. That includes brisk walking, cycling, lawn-mowing — anything that gets you breathing a little harder than normal for at least 10 minutes at a time.

A recently published study of nearly 2 million people in Kaiser's southern California network found that less than a third met physical activity guidelines during the program's first year ending in March 2011. That's worse than results from national studies. But promoters of the vital signs effort think Kaiser's numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identical program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

"There are some real opportunities there to kind of shift patients' expectations about the value of physical activity on health," Joy said.

NorthShore University HealthSystem in Chicago's northern suburbs plans to start an exercise vital sign program this month, eventually involving about 200 primary care doctors.

Dr. Carrie Jaworski, a NorthShore family and sports medicine specialist, already asks patients about exercise. She said some of her diabetic patients have been able to cut back on their medicines after getting active.

Dr. William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, said measuring a patient's exercise regardless of method is essential, but that "naming it as a vital sign kind of elevates it."

Figuring out how to get people to be more active is the important next step, he said, and could have a big effect in reducing medical costs.

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Online:

Exercise: http://1.usa.gov/b6AkMa

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Pastor Accused of Killing Wives Faces Trial

Jury selection is scheduled to begin Monday for Pastor Arthur Schirmer, who is accused of killing his second wife and then staging a car accident to hide it.

Schirmer, 64, also faces a second trial at a later date for the death of his first wife. He has said he is innocent of all charges.

In 2008, the pastor and his wife, Betty, were involved in what appeared at the time to be a car crash. Schirmer told police at the time that he had been driving 55 mph and swerved to miss a deer, causing him to drive off the road, according to a police affidavit obtained by ABC News.

Schirmer also said at the time that his wife's head had come forward and struck the windshield, according to the affidavit. Betty died a day later and her body was cremated at the request of Schirmer.

It wasn't until a grisly suicide in 2010 inside Schirmer's office that authorities decided to revisit the case of Betty Schirmer's death and arrest the pastor.

The man who broke in and shot himself at the desk in Schirmer's office at the Reeders United Methodist Church, Joseph Mustante, was the husband of the pastor's secretary, Cynthia Mustante, Poconos Township Police Detective James Wagner said.

Pocono Record, David Kidwell/AP Photo

Mustante's suicide was prompted by the discovery that his wife and the pastor had apparently been having an affair, Wagner said. He was alone at the time of his death.

Investigators looking into the suicide say that several church parishioners had concerns about the deaths of Schirmer's two wives.

"That suicide eventually exposed the affair publicly and subsequent to that, questions arose about the loss of [Schirmer's] wives and his character became questionable," Wagner said.

Relaunching the investigation into the two deaths, Wagner said he quickly suspected that "foul play existed, and the car crash was staged," allegedly, by Schirmer. Wagner said investigators also believed there was something "suspicious" about the first wife's death, a marriage that investigators had not known about prior to the suicide.

Investigators Look Into Deaths of Rev. Arthur Schirmer's Wives

Schirmer's first wife, Jewel, died in April 1999 from a traumatic brain injury after she purportedly fell down a flight of stairs in Lebanon, Pa., Wagner said.

Lebanon is about 100 miles southwest of Reeders, where Schrimer later moved with his second wife.

At the time of Jewel's death, Wagner said, a relative told police that he suspected Schirmer may have had a hand in his wife's death but that the investigation was "never completed."

On Dec. 11, 2012 -- more than 13 years after Jewel died, a Lebanon County judge ruled Schirmer would be tried for her murder.

When investigators looked at the death of Betty Schirmer, they saw inconsistencies, Wagner said.

"There was no airbag deployment and it simply looked like a car that had driven off the road at a very low speed," Wagner said. "It didn't match the injuries to [Betty's head].

"I know there are people out there who probably know him and feel like there is absolutely no way he would be capable of doing this," Wagner of Schirmer. "But they clearly don't know him."

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Venezuela lawmakers elect Chavez ally as Assembly chief

CARACAS (Reuters) - Venezuelan lawmakers re-elected a staunch ally of Hugo Chavez to head the National Assembly on Saturday, putting him in line to be caretaker president if the socialist leader does not recover from cancer surgery.

By choosing the incumbent, Diosdado Cabello, the "Chavista"-dominated legislature cemented the combative ex-soldier's position as the third most powerful figure in the government, after Chavez and Vice President Nicolas Maduro.

"As a patriot ... I swear to be supremely loyal in everything I do, to defend the fatherland, its institutions, and this beautiful revolution led by our Comandante Hugo Chavez," Cabello said as he took the oath, his hand on the constitution.

He had earlier warned opposition politicians against attempting to use the National Assembly to "conspire" against the people, saying they would be "destroyed" if they tried.

Thousands of the president's red-clad supporters gathered outside parliament hours before the vote, many chanting: "We are all Chavez! Our comandante will be well! He will return!"

If Chavez had to step down, or died, Cabello would take over the running of the country as Assembly president and a new election would be organized within 30 days. Chavez's heir apparent, Maduro, would be the ruling Socialist Party candidate.

Chavez, who was diagnosed with an undisclosed form of cancer in his pelvic area in mid-2011, has not been seen in public nor heard from in more than three weeks.

Officials say the 58-year-old is in delicate condition and has suffered multiple complications since the December 11 surgery, including unexpected bleeding and severe respiratory problems.

Late on Friday, Maduro gave the clearest indication yet that the government was preparing to delay Chavez's inauguration for a new six-year term, which is scheduled for Thursday.

'CHAVEZ IS PRESIDENT'

Maduro said the ceremony was a "formality" and that Chavez could be sworn in by the Supreme Court at a later date.

The opposition says Chavez's absence would be just the latest sign that he is no longer fit to govern, and that new elections should be held in the South American OPEC nation.

Brandishing a copy of the constitution after his win in the Assembly, Cabello slammed opposition leaders for writing a letter to foreign embassies in which they accused the government of employing a "twisted reading" of the charter.

"Get this into your heads: Hugo Chavez was elected president and he will continue to be president beyond January 10. No one should have any doubt ... this is the constitutional route," he said as fellow Socialist Party lawmakers cheered.

The opposition sat stony-faced. One of their legislators had earlier told the session that it was not just the head of state who was ill, "the republic is sick."

Last year, Chavez staged what appeared to be a remarkable comeback from the disease to win re-election in October, despite being weakened by radiation therapy. He returned to Cuba for more treatment within weeks of his victory.

Should the president have to step down after 14 years in office, a new vote would probably pit Maduro, a 50-year-old former bus driver and union leader, against opposition leader Henrique Capriles, the 40-year-old governor of Miranda state.

Capriles lost to Chavez in October's presidential election.

"I don't think Maduro would last many rounds in a presidential race. He's not fit for the responsibility they have given him," Capriles said after the vice president's appearance on state television.

Chavez's condition is being watched closely by leftist allies around Latin American who have benefited from his oil-funded generosity, as well as investors attracted by Venezuela's lucrative and widely traded debt.

The country boasts the world's biggest crude reserves. Despite the huge political upheaval Chavez's exit would cause, the oil industry is not likely to be affected much in the short term, with an extension of "Chavismo" keeping projects on track, while a change in parties could usher in more foreign capital.

(Additional reporting by Deisy Buitrago; Editing by Vicki Allen)

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Indian troops kill Pakistani soldier in Kashmir

ISLAMABAD: A Pakistani soldier was killed and another wounded Sunday when Indian troops stormed a military post on the two countries' de facto border in Kashmir, the military said.

It said an exchange of fire was continuing after the Indian incursion across the Line of Control marking the frontier in the Haji Pir sector, 80 kilometres (49 miles) north of Islamabad.

Indian troops had crossed the line and "physically raided a checkpost named Sawan Patra", Pakistan's military said in a statement.

"Pakistan Army troops effectively responded to the attack successfully. One Pakistani soldier embraced martyrdom while another was critically injured," it said.

The Indian troops retreated, leaving behind a gun and a dagger, and an exchange of fire was continuing, the military said.

Muslim-majority Kashmir is a Himalayan region which India and Pakistan both claim in full but rule in part. It was the cause of two of their three wars since independence from Britain in 1947.

India suspended its peace process with Pakistan after deadly attacks by Pakistan-based militants in 2008 in Mumbai. Talks only resumed in February last year.

Both sides remain deadlocked over Kashmir but have made some progress on less contentious subjects such as trade.

The nuclear-armed neighbours have observed a ceasefire in Kashmir since November 2003 but there have been occasional small-time clashes and accusations of violations from both sides.

Kashmir has been racked by militancy since 1989 when an insurgency against Indian rule erupted. Around 47,000 people have died, though militant violence has decreased in recent years.

- AFP/fa

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Cold wave continues in J&K

SRINAGAR: There was no respite from the intense cold as the temperatures remained much below the freezing point in the Kashmir Valley and the Ladakh region of the state, said a weather official here Sunday.

"The night temperature was minus 4.6 degrees celsius in Srinagar. It was minus 8.0 in Pahalgam and minus 9.0 degrees celsius in Gulmarg today (Sunday)," an official of the Met office told IANS.

Leh town in the Ladakh region was the coldest town in the state where the temperature dropped to minus 18.0 degrees celsius. In Kargil town of Ladakh region it was 17.4 degrees celsius, said the official.

According to the official, the cold conditions in the state would continue during the next 24 hours because of the dry weather dry here.

"Cold wave conditions are likely to continue in the state during the next 24 hours because of the dry weather. In Jammu region foggy weather can disrupt road and air traffic," the official said.

Parts of Dal Lake in summer capital Srinagar have already frozen here as fisherman and Shikarawallahs find it difficult to row their boats in the Kashmir Valley these days.

Freeze and frost on the city roads has made morning and evening passage for commuters and motorists risky as most of them prefer to remain indoors till the feeble winter sunshine breaks the frost.

Kashmir is passing through the harsh 40-day winter period known locally as the 'Chillai Kalan' which began here Dec 21 and will end Jan 30.

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