Nightmare Ends: Passengers Leave Disabled Ship

After five days without power in the Gulf of Mexico, the Carnival Triumph cruise ship carrying more than 4,000 people arrived in Mobile, Ala., to greet a cheering crowd of friends and family members waiting to embrace their loved ones.

Passengers began to disembark the damaged ship around 10:15 p.m. CT Thursday in Mobile, Ala. The last passenger disembarked the ship at 1 a.m. local time, according to Carnival's Twitter handle.

As the ship docked, passengers lined the decks of the ship, waving, and whistling to those on shore. "Happy V-Day" read a homemade sign made for the Valentine's Day arrival and another, more starkly: "The ship's afloat, so is the sewage."

Some still aboard chanted, "Let me off, let me off!" and "Sweet Home Alabama."

The Carnival Triumph departed Galveston, Texas, last Thursday and lost power Sunday after a fire in the engine room disabled the vessel's propulsion system and knocked out most of its power.

After power went out, passengers texted ABC News that sewage was seeping down the walls from burst plumbing pipes, carpets were wet with urine, and food was in short supply. Reports surfaced of elderly passengers running out of critical heart medicine and others on board squabbling over scarce food.

Click Here for Photos of the Stranded Ship at Sea

Passengers said many of the cabins became intolerable with the smell of raw sewage. They were forced to create makeshift beds out of lounge chairs on the ship's deck.

AP Photo/John David Mercer

Girl Disembarks Cruise Ship, Kisses the Ground Watch Video

Carnival CEO Gerry Cahill: 'I Want to Apologize' Watch Video

Carnival Cruise Ship Passengers Line Up for Food Watch Video

"We kind of camped out by our lifeboat. We would have nightmares about Titanic basically happening," passenger Kendall Jenkins told ABC News Radio after disembarking from the ship.

"I am just so blessed to be back home," she added.

Jenkins was one of many passengers that were photographed kissing the ground when they exited the ship.

WATCH: Carnival CEO Gerry Cahill Apologizes to Passengers

Approximately 100 buses were waiting to take passengers on the next stage of their journey. Passengers have the option to take a bus ride to New Orleans or Galveston, Texas, where the ill-fated ship's voyage began. From there, passengers will take flights home, which Carnival said they would pay for.

Inside the buses, Carnival handed out bags of food that included French fries, chicken nuggets, honey mustard barbecue sauce and apples.

Deborah Knight, 56, decided to stay in Mobile after the arduous journey was over rather than board a bus for a long ride. Her husband Seth drove in from Houston and they checked in at a downtown Mobile hotel.

"I want a hot shower and a daggum Whataburger," said Knight.

She said she was afraid to eat the food on board and had gotten sick while on the ship.

Cruise Ship Newlyweds Won't Be Spending Honeymoon on a Boat

For 24-year-old Brittany Ferguson of Texas, not knowing how long passengers had to endure their time aboard was the worst part.

"I'm feeling awesome just to see land and buildings," Ferguson said, who was in a white robe given to her aboard. "The scariest part was just not knowing when we'd get back," she told The Associated Press.

Carnival president and CEO Gerry Cahill praised the ship's crew and told reporters that he was headed on board to apologize directly to its passengers shortly before the Carnival Triumph arrived in Mobile.

"I know the conditions on board were very poor," Cahill said Thursday night. "I know it was very difficult, and I want to apologize again for subjecting our guests for that. ... Clearly, we failed in this particular case."

Luckily no one was hurt in the fire they triggered the power outage, but many passengers aboard the 900 foot colossus said they smelled smoke and were living in fear.

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South Korea unveils missile it says can hit North's leaders

SEOUL (Reuters) - South Korea unveiled a cruise missile on Thursday that it said can hit the office of North Korea's leaders, trying to address concerns that it is technologically behind its unpredictable rival which this week conducted its third nuclear test.

South Korean officials declined to say the exact range of the missile but said it could hit targets anywhere in North Korea.

The Defence Ministry released video footage of the missiles being launched from destroyers and submarines striking mock targets. The weapon was previewed in April last year and officials said deployment was now complete.

"The cruise missile being unveiled today is a precision-guided weapon that can identify and strike the window of the office of North Korea's leadership," ministry spokesman Kim Min-seok told reporters.

North Korea has forged ahead with long-range missile development, successfully launching a rocket in December that put a satellite into orbit.

The North's ultimate aim, Washington believes, is to design an intercontinental ballistic missile capable of carrying a nuclear warhead that could hit the United States.

North Korea, which accuses the United States and its "puppet", South Korea, of war-mongering on an almost daily basis, is likely to respond angrily to South Korea flexing its muscles.

North Korea, technically still at war with the South after their 1950-53 conflict ended in a truce, not a peace treaty, carried out its third nuclear test on Tuesday, drawing condemnation from around the world including its only major ally China.

The test and the threat of more unspecified actions from Pyongyang have raised tensions on the Korean peninsula as the South prepares to inaugurate a new president on February 25.

"The situation prevailing on the Korean peninsula at present is so serious that even a slight accidental case may lead to an all-out war which can disturb the whole region," North Korea's official KCNA news agency said.

(This story has been refiled to drop redundant "said" in fourth paragraph)

(Reporting by Ju-min Park; Editing by Nick Macfie)

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Third Japanese dies after Guam tourist attack

HAGATNA: The death toll from a frenzied attack on Japanese tourists in the Pacific nation of Guam rose to three on Thursday when a man mowed down by the killer's car succumbed to his injuries, officials said.

The attack happened late on Tuesday when a local man drove his car up a pavement near a resort, injuring six, then went on a stabbing rampage after crashing into a convenience store, wounding another eight.

All 14 victims, including an eight-month-old baby and a three-year-old toddler, were Japanese.

The Guam Memorial Hospital said the third person to die was a 51-year-old man but refused to give further details, saying next of kin in Japan were still being notified.

Two women, named in court documents as 81-year-old Kazuko Uehara and Rie Sugiyama, 29, were stabbed to death in the attack, which has stunned the normally sleepy tropical tourist destination.

The hospital said six people were discharged on Thursday and one had been transferred to Japan, with four patients still receiving care at the facility.

Local man Chad Ryan Desoto, 21, was charged over the attack on Wednesday.

Prosecutors allege that after he was arrested Desoto admitted to police that he was intent on using both his car and his knife to hurt as many people as possible.

Desoto's motive for the attack remains unknown.

- AFP/al

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Times campaign in support of #onebillionrising

NEW DELHI: People from all walks of life are coming together today to pledge their commitment to put an end to violence against women. A series of cultural events have been planned across the country as part of the global campaign which is being called #onebillionrising.

The campaign was started by playwright and activist Eve Ensler (known for her play The Vagina Monologues) against all forms of "sexual abuse". The word "billion", say the organizers, refers to the one billion women who are survivors of abuse.

Times campaign in support of #onebillionrising: Pledge your commitment.

Women organizations, elected representatives, legal luminaries, actors, artists, NGOs and academic institutions apart from individuals are expected to participate in the day-long programme, its organizers said. The campaign will simultaneously be held in 200 other countries.

In New Delhi, its highlight will be a cultural event at Parliament Street between 5pm and 8pm, which will feature a play followed by song and dance performances by students of Lady Shri Ram College, Miranda House and Kamala Nehru College.

"We thank Delhi Metro for joining OBR campaign to make Delhi a safe, gender-friendly and inclusive city," Anjlee Agarwal, executive director of Samarthayam, an organization working for the rights of the differently-abled, said.

South Asia Coordinator of the OBR campaign Kamla Bhasin said, "We are launching Indian women`s and girl`s freedom struggle tomorrow and we are going to question every patriarchal establishment including ourselves. We seek freedom from patriarchy and freedom from violent masculinity. "

(Inputs from PTI)

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Morning-after pill use up to 1 in 9 younger women

NEW YORK (AP) — About 1 in 9 younger women have used the morning-after pill after sex, according to the first government report to focus on emergency contraception since its approval 15 years ago.

The results come from a survey of females ages 15 to 44. Eleven percent of those who'd had sex reported using a morning-after pill. That's up from 4 percent in 2002, only a few years after the pills went on the market and adults still needed a prescription.

The increased popularity is probably because it is easier to get now and because of media coverage of controversial efforts to lift the age limit for over-the-counter sales, experts said. A prescription is still required for those younger than 17 so it is still sold from behind pharmacy counters.

In the study, half the women who used the pills said they did it because they'd had unprotected sex. Most of the rest cited a broken condom or worries that the birth control method they used had failed.

White women and more educated women use it the most, the research showed. That's not surprising, said James Trussell, a Princeton University researcher who's studied the subject.

"I don't think you can go to college in the United States and not know about emergency contraception," said Trussell, who has promoted its use and started a hot line.

One Pennsylvania college even has a vending machine dispensing the pills.

The morning-after pill is basically a high-dose version of birth control pills. It prevents ovulation and needs to be taken within a few days after sex. The morning-after pill is different from the so-called abortion pill, which is designed to terminate a pregnancy.

At least five versions of the morning-after pills are sold in the United States. They cost around $35 to $60 a dose at a pharmacy, depending on the brand.

Since it is sold over-the-counter, insurers generally only pay for it with a doctor's prescription. The new Affordable Care Act promises to cover morning-after pills, meaning no co-pays, but again only with a prescription.

The results of the study were released Thursday by the Centers for Disease Control and Prevention. It's based on in-person interviews of more than 12,000 women in 2006 through 2010. It was the agency's first in-depth report on that issue, said Kimberly Daniels, the study's lead author.

The study also found:

—Among different age groups, women in their early 20s were more likely to have taken a morning-after pill. About 1 in 4 did.

—About 1 in 5 never-married women had taken a morning-after pill, compared to just 1 in 20 married women.

—Of the women who used the pill, 59 percent said they had done it only once, 24 percent said twice, and 17 percent said three or more times.

A woman who uses emergency contraception multiple times "needs to be thinking about a more regular form" of birth control, noted Lawrence Finer, director of domestic research for the Guttmacher Institute, a nonprofit group that does research on reproductive health.

Also on Thursday, the CDC released a report on overall contraception use. Among its many findings, 99 percent of women who've had sex used some sort of birth control. That includes 82 percent who used birth control pills and 93 percent whose partner had used a condom.

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Online:

CDC report: http://www.cdc.gov/nchs/

Emergency contraception info: http://ec.princeton.edu/index.html

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Dorner Not IDed, But Manhunt Considered Over

Though they have not yet identified burned remains found at the scene of Tuesday's fiery, armed standoff, San Bernardino, Calif., officials consider the manhunt over for Christopher Dorner, the fugitive ex-cop accused of going on a killing spree.

"The events that occurred yesterday in the Big Bear area brought to close an extensive manhunt," San Bernardino County Sheriff John McMahon told reporters this evening.

"I cannot absolutely, positively confirm it was him," he added.

However, he noted the physical description of the suspect authorities pursued to a cabin at the standoff scene, as well as the suspect's behavior during the chase and standoff, matched Dorner, 33.

The charred remains of the body believed to be Dorner were removed from the cabin high in the San Bernardino Mountains near Big Bear, Calif., the apparent site of Dorner's last stand. Cornered inside the mountain cabin Tuesday, the suspect shot at cops, killing one deputy and wounding another, before the building was consumed by flames.

"We did not intentionally burn down that cabin to get Mr. Dorner out," McMahon said tonight, though he noted pyrotechnic canisters known as "burners" were fired into the cabin during a tear gas assault in an effort to flush out Dorner. The canisters generate high temperatures, he added.

The deputies wounded in the firefight were airlifted to a nearby hospital, where one died, police said.

Christopher Dorner Believed Dead After Shootout with Police Watch Video

Carjacking Victim Says Christopher Dorner Was Dressed for Damage Watch Video

Christopher Dorner Manhunt: Inside the Shootout Watch Video

The deceased deputy was identified tonight as Det. Jeremiah MacKay, 35, a 15-year veteran and the father of two children -- a daughter, 7, and son, 4 months old.

"Our department is grieving from this event," McMahon said. "It is a terrible deal for all of us."

The Associated Press quoted MacKay on the Dorner dragnet Tuesday, noting that he had been on patrol since 5 a.m. Saturday.

"This one you just never know if the guy's going to pop out, or where he's going to pop out," MacKay said. "We're hoping this comes to a close without more casualties. The best thing would be for him to give up."

The wounded deputy, identified as Alex Collins, was undergoing multiple surgeries for his wounds at a hospital, McMahon said, but was expected to make a full recovery.

Before the final standoff, Dorner was apparently holed up in a snow-covered cabin in the California mountains just steps from where police had set up a command post and held press conferences during a five-day manhunt.

The manhunt for Dorner, one of the biggest in recent memory, led police to follow clues across the West and into Mexico, but it ended just miles from where Dorner's trail went cold last week.

Residents of the area were relieved today that after a week of heightened police presence and fear that Dorner was likely dead.

"I'm glad no one else can get hurt and they caught him. I'm happy they caught the bad guy," said Ashley King, a waitress in the nearby town of Angelus Oaks, Calif.

Hundreds of cops scoured the mountains near Big Bear, a resort area in Southern California, since last Thursday using bloodhounds and thermal-imaging technology mounted to helicopters, in the search for Dorner. The former police officer and Navy marksman was suspected to be the person who killed a cop and cop's daughter and issued a "manifesto" declaring he was bent on revenge and pledging to kill dozens of LAPD cops and their family members.

But it now appears that Dorner never left the area, and may have hid out in an unoccupied cabin just steps from where cops had set up a command center.

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U.S. says to take lead to contain North Korea

SEOUL (Reuters) - U.S. President Barack Obama said North Korea's third nuclear test, in defiance of U.N. resolutions, was a threat and a provocation and that the United States would lead the world in responding.

North Korea has said Tuesday's test was an act of self-defense against "U.S. hostility" and threatened stronger steps if necessary.

"Provocations of the sort we saw last night will only isolate them further, as we stand by our allies, strengthen our own missile defense, and lead the world in taking firm action in response to these threats," Obama said in his State of the Union address, delivered 24 hours after the North's test.

North Korea tested nuclear devices in 2006 and 2009. But despite the three tests and a long-range rocket launch, it is not believed to be close to manufacturing a nuclear missile capable of targeting the United States.

But Washington believes the isolated state's ultimate aim is to design an intercontinental ballistic missile capable of carrying a nuclear warhead that could reach the continental United States. North Korea says its rocket program is aimed at putting satellites in space.

The latest test has drawn condemnation from around the world, including from China which for years has been the North's only major ally.

The U.N. Security Council held an emergency meeting at which its members, including China, "strongly condemned" the test and vowed to start work on appropriate measures in response, the president of the council said.

North Korean leader Kim Jong-un, the third member of his family to rule, has presided over two long-range rocket launches and a nuclear test during his first year in power, pursuing policies that have propelled his impoverished and malnourished country closer to becoming a nuclear weapons power.

North Korea said the test had "greater explosive force" than those in 2006 and 2009. Its KCNA news agency said it had used a "miniaturised" and lighter nuclear device, indicating it had again used plutonium, which is suitable for use as a missile warhead.

EXASPERATED

China, which has shown signs of increasing exasperation with the recent bellicose tone of its reclusive neighbor, summoned the North Korean ambassador in Beijing and protested sternly, the Chinese Foreign Ministry said.

Foreign Minister Yang Jiechi said China was "strongly dissatisfied and resolutely opposed" to the test and urged North Korea to "stop any rhetoric or acts that could worsen situations and return to the right course of dialogue and consultation as soon as possible".

Analysts said the test was a major embarrassment to China, which is a permanent member of the Security Council and North Korea's sole major economic and diplomatic ally.

Obama said the test would be a setback for North Korea's economic development.

"The regime in North Korea must know that they will only achieve security and prosperity by meeting their international obligations," he said.

U.S. ambassador to the United Nations Susan Rice said Washington and its allies intended to "augment the sanctions regime" already in place due to Pyongyang's previous atomic tests. North Korea is already one of the most heavily sanctioned states in the world and has few external economic links that can be targeted.

Japanese Prime Minister Shinzo Abe said the test was a "grave threat" that could not be tolerated.

Russian Foreign Minister Sergei Lavrov urged North Korea to abandon its nuclear arms program and return to talks. NATO condemned the test as an "irresponsible act."

South Korea, still technically at war with North Korea after a 1950-53 civil war ended in a truce, also denounced the test. Obama spoke to South Korean President Lee Myung-bak on Tuesday and told him the United States "remains steadfast in its defense commitments" to South Korea, the White House said.

MAXIMUM RESTRAINT

North Korea's Foreign Ministry said the test was "only the first response we took with maximum restraint".

"If the United States continues to come out with hostility and complicates the situation, we will be forced to take stronger, second and third responses in consecutive steps," it said in a statement carried by the KCNA news agency.

North Korea - which gave the U.S. State Department advance warning of the test - often threatens the United States and its "puppet", South Korea, with destruction in colourful terms.

North Korea told the U.N. disarmament forum in Geneva that it would never bow to resolutions on its nuclear program and that prospects were "gloomy" for the denuclearization of the divided Korean peninsula because of a "hostile" U.S. policy.

The magnitude of the explosion was roughly twice that of the 2009 test, according to the Vienna-based Comprehensive Nuclear-Test Ban Treaty Organization.

U.S. intelligence agencies were analyzing the event and found that North Korea probably conducted an underground nuclear explosion with a yield of "approximately several kilotons", the Office of the Director of National Intelligence said.

Nuclear experts have described the previous two tests as puny by international standards. The yield of the 2006 test has been estimated at less than 1 kiloton (1,000 tons of TNT equivalent) and the second at some 2-7 kilotons, compared with 20 kilotons for a Nagasaki-type bomb.

Initial indications are that the test involved the latest version of a plutonium-based prototype weapon, according to one current and one former U.S. national security official. Both previous tests involved plutonium. If it turns out the test was of a new uranium-based weapon, it would show that North Korea had made more progress on uranium enrichment than previously thought.

"VICIOUS CYCLE"

When Kim Jong-un, who is 30, took power after his father's death in December 2011, there were hopes that he would bring reforms and end Kim Jong-il's "military first" policies.

Instead, North Korea, whose economy is smaller than it was 20 years ago and where a third of children are believed to be malnourished, appears to be trapped in a cycle of sanctions followed by further defiance.

"The more North Korea shoots missiles, launches satellites or conducts nuclear tests, the more the U.N. Security Council will impose new and more severe sanctions," said Shen Dingli, a professor at Shanghai's Fudan University.

"It is an endless, vicious cycle."

Options for a response from the international community appear to be few. Diplomats at the United Nations said negotiations on new sanctions could take weeks since China is likely to resist tough new measures for fear they could lead to further retaliation by the North Korean leadership.

Significantly, the test comes at a time of political transition in China, Japan and South Korea, and as Obama begins his second term.

The North's longer-term game plan may be to restart international talks aimed at winning food and financial aid. China urged it to return to the stalled "six-party" talks on its nuclear programme, hosted by China and including the two Koreas, the United States, Japan and Russia.

(Additional reporting by Jack Kim, Christine Kim and Jumin Park in SEOUL; Linda Sieg in TOKYO; Louis Charbonneau and Michelle Nichols at the UNITED NATIONS; Fredrik Dahl in VIENNA; Michael Martina and Chen Aizhu in BEIJING; Mette Fraende in COPENHAGEN; Adrian Croft, Charlie Dunmore and Justyna Pawlak in BRUSSELS; Mark Hosenball, Paul Eckert, Roberta Rampton, Tabassum Zakaria and Jeff Mason in WASHINGTON; Editing by Raju Gopalakrishnan)

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16 gunmen killed in Thai military base attack: army

NARATHIWAT, Thailand: In one of the most deadly attacks in Thailand's long-running insurgency, scores of heavily-armed gunmen stormed a southern army base on Wednesday, leaving 16 militants dead, authorities said.

In the unusually brazen early-morning assault, 100 militants, dressed in army fatigues and armed with AK47 and M16 assault rifles, attacked the unit in Narathiwat province, unit commander Captain Somkiat Pholprayoon said.

"Sixteen militants were confirmed dead after the attack," he told reporters at the scene, adding that the military and police were in "hot pursuit" of the 60 to 70 militants who fled the base after the attack.

The government expressed sorrow over the deaths, one of the highest single death tolls in some eight years of violence in Thailand's deep south, but praised the military operation, saying the army have had no choice.

"The government has no policy of using violence to deal with southern unrest but in this incident (militants) attacked the military base," Deputy Prime Minister Chalerm Yubamrung told reporters in Bangkok.

A shadowy insurgency has been fighting for greater autonomy for the country's southernmost provinces since 2004, with shootings and bombings occurring on a near-daily basis.

More than 5,500 people have been killed, both Buddhist and Muslim, in the bloody conflict.

Chalerm, who heads the government's special body in charge of the southern unrest, recently proposed imposing a curfew in certain areas of the most affected provinces.

"If we impose a curfew, then militants will find it more difficult to enter the area," he said on Wednesday.

Religious leaders oppose the move, saying it will do nothing to solve the underlying problems. The Thai cabinet is set to discuss the proposal on Friday.

Critics accuse the government of failing to address the grievances of Thailand's Malay Muslim minority, including alleged abuses by the military and a perceived lack of respect for their ethnic identity, language and religion.

Members of Thailand's security forces are frequently targeted in ambushes and roadside bombs, but organised attacks on military bases are relatively rare.

No military casualties were reported in the early hours assault at the base in the Bacho district of Narathiwat province, one of three Muslim-dominated provinces near the border with Malaysia. An army spokesman had earlier put the militants' death toll at 17.

"We learned of the attack in advance from defected militants," Colonel Pramote Promin, southern army spokesman told Thai television.

He added that a key local leader of the fighters, who wore bulletproof vests during the attack, had been killed in the clashes.

Southern army commander Lieutenant General Udomchai Thammasarorat called for local villagers to stay in their homes for 24-hours, for their "safety and to prevent any confusion during the pursuit of militants", he told broadcaster Thai PBS.

A report by the International Crisis Group on the violence in December said insurgents had grown "bolder and stronger" amid political inaction from successive Bangkok governments.

The attack on Wednesday is "part of a trend" towards bigger, bolder attacks by militants showing a new "willingness on the part of militants to engage the security forces head on," said Matthew Wheeler, an ICG South East Asia analyst.

"The fact that so many militants were killed is very unusual," he said, adding the last time there was such a high death toll was in April 2004.

The ICG report recommended a greater push towards decentralisation and closer engagement with local civil society groups and peace negotiations with insurgents.

It added that the deployment of 60,000 security forces and an emergency decree "have not achieved any appreciable decline in casualties".

- AFP/al

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Raman to lead BJP to a hat-trick in Chhattigarh, says Rajnath Singh

RAIPUR: Bharatiya Janata Party president Rajnath Singh gave Chief minister Raman Singh a pat on the back for introducing the unique Food Security Act and other welfare schemes saying that he would lead the party to score a hat-trick in the upcoming assembly elections.

Talking to newsmen here on his arrival here to attend a meeting of Bharatiya Janata Yuva Morcha (BJYM), he said Chhattisgarh has set a milestone with the enactment of a legislation to ensure food security through an efficient public distribution system.

"Next assembly polls, under leadership of chief minister Raman Singh, will see that BJP scoring a hat-trick", he added.

Referring to the UPA government at the centre, the BJP chief said all its economic policies have miserably failed, leading to price rise and putting the country's economy on the down slide.

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Study questions kidney cancer treatment in elderly

In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.

Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.

After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.

The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.

The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.

"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."

He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.

In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.

However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.

Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.

They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.

Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.

After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.

Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.

The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.

Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.

One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.

"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."

Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.

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Online:

Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer

and http://www.cancer.gov/cancertopics/types/kidney

Study: http://gucasym.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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