Dr. Davis is one of San Francisco's finest house call specialist physicians and has been providing house calls and office visits to the Bay Area since 2005. His practice is built upon the philosophy that excellent customer service and excellent patient care go together. Dr. Davis works out of a charming 100-year-old Victorian home, and he believes that healing should begin when you walk in the door. While trained in modern medicine, Dr. Davis also has a deep appreciation of cultural anthropology, the natural sciences, and philosophy all of which he integrates with his medical practice. Dr. Davis received his MD from the University of Florida and completed his Family Practice residency at Lehigh Valley Family Practice. He has also lived, studied, and traveled abroad extensively, including for one year in Beijing, China, where he studied and practiced the principles of Traditional Chinese Medicine and Acupuncture.
JUSTIN C. K. DAVIS, MD: Hi, I'm Dr. Justin Davis and today, I'm going to talk to you a little about uterine cancer. The uterine cancer describes cancer of the uterus which is part of the reproductive system of all women. Because uterus is a large organ, there are different kinds of cancer that people may have associated with the uterus but today, I'm going to describe to you in detail the two most common types; one, which affects mostly the older population is called endometrial cancer and the other one which tends to affect younger women is called cervical cancer. So to begin, endometrial cancer describes uterine cancer when it affects the endometrium. The endometrium is the inside lining of the uterus. Endometrial uterine cancer occurs most commonly after menopause; meaning after a woman has gone through her normal life changes and stopped menstruating. Typically, the most common ages that a woman will present with uterine cancer is in her 60s or 70s, so fairly at an advanced age. The most common symptom that women will have when they present with uterine cancer is abnormal vaginal bleeding; so bleeding or spotting that's coming from the vagina. Now, because most women that get it have already stopped menstruating, usually it is very easy to identify that this is abnormal and because of this, which is a good thing, it makes it easier to identify many cases of uterine cancer earlier. Now the good thing is that when uterine cancer is identified early enough, the cure rate is very good; sometimes, it can even be as high as 90% when caught very early. Other symptoms of endometrial cancer are if it has gotten a little bit more advanced, you may experience pelvic pain, pain during intercourse, fatigue, weight loss; the basic treatment is if it's caught early is to remove the uterus and sometimes the accompanying organs, the fallopian tubes and the ovaries. If there has been no spread, then often this is enough to get a complete cure of endometrial cancer. Sometimes, depending on different circumstances, the stage of the disease, if it has spread or not, your doctor will discuss other options with you such as radiation therapy, chemotherapy, or even hormonal therapy to help treat endometrial cancer. As far as preventing endometrial cancer, the best prevention is to catch it early first of all. So, if you have any potential signs, particularly abnormal bleeding or spotting, it is always a good idea to let a physician know. Additionally, yearly woman exam, known as a Pap smear even after--sexually active potentially or after you're not having your menstrual cycle, can still help sometimes to identify endometrial cancer early on. Another important aspect in identifying or preventing endometrial cancer is the endometrium, the inside lining of the uterus, is very sensitive to estrogen. So, things that cause estrogen levels to be higher are more likely to cause the endometrium to proliferate, meaning get larger, which can cause it to be more likely to eventually develop cancers. So, women that have very high fat contents in their diets and excessive body fat or eat foods that are rich with injected hormones such as certain kinds of beef or poultry may have a higher estrogen content and may be a little more susceptible to getting endometrial cancer. Also, women who get hormone therapy, if you only get estrogen and it is not balanced with progesterone, then this may also make you a little bit more likely to get endometrial cancer. Finally, something that some of you may find interesting is there has always been a lot of controversy about whether or not to use oral contraceptives in young women for birth control. Well, it is still a bit of a controversial subject in some areas but we have definitively now found that women that get traditional oral contraceptive therapy with estrogen- and progesterone-balanced medicine are actually less likely to have endometrial cancer and the longer you're on it, that actually the less likely you are to have this kind of cancer. Primarily if you suspect that you may have endometrial cancer, then the best action is to immediately notify a physician because it can be very easily diagnosed; and once again, the sooner it is diagnosed, the more complete and easy to cure will be. Now, let us move on to cervical cancer. The cervix is the very tip of the uterus that's half in the pelvic area and extends half way into the vaginal canal. The reason the cervix is there is that it's a sort of round circular-looking organ that has a small hole in it and this hole prevents sperm to be able to move up and into the uterus eventually impregnating an egg and causing a pregnancy and then when it is time to have your baby, the cervix will expand and get much larger, actually opening up wide enough that a baby can come out. Now, cervical cancer is a very preventible cancer but occurs mostly in younger women from their 20s up until the 40s. Now, when I say it's preventible, it's preventible because we have very good screening techniques for it that can identify early cancerous changes and recently, there has been a vaccination, that many of you have heard about and I'll talk about in a moment, that has almost completely eliminated the risk of cervical cancer and if you combine the two, screening and vaccination, you have a very lower risk of getting cervical cancer. So, what are the symptoms of cervical cancer? Often early on, there really are no symptoms but later on as the disease progresses, you may notice abnormal vaginal bleeding or spotting or even pain associated with the cervix or the pelvic organs. Treatment again is based first at prevention, that yearly exam that doctors always urge you to have called the Pap smear. Pap smear is actually when we take a sample of some cells from the cervix and we look at those under a microscope and cervical cancer usually occurs very slowly over time, perhaps a few years with some typical changes along the way. So, if you see these cells while they're still changing, there is plenty of time to prevent it progressing into cervical cancer. Prevention is primarily by having the screening exams and if we find irregular cells, then we can destroy those cells before they turn into cervical cancer and as I had mentioned before, there is now a vaccine called HPV vaccine that can actually prevent a certain kind of virus, the papilloma virus, that is responsible for causing most cervical cancers. So, a combination again of this vaccine with regular screening can prevent most women from getting cervical cancer or having it progress into a more serious form of cancer. Action to be taken? Well, anytime that you're unsure that you're having pain, pelvic pain or abnormal bleeding, it's always a good idea regardless of the cause to let your physician know.
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