ASL Information on Uterine Cancer

The Cancer Few Women Know.

I.    Introduction

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Ok everyone, now that we have had a chance to socialize and chat a little, I’d like for us to turn our attention to Joni who will give us some information about uterine cancer.  I saw Joni give a presentation on this topic at a friend’s house and I learned so much about uterine cancer from her.   Her presentation was in ASL, so the information was clear and easy to understand.  I wanted to learn more about uterine cancer myself and decided to have this coffee clutch so that I could share the information with some of my friends as well.

Joni is from this area and she is very knowledgeable about uterine cancer.  Organizations like the American Cancer Society and the National Cancer Institute have programs that work with volunteers.  These volunteers are knowledgeable about various cancers.  They travel all over the country to help people like us learn more about cancer and how we can take care of ourselves.  Perhaps after today’s presentation, you’ll be interested in becoming a volunteer for one of these organizations as well.   Let me introduce, Joni.

As Deaf women, we know it is especially hard for Deaf and Hard of Hearing women to get the health information they need.  Today, we would like to present to you some important information about your health.  We hope this information will be helpful for you and for the people you love.

II.    Cancer and Women

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Specifically, we want to talk with you about cancer.  Cancer is a disease where abnormal cells start to grow rapidly.  If the cell’s growth is not controlled, death can result. For women, breast cancer is the most commonly occurring cancer. 

However, as more and more women have started smoking, more women are developing lung cancer.  Because lung cancer is hard to treat, more women die from lung cancer than any other cancer.

Because breast cancer and lung cancer are so common and so serious, women are more likely to hear about these two cancers.  There are many other cancers that can affect women.  We are here to talk to you today about one very important cancer that occurs in women:  uterine cancer.

Uterine cancer begins in the uterus.  The uterus is an organ located above your vagina.  It is one of the most common cancers in women, and happens most often between the ages of 50 and 70.

It is important for women of all ages to learn about uterine cancer.  Gathering information about potential benefits and risks of screening and treatment for uterine cancer lets you make informed decisions about your health care.

III.    Overview

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Before we start, let’s introduce ourselves.

I’m Leslie.

My name’s Miriam.

My name is Lupe.

I’m Tanni

Hi.  I’m Danny.  I’m here with my wife.

I’m Melanie.  I know someone with cancer, could you start by explaining what cancer is?

Good question. Please ask me any questions as we go along.  Let me explain what cancer is.  Cancer is a disease of the cells of your body.  Your body contains trillions of cells.  Cells are like building blocks for your body.  Cells with similar functions form groups within our bodies. Cells and groups of cells, keep your body functioning smoothly.

Every day, old cells are dying, and new ones are replacing them.  Your body makes new cells when one cell makes identical copies of itself.  Sometimes a cell makes a mistake when it copies itself and produces a damaged cell.  These damaged cells can divide very rapidly and create a group of damaged cells called a tumor.  These cells can break away and create tumors in other areas of the body.  If the growth of these numerous tumors is not controlled, it can cause death.  Death is caused by the tumors interfering with the body’s normal functioning.

IV.    Tumor Types  

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Is there more than one type of tumor?

Yes.  There are two different types of tumors.  One is called a benign tumor.  The benign tumor tends not to spread to other parts of the body.  It is not cancer, nor is it dangerous, but most of the time this will need to be removed because it can interfere with your body's normal functioning.  The second type, the malignant tumor, is dangerous and can spread throughout the body and grow uncontrollably.  If allowed to grow, it will cause death.  This second type of growth that spreads and grows rapidly and uncontrolably is cancer.

V.    Malignant Tumors

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Why is a malignant tumor so dangerous?

Cells from a malignant tumor can break away from the original tumor and move to other parts of the body.  There they begin to grow into other tumors.  The more tumors there are in the body, the harder it is for the body's normal cells to function.  Eventually there aren't enough normal cells to keep the body functioning properly.  This process is called metastasis.  Malignant tumors all have the potential to spread or metastasize.  When this process of tumor cells spreading has already occurred, it is called metastatic cancer.

VI.    Description

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So, what is uterine cancer?

There are four topics we should discuss about uterine cancer. 

  1. Description
  2. Risk
  3. Detection
  4. Treatments

Number 1:

Description of uterine cancer.  Your uterus is an organ the size of a lemon that is hollow inside and muscular outside.  It is located above your vagina. 

The uterus is the organ in which a baby grows and from which menstrual flow comes.  The cells that line the uterus are called endometrial cells.  Most uterine cancer happens when a damaged endometrial cell from the lining of the uterus multiplies to make a malignant tumor.  Therefore, uterine cancer can also be called endometrial cancer.  We do not know exactly what causes the damage to happen.

VII.    Risks

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How do I know if I am at risk for uterine cancer?

Number 2:

Risk of uterine cancer.  Uterine cancer is the fourth most common cancer among American women.  Women who are above the age of 50 or have gone through menopause are at increased risk for this disease.  White women are at higher risk than African-American women.  Pacific Islander/Asian-American women and Hispanic-American women are also at risk but their chance of getting uterine cancer is lower.

Every woman's body makes two different hormones.  One hormone is called estrogen and the other is called progesterone.  If you have a condition in which your body produces high levels of the hormone estrogen but does not make enough of the other hormone progesterone to balance the estrogen, then you are at increased risk of getting uterine cancer. 

This can happen in someone who is overweight, has irregular periods, has trouble getting pregnant, or has been taking estrogen replacement for a long time.  Women with high blood pressure or diabetes are also at increased risk for developing this cancer.  A personal or family history of breast, ovarian, or colon cancer may also increase the risk of developing uterine cancer.  Tamoxifen, a drug used to treat breast cancer can also increase a woman's risk of getting uterine cancer.  If  a woman has any of those seven conditions, her risk for uterine cancer is greatly increased.

VIII.    Is Uterine Cancer Common?

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How common is uterine cancer?

Each year 34,000 women in the United States get uterine cancer and 6,000 women die from uterine cancer.  If uterine cancer is detected early, it can be treated more easily, and even cured.

IX.    Early Detection

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What is early detection?

Number 3:

Detection of uterine cancer.  Early detection means that you find the tumor before it has spread to other sites in the body.  Late detection means that you find the tumor after it has already spread to other parts of the body.

X.    Screening

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What are the ways uterine cancer can be found early?

Fortunately, there is an early warning symptom for uterine cancer.  Most women with uterine cancer have abnormal vaginal bleeding.  This means they might have very heavy periods, bleed between their periods, bleed after they have gone through menopause, bleed after having sexual intercourse, or pain during sexual intercourse.  If you have any of these types of bleeding, you should contact your doctor right away.

Your doctor can perform several types of exams to determine the cause of the abnormal vaginal bleeding.  Your doctor will need to do a pelvic exam.  In this exam, your doctor will give you a gown and ask you to undress.  You will have a sheet to cover yourself during the exam.  You will lie down on an examination table and place your feet in stirrups located on either side of the table. Your doctor will then place two gloved fingers inside your vagina and press on your lower abdomen with the other hand.  The purpose of this test is to determine the size of your uterus and to feel for any hard areas.  Even without symptoms, you should have a pelvic exam done once a year beginning three years after having sexual intercourse or no later than age 21.

Your doctor may need to remove a small sample of the lining of your uterus to check for cancer cells.  This is called a biopsy.  The tissue will be examined under a microscope to look for cancer cells.  This procedure is similar to a pelvic exam.  Your doctor will insert a speculum into your vagina in order to see the opening of your uterus.  This lower portion of the uterus that contains the opening is called the cervix.  The doctor will insert a narrow straw-like instrument through this opening and remove a small sample of the lining of the uterus for examination.  This test causes mild discomfort but not enough to require medicine to numb the area.

XI.    D&C

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I think my friend had something called a D&C.

That is correct.  The letters D&C stand for Dilatation & Curettage.  A D&C is a minor surgical procedure used to get a larger sample of tissue from the lining of the uterus.  During this procedure, the doctor will give you some numbing medicine.  The doctor will then dilate your cervix and use a scoop-like instrument to scrape tissue from the uterine lining.  This sample is sent to the laboratory. 

XII.    What Happens Next?

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If I have uterine cancer, what happens to me next?

If cancer is found, more blood tests, urine tests, or x-rays may need to be done to see if the cancer has spread to other parts of the body.  That helps the doctor to give you recommendations for the best possible treatment choices.

XIII.    Types of Treatment

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What are the possible treatment choices?

Number 4:

Treatments.  There are three possible treatments for uterine cancer. They are surgical removal of the uterus, ovaries, and tubes that connect your uterus to your ovaries, radiation therapy and/or chemotherapy.

The earlier a tumor is found, the more options one has for treatment.  You and your doctor need to choose your treatment based on the stage of your cancer and your personal needs and preferences.  Together you will consider the size of your tumor, the speed of your tumor’s growth, your age, your general health, your desire to have children and your feelings about the side effects of the treatments.  Now let us discuss each of the choices.

In most cases, the doctor will suggest surgically removing your uterus, your ovaries, and the fallopian tubes that connect the uterus to the ovaries.  This procedure will remove the cancer cells from the body.  However, there are short-term and long-term side effects related to this surgery.  First, if the uterus is removed, you cannot have children.  Second, if you have not yet reached menopause naturally, removal of the ovaries will cause you to begin menopause.  Because the onset of menopause is the result of the surgical removal of the cells that produced your body's female hormones, the onset of menopause will be sudden, instead of a natural slow onset of menopause.  As a result, you may experience hot flushes, mood changes, and the symptoms commonly associated with menopause.  Since menopause can increase the risk of bone loss, you and your doctor should discuss how to slow this process.  Third, there are always risks to surgery such as infection and bleeding, and risks from receiving anesthesia, the drugs that put you to sleep during surgery.  Depending on the size and location of the tumor, surgery may or may not be an option.  If surgery is the recommended treatment, be sure to choose a surgeon who specializes in cancer surgery of the female organs.

XIV.    Radiation

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What about radiation?  How does that work?

Radiation therapy uses very strong X-rays to kill the cancer cells.  It can be used as a treatment alone or in combination with other treatments.  There are two ways to deliver radiation treatment.  First, X-ray beams can be aimed directly at the uterine cancer cells from an external machine.

Second, you can have an applicator that gives off radiation placed directly into your uterus or vagina for several minutes, a number of hours, or even a few days.  This releases constant amounts of radiation to kill the cancer cells over a specific period of time.

XV.    Side Effects

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Are there side effects from the radiation?

The radiation will still kill some healthy cells in that area of the body.  This may cause skin changes such as redness or peeling, vaginal or rectal pain, vaginal narrowing, nausea, loss of appetite, tiredness, feeling the need to urinate more often, diarrhea, and/or softening of your bones.  Most of these side effects last only about two weeks after you stop radiation. However, there are long-term side effects.  Some women report sexual difficulties and early menopause.  You should talk with your doctor if these side effects occur or if the short term side effects last longer than they should.

XVI.    Chemotherapy

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What if the uterine cancer has spread?

When cancer spreads, chemotherapy is usually recommended.  However, at this time, most cases of uterine cancer do not respond well to chemotherapy that is currently available.  Still, this may be an option for some patients.  And in the future, newer drugs may be discovered that are more effective for treating uterine cancer.  Chemotherapy uses drugs in the form of pills or intravenous injections that kill any cells in your body that are dividing quickly.  Cancer cells divide rapidly.  However, so do some other healthy cells, like those in your mouth, your stomach, your intestines, your bones, and your hair.  Therefore, the drugs can also kill healthy cells in these places.  When chemotherapy kills these healthy cells, the result can be mouth sores, tiredness, weakness, hair loss, diarrhea, and an upset stomach.

XVII.    Hormone Therapy

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That is discouraging.  Are there other treatment options?

Yes, there's one more.  We mentioned earlier that estrogen is a hormone that women naturally produce.  When it is produced in high levels it can encourage cancer cells in the uterus to grow.  Progesterone is another hormone that women produce.  This hormone helps balance the effects of estrogen.  This balance is important in the control of uterine cancer.  Progesterone can be used as a type of hormone therapy to treat uterine cancer that is not fully destroyed by surgery and radiation.

XVIII.    Prevention

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Is there anything I can do to prevent uterine cancer?

We still do not know what causes uterine cancer.  Therefore, there is no good way to prevent it.  However, you can lower your risk of uterine cancer by doing the following:  controlling your weight with exercise and a healthy diet, eating a low-fat diet that has multiple servings of fruits and vegetables and only small amounts of red meats, controlling your blood pressure and having yearly pelvic exams and pap smears.  Also, be sure to report any unusual vaginal spotting or bleeding to your doctor.  If you are taking hormone replacement therapy, consult your doctor and follow his or her instructions.

XIX.    Clinical Trials

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I have heard friends talk about clinical trials.  What are they?

Clinical trials are studies done to find new ways to diagnose and treat cancer and many other diseases.  Clinical trials also search for ways to prevent cancer and reduce symptoms.  You should keep an open mind about clinical trials.  Ask your doctor about any clinical trials that could benefit you.  The National Cancer Institute has lots of information about clinical trials.  They will help you make an informed treatment decision.  The best idea is to stay open to the possibility of clinical trials because they can offer new solutions for you and for other people with similar problems.

XX.    Summary

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Well, we hope that this video has answered some of your questions and concerns about uterine cancer.  Let us summarize a few important things for you.

Women over the age of 50 are at higher risk of getting uterine cancer.  However, it is important to know that one out of four women who gets uterine cancer is younger than 50 years old.  Therefore, any woman who has unusual vaginal bleeding, such as between periods or after sexual intercourse, should speak to her doctor right away.

XXI. Resources

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The better you understand uterine cancer, the more power you have to make the right choices for your own body and health.  You can call the American Cancer Society and the National Cancer Institute for more information or visit their web sites.

With what you have learned today, you can make a difference for yourself and your community by being informed and by making responsible decisions about cancer screening.  We enjoyed sharing this information with you and hope you will share it with many others.  Together, we can improve the health of the Deaf and Hard of Hearing community by making sure its members have the most accurate and current information available.  Remember, this video was prepared in 2003.  New information about uterine cancer is always developing.