The following
program presents principles
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designed to
promote good health and
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is not intended to take
the place of personalized
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professional care.
The opinions and ideas
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expressed are
those of the speaker.
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Viewers are
encouraged to draw their
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own conclusions about
the information presented.
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Hello and welcome to
Health For A Lifetime.
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I'm your host Don
Mackintosh and today
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we are gonna be
talking about gynecological
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health and that
just means female health
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and so we're glad that
you're joining us today
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and we're also thankful
that Dr. Christine Salter
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is with us from
St. Louis, Missouri.
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We're glad you're with us today.
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Thank you I'm
delighted to be here.
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Now you practice
in family medicine.
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That's right. And I'm
sure that both men and
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women come to see
you, but I'm sure that
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you see a lot of women
as well in the practice.
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I do. And we're
gonna talk about women's
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health issues today.
What are we gonna talk
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about specifically?
We're gonna talk about
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the ovaries, the
uterus and the cervix.
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Okay and these
things, these parts of the
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female anatomy have special
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blessings and
challenges. That's right,
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absolutely, we can't
do without the ovaries.
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The ovaries is where
they produce a lot of
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the hormones and so
they're a important part
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of the what makes
a woman a woman comes
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from the ovaries.
And what makes a man
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a man, if we don't have
the ovaries, we wouldn't
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have any men
either. That is true.
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Right so. So yes,
small, small organs but very,
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very powerful and then
the uterus which is very
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important for
carrying babies, so a good
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uterine help, but
they can be problems too
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then also with the
cervix and so we want,
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to talk about those things and.
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Well, let's talk
about then in that order,
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ovarian, ovarian
problems, what kind of
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things can develop.
What's the significance
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of that. Okay, well
you know the ovaries that
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can develop some
simple cyst, they can
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become painful and
easily treated okay and
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beside those are benign, they're
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just problems,
painful. But then that the most
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concern is ovarian
cancer and the problem
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with ovarian cancer
is that it's not easily
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detected, there is no
real screening for it and so
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that's what makes it,
even though it's not a
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frequent cancer it is
the most deadly cancer.
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Once you get
it. Once you get it.
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So and the reason
there is no screening is
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because it's right in
the middle there, you can't
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touch it, you can't feel
it, it doesn't really bump
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up against anything.
Right, exactly and even
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when we do an
internal exam you know it's
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really hard to feel,
unless there is a huge
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growth there then
it becomes very obvious
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but by the time
it's gotten to that size,
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then usually it's
already spread to other areas.
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So if there is no
way to screen it, but
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what can be done about
it? Well my concern is my
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burden is that
woman recognize symptoms
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of ovarian cancer
and they're very benign
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symptoms, vague abdominal pain.
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So a new onset
pain that's just nagging
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and it just won't
go away, we want you to
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go and get that checked out.
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Something new abdominal pain,
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the other thing is going
to the bathroom frequently.
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Now that happens a
lot. And a lot of things can
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cause that, but one
of them could be this.
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One of them could
be ovarian cancer then
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the other symptom is bloating.
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Now some times we
get bloated after eating
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a meal that
doesn't quite set with us,
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but that bloating goes away.
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The bloating
we're talking about is a
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bloating that comes
and it stays and just
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get worse, you know,
then your belt gets tight
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and your clothes
not fit in quite well,
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still got that
vague abdominal pain,
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you know, still going to
bathroom more frequently.
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We want, we want
women to come in,
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get checked, get
those symptoms evaluated.
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It could be that we
might catch it early
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and that it may not have spread
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you know far and
so. So, the bloating,
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vague abdominal
pain and what else?
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And urinary
frequency. Okay and now when
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someone comes in and
tells you those three
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things you said
well what do you then?
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So, what I do is I
of course do a physical
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exam and will also
send them for a ultra sound,
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of the ovaries. Of the ovaries,
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and then,
actually the entire uterus.
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Of the uterus and the
ovaries and I may even
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do a CT scan to
really evaluate, then I may
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do a blood
test. To look for some
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of the markers
of ovarian cancer.
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So what do you see in the blood?
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There is a particular
hormone that's released.
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I see, that is
elevated and then we can test if
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we have ovarian cancer.
It's not a good screening
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test but it's a reasonable
test if you're suspecting,
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it's call CA-125.
Now a lot of women,
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and you get that,
there is a email that's going
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around saying get
your doctor to check
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CA-125, it's not a
great screening test because
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other conditions
like fibroids and
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endometriosis can
also raise the CA-125.
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So we don't routinely
screen using that test
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and say well it's
elevated, better go
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get your ovaries
out. Right. But if you are
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suspecting ovarian
cancer that one of the
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tests that you would
do in addition to the
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imaging study.
So the vague pain,
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the bloating, the
urinary frequency would cause
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you to look for that
now why would they have
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urinary frequency
because of the bloating
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then pushing on
the bladder or what?
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Pushing on the
bladder, just the proximity of
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the reproductive organs
and the irritation that's
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going on, is gonna
irritate the bladder.
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Okay. And the
bladder is easily irritated.
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And I suppose I
mean you could screen
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everybody with a
CAT scan and different
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things but
that's highly expensive.
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It's highly
expensive and highly damaging
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because CAT scan is
radiation, so we don't
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want to do, expose
people to unnecessary radiation.
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MRI. MRI that comes
very expensive. Yeah.
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You see so. That's why
they don't screen like that.
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And that's why, that's
why it's not screened for.
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So what ages does
this usually develop?
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This is in the older
women, so we're talking
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greater than 50.
Now, young women can also
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develop a type of
ovarian cancer and that
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would rely on the
index of suspicion of the
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physician. You know
having those symptoms
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or an irregular
menstrual cycle and irregular
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menstrual bleeding,
that will alert the physician
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to just dig a little
deeper in a younger woman,
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but certainly in
older women and the
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suspicion is
much higher and we go
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looking for these and
especially if she's been
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on hormone replacement,
if she is at this estrogen
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dominance, again that
driving force we really
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want to look for
that. It is a deadly cancer,
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you know, it really.
Once it gets started,
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not too much to do,
unless it's still within
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the ovary. Within
the ovary, they're taken
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out and it's 100% cure of that.
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Okay so that's,
that's one concern we have,
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so that we've covered the
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ovaries,
anything else about them?
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No I think that's good, I
think we can move onto the.
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Okay, we have our
next one, uterine health.
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Talk to us about
that. Okay well, uterus,
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a common condition of
the uterus are fibroids.
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Lot of women have
fibroids, very common,
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again estrogen
driven. And so woman having
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menstrual cycles
throughout their,
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their reproductive
life, then they go into
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perimenopause, when
the cycles, you know
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when the ovaries are
beginning to shut down,
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okay and so then the
cycles become irregular.
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Right. Okay. So that
time is a little bit of a
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dangerous time
because the endometrial lining
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can develop
malignancy and cause bleeding,
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so is it because.
You're having your monthly
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or it is because of
this bleeding. Right.
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Okay. Then you get
into the post menopause,
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menopause is defined
as no menstrual cycle for
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12 months.
Okay. Okay, so then my
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concern is a women
could have endometrial
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cancer and have may
be one or two spots of
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blood, which she
may completely ignore
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because it's not,
most women are thankful
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than not having this
menstrual cycles anymore.
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Right. And so then
they see this little drop of
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blood and think oh you
know, it's just a little
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drop and they ignore
it. But that little drop of
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blood may signal an
endometrial of the inner
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lining of the uterus cancer.
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So this is after
you've gone through,
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I mean kind of that
no man's land you could
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have a problem too.
But this is especially
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for the person
that has not had a
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period for 12 months.
They're actually consider
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postmenopausal. Right, exactly.
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Don't ignore just that one spot.
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Right but then lets,
let's also discuss the
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risk for endometrial cancer.
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Okay let's talk about
that. Okay so women who
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is obese. Okay.
And woman who has
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hypertension,
diabetes, they're at risk for
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endometrial cancer.
And again this is about,
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this all to do with,
with the hormones and
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there's hormonal
changes that occur in
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those metabolic
conditions. So especially if a
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woman who is obese
and though often the
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diabetes and the hypertension go
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together, and they may have high
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cholesterol too.
The deadly cortex.
00:09:50.61\00:09:54.14
Exactly, exactly
and so if a woman like
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that represents and
she has some you know
00:09:58.15\00:10:01.40
some menstrual
bleeding, oh then that
00:10:01.41\00:10:03.53
red flag goes up.
Okay, so we want women
00:10:03.54\00:10:07.06
to know that you
may not have any pain,
00:10:07.07\00:10:10.32
it may just be
that one drop of blood,
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we want you to go
and see a physician.
00:10:13.89\00:10:15.30
And then when they
go see their family
00:10:15.31\00:10:18.09
medicine
specialist. Okay. What there,
00:10:18.10\00:10:20.60
what happens?
Again we do an internal
00:10:20.61\00:10:22.59
exam, we often do a
Pap smear to look for
00:10:22.60\00:10:25.65
abnormal and the
endometrial cells that
00:10:25.66\00:10:27.35
maybe shown on
the Pap smear that may
00:10:27.36\00:10:28.87
come through and
then we do the ultrasound.
00:10:28.88\00:10:31.55
Again we do that
diagnostic ultrasound
00:10:31.82\00:10:33.88
to identify and
will show us the lining,
00:10:34.56\00:10:36.95
that endometrial
line, will show us is there
00:10:36.96\00:10:38.74
an area of irregularity
in there and if we do
00:10:38.75\00:10:41.77
see that, we can actually
go in and biopsy the area.
00:10:41.78\00:10:44.14
And you can do
that in your office.
00:10:44.15\00:10:45.70
Now in my office I
can do an endometrial
00:10:45.94\00:10:47.56
biopsy and I do
that but if I really am
00:10:47.57\00:10:52.57
suspecting that this
is endometrial cancer
00:10:52.58\00:10:54.59
I do send them on to
the gynecologist and have
00:10:55.00\00:10:58.19
them go and then
they go I should do
00:10:58.20\00:10:59.63
dilatation and
curettage and really clean the
00:11:00.45\00:11:03.14
entire area off and
look at those cells and if
00:11:03.15\00:11:06.44
there is any
thing abnormal then they
00:11:06.45\00:11:08.83
will proceed to hysterectomy.
00:11:08.84\00:11:10.15
Okay, so to avoid
endometrial cancer
00:11:11.23\00:11:15.03
to start with, avoid
obesity, proper diet,
00:11:15.04\00:11:19.67
exercise. All the
things that would be normally
00:11:21.19\00:11:24.05
something we do to be healthy.
00:11:24.06\00:11:25.18
Exactly so all
those things and then
00:11:25.19\00:11:28.57
of course the
hormones, really not using
00:11:28.58\00:11:33.05
unopposed
estrogen 'cause unopposed
00:11:33.06\00:11:36.44
estrogen and that's
why a woman who has a
00:11:36.45\00:11:38.89
uterus if she's given
estrogen, must also be
00:11:38.90\00:11:42.81
given progesterone,
okay because if the
00:11:42.82\00:11:46.58
progesterone is not
there is going to drive
00:11:46.59\00:11:48.50
that process for
endometrial lining.
00:11:48.51\00:11:51.00
So we want to
look at the hormones,
00:11:51.01\00:11:53.18
make sure she is
exercising, so she's
00:11:54.09\00:11:55.73
not getting obese,
make sure she doing all the
00:11:55.74\00:11:58.10
lifestyle for
high blood pressure.
00:11:58.11\00:11:59.64
Which is the same
thing exercising fruits and
00:12:00.28\00:12:02.36
vegetables, whole
grains or low salt diet,
00:12:02.37\00:12:04.96
avoiding alcohol,
'cause that contributes to high
00:12:05.48\00:12:07.97
blood pressure and
really creating the
00:12:07.98\00:12:11.68
hormonal milieu that
will not promote growth
00:12:12.05\00:12:16.88
of the endometrial
lining. Okay and then avoiding
00:12:16.89\00:12:19.92
ovarian cancer, what
can we do to avoid that,
00:12:19.93\00:12:21.98
same kind of stuff.
It's going to put the same
00:12:21.99\00:12:23.33
kind of thing,
because of the estrogen
00:12:23.34\00:12:26.30
that's driving it. So
you know we're exposed
00:12:26.31\00:12:30.65
to toxins all the
time. Right. So the very best
00:12:30.66\00:12:33.41
you can do is to do
those lifestyle factors
00:12:33.42\00:12:37.09
and then you know if
there is a family history
00:12:37.10\00:12:39.62
okay, if there is family
history for ovarian cancer.
00:12:40.70\00:12:43.89
Especially if there
is also a family history
00:12:43.90\00:12:45.16
of breast cancer
and again with colon
00:12:45.17\00:12:47.60
cancer, then again
your individual suspicion is
00:12:47.61\00:12:50.05
much higher.
Okay, some women choose
00:12:50.06\00:12:52.86
to have
prophylactic, prophylactic
00:12:52.87\00:12:55.41
ureterostomies,
mean they get the
00:12:55.42\00:12:57.46
ovaries taken out.
And would you suggest
00:12:57.47\00:13:00.35
that, it's a very
drastic measure and that's
00:13:00.36\00:13:02.98
something that I
have really have them pray
00:13:02.99\00:13:05.61
and discuss you know.
Because of the all the
00:13:05.62\00:13:07.81
hormonal changes
that come, it just kind of
00:13:07.82\00:13:09.70
change their personality maybe.
00:13:09.71\00:13:11.07
Exactly, exactly, I
have woman where they've
00:13:11.53\00:13:14.00
done that and it's
just, it's hormonally
00:13:14.53\00:13:17.01
devastating to them,
so they've got to really
00:13:17.02\00:13:19.27
look you know of that
risk versus benefit to
00:13:19.28\00:13:22.35
make that decision about that.
00:13:22.36\00:13:23.87
We're talking with
Dr. Christine Salter,
00:13:25.59\00:13:27.30
we're talking
about woman's health and
00:13:27.31\00:13:29.96
we have learned some
important things when
00:13:29.97\00:13:31.31
we come back we will
talk some others issues.
00:13:31.32\00:13:33.48
I know you
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where can you find a
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00:14:32.69\00:14:34.72
Welcome back we're talking with
00:14:37.73\00:14:38.98
Dr. Christine
Salter, she's specialist in
00:14:38.99\00:14:41.74
family
medicine, she practices in
00:14:41.75\00:14:43.68
St. Louis we're
glad that you're with us.
00:14:43.69\00:14:45.26
Thank you, I'm glad to be here.
00:14:45.27\00:14:46.54
And we've been talking
about women's health issues.
00:14:46.55\00:14:48.52
Yes we have. We've
talked about ovarian
00:14:48.53\00:14:50.33
cancer and you know
that you really can't
00:14:50.34\00:14:53.59
screen for it, but
bloating, unusual pain,
00:14:54.25\00:14:58.32
going to the bathroom
a lot, these are signs
00:14:58.82\00:15:00.85
to go to see someone.
Exactly. Get it checked
00:15:00.86\00:15:03.12
out and then we've
talked out endometrial
00:15:03.13\00:15:05.68
cancer and now
we want to move on.
00:15:06.56\00:15:09.32
We wanna talk
about cervical cancer.
00:15:10.13\00:15:11.94
Cervical cancer absolutely,
00:15:11.95\00:15:13.89
my concern about
cervical cancer is that
00:15:15.16\00:15:17.52
no woman should die of
cervical cancer, because
00:15:18.15\00:15:21.52
it's so easy to screen for it.
00:15:21.53\00:15:23.41
By a pap smear of a woman exam.
00:15:24.61\00:15:27.40
But lot of women
do not want to come in
00:15:27.67\00:15:30.61
for a well women
exam, they say oh no,
00:15:30.79\00:15:32.82
I don't have that
time you know and they
00:15:33.23\00:15:36.45
feels it is invasive somehow.
00:15:36.46\00:15:38.12
But it's not
invasive, it is very simple,
00:15:39.08\00:15:41.85
it should be
relatively painless and it just
00:15:42.75\00:15:47.51
taking a little sample
of cells so we can send off
00:15:47.97\00:15:50.65
and look for
premalignant lesions,
00:15:50.66\00:15:53.11
you know. But woman
don't come in for that,
00:15:53.66\00:15:56.47
then the lesion,
then the cancer comes and
00:15:56.48\00:15:59.61
advances and it's a, it's
a kind of cancer, cervical
00:15:59.62\00:16:03.40
cancer doesn't spread in
the distant, it doesn't go
00:16:03.41\00:16:07.10
to the brain, to
lungs or like that.
00:16:07.11\00:16:08.81
It's local invasion.
And I have taken care
00:16:09.11\00:16:12.92
of patients like that,
it's just a horrible way to
00:16:12.93\00:16:15.08
die and to think that
it could be completely
00:16:15.09\00:16:18.60
avoided with regular pap smears.
00:16:18.83\00:16:21.35
So what is the risk for
a typical lady in Western
00:16:21.76\00:16:25.59
society or America
from cervical cancer?
00:16:26.12\00:16:29.56
Well it's very common
and the problem is that
00:16:29.57\00:16:33.94
the risk really from
the sexual transmitted
00:16:35.09\00:16:36.60
diseases okay. Okay. The human
00:16:36.61\00:16:38.68
Papillomavirus is
been implicated in this
00:16:38.69\00:16:41.42
and usually that
occurs from multiple sexual
00:16:41.88\00:16:45.02
partners and usually
what happens, a woman
00:16:45.03\00:16:48.49
may have had
multiple sexual partners in a
00:16:49.09\00:16:51.89
young age and then
develop cervical cancer
00:16:51.90\00:16:55.16
later on, so now she
is changed her lifestyle,
00:16:55.17\00:16:58.27
is now married and
you know not doing that.
00:16:59.45\00:17:02.90
Right. And then
decide why don't I get pap
00:17:03.44\00:17:05.58
smears done because
you know I just don't
00:17:05.59\00:17:07.53
have that you know
the speculum put into me.
00:17:07.54\00:17:09.92
And she's the one
that maybe harboring a high
00:17:10.70\00:17:13.03
risk human Papillomavirus
that's gonna turn into
00:17:13.04\00:17:16.44
cervical cancer. So
especially if you've
00:17:16.45\00:17:22.42
been involved in
you know multiple sexual
00:17:22.43\00:17:25.67
partners you need to
be checked. Absolutely.
00:17:25.68\00:17:27.99
But even if that's not
the case you need to be
00:17:28.38\00:17:30.77
checked and when is
that do you need to start
00:17:30.78\00:17:32.92
getting these pap smears.
Well usually the American
00:17:32.93\00:17:38.05
college of gynecologists,
they recommend age 18
00:17:38.46\00:17:41.43
and even the use of
preventive task force.
00:17:41.80\00:17:43.57
I personally do
not press a woman to do
00:17:44.24\00:17:47.37
that if she is
not sexually active.
00:17:47.38\00:17:49.50
Okay so if she is
sexually active go for sure.
00:17:49.73\00:17:53.12
No matter what
age you are. Right.
00:17:53.13\00:17:54.75
Okay and we hope
that you know everything
00:17:55.01\00:17:56.71
16 and being
sexually active we would want
00:17:56.72\00:17:59.13
the young ladies to
wait until the marriage.
00:17:59.75\00:18:01.31
But whenever sexual
activity occurs that's
00:18:02.06\00:18:05.13
when the screening
needs to start okay.
00:18:05.14\00:18:08.30
And we screen for
those, with abnormal
00:18:08.56\00:18:10.67
cells and we also look
for the high risk human
00:18:10.68\00:18:13.20
Papillomavirus, and
if you don't have it and
00:18:13.21\00:18:16.53
it's inactive, then
we say you do annual test
00:18:16.54\00:18:19.39
and if three or
normal then we can spread it
00:18:19.57\00:18:22.56
out to maybe
every couple of years.
00:18:22.57\00:18:24.67
But there are some
lifestyle factors that do
00:18:25.59\00:18:27.53
effect cervical
cancer. Well of course one of
00:18:27.54\00:18:30.73
them has to do with
sexual activity but what
00:18:30.74\00:18:32.52
are some of the others? Smoking.
00:18:32.53\00:18:34.56
Smoking again.
Smoking again increase
00:18:35.21\00:18:37.10
the risk for cervical cancer.
00:18:37.11\00:18:39.27
It's amazing I
mean you wouldn't think
00:18:39.55\00:18:40.91
I mean it's the opposite end.
00:18:40.92\00:18:42.26
It's the opposite
end exactly. But it does.
00:18:42.66\00:18:45.19
But it's got
toxins and carcinogens.
00:18:45.38\00:18:47.96
Also the diet,
they found that, woman
00:18:49.50\00:18:51.96
who have high levels
of antioxidants in the
00:18:52.60\00:18:55.20
blood stream,
vitamin C, beta-carotene,
00:18:55.21\00:18:58.73
that they have low
risk for cervical cancer.
00:18:59.57\00:19:01.41
So more carrots, more
apples, lots, variety of
00:19:02.44\00:19:06.61
fruits and vegetables
to raise the antioxidant
00:19:06.62\00:19:10.30
levels in the blood
streams and food grade
00:19:10.31\00:19:13.07
nutritional supplements
to raise those antioxidant
00:19:13.40\00:19:15.72
levels to protect the cervix.
00:19:15.73\00:19:18.23
Now we want to
mention that the early,
00:19:19.16\00:19:22.17
that sexual
activity occurs the more
00:19:22.18\00:19:24.79
damaging that it is
because the immature
00:19:24.80\00:19:29.18
cervix has those
cells that are more
00:19:29.19\00:19:32.08
susceptible. Because
they're still developing.
00:19:32.09\00:19:34.31
Because they're
still developing on the
00:19:34.32\00:19:35.32
outside so they are
more susceptible to the
00:19:35.33\00:19:37.42
papillomavirus,
they're more susceptible to the
00:19:37.43\00:19:39.61
AIDS virus.
They're most susceptible to
00:19:39.62\00:19:42.76
those organisms,
to the chlamydia and
00:19:42.77\00:19:45.02
gonorrhea okay so,
we want to leave sexual
00:19:45.03\00:19:48.85
activity the latest
possibly till we got.
00:19:48.86\00:19:52.48
Well I mean look
I mean also sexual
00:19:52.49\00:19:54.67
activity with people
that don't have chlamydia
00:19:54.68\00:19:57.45
and gonorrhea and
Syphilis and all these
00:19:57.46\00:19:59.28
things. Exactly. I
mean, so watch who you're
00:19:59.29\00:20:01.76
running with,
that's a lifestyle factor.
00:20:01.77\00:20:03.29
That is exactly
and remember whoever
00:20:03.30\00:20:06.71
you have sexual
activity with you also having
00:20:06.72\00:20:08.91
sexual activity
who they've had sexual
00:20:08.92\00:20:10.37
activity with.
Right, so we want young
00:20:10.38\00:20:15.13
ladies to be careful
who they choose and make
00:20:15.14\00:20:19.15
sure they know about
their previous activities.
00:20:19.16\00:20:23.23
I mean so they never
need to get this for a
00:20:23.24\00:20:25.06
number of reasons,
not just screening but
00:20:25.07\00:20:26.97
because I mean God intended.
00:20:26.98\00:20:29.43
I mean if you read
Leviticus what is it 18
00:20:30.11\00:20:32.97
and you just follow
it, which is no until yes.
00:20:33.43\00:20:36.75
Right, exactly.
And all those different
00:20:36.76\00:20:38.11
variations there
then you're safe.
00:20:38.52\00:20:41.86
I bet you have some
pretty frank talks with
00:20:41.87\00:20:43.55
people in your
office. Yes I do, yes I do.
00:20:43.56\00:20:46.46
I like point blank
you know, ask about sexual
00:20:46.47\00:20:49.99
activity and encourage
a lifestyle of chastity,
00:20:50.00\00:20:52.72
not just abstinence,
it's not enough I'm being
00:20:52.73\00:20:55.86
abstinent, we want a
lifestyle of chastity.
00:20:55.87\00:20:59.48
The very behaviors
you know some may not
00:21:00.07\00:21:03.07
have gone to full grown
sexual activity but they
00:21:03.08\00:21:06.12
may be doing other
things that is not a
00:21:06.13\00:21:09.29
lifestyle of
chastity. So we want the young
00:21:09.30\00:21:14.08
people to be
chased, keeping themselves
00:21:14.09\00:21:17.77
pure and safe sexual
activity for marriage
00:21:18.68\00:21:22.51
in the way that God intended it.
00:21:22.52\00:21:23.72
You know I don't
know if you ever when I,
00:21:23.96\00:21:26.01
I used to work in
an emergency department
00:21:26.02\00:21:27.73
and that chapter, Leviticus 18,
00:21:27.95\00:21:30.46
that just goes
through all those things,
00:21:30.99\00:21:32.40
I don't know that
you can improve on that.
00:21:32.83\00:21:34.36
If you just go
through it, you just you reach
00:21:35.04\00:21:37.13
people and they
just, they say hey look
00:21:37.14\00:21:39.20
you know if you're
involved in any of these things,
00:21:39.21\00:21:40.91
you know check yes
or no. That's right.
00:21:41.06\00:21:42.82
Then if you are, you
know you're in trouble.
00:21:42.83\00:21:46.28
Exactly, exactly. So,
I mean you know I think
00:21:47.28\00:21:50.21
it's great that you
can, you can talk with
00:21:50.22\00:21:52.34
with people about
these things, I mean it
00:21:52.58\00:21:55.03
sometimes might be
considered a touchy
00:21:55.04\00:21:57.18
area but look if you
don't tell people what's
00:21:57.19\00:22:00.22
up they can
really get into problems.
00:22:00.23\00:22:02.08
They really can.
So we need to find out
00:22:02.28\00:22:05.42
this information,
we need to find out you
00:22:05.43\00:22:07.58
know the sexual
history and screen perfectly.
00:22:07.59\00:22:12.06
The woman who is 60
who thinks she does not
00:22:12.70\00:22:15.00
to be screened,
when we find out you know
00:22:15.01\00:22:18.54
how many several
problems she's had in
00:22:18.55\00:22:20.27
her life time that
puts into the high risk
00:22:20.28\00:22:23.14
category and it's
important that she is screened.
00:22:23.15\00:22:25.37
Okay, so we've
talked about having the pap
00:22:25.56\00:22:29.53
smears, we've
talked about knowing what
00:22:29.54\00:22:33.10
your history has
been, hopefully not a long
00:22:33.11\00:22:35.97
history but if you
said now if it's more than
00:22:35.98\00:22:38.53
5 people during
your life time you're at
00:22:39.06\00:22:40.82
very high risk. Yes,
you're at higher risk
00:22:40.83\00:22:42.53
absolutely. And then
what were the other risk
00:22:42.54\00:22:45.54
factors, we need to
talk about lifestyle things.
00:22:45.55\00:22:47.40
So we've talked
about diet, having lots of
00:22:47.67\00:22:51.50
antioxidants in the
blood stream, right,
00:22:51.51\00:22:53.05
from fruits and vegetables and
00:22:53.06\00:22:55.43
a recent study was
done on the use of birth
00:22:55.58\00:22:58.11
control pills that long
term use of birth control
00:22:58.12\00:23:00.88
pills may also
increase the risk for
00:23:00.89\00:23:04.25
premalignant transformation.
00:23:04.93\00:23:06.25
So we tried to look
at things all in context
00:23:06.88\00:23:09.65
and really get a bird's
eye view at the patient,
00:23:10.08\00:23:13.05
see how aggressive we need to be
00:23:15.03\00:23:16.62
in their
screening. So, for some women
00:23:16.98\00:23:19.87
there will always
be annual and other
00:23:19.88\00:23:22.05
women if they're at
low risk and they've had 3
00:23:22.06\00:23:24.06
normal pap smears
then we can you know.
00:23:24.07\00:23:26.96
Maybe back it off every 2 years.
00:23:27.61\00:23:29.51
Every 2 years
exactly. So you know I'm kind
00:23:29.52\00:23:35.47
of glad I'm a man but
then I'm very glad there
00:23:35.48\00:23:39.37
are women too
you know what I mean,
00:23:39.38\00:23:40.78
but there is just some
more variables to think
00:23:40.79\00:23:43.13
about for the
female. Yes there is and if a
00:23:43.14\00:23:47.21
premalignant lesion
is found, it's easily
00:23:47.22\00:23:49.59
treated. I mean
that's the really great news
00:23:49.60\00:23:52.59
about being
screened for cervical cancer,
00:23:52.60\00:23:55.34
it is easily treated
that as soon as they can
00:23:55.76\00:23:58.35
freeze you know and
depend on the extent
00:23:58.54\00:24:01.09
of it, they may just
do a surgical procedure
00:24:01.10\00:24:03.45
to remove part of
the cervix that has those
00:24:03.86\00:24:08.45
malignant cells, otherwise that
00:24:08.46\00:24:11.00
malignancy is
just going to track and
00:24:11.01\00:24:13.09
invade and it invades locally.
00:24:13.10\00:24:15.28
So there are things,
there are things that
00:24:16.13\00:24:18.36
can be done. Wonderful, now you
00:24:18.37\00:24:21.30
know talking about
all of these issues with
00:24:21.31\00:24:24.06
women's health, there
is just the overall message
00:24:24.07\00:24:26.67
here is to just have
good health through exercise,
00:24:26.68\00:24:30.48
diet all those
different things and if you just
00:24:30.49\00:24:33.39
leave by the book so
to speak, you can avoid a
00:24:33.40\00:24:36.79
lot of these
problems but even having said
00:24:36.80\00:24:38.90
that we live in an
age where there are so
00:24:38.91\00:24:42.29
many things, so
many factors that are in
00:24:42.30\00:24:44.51
applying, it's
wise to be checked.
00:24:44.52\00:24:46.84
It is, you know
I've had patients say,
00:24:47.31\00:24:48.97
but I'm healthy, I
eat really well you know
00:24:49.63\00:24:52.61
I do this, I do that but
still it's important to be
00:24:52.62\00:24:58.18
screened and just
say it's important to be
00:24:58.19\00:25:00.43
categorized and say,
are you low at risk or are
00:25:00.44\00:25:02.77
you high at risk,
just look at everything,
00:25:02.78\00:25:04.54
where are you in
the risk category?
00:25:05.40\00:25:08.82
And based on
that we'll go forward.
00:25:09.30\00:25:10.95
It's not enough just
say well you know I eat
00:25:10.96\00:25:12.36
healthy and I don't
think I'm going to have that,
00:25:12.37\00:25:14.43
because you're
not gonna have any
00:25:14.44\00:25:15.47
symptoms until it's spread.
00:25:15.48\00:25:18.13
You'll have no
symptoms until it's not
00:25:18.46\00:25:20.11
locally invading.
So and we don't want
00:25:20.30\00:25:23.59
you to wait
until those symptoms.
00:25:23.60\00:25:24.93
You know I can't
think of a more important
00:25:24.94\00:25:27.31
person I might I mean
this is gonna sound bad
00:25:27.32\00:25:29.72
to all the guys
out there, then a mom.
00:25:29.73\00:25:32.41
Then the mom in the home.
00:25:33.32\00:25:35.25
I mean I think the
guys are important too
00:25:35.61\00:25:38.06
I mean but I'm just
saying when mom's not
00:25:38.17\00:25:42.40
happy, no one is
happy, as the saying goes.
00:25:42.41\00:25:44.16
That's right.
And there's so much
00:25:44.17\00:25:46.41
glue there you know
holds things together
00:25:46.42\00:25:49.19
that, that we
really want the, the women
00:25:49.66\00:25:51.80
listening today to
take this to heart.
00:25:51.81\00:25:53.42
We really want them
to, we want that their
00:25:54.76\00:25:56.40
husbands encourage
women to take care of
00:25:57.19\00:25:59.24
themselves, encourage
them to go and get that
00:25:59.25\00:26:01.72
well women exam,
encourage them to get
00:26:01.73\00:26:03.70
that annual preventive
exam, so they're doing
00:26:03.71\00:26:06.36
all those
things, encourage them,
00:26:06.37\00:26:07.97
be an accountability partner.
00:26:09.26\00:26:10.68
You know with
exercise, with eating well.
00:26:11.06\00:26:13.40
Do all those things that
will encourage her health.
00:26:14.42\00:26:17.08
What do you says to
the woman that maybe has
00:26:17.38\00:26:18.88
developed
cervical cancer recently?
00:26:18.89\00:26:21.86
What kind of
things happen right then,
00:26:22.49\00:26:24.16
you know maybe
someone is just really
00:26:24.17\00:26:25.34
anxious and they're
thinking, what's the
00:26:25.35\00:26:27.01
next thing that's gonna happen?
00:26:27.02\00:26:28.08
Again, that depends
on how far gone it is,
00:26:28.86\00:26:32.20
but probably she
will need to have surgery
00:26:32.21\00:26:35.21
and if it's
pre-malignant, if it's advance
00:26:35.71\00:26:38.55
pre-malignant lesion,
they'll just take off part
00:26:38.56\00:26:41.18
of the cervix. If it's
really, fairly extensive
00:26:41.19\00:26:43.80
then they will
actually do a actual
00:26:44.17\00:26:45.25
hysterectomy and take
the entire uterus out.
00:26:45.26\00:26:50.32
So the cervix is
the neck, cervix means
00:26:50.72\00:26:53.19
neck, so it's the
neck of the uterus. Right.
00:26:53.20\00:26:55.63
Okay, and so they
can just go in and
00:26:55.64\00:26:57.60
take off small
parts. If it's you know,
00:26:57.61\00:27:01.91
if it's you know we
say it, it's not invaded,
00:27:01.92\00:27:05.28
so they can take
off small parts, but if
00:27:05.58\00:27:07.15
there's a Frank
cancer they we will
00:27:07.16\00:27:09.36
need to go in and take.
Another reason to get it
00:27:09.37\00:27:12.47
checked before
hand, especially in those
00:27:12.48\00:27:14.18
people that haven't
had children or maybe
00:27:14.19\00:27:16.62
wanting to do that,
you want to make sure that
00:27:16.63\00:27:18.37
these kind of
things are taken care of.
00:27:18.38\00:27:19.90
Exactly and during
pregnancy we always
00:27:20.15\00:27:21.88
check in the
initial obstetric visit,
00:27:21.89\00:27:24.16
we do a pap smear to
make sure that everything
00:27:24.93\00:27:27.52
is gonna be fine
for those next 9 months.
00:27:27.53\00:27:29.29
So the real
message then is prevention,
00:27:30.35\00:27:33.03
absolutely, and
akin that seriously.
00:27:33.56\00:27:35.93
Absolutely.
Thank you so much for
00:27:36.16\00:27:37.87
spending time with us
today, and thank you to
00:27:37.88\00:27:40.09
your patients and also to your
00:27:40.10\00:27:42.59
husband and your fine children.
00:27:42.60\00:27:43.57
Thank you. It's a
pleasure to be here.
00:27:43.87\00:27:45.21
And we're glad that
you've been with us as
00:27:45.49\00:27:46.75
well. This has been
an important program,
00:27:46.76\00:27:49.33
don't minimize it. If
you haven't had a screening,
00:27:49.34\00:27:52.74
if you haven't had
that Pap smear or been
00:27:52.75\00:27:54.74
checked, take care of
it. Make the appointment
00:27:54.75\00:27:56.97
today, and have health
that lasts for a lifetime.
00:27:56.98\00:27:59.56