♪.

STEVE: COMING UP NEXT ON "ARIZONA HORIZON," PRESIDENT-ELECT DONALD TRUMP AND PLANS TO DO AWAY WITH BIRTHRIGHT CITIZENSHIP.

>>> A COUPLE IS INDICTED FOR DEFRAUDING THE ESA UNIVERSAL VOUCHER PROGRAM.

>>> AND THE IMPORTANCE OF PANCREATIC CANCER AWARENESS.

THOSE STORIES AND MORE NEXT ON "ARIZONA HORIZON."

.

STEVE: GOOD EVENING AND WELCOME TO "ARIZONA HORIZON."

I'M STEVE GOLDSTEIN IN FOR TED SIMONS TONIGHT.

PRESIDENT-ELECT DONALD TRUMP SUGGESTED KARI LAKE AS NEXT DIRECTOR FOR VOICE OF AMERICA, A RADIO SERVICE RUN BY THE U.S. GOVERNMENT THAT PRODUCES AWARD WINNING JOURNALISM WHICH PROMOTES U.S.

VALUES WORLDWIDE.

IT RUNS OTHER BROADCASTING NETWORKS.

A VETERAN OF THE NEWS ORGANIZATION TOLD CNN THAT TRUMP IS PUTTING THE CART BEFORE THE HORSE IN ANNOUNCING LAKE AS DIRECTOR OF VOICE OF AMERICA.

ACTIONS TAKEN WITHIN THE U.S.

GLOBAL AGENCY MEDIA LED TO REFORMS INCLUDING INTERNATIONAL BROADCAST ADVISORY BOARD WHICH WORKS WITH THE CEO OF THE AGENCY TO PROMOTE THE DIRECTOR OF VOICE OF AMERICA.

A NEW DIRECTOR WAS APPOINTED MONTHS AGO.

>>> PRESIDENT JOE BIDEN COMMUTED THE SENTENCES OF 150 PEOPLE AND PARDONED 39 PEOPLE CONVICTED OF NONVIOLENT CRIMES.

IT'S LARGEST SINGLE DAY ACT OF CLEMENCY IN MODERN DAY HISTORY.

THOSE WHO INVESTIGATED TRUMP'S EFFORT TO OVERTURN THE 2020 ELECTION AND FACING POSSIBLE RETRIBUTION WHEN TRUMP TAKES OFFICE.

>>> NEW REPORT BY DEPARTMENT OF JUSTICE INSPECTOR FOUND THE FBI SHOULD HAVE DONE MORE TO COLLECT INTELLIGENCE BEFORE THE JANUARY 6 CAPITOL RIOT THOUGH THEY DID PREPARE FOR THE POSSIBILITY OF VIOLENCE THAT DAY.

THE REPORT SAYS NO UNDERCOVER FBI EMPLOYEES WERE PRESENT ON JANUARY 6 AND NONE OF THE INFORMANTS WAS AUTHORIZED TO PARTICIPATE.

DESPITE CLAIMS BY REPUBLICANS IN CONGRESS THAT THE FBI PLAYED A ROLE IN THE INSURRECTION.

THEY STORMED THE BUILDING IN A VIOLENT CLASH WITH POLICE THAT DAY.

FBI INFORMANT WHO LIED ABOUT THE BIDEN FAMILY AND CONNECTION TO UKRAINIAN ENERGY COMPANY CUT A PLEA DEAL BY SPECIAL COUNSEL DAVID WEISS.

ALEXANDER SMIRNOV IS SET TO PLEAD GUILTY TO FOUR CHARGES, PROVIDING FALSE INFORMATION TO THE FBI AND TAX EVASION.

IN 2020, SMIRNOV TOLD THE FBI BURISMA WAS ALLEGEDLY PAYING OFF PRESIDENT BIDEN WHEN HE WAS VICE PRESIDENT AND SAID BURISMA WAS PAYING OFF HUNTERER BIDEN.

SMIRNOV COULD GET BETWEEN FOUR AND SIX YEARS IN PRISON.

>>> PRESIDENT-ELECT DONALD TRUMP IS CHANGING MESSAGING ON INFLATION SAYING DURING HIS CAMPAIGN, WHEN I WIN, I WILL BRING PRICES DOWN STARTING ON DAY ONE.

IN AN INTERVIEW RELEASED IN "TIME" MAGAZINE, TRUMP SAID ABOUT GROCERY PRICES GOING DOWN, QUOTE, YOU KNOW IT'S VERY HARD, A BETTER SUPPLY CHAIN IS GOING TO BRING THEM DOWN.

TRUMP USED THE SLOGAN SAYING DRILL BABY DRILL SAYING IT WILL BRING DOWN PRICES ON ALL PRODUCTS.

>>> THE MYSTERY CONTINUES OVER LARGE DRONES FLYING OVER NEW JERSEY AND MID-ATLANTIC REGION.

SENATOR RICHARD BLUMENTHAL OF CONNECTICUT SAYS THE DRONES SHOULD BE SHOT DOWN IF NECESSARY.

A WHITE HOUSE SPOKESPERSON IS ABLE TO SHED MORE LIGHT ON THE MYSTERY DRONES.

>> WE HAVE NO INFORMATION THAT THE DRONES PROVIDE A NATIONAL SECURITY OR PUBLIC SAFETY THREAT, OR HAVE A FOREIGN NEXUS.

WE HAVE NOT BEEN ABLE TO, NEITHER HAVE STATE AND LOCAL LAW ENFORCEMENT AUTHORITIES CORROBORATE ANY OF THE REPORTED VISUAL SIGHTINGS.

TO THE CONTRARY, UPON REVIEW OF AVAILABLE IMAGERY, IT APPEARS MANY OF THE REPORTED SIGHTINGS ARE MANNED AIRCRAFT THAT ARE OPERATED LAWFULLY.

STEVE: WE HAVE BIRTH RIGHT CITIZEN SHIP WHERE ANYBODY BORN IN THE UNITED STATES HAS AUTOMATIC CITIZEN SHIP.

JOINING US IS ATTORNEY STEPHEN MONTOYA, WELCOME BACK TO "ARIZONA HORIZON," SIR, THANKS FOR BEING HERE.

>> THANK YOU.

STEVE: A BRIEF HISTORY LESSONS, THEN.

WHEN AND WHY DID BIRTH RIGHT CITIZENSHIP COME ABOUT IN THE U.S.?

>> WELL, IT CAME ABOUT BEFORE UNITED STATES BECAME A COUNTRY, IT IS PART OF EARLY AMERICAN HERITAGE BECAUSE AMERICA WAS A COLONY OF ENGLAND AND ENGLAND HAD BIRTH RIGHT CITIZENSHIP SINCE AT LEAST THE EARLY 1600s, A CASE CALLED KAVENL'S CASE WAS DECIDED THAT SAID THAT ANYONE BORN IN THE KING'S REIGN OWED ALLEGIANCE TO THE KING AND A SCOTSMAN UNDER THE KING OF ENGLAND, KING JAMES II, HAD TO BE CONSIDERED AN ENGLISHMAN FOR PURPOSES OF CITIZENSHIP AND COULD ONLY LAND IN ENGLAND.

SO THE EARLY COLONIES ALL ADOPTED BIRTHRIGHT CITIZENSHIP.

IT WAS REPUDIATED AS TO AFRICAN-AMERICANS WHO WERE ENSLAVED IN THE 1857 CASE OF DREAD SCOTT V. SANFORD, THE INFAMOUS CASE.

AND IT WAS REVERSED, THAT CASE, SPECIFICALLY BY A COUPLE OF THINGS.

ONE OF WHICH WAS THE AMERICAN CIVIL WAR, AND THEN IT WAS ALSO REVERSED BY THE 13th AMENDMENT, ABOLISHING SLAVERY IN 1865, AND THE 14th AMENDMENT DEFINED CITIZENSHIP CONSTITUTIONALLY IN SECTION ONE, AND IT BASICALLY STATES THAT EVERYONE BORN IN THE UNITED STATES AND SUBJECT TO THE JURISDICTION OF THE UNITED STATES IS A CITIZEN OF THE STATE THEY WERE BORN IN, AND A CITIZEN OF THE UNITED STATES.

STEVE: THAT BRINGS US TO HOW CHALLENGING, HOW DIFFICULT, HOW CONTROVERSIAL WOULD IT BE TO CARRY THIS OUT?

WOULD IT BE AMENDING THE CONSTITUTION IF PRESIDENT-ELECT TRUMP AND SOME OF HIS FRIENDS WANTED TO MAKE THIS HAPPEN?

>> IT'S GOING TO BE VERY CONTROVERSIAL.

IT'S GOING TO BE -- THE SO-CALLED LIBERALS ARE AGAINST IT.

A LOT OF THE CONSERVATIVES ARE AGAINST IT, TOO.

BIRTH RIGHT CITIZEN SHIP IS PART OF THE HERITAGE OF THE UNITED STATES, AS I POINTED OUT, AND THE -- A LOT OF CONSERVATIVE JURISTS ARE TEXTURALISTS.

THEY BELIEVE YOU HAVE TO TAKE THE WORDS OF THE CONSTITUTION VERY STRICTLY.

YOU HEARD OF THE TERM STRICT CONSTRUCTIONISTS, AND THE 14th AMENDMENT, THE FOURTH SENTENCE SAYS ANYONE BORN IN THE UNITED STATES AND SUBJECT TO JURISDICTION IS A CITIZEN OF THE UNITED STATES, AND IT'S GOING TO BE HARD TO GET AROUND THAT.

HERE'S THE ARGUMENT, THOUGH, THAT YOU DON'T HAVE TO AMEND THE CONSTITUTION BECAUSE IN FACT, CONGRESS CAN STATUTORILY SAY THAT THE CHILDREN OF UNDOCUMENTED IMMIGRANTS ARE NOT CITIZENS OF THE UNITED STATES BECAUSE NOT SUBJECT TO THE JURISDICTION OF THE UNITED STATES IN THE FIRST SENTENCE OF THE FIRST AMENDMENT HAS A SPECIAL MEANING IN THIS CONTEXT, AND IN ORDER TO HAVE JURISDICTION, IN THIS PARTICULAR CONTEXT, IT'S NOT THE TRADITIONAL MEANING OF JURISDICTION THAT FIRST YEAR LAW STUDENTS LEARN, AND THIRD YEAR LAW STUDENTS LEARN, AND LAWYERS APPLY EVERY DAY.

IT'S SOMETHING DIFFERENT.

IT MEANS POLITICAL JURISDICTION.

YOU CAN VOTE?

CAN YOU RUN FOR OFFICE?

THE PROBLEM WITH THAT IS IT FLIES IN THE FACE OF THE LANGUAGE OF THE 14th AMENDMENT, BUT MOREOVER, IT FLIES IN THE FACE OF THE HISTORY OF THE AMENDMENT BECAUSE WHEN YOU LOOK AT THE DRAFTING OF THE AMENDMENT, THE DRAFTERS OF THE AMENDMENT CONSIDERED THIS, AND SAID, HEY, THERE WAS A THREAT.

A PENNSYLVANIA SENATOR, HEY, WE'RE GOING TO BE OVERRUN BY THE CHINESE, THEY'RE TRESPASSING.

WE DON'T WANT THEIR CHILDREN TO BE CITIZENS, DO WE?

AND THE MAJORITY OF THE SENATE SAID, YES, WE DO, AND ENACTED THE 14th AMENDMENT THAT WAS LAWFULLY RATIFIED BY THREE FOURTHS OF THE STATES.

STEVE: IN CURRENT POLITICS, THOUGH, WE KNOW THAT PRESIDENT TRUMP, DURING HIS FIRST TERM WAS ADVOCATING FOR SOMETHING LIKE THIS AS WELL, AND SOME PEOPLE ARE NERVOUS THAT DURING THE FIRST TERM, THOUGH THERE WERE THINGS THAT HAPPENED THAT PEOPLE DIDN'T LIKE.

THERE WERE GUARDRAILS, CHECKS AND BALANCES, A CONCERN THAT THOSE WHO WOULD HAVE TALKED PRESIDENT TRUMP OUT OF IT, EVEN IN HIS OWN CABINET MAY NOT BE THERE RIGHT NOW.

DO YOU THINK THERE WOULD BE A LEGITIMATE EFFORT, AS DIFFICULT AS IT IS TO PULL IT OFF, WOULD THEREBY A LEGITIMATE EFFORT TO HAVE THIS HAPPEN?

WOULD THEY PUT THE ENERGY INTO IT?

>> I WOULD NOT CALL IT LEGITIMATE EFFORT, BUT I DO THINK THERE IS AN EFFORT, AND I'LL TELL YOU WHY.

IF YOU GOOGLE THIS, WHICH I HAVE THIS MORNING, THERE ARE LITERALLY DOZENS OF SEVERAL PRONOUNCEMENTS BY PRESIDENT-ELECT TRUMP HE'S GOING DO THIS ON THE FIRST DAY, AND I BELIEVE HIM.

I DON'T THINK IT'S GOING TO GET VERY FAR AFTER HIS PRONOUNCEMENT, BUT HE CAN ISSUE EXECUTIVE ORDERS, FOR EXAMPLE, HE CAN ORDER CUSTOMS NOT TO GIVE ANYONE A PASS PORT, A U.S. PASSPORT UNLESS THEY CAN SHOW, NOT ONLY THEY WERE BORN IN THE UNITED STATES, BUT THEIR PARENTS WERE LAWFULLY IN THE UNITED STATES.

HE CAN ACTUALLY IMPOSE SOME OF THIS BY MEANS OF EXECUTIVE ORDER THAT WILL BE CHALLENGED IN THE COURTS AND I THINK JOINED BY ENFORCEMENT BY THE COURTS AND COULD GO UP TO THE SUPREME COURT.

STEVE: HOW DOES THIS POTENTIALLY COMPLICATE THE IDEA THAT WE'VE HEARD BOTH SIDES OF THE AISLE SAY NICE THINGS ABOUT SO-CALLED DREAMERS.

HOW DOES IT AFFECT THEIR PLIGHT?

BECAUSE THIS WOULD SEEM LIKE PRESIDENT-ELECT TRUMP IS NOT THEIR ADVOCATE?

>> HE'S NOT GOING TO BE THEIR ADVOCATE.

HE'S NEVER BEEN THEIR ADVOCATE AND IT'S DEFINITELY GOING TO HAVE ADVERSE IMPACT ON DREAMERS WHO ARE IN EXTREMELY PRECARIOUS POSITION IN ANY EVENT.

THE ONLY THING THAT SAVES THE DREAMERS IN THE LONG RUN IS AN ACT OF CONGRESS NATURALIZING THEM, AND WHETHER THAT'S GOING TO COME, YOUR GUESS IS PROBABLY BETTER THAN MINE.

STEVE: DOWN TO LESS THAN A MINUTE.

I WANT TO ASK YOU A PHILOSOPHICAL QUESTION.

AS SOMEONE WHO'S HEARD ABOUT THIS FOR YEARS, LAWSUITS -- >> I PREPARED A LAWSUIT AGAINST A POTENTIAL BILL LIKE THIS IN ARIZONA IN THE 90s.

STEVE: SO WITHOUT KNOWING THE ANSWER -- >> WHEN I WAS STILL YOUNG.

STEVE: NEITHER ONE OF US ARE PSYCHOLOGISTS, BUT BRIEFLY WHY DOES THIS KEEP COMING UP?

>> WELL, FEAR OF THE OTHER IS A CONSTANT IN AMERICAN HISTORY, IT'S A CONSTANT IN LIFE.

THE ALIEN ACT UNDER A FOUNDING FATHER NAMED JOHN ADAMS WAS PITTING US AGAINST THE FRENCH.

THE FRENCH AND THE SPANISH WERE CONSPIRING AGAINST THE ANGLO-SAXON AMERICAN FOUNDERS.

SO THE FEAR OF THE OTHER, THE FEAR OF THE UNKNOWN IS A CONSTANT IN LIFE IN HISTORY.

>> THE HUMAN CONDITION, STEPHEN MONTOYA, THANK YOU SO MUCH.

>> THANK YOU, SIR.

.

STEVE: THE ARIZONA ATTORNEY GENERAL HAS INDICTED AN OUT-OF-STATE COUPLE FOR DEFRAUDING EMPOWERMENT SCHOLARSHIP ACCOUNT UNIVERSAL VOUCHER PROGRAM.

THE FRAUD BEGAN IN 2022 AND AMASSED MORE THAN $110,000.

THE GRAND CANYON INSTITUTE SAYS THE CASE RAISES SIGNIFICANT FINANCIAL INTEGRITY QUESTIONS.

FOR MORE, DAVID WELLS, RESEARCH DIRECTOR AT GRAND CANYON INSTITUTE.

GOOD TO SEE YOU.

>> GOOD TO SEE YOU.

STEVE: HOW DID THIS RECENT CASE COME ABOUT THAT LED TO THIS INDICTMENT?

THIS IS A LONG-WINDED SECOND PART OF THE QUESTION, HOW MUCH IS GOING ON THAT WE DON'T KNOW ABOUT?

>> I DON'T KNOW, I WAS ABLE TO BRING SOME OF THE KIDS WITH ME, SO ACTUALLY, PENNY AND JOY FOX AND TUCKER, VANCE, WYATT, ARLO, ROCKY AND MIKEY GILL HERE.

AND OTHER KIDS WOULDN'T FIT BEHIND ME, VIT I HAVE THE DIAZ, HOBBS AND COLE KIDS BEHIND ME.

STEVE: HOW MANY KIDS?

>> 43 OUT OF 50.

IF THEY WEREN'T SO GREEDY BECAUSE PRESUMING THESE KIDS WERE APPROVED AND THESE ARE VERY PROMISCUOUS FAMILIES THAT HAVE LOTS OF KIDS, BUT I THINK THAT MIGHT BE WHY THEY GOT CAUGHT.

THE IDEA IS THAT IF YOU'RE NOT THAT GREEDY ABOUT IT, WE DON'T KNOW HOW MANY FOLKS SHOULDN'T BE GETTING ESAs AND THEY LIVED IN COLORADO AND SUPPOSEDLY LIVED IN UTAH AND GOT EXPENSES PAID FOR PRESUMABLY IN COLORADO.

STEVE: WHAT DO YOU MAKE OF SUPERINTENDENT HORNE TAKING CREDIT FOR WHATEVER EXTENT CATCHING THESE FOLKS?

>> WELL, I MEAN, THEY GOT CAUGHT.

I DON'T KNOW WHEN THEY STARTED TO LOOK AT IT AND SO FORTH, BUT IT'S CLEAR THAT UNDER HIS ADMINISTRATION, THE EXPENSES WERE APPROVED AND KIDS WERE MADE LEGITIMATE WHEN THEY WEREN'T.

SO IT DID CATCH ON, WHICH IS GOOD, BUT WE HAVE TO HAVE MUCH MORE OVERSIGHT.

WHAT'S REALLY DISTURBING IS LIKE THEY HAVE NO STAFF, THEY DON'T HAVE ENOUGH STAFF TO OVERSEE THE PROGRAM, WHAT HORNE ALSO ANNOUNCED, THE BACKLOG OF UNDER $2,000, WE'RE GOING TO APPROVE THAT, AND LOOK AT IT LATER.

IF YOU'RE UNDERSTAFFED, HOW ARE YOU GOING TO GO BACK AND CHECK THOSE KIND OF THINGS FOR FRAUD?

STEVE: IT SEEMS QUITE BIZARRE.

AND YOU HAVE IDEAS TO MAKE SURE SINCE THE VOUCHER PROGRAM EXPANDED, WAYS TO KEEP IT IN CHECK.

TELL US THE IDEAS.

>> WHAT SHOULD HAPPEN IS GOVERNOR HOBBS AND SUPERINTENDENT HORNE OUGHT TO HAVE A JOINT SPECIAL SESSION OF THE LEGISLATURE.

IT'S A WIN-WIN.

THE IDEA IS HORNE NEEDS MORE STAFF, AND GOVERNOR HOBBS SHOULD BE CALLING FOR REFORMS TO THE ESA PROGRAM.

I THINK IT'S SOMETHING EVERYBODY COULD COME TOGETHER ON.

PART OF WHAT WE WANT TO SEE IS AUDIT OF WHAT'S OCCURRED SO FAR BECAUSE WE WONDER ABOUT A LOT OF THE KINDS OF EXPENSES AND A LOT OF THIS IS HOME-SCHOOLING.

HOME-SCHOOLING OPENED UP A PANDORA'S BOX OF POSSIBILITIES AND WE'D LIKE TO SEE PARENTS HAVE TO DOCUMENT AN EDUCATIONAL PLAN FOR KIDS, THEN SHOW THEY FULFILLED SOMETHING WITH IT AND HAVE TO REAPPLY EACH YEAR, AND THERE'S MONEY TO HELP DO ALL.

THIS WE ESTIMATE THERE'S $360 MILLION AT THE END OF LAST YEAR THAT WASN'T SPENT SO YOU CAN TAKE THAT MONEY AND USE IT TO PAY FOR STAFF AND MANY OTHER THINGS.

STEVE: WHY IS THAT MONEY NOT GOING INTO THE GENERAL FUND FOR OTHER USES?

>> YOU HAVE TO PASS LEGISLATION TO MAKE THAT HAPPEN.

SO RIGHT NOW, WHEN A PARENT GETS ESA VOUCHER, IT'S IN THEIR ACCOUNT, LIKE A DEBIT CARD AND THEY SPEND IT AS LONG AS EXPENSES ARE APPROVED.

STEVE: HOW MUCH MORE COMPLICATED HAS THIS BECOME WITH THE EXPANSION OF THE PROGRAM, WHICH WE KNOW ARIZONA VOTERS REJECTED IT BUT IT WAS PUT THROUGH AND WE HAVE THIS.

NOW THAT THERE ARE SO MANY MORE OPPORTUNITIES, SO MUCH MORE MONEY, I ASKED YOU AT THE BEGINNING MORE CONCERNS ABOUT FRAUD, BUT HOW MUCH MORE COMPLICATED HAS IT BECOME WHEN THERE'S SO MUCH MONEY GOING AROUND HERE?

>> WHEN YOU HAVE THE HOME-SCHOOLING PIECE OF IT, AND YOU MADE THE PROGRAM SO MUCH BIGGER.

GENERALLY IN ARIZONA, IF THE LEGISLATURE LIKES SOMETHING, THEY DON'T PUT FUNDS IN IT.

WE HAD ISSUES WITH CHARTER SCHOOLS AND DIDN'T PUT ENOUGH STAFF TO OVERSEE CHARTERS.

IN 2018, WE WERE CRITICIZED FOR WHAT WAS GOING ON, THAT IS SOMETHING THAT HAS TO BE GIVEN A LOT MORE THOUGHT AND SCRUTINY.

WE'LL HAVE A REPORT OUT SOON LOOKING AT FISCAL YEAR 23 THAT MOST OF THE RECIPIENTS ARE USING HOME-SCHOOLING.

THEY'RE NOT ALL PRIVATE SCHOOLS.

HOME SCHOOLING IS A REAL MESS.

STEVE: IT IS SUCH A PARTISAN ISSUE, WHEN YOU TALK ABOUT MAKING IT MORE EFFICIENT, TAKING CARE OF IT IN A PROPER WAY, LESS WASTE OF MONEY, PEOPLE WHO NEED IT GETTING THE FUNDS, IT WOULD -- I WOULD THINK THAT WOULD BRING PEOPLE TOGETHER.

BECAUSE IT'S SO PARTISAN, WE WON'T SEE THAT.

WE MENTIONED HOBBS AND LEARN GETTING TOGETHER, WE'RE NOT GOING TO SEE THAT, ARE WE?

>> THEY CAN TAKE CREDIT FOR IT WHEN THEY DO.

I'LL BACK OFF.

STEVE: DO YOU THINK THE CONCEPT WHEN THEs VOUCHER PROGRAM WAS CREATED, IN SOME CASES FOR FOLKS WHO MOST CASES LOW INCOME OR FOLKS WITH DISABILITIES, WAS IT A GOOD IDEA AT THE TIME AND BECOME TOO MUCH OF A BEAR.

>> I DON'T THINK IT WAS A GOOD IDEA.

A PRIVATE SCHOOL SUBSIDIES ARE NOT ACCOUNTABLE, WE'VE SHOWN THEY ACTUALLY HELP WEALTHIER FOLKS.

I KNOW LOW-INCOME FAMILIES WHO STARTED IN ESA, BUT THE REASON IS THEY HAVE ONE CAR, THE CHILD DOESN'T WANT TO GO TO SCHOOL.

IF THEY MISS SCHOOL, THEY CAN'T GET THE BUS OR GET THE KID TO SCHOOL.

IF WE PROVIDED BETTER SUPPORT FOR FAMILIES LIKE THAT, THAT CHILD WOULD BE A BETTER STATE AND THE ESA PROGRAM IS NOT GOING TO SEE THAT.

STEVE: DAVE WELLS, GOOD TO SEE YOU.

>> GOOD TO SEE YOU.

.

STEVE: PANCREATIC CANCER HAS THE HIGHEST MORTALITY RATE AMONG ALL MAJOR CANCERS, A DANGEROUS GAP ENGINE OF PANCREATIC CANCER AMONG ADULTS UNDER 50.

THIS IS A GRAVE CONCERN AS CASES ARISE WITH MANY NOT AWARE OF THE WARNING SIGNS.

JOINING US IS DR. MADAPPA KUNDRANDA, A GASTROINTESTINAL ONCOLOGIST, DOCTOR, THANK YOU VERY MUCH FOR BEING HERE.

THE MOST BASIC QUESTION: WHAT DOES THE PANCREAS DO FOR US?

WHY IS IT SO IMPORTANT?

>> IT'S AN ORGAN THAT HELPS WITH MULTIPLE FUNCTIONS INCLUDING REGULATING BLOOD SUGAR, INCLUDING HELPING WITH DIGESTION.

DEPENDS WHAT WE CALL THE EXOCRINE AND ENDOCRINE SYSTEMS.

STEVE: WE'VE BECOME AWARE OF THE IDEA THAT PANCREATIC CANCER IS SUCH A KILLER, IS THAT BECAUSE PEOPLE ARE NOT PAYING MUCH ATTENTION, PEOPLE UNDER THE AGE OF 50 AREN'T AWARE OF THE SYMPTOMS.

IT DOESN'T SEEM LIKE IT'S AS COMMON AS THE OTHER CANCERS BUT IT IS MORE OF A KILLER THAN SOME OF THEM?

>> ABSOLUTELY RIGHT ABOUT THAT.

THE NUMBERS ARE BETWEEN 20,000 TO 25,000, BUT THE MORTALITY PER YEAR IS COMPARABLE.

THAT'S THE REASON IT'S A PROBLEM.

ONE OF THE TOP THREE TO FOUR KILLERS IN MEN AND IN WOMEN BUT WITHIN THE TOP TEN IN TERMS OF INCIDENTS, RIGHT?

AND IT IS A COMBINATION OF NOT HAVING A SCREENING TEST.

THE ONE TIME WE MADE THE MOST IMPACT CANCER SUCH AS THE PROSTATE, WE HAVE A TEST SCREEN FOR THAT.

BREAST CANCER YOU HAVE THE MAMMOGRAMS.

COLONOSCOPIES FOR COLON CANCER, WE DON'T HAVE A UNIVERSAL TEST WE CAN UTILIZE AND ALL PATIENTS SCREENED FOR PANCREATIC CANCER.

HIGHER RISK PATIENTS, GENETIC SYNDROME, THOSE THAT HAVE CYSTS, YOU TRY TO IDENTIFY THEM SOONER AND GET A CURATIVE INTENT.

EVEN IN 2024, OF 100 PATIENTS WE DIAGNOSE WITH PANCREATIC CANCER, IT'S LESS THAN 20, THE REALISTIC NUMBERS ARE LESS THAN 10 THAT CAN POTENTIALLY BE CURED OF THE DISEASE.

STEVE: WELL, WHAT ARE THE SYMPTOMS?

THINGS PEOPLE SHOULD BE LOOKING OUT FOR IF THEY'RE FEELING A CERTAIN WAY?

AND THEN IF THEY FEEL THEY HAVE SYMPTOMS, WHAT'S THE NEXT STEP?

DO YOU SEE THE FAMILY PHYSICIAN?

YOU SEE A SPECIALIST?

>> THAT'S THE TOUGH STOP, BECAUSE THE SYMPTOMS CAN BE WEAK, AND THAT'S WHY IT'S CALLED A SILENT KILLER, RIGHT?

ONE OF THE MOST COMMON SYMPTOMS ARE PATIENTS WITH JAUNDICE, AND TYPICALLY IT'S PAINLESS JAUNDICE.

NOW A LOT OF THINGS CAN CAUSE THAT, IF YOU HAVE A STONE IN THE BILE DUCT, CAN CAUSE PAINLESS JAUNDICE, BUT THE BIGGEST THING IS, WHEN YOU HAVE SYMPTOMS SUCH AS JAUNDICE THAT COULD BE TOO LATE WHEN PATIENTS ARE DIAGNOSED, AND THAT'S THE PROBLEM.

THE MOST COMMON SYMPTOMS ARE WEIGHT LOSS WHICH IS UNINTENTIONAL.

YOU COULD HAVE NONSPECIFIC GI SYMPTOMS LIKE ABDOMINAL PAIN, CRAMPS, SOME OF THEM HAVE PAIN TOWARDS THE LOWER BACK, SOME MISTAKE IT FOR BACK PAIN.

IT'S ALL OF THE NONSPECIFIC SYMPTOMS, THAT'S WHAT MAKES IT SO DIFFICULT TO PICK IT UP IN TIME.

STEVE: MUST BE DIFFICULT WITH SO MANY DIFFERENT ILLNESSES BECAUSE THERE ARE SO MANY SHARED SYMPTOMS?

>> EXACTLY.

THAT'S WHY YOU CAN'T PINPOINT IT AND SAY THIS IS WHAT'S CAUSING IT BECAUSE OF THE BARRAGE OF NONSPECIFIC GI SYMPTOMS AND A MAJORITY OF THE SYMPTOMS CAN BE BENIGN.

STEVE: ARE THERE PEOPLE WHO ARE MORE SUSCEPTIBLE TO PANCREATIC CANCER?

DIET, EXERCISE, THINGS LIKE THAT, THAT PEOPLE SHOULD LOOK OUT FOR?

>> ABSOLUTELY.

IT IS ABOUT 2 TO 5% AND SOME OF THE OTHER THINGS WE PICK UP ARE NOW ALMOST ANY PATIENT THAT COMES INTO THE EMERGENCY ROOM GETS A FULL BODY SCAN, RIGHT?

SO SOMETIME WE PICK UP THE PANCREATIC CYSTS AND SOME OF THE CYSTS CAN TURN INTO MALIGNANCY.

WHEN WE PICK THOSE UP WE WORK THEM AT BANNER MD ANDERSON AND COME UP WITH A PLAN WHAT SURVEILLANCE WOULD LOOK LIKE WHICH IS DIFFERENT IN TERMS OF SOMEONE WHO DOESN'T HAVE A PANCREATIC CANCER WHERE SCREENING IS AVAILABLE.

STEVE: ARE YOU HEARING ABOUT PROGRESS THAT MAYBE THERE WILL BE ESPECIALLY BECAUSE IT'S A SILENT KILLER A TEST FOR PANCREATIC CANCER IN THE NEAR FUTURE?

>> YES, DEFINITELY.

THERE'S A LOT OF PROGRESS BEING MADE IN THE CONTEXT OF WHAT WE'RE LOOKING AT THE DNA OFF THE TUMOR TO SEE IF IT'S CIRCULATING IN THE BLOODSTREAM TO PICK THAT UP EARLY.

WE HAVE OTHER MODALITIES, ENDOSCOPIC ULTRASOUNDS, THE TECHNIQUES ARE GETTING MUCH BETTER, SAFFIER IN TERMS OF EARLIER DIAGNOSIS AND HAS BEEN HELPFUL BUT WE'RE NOT THERE YET.

STEVE: LESS THAN A MINUTE TO GO.

I HATE TO ASK A MORBID CONVERSATION, BUT WHEN SOMEONE IS SUFFERING FROM PANCREATIC CANCER, HOW PAINFUL IS IT?

IS IT ONE OF THOSE THAT IT HITS VERY HARD AND ALSO HITS QUICKLY AT THE SAME TIME?

>> AND IT REALLY DEPENDS WHERE THE TUMOR IS LOCATED.

IF YOU HAVE IT AT THE HEAD OF THE NECK OF THE PANCREAS PRESSES ON THE NERVES, THERE IS PAIN, IF YOU HAVE IT ON THE TAIL, THERE IS NO PAIN.

WHEN YOU ARE LOSING WEIGHT, LOSING MUSCLE MASS, YOUR APPETITE IS LOW, YOU'RE GETTING WEAKER, THOSE ARE THE ONES THE SYMPTOMS THAT WE NEED A WHOLE TEAM TO WORK WITH YOU WITH A DIETICIAN, WITH A NUTRITIONIST, WITH PHYSICAL THERAPY TO WORK WITH YOU THROUGH ALL OF THAT, TO BASICALLY OPTIMIZE THE QUALITY OF LIFE IN THOSE SITUATIONS.

STEVE: DOCTOR, THANK YOU SO MUCH FOR THE IMPORTANT INFORMATION, APPRECIATE YOUR TIME.

>> YOU'RE WELCOME.

STEVE: THAT'S ALL FOR THIS EDITION OF "ARIZONA HORIZON."

I'M STEVE GOLDSTEIN FOR TED SIMONS.

THANK YOU VERY MUCH FOR WATCHING.