00:00:00:15 - 00:00:04:02 I’m Dr. Rob Winn and you're listening to Real Cancer Talk 00:00:04:02 - 00:00:07:13 from VCU Massey Comprehensive Cancer Center. 00:00:07:13 - 00:00:10:00 All right, friends, it is 3:02. 00:00:10:00 - 00:00:15:08 Again, it's Friday, September 19th, and it's, you know, in the 3:00 vicinity. 00:00:15:08 - 00:00:18:08 So it's facts and faith Friday time. 00:00:18:11 - 00:00:20:20 I really appreciate y'all being here. 00:00:20:20 - 00:00:23:20 Today we're going to talk about something that I don't get 00:00:24:05 - 00:00:27:02 I don't believe gets enough amplification. 00:00:27:02 - 00:00:30:01 People don't like to talk so much about 00:00:30:01 - 00:00:33:01 reproductive organs statements. 00:00:33:24 - 00:00:36:24 But today we're going to talk about endometrial cancer. 00:00:36:24 - 00:00:39:22 Understanding the risk factors. 00:00:39:22 - 00:00:44:05 And, you know, the symptoms and empowering women in the fight against... 00:00:44:05 - 00:00:47:03 I always mess up on this. 00:00:47:03 - 00:00:50:10 Oh, Gynecological cancer. 00:00:51:23 - 00:00:54:03 That's a hard word. 00:00:54:03 - 00:00:57:03 Crazy, and try to say it in Spanish. 00:00:57:03 - 00:00:58:10 That's even wilder. 00:00:58:10 - 00:01:01:19 But, anyway, before I go, 00:01:01:19 - 00:01:05:12 any further, it's our custom to start with an opening prayer. 00:01:05:12 - 00:01:09:17 And today, Reverend Doctor Whitehead, has agreed to lead us in prayer. 00:01:11:07 - 00:01:12:06 Let us pray. 00:01:12:06 - 00:01:14:02 A God of grace and God of love. 00:01:14:02 - 00:01:16:13 God of hope and justice and power. 00:01:16:13 - 00:01:20:06 We thank you for this time and this space that we can gather. 00:01:20:12 - 00:01:22:12 We pray for those who are present today. 00:01:22:12 - 00:01:25:12 We thank you for the facts that we can align 00:01:25:12 - 00:01:28:10 with our faith, that we can make our communities better. 00:01:28:10 - 00:01:29:22 So guide us and direct us now. 00:01:29:22 - 00:01:33:02 It is in the powerful name of Christ, our Redeemer, that we pray 00:01:33:05 - 00:01:35:18 and we give thanks. Amen. 00:01:35:18 - 00:01:36:23 Amen. Amen. 00:01:36:23 - 00:01:39:23 Thank you so much, Reverend Doctor Whitehead. 00:01:40:11 - 00:01:45:07 We are going to play around a little bit because I know that Doctor 00:01:45:07 - 00:01:50:03 Winn is at a conference, but he definitely will be joining us 00:01:50:03 - 00:01:54:09 with his update and, a his PSA about prostate screening. 00:01:54:09 - 00:01:57:14 So again, this conversation is not just about our womenfolk, 00:01:57:14 - 00:01:59:11 but we also need to make sure our 00:01:59:11 - 00:02:02:07 menfolk are doing what they need to do to protect themselves. 00:02:02:07 - 00:02:06:12 Today we're also talking about endometrial cancer. 00:02:06:12 - 00:02:09:13 And we have two wonderful, wonderful 00:02:10:08 - 00:02:13:22 experts with us, Monika Brown and Erika Brown. 00:02:13:22 - 00:02:14:24 They are not related. 00:02:14:24 - 00:02:18:00 I figured that out before we had our conversation. 00:02:19:03 - 00:02:20:24 But I'm going to just tell you 00:02:20:24 - 00:02:24:12 something, briefly about the resumes, because, again, I could go on for days, 00:02:24:17 - 00:02:27:17 reading the resumes, but so Monika Brown 00:02:27:17 - 00:02:30:10 is a women's health nurse practitioner. 00:02:30:10 - 00:02:34:09 And her she believes her true calling is caring for patients 00:02:34:09 - 00:02:37:09 living with gynecological cancers. 00:02:37:20 - 00:02:40:13 Her first experience in the field was working as a registered nurse 00:02:40:13 - 00:02:43:13 in the operating room. 00:02:43:21 - 00:02:46:05 This is what she had this to say about her experiences. 00:02:46:05 - 00:02:48:09 “When I decided to become a nurse practitioner. 00:02:48:09 - 00:02:53:04 Gynecologic oncology was my first and only choice.” 00:02:53:04 - 00:02:56:05 So she pursued a master's degree in nursing from Old Dominion 00:02:56:05 - 00:02:58:09 with a women's health concentration. 00:02:58:09 - 00:03:02:17 She earned that degree as well as a with a bachelor's in nursing from ODU, 00:03:02:17 - 00:03:07:07 and a registered nursing diploma from the Sentara School of Health Professions. 00:03:09:11 - 00:03:12:11 She's wonderful, but by all descriptions. 00:03:12:15 - 00:03:16:11 But this I thought this was particularly telling about who she was as a person. 00:03:17:00 - 00:03:19:17 Brown considers each person that she treats, along 00:03:19:17 - 00:03:23:15 with their family members or friends, as part of the team in fighting cancer. 00:03:23:21 - 00:03:27:09 “I'm here to create an empowering and open environment for patients 00:03:27:09 - 00:03:31:22 and their families.” So we're so excited that Monika is here with us today. 00:03:32:07 - 00:03:36:09 And we also have Erika, not her relative, Erika Brown. 00:03:37:03 - 00:03:39:17 She's a registered nurse, specializing 00:03:39:17 - 00:03:43:23 in gyn gynecological and oncology. 00:03:43:23 - 00:03:47:07 I'm tired of all these very long multi syllabic words, but that's okay. 00:03:47:23 - 00:03:50:16 Shorten it to Gyn Onc. That's okay. 00:03:50:16 - 00:03:53:04 Okay. Gyn Onc? Okay, okay. 00:03:53:04 - 00:03:56:12 Her goal is to make patients feel heard and understood. 00:03:57:01 - 00:04:01:09 Her personal philosophy is to treat every single patient like family, emphasizing 00:04:01:09 - 00:04:05:01 a patient centered care approach and helping to meet all of their needs. 00:04:06:03 - 00:04:09:03 Again, we're so blessed to have both of them with us here today. 00:04:09:06 - 00:04:11:10 And without any further words 00:04:11:10 - 00:04:14:14 coming out of my mouth, I'm going to turn it over to Monika. 00:04:14:14 - 00:04:17:14 And, Erika, thank you for being here. 00:04:19:02 - 00:04:20:20 Thank you so much for having us. 00:04:20:20 - 00:04:26:02 We have a, a little bit of a presentation to go through for you guys. 00:04:27:03 - 00:04:29:18 And I think talking to Rachel the other day, 00:04:29:18 - 00:04:33:24 she said this will be available to those who want it. 00:04:34:21 - 00:04:37:06 But I think it's a a good thing 00:04:37:06 - 00:04:41:22 to take a look at if this will load. 00:04:42:12 - 00:04:44:02 There it is. Okay. 00:04:44:02 - 00:04:48:00 Again, I'm Erika, and my lovely nurse practitioner. 00:04:48:00 - 00:04:50:13 One of the two Monika’s on here. 00:04:50:13 - 00:04:54:23 And we're going to talk to you about, Gynecologic Cancer Awareness Month 00:04:55:07 - 00:04:58:14 specifically targeting, endometrial cancers 00:04:58:20 - 00:05:03:04 and diving deeper, specifically endometrial cancer. 00:05:03:11 - 00:05:05:18 And the impact on the black community. 00:05:05:18 - 00:05:10:21 How can we help, black women, meaning like, you know, 00:05:11:05 - 00:05:14:05 getting them tested early, doing, you know, 00:05:14:07 - 00:05:17:03 more, more things than one. 00:05:17:03 - 00:05:21:14 And then you'll get to see our team, at the end of this slide. 00:05:23:09 - 00:05:24:21 So overall, GYN 00:05:24:21 - 00:05:29:08 cancers is any cancer that originates from the female reproductive tract. 00:05:29:08 - 00:05:34:08 So we have ovarian, fallopian tube, cervical of course 00:05:34:08 - 00:05:36:24 uterine, vulva and vaginal. 00:05:36:24 - 00:05:40:10 So any of the lady bits can be affected. 00:05:41:03 - 00:05:43:11 Specifically black women 00:05:43:11 - 00:05:46:11 are more affected by the GYN cancers. 00:05:46:15 - 00:05:50:01 And it is also more deadly for us as well. 00:05:51:14 - 00:05:55:02 Sometimes because they're diagnosed at a later stage, 00:05:56:07 - 00:06:01:01 and likely to receive, you know, just basic care. 00:06:01:01 - 00:06:04:20 They some, some doctors that they've gone to having delve 00:06:04:20 - 00:06:08:13 deep enough into what their symptoms are. 00:06:08:17 - 00:06:12:12 And I think in one of the slides later on, I will explain to you, 00:06:12:12 - 00:06:17:09 you know, it's been that, the symptoms that some women described 00:06:17:09 - 00:06:21:01 have been termed normal, which in fact, they are not. 00:06:21:10 - 00:06:24:01 And then when they come see us, 00:06:24:01 - 00:06:28:00 they have high grade endometrial cancer that they're needing chemo and radiation 00:06:28:00 - 00:06:33:00 and all of these things for, and then there are a lot of, 00:06:33:02 - 00:06:37:17 studies out here for, you know, you know, our clinical trials, but 00:06:39:00 - 00:06:40:10 there's less funding, 00:06:40:10 - 00:06:44:17 and dedicated studies for that impact, for cancers that impact black women. 00:06:45:15 - 00:06:48:02 Which is very bad. 00:06:48:02 - 00:06:50:17 But unfortunately, our world, 00:06:50:17 - 00:06:54:18 and it's the most common gyn cancer in the US. 00:06:54:23 - 00:06:58:15 We have about 66,000 new cases 00:06:58:15 - 00:07:01:18 and almost 14,000 deaths, 00:07:01:18 - 00:07:04:18 that is caused by this endometrial cancer. 00:07:05:10 - 00:07:07:23 And then we are in Virginia. 00:07:07:23 - 00:07:12:07 We are number 12 in the United States for endometrial cancer incidence and deaths. 00:07:13:11 - 00:07:16:11 And I'm going to hand it over to Mo. 00:07:17:24 - 00:07:20:09 Hey everyone. 00:07:20:09 - 00:07:24:24 So one thing I want to focus on is the bottom of the screen 00:07:24:24 - 00:07:29:07 where it says it is now more deadly than ovarian cancer. 00:07:29:17 - 00:07:33:10 13, 12 years ago 00:07:33:10 - 00:07:36:10 when I started in do you technology 00:07:36:24 - 00:07:39:19 in the metro, cancer was the one to get 00:07:39:19 - 00:07:43:11 because you had the surgery, you got your uterus out, 00:07:44:09 - 00:07:48:06 you were okay most of the gyncology Now ovarian cancer, 00:07:48:07 - 00:07:52:20 endometrial cancer has surpassed ovarian cancer when it comes to 00:07:53:18 - 00:07:57:01 incidence of diagnosis and mortality. 00:07:57:22 - 00:08:00:06 And leading the pack, of course, like Erika 00:08:00:06 - 00:08:03:23 had said before, is black women. Why? 00:08:05:06 - 00:08:06:05 I'll get into that later. 00:08:06:05 - 00:08:10:12 But like I said, here is the third most overall cancer. 00:08:11:01 - 00:08:14:10 And then it's leading by deaths by number four. 00:08:15:00 - 00:08:19:00 But like it was said before, no one was talking about it. 00:08:19:23 - 00:08:24:15 And so hence this is during Cancer Awareness month. 00:08:24:15 - 00:08:26:04 But again 00:08:26:04 - 00:08:29:19 we don't see any ribbons or banners like we do for breast cancer awareness. 00:08:30:12 - 00:08:33:12 These statistics are driven 00:08:34:21 - 00:08:36:00 by three different types. 00:08:36:00 - 00:08:38:13 Number one, you have Hispanics. 00:08:38:13 - 00:08:41:24 And that's the most alarming one for African-American women. 00:08:42:10 - 00:08:46:24 That one isn't as common as oh, I'm just bleeding. 00:08:47:14 - 00:08:50:05 It sometimes doesn't even show up as bleeding. 00:08:50:05 - 00:08:53:16 And so I'm going to get later into what to look for. 00:08:53:16 - 00:08:59:02 But, remember I was saying, like, get the hysterectomy and you're good to go. 00:08:59:17 - 00:09:02:24 You see here the diagnosis years of diagnosis 00:09:02:24 - 00:09:08:09 at the bottom of that first graph and Hispanic, non-Hispanic, all of that. 00:09:08:09 - 00:09:12:00 You see the number here where it is, is which one is that? 00:09:12:18 - 00:09:14:23 It's the red one. We're right at the top. 00:09:17:01 - 00:09:19:06 Even from 2000. 00:09:19:06 - 00:09:21:14 And we just continue to climb. 00:09:21:14 - 00:09:24:14 So that tells you right there that, 00:09:24:16 - 00:09:26:07 okay, okay. 00:09:26:07 - 00:09:28:17 It's okay, it's okay, it's fine. 00:09:28:17 - 00:09:31:10 It's. 00:09:31:10 - 00:09:34:10 Typing all the time. 00:09:34:22 - 00:09:37:22 Type one endometrial cancer 00:09:37:23 - 00:09:42:03 again, as you can see from diagnosis, 00:09:42:08 - 00:09:47:13 there are a lot more non-Hispanic white women being diagnosed with type one. 00:09:47:17 - 00:09:51:17 Of course, type one is easier to treat naturally. 00:09:51:24 - 00:09:55:03 Now you have non-Hispanic Asian Pacific 00:09:55:03 - 00:09:59:12 Islanders down here, which that's a decent amount, 00:09:59:12 - 00:10:04:14 and it's a little bit higher than the I'm sorry, lower than the African American. 00:10:04:14 - 00:10:08:18 But if you can see Hispanic, black, Pacific Islander, 00:10:08:19 - 00:10:11:22 we're all pretty much in there together within a few tenths of a point. 00:10:13:11 - 00:10:16:11 The reason why the stage one, 00:10:16:22 - 00:10:20:24 I believe, and this is what we all believe honestly, is a lot. 00:10:21:07 - 00:10:24:04 There have a lot more women being diagnosed at this stage 00:10:24:04 - 00:10:28:15 is because of access to care and non bias. 00:10:28:15 - 00:10:30:07 When they are coming to get care. 00:10:31:12 - 00:10:34:12 If you look at the next slide, you can see that 00:10:34:17 - 00:10:38:04 flip it around, type two and above go back area. 00:10:39:11 - 00:10:40:05 Oh sorry. 00:10:40:05 - 00:10:42:18 The next one type two and above. 00:10:42:18 - 00:10:45:18 We just completely surpassed everyone else 00:10:46:13 - 00:10:49:08 just from one type. 00:10:49:08 - 00:10:51:21 Flip that thing completely around. 00:10:51:21 - 00:10:54:21 And that's the issue. 00:10:55:02 - 00:10:57:08 Now you can go Erika. 00:10:57:08 - 00:10:58:02 okay. 00:10:58:02 - 00:11:00:23 Second 00:11:00:23 - 00:11:04:10 largest black white mortality gap of all cancers. 00:11:04:17 - 00:11:06:03 I'm going to say it again. 00:11:06:03 - 00:11:11:03 Second largest black white mortality gap of all cancers. 00:11:11:03 - 00:11:14:03 We just seen it on that slide before. 00:11:14:24 - 00:11:17:17 And the survival rate 00:11:17:17 - 00:11:21:07 is significantly lower at 21% for black women. 00:11:23:10 - 00:11:26:12 And again, like I was saying before, the aggressive cancers 00:11:26:12 - 00:11:29:12 are more likely to be diagnosed under black women 00:11:29:12 - 00:11:31:22 than anyone else. 00:11:31:22 - 00:11:36:09 Abnormal uterine bleeding, like I said, is usually the most common thing. 00:11:36:20 - 00:11:39:15 But constant pelvic pain, pain 00:11:39:15 - 00:11:43:10 and bleeding with intercourse, nausea, bloating, decreased appetite. 00:11:43:10 - 00:11:47:13 How many times has anyone been nauseous, bloating, or had decreased appetite 00:11:47:13 - 00:11:51:06 and assumed that it was something they ate last night, right? 00:11:51:19 - 00:11:53:13 Or difficulty going to the bathroom? 00:11:53:13 - 00:11:56:11 Oh, that's just the change of life, right? 00:11:56:11 - 00:11:59:04 Itching, pain, bleeding, lump or whatever in the vulva. 00:11:59:04 - 00:12:02:07 So these are all signs of gynecologic cancer 00:12:02:07 - 00:12:05:22 that we can all just kind of put all to something else. 00:12:05:22 - 00:12:09:18 And this is why awareness needs to be raised, number one. 00:12:09:18 - 00:12:12:18 Because in the black community, we're so focused on everyone else, 00:12:12:18 - 00:12:15:18 especially the women, that we're not taking care of ourself. 00:12:15:18 - 00:12:17:16 So we oh, that's just something I ate last night. 00:12:17:16 - 00:12:18:22 Oh, I don't go to the doctor for that 00:12:20:00 - 00:12:22:23 until we really do. 00:12:22:23 - 00:12:23:05 All right. 00:12:23:05 - 00:12:26:05 Erika. 00:12:28:17 - 00:12:31:05 So again, why is it important to talk about? 00:12:31:05 - 00:12:35:19 I talked to again about normalizing our entire lives, you know, bleeding is 00:12:36:04 - 00:12:39:23 we need to make sure that we know, especially after menopause. 00:12:40:14 - 00:12:43:19 Bleeding is not normal in any way, shape or form. 00:12:44:17 - 00:12:48:06 As we all know, a lot of African-American women have fibroids. 00:12:48:19 - 00:12:51:19 Fibroids can then sometimes turn into cancer. 00:12:52:04 - 00:12:55:14 But we can't just assume, oh, I have fibroids, I'm bleeding from the fibroid. 00:12:55:21 - 00:12:58:15 That's not acceptable and it's not okay. 00:12:58:15 - 00:13:01:14 And so it should always be evaluated. 00:13:01:14 - 00:13:05:00 A biopsy is necessary every time a pap 00:13:05:00 - 00:13:09:24 smear, ultrasound, these are all things that even though 00:13:10:14 - 00:13:13:12 pap smear, ultrasound, pelvic exam can help. 00:13:13:12 - 00:13:15:19 You need a biopsy any time period. 00:13:15:19 - 00:13:17:23 Point blank you have abnormal uterine bleeding. 00:13:19:15 - 00:13:22:14 A lot of times again, women come in. 00:13:22:14 - 00:13:23:01 They don't. 00:13:23:01 - 00:13:26:14 They avoid their symptoms until they can become severe, like I said before. 00:13:26:14 - 00:13:31:15 And so what we're trying to push for everyone is every little symptom 00:13:31:15 - 00:13:35:04 is worth being evaluated so we can get that number up 00:13:35:17 - 00:13:40:05 to the stage ones, and not the stage twos and threes. 00:13:40:05 - 00:13:43:05 Of course. 00:13:44:08 - 00:13:46:06 And this is our team. 00:13:46:06 - 00:13:49:16 You see myself there, that's Kelly, that's our, 00:13:49:22 - 00:13:54:11 other nurse practitioner doctor Sawyer and Doctor Wahl are two physicians. 00:13:54:11 - 00:13:56:07 And then Doctor Emma Fields. 00:13:56:07 - 00:13:59:06 She is actually our radiation oncologist 00:13:59:06 - 00:14:04:08 a lot of times, mostly our endometrial and cervical cancer patients end up 00:14:04:08 - 00:14:07:23 with, needing some form of radiation depending on the stage. 00:14:08:07 - 00:14:11:07 I do want to caveat and say that currently 00:14:11:07 - 00:14:14:22 at VCU we have nine trials open 00:14:14:22 - 00:14:19:07 and five of them are endometrial cancer trials. 00:14:20:16 - 00:14:23:20 I can't stress enough that because of medical mistrust 00:14:23:22 - 00:14:27:02 in African-American community, we can name see here now 00:14:27:02 - 00:14:30:02 and name ten different things that have happened over history. 00:14:30:03 - 00:14:32:23 Why we don't trust healthcare. 00:14:32:23 - 00:14:37:05 We don't have enough African-American women in these studies. 00:14:38:04 - 00:14:41:04 And so with that being said, we're not being studied 00:14:41:05 - 00:14:43:16 how we respond to certain treatment. 00:14:43:16 - 00:14:47:08 So we're given these treatments without the proper amount 00:14:47:08 - 00:14:50:11 of attention to our bodies. 00:14:51:10 - 00:14:54:24 So we're just getting drugs that were tested on everyone else and not us. 00:14:54:24 - 00:14:56:08 Maybe 1 or 2. 00:14:56:08 - 00:14:59:09 So we have five studies open 00:14:59:09 - 00:15:02:11 right now, just for intermediate cancer. 00:15:02:11 - 00:15:03:17 And then from what I understand 00:15:03:17 - 00:15:06:17 from our research team, there's one more coming down the pipeline. 00:15:06:21 - 00:15:09:18 So they're really doing their job 00:15:09:18 - 00:15:12:24 on the research side of things to kind of bring it to the forefront. 00:15:12:24 - 00:15:17:07 And, we really work closely with, the guys that we work 00:15:17:07 - 00:15:20:18 with as well to make sure that things aren't being overlooked. 00:15:23:04 - 00:15:25:05 Erika, 00:15:25:05 - 00:15:26:24 I didn't okay, 00:15:26:24 - 00:15:27:19 okay. 00:15:27:19 - 00:15:32:07 These, these ribbons, which most people would probably never see, ever. 00:15:33:01 - 00:15:34:17 The ovarian cancer is the teal. 00:15:34:17 - 00:15:38:04 When uterine is is peach. 00:15:38:10 - 00:15:41:01 And then you have a vulvar which is the light purple. 00:15:41:01 - 00:15:43:23 Vaginal cancer, which is the blue in the cervical cancer 00:15:43:23 - 00:15:45:23 is kind of like a mix of the teal and the white. 00:15:45:23 - 00:15:50:01 What's not pictured here is, if you look at that, 00:15:50:10 - 00:15:53:16 the gynecologic cancer awareness banner at the side, 00:15:53:24 - 00:15:56:24 all dying cancers fall under that darker purple. 00:15:58:01 - 00:16:00:14 And so again, small 00:16:00:14 - 00:16:04:05 but mighty and survivor 00:16:04:05 - 00:16:07:05 actually is an excellent source of information. 00:16:07:09 - 00:16:10:05 If anyone wants to go on that website, 00:16:10:05 - 00:16:13:05 it they can give you information, they can connect you to providers. 00:16:13:07 - 00:16:15:23 It's an amazing source. 00:16:15:23 - 00:16:18:24 To help get awareness out and below 00:16:18:24 - 00:16:21:24 the belt is what we like to say all the time. 00:16:21:24 - 00:16:24:02 Either that or belly button and below. 00:16:24:02 - 00:16:25:22 That's our jurisdiction. 00:16:25:22 - 00:16:29:05 I pray that one day we can have the same report 00:16:29:05 - 00:16:33:20 that Doctor Winn has in regards to prostate cancer for endometrial cancer. 00:16:37:13 - 00:16:39:10 Well, that's all we have. 00:16:39:10 - 00:16:42:10 Unless anyone has questions. 00:16:42:13 - 00:16:45:10 So, Monica and Erica, 00:16:45:10 - 00:16:48:18 thank you so much for this very timely presentation. 00:16:48:22 - 00:16:53:04 Because even though I've been in this cancer sandbox for a while, I did not know 00:16:53:04 - 00:16:57:15 the facts that you were sharing about how endometrial cancer has surpassed, 00:16:58:05 - 00:17:01:05 you know, ovarian cancer. 00:17:02:10 - 00:17:03:11 I have lots of questions. 00:17:03:11 - 00:17:06:11 I know others might have questions as well, but 00:17:06:16 - 00:17:08:22 let's talk a bit about the, 00:17:08:22 - 00:17:12:24 the the slide that you showed between the type one and type two. 00:17:13:11 - 00:17:16:07 Type one is like early detection 00:17:16:07 - 00:17:19:22 of endometrial cancer at you would think that that's when you're type one. 00:17:19:22 - 00:17:22:22 And type two is a further diagnosis at a later stage. 00:17:23:06 - 00:17:27:08 So that could either be stage or type of cancer. 00:17:27:08 - 00:17:32:03 So there's different like high grade and low grade cancer types. 00:17:32:14 - 00:17:38:06 And so most of the time the type two are the higher grade cancers, 00:17:39:14 - 00:17:42:15 whereas the lower grade or the type ones are more aggressive 00:17:42:15 - 00:17:45:12 meaning they're more aggressive, meaning they could spread faster. 00:17:45:12 - 00:17:48:08 Is that what you mean? Exactly. 00:17:48:08 - 00:17:51:16 More aggressive, spread faster, more silent until they're not. 00:17:52:23 - 00:17:53:07 Okay. 00:17:53:07 - 00:17:56:07 Well, I tell you, during the course of this conversation, 00:17:57:22 - 00:18:00:11 even though, again, I've been in this cancer 00:18:00:11 - 00:18:03:18 sandbox for a while, I start to feel uncomfortable. 00:18:03:18 - 00:18:04:11 Right? 00:18:04:11 - 00:18:07:13 People don't feel comfortable when they're talking about the lady bits 00:18:07:13 - 00:18:10:23 or below the belt, or whatever you want to call it, because that's 00:18:10:23 - 00:18:14:22 considered like an intensely private right? 00:18:16:01 - 00:18:18:06 How can we get people 00:18:18:06 - 00:18:22:11 over themselves into thinking that guess what? 00:18:22:11 - 00:18:26:16 If there's anything that looks any way, any way, shape or form 00:18:26:19 - 00:18:31:08 out of the ordinary, I need to go see about myself, 00:18:31:09 - 00:18:37:02 or I'd encourage my girlfriend or my mother or my cousin to do this. 00:18:37:02 - 00:18:37:20 These things. 00:18:39:21 - 00:18:40:22 So I will 00:18:40:22 - 00:18:44:10 tell you that coming out the gate, I am very 00:18:45:06 - 00:18:49:08 I'm known for being very open and honest about genitalia, just because it's 00:18:49:15 - 00:18:52:15 if we can talk about our elbow, we can talk about our genitalia. 00:18:52:15 - 00:18:56:03 So when I talk with my patients, 00:18:56:03 - 00:19:01:05 a lot of them are actually taken aback about how open I am about their genitalia. 00:19:01:10 - 00:19:04:10 And I think, honestly, in the 00:19:04:17 - 00:19:07:18 as a society as a whole, we just need to be more frank about it 00:19:07:23 - 00:19:09:13 and have those conversations. 00:19:09:13 - 00:19:12:00 Don't shy behind it, because nine times out of ten, 00:19:12:00 - 00:19:14:11 someone else is going through what you're going through, 00:19:14:11 - 00:19:16:11 and unless you open up and talk about it, 00:19:16:11 - 00:19:19:06 no one else is going to talk about it either. 00:19:19:06 - 00:19:21:22 You know, I did have one question. 00:19:21:22 - 00:19:25:22 And I know that, in particular for women, 00:19:26:09 - 00:19:31:15 as we were going back over our data and going back over some of the CDC data, 00:19:31:17 - 00:19:35:24 it is absolutely clear that endometrial cancer is certainly on the rise. 00:19:35:24 - 00:19:37:15 The United States. 00:19:37:15 - 00:19:40:23 It's interesting that you say that because the treatments 00:19:40:23 - 00:19:44:16 for endometrial cancers are not nearly as readily available as for others. 00:19:45:17 - 00:19:46:05 But as I was 00:19:46:05 - 00:19:50:00 looking on the, and just reviewing here, you know, 00:19:50:00 - 00:19:54:24 colorectal cancer, certainly, remains number three on that list for women. 00:19:54:24 - 00:19:57:03 And, endometrial number four. 00:19:57:03 - 00:20:00:12 And unfortunately, lung cancer is still 00:20:00:12 - 00:20:04:00 one of the leading causes of, you know, leading causes in breast. 00:20:04:16 - 00:20:08:01 But given the fact that endometrial cancer and the context 00:20:08:01 - 00:20:12:01 we talk about screening for endo, I mean, for breast cancer, 00:20:12:20 - 00:20:16:08 screenings that are available for colorectal cancers 00:20:16:08 - 00:20:19:10 and some of even the screenings that are available for lung cancer. 00:20:19:21 - 00:20:23:09 What is the status of screening for endometrial? 00:20:24:03 - 00:20:25:17 There is no screening. 00:20:25:17 - 00:20:28:20 The only one of our cancers that we treat 00:20:28:20 - 00:20:32:11 that actually has a screening is cervical. 00:20:33:00 - 00:20:34:20 Yeah that's so got it. 00:20:34:20 - 00:20:38:19 So it still remains that while lung cancer certainly in breast cancer 00:20:38:19 - 00:20:43:02 and colorectal certainly are still I mean not not the days of 00:20:43:02 - 00:20:46:02 those aren't done and put behind us although getting better. 00:20:46:07 - 00:20:51:18 But the endometrial cancer rise means that if we don't screen it then, 00:20:51:22 - 00:20:56:18 if we don't have any screening available, then, is it just luck? 00:20:58:13 - 00:20:59:04 Right now? 00:20:59:04 - 00:21:02:19 I feel like sometimes it is or really good provider that you're seeing. 00:21:02:19 - 00:21:03:10 Thank you. 00:21:03:10 - 00:21:06:21 We have some amazing genes in this area 00:21:07:01 - 00:21:10:12 that really are focused and catch up very quickly. 00:21:11:22 - 00:21:14:22 But of course, we also serve rural Virginia, 00:21:15:04 - 00:21:18:15 where they're not going or they're going to their primary care 00:21:18:15 - 00:21:21:04 maybe once a year, and they're not doing pelvic exams. 00:21:21:04 - 00:21:26:11 And it's just not cohesively all around being evaluated. 00:21:26:23 - 00:21:29:02 And, and, is there any hope? 00:21:29:02 - 00:21:32:02 You know, we have all these blood tests that we know are, you know, 00:21:32:07 - 00:21:37:05 I mean, they're not miracles either, but, you know, we have the, multi, early 00:21:37:05 - 00:21:40:24 cancer detection stuff and we have all the circulating 00:21:41:00 - 00:21:43:07 tumor stuff that we can get from a blood and tell your cancer. 00:21:43:07 - 00:21:46:01 Is there any of that happening for endometrial? 00:21:46:01 - 00:21:49:23 So for this one I'm going to tap Doctor Jackie Wall. 00:21:49:23 - 00:21:53:19 So she can go a little bit further into that one. Yes. 00:21:53:19 - 00:21:54:15 Great question. 00:21:54:15 - 00:21:55:20 There actually is. 00:21:55:20 - 00:21:59:01 And Monika and Erika have done such a great job talking about 00:21:59:01 - 00:22:00:06 this really important cancer. 00:22:00:06 - 00:22:02:09 So thank you to them for all their time. 00:22:02:09 - 00:22:06:00 But yes, there is you know, this is not real world ready yet, 00:22:06:00 - 00:22:07:17 but it's still in development. 00:22:07:17 - 00:22:10:17 But this has been going on for several years where there's actually 00:22:10:19 - 00:22:16:01 a study going on, that uses a tampon, for women who are going to have, 00:22:16:09 - 00:22:19:21 usually a hysterectomy or some other type of surgery for various 00:22:19:21 - 00:22:23:12 indications can be benign or can be with a known cancer diagnosis, 00:22:23:20 - 00:22:26:19 but they basically have a tampon that's put in before their surgery. 00:22:26:19 - 00:22:29:18 And then the molecular data from that is being analyzed to see 00:22:29:18 - 00:22:33:13 if that is going to be able to be used for some sort of a screening test 00:22:33:15 - 00:22:36:07 in the future. So still has a lot to come for that. 00:22:36:07 - 00:22:41:10 But that's a multi institution study that's been going on for several years 00:22:41:10 - 00:22:44:08 at many different sites. So very promising. 00:22:44:08 - 00:22:45:08 But you're completely right. 00:22:45:08 - 00:22:48:08 You know, this is a cancer that's more and more common. 00:22:48:10 - 00:22:52:14 Some women are lucky and have symptoms, they may have abnormal bleeding 00:22:52:14 - 00:22:53:21 after menopause 00:22:53:21 - 00:22:56:03 or abnormal vaginal discharge after menopause, 00:22:56:03 - 00:22:57:20 which prompts them to visit their doctor. 00:22:57:20 - 00:22:59:06 But not everyone does. 00:22:59:06 - 00:23:04:07 And so really working on getting better screening is going to be really important 00:23:04:07 - 00:23:07:18 to reduce the increase in the deadliness of this cancer. 00:23:08:13 - 00:23:11:23 And last question I have, we used to say that rectal cancer, 00:23:12:04 - 00:23:16:01 for example, when you got rectal cancer, it was 100% surgeries. 00:23:16:01 - 00:23:19:12 And then we moved away from that because we had advancement with medicines. 00:23:20:01 - 00:23:23:22 If someone has endometrial cancers, what are the new advancements? 00:23:23:22 - 00:23:24:18 So are one. 00:23:24:18 - 00:23:29:14 Are there really just available therapies out there or is it still the old school? 00:23:29:23 - 00:23:34:00 You know that if we can't cut it out there, but that we can do for you. 00:23:35:09 - 00:23:36:04 That's a great question. 00:23:36:04 - 00:23:41:01 The mainstay of most treatment for most uterine cancer remains surgery. 00:23:41:09 - 00:23:45:17 It's curative for women often who are diagnosed with stage one disease. 00:23:45:17 - 00:23:47:05 And again, those are going to be the women 00:23:47:05 - 00:23:50:07 who have an obvious symptom, usually bleeding or discharge. 00:23:51:06 - 00:23:54:02 As Monika and Erika alluded to, there are 00:23:54:02 - 00:23:58:22 there's an increased rise in these more aggressive histologic types 00:23:58:22 - 00:24:03:06 of serous uterine cancer, for example, these are sometimes diagnosed 00:24:03:06 - 00:24:06:15 when they've already metastasized or spread out of the uterus. 00:24:06:15 - 00:24:10:11 So patients may have disease in some instances in their lungs, 00:24:10:11 - 00:24:11:15 in their chest rarely. 00:24:11:15 - 00:24:15:23 And their liver, and for these patients, we actually treat them a little bit more 00:24:15:23 - 00:24:19:24 like ovarian cancer, because the cancer can behave more that way. 00:24:20:14 - 00:24:23:00 So if they have spread of the disease outside of the uterus 00:24:23:00 - 00:24:27:03 at the time of diagnosis, we actually usually administer chemotherapy first. 00:24:27:13 - 00:24:30:08 But then we would still recommend a hysterectomy. 00:24:30:08 - 00:24:34:20 After receiving several chemotherapy treatments as the gold standard, 00:24:34:21 - 00:24:39:07 usually followed by more, chemotherapy later. 00:24:39:08 - 00:24:40:18 There be, 00:24:40:18 - 00:24:45:10 I think, you know, very rare instances in which surgery is not an option. 00:24:45:15 - 00:24:47:16 But those would be really patient specific. 00:24:47:16 - 00:24:48:15 So for the vast 00:24:48:15 - 00:24:52:07 majority of patients having surgery is still at the forefront of their care. 00:24:52:18 - 00:24:53:02 Thank you. 00:24:53:02 - 00:24:55:22 So we're back to trying to catch it early. 00:24:55:22 - 00:24:56:07 That's right. 00:24:57:12 - 00:24:58:11 And and 00:24:58:11 - 00:25:02:01 to that point again Doctor Winn and Doctor Wall see we have surprise 00:25:02:01 - 00:25:05:09 guest that just pop on from time to all these experts. 00:25:06:18 - 00:25:09:04 Thank you for underscoring the fact that screening is not where it needs 00:25:09:04 - 00:25:14:06 to be right now for us to figure out who's likely to have endometrial cancer. 00:25:14:22 - 00:25:19:18 But let's talk a minute or two about premenopausal women, right? 00:25:20:07 - 00:25:22:13 Yeah. Again, there are a lot of them on this call. 00:25:22:13 - 00:25:26:04 There are a lot of men on this call who love women, and they understand that 00:25:26:16 - 00:25:31:18 everybody's sort of menstrual cycle and what they experience is kind of different. 00:25:31:21 - 00:25:32:07 Right? 00:25:32:07 - 00:25:35:23 So for some women all their lives, they might have like, yeah, 00:25:35:23 - 00:25:38:17 I feel like we're all adults have bled a lot. Right. 00:25:38:17 - 00:25:42:03 And then there are others who, you know, have, you know, certain 00:25:42:18 - 00:25:45:04 idiosyncrasies with respect to their menstruation. 00:25:45:04 - 00:25:48:10 I think it becomes increasingly difficult for people to sort of 00:25:48:10 - 00:25:50:03 make that assessment. 00:25:50:03 - 00:25:51:09 What is too much? 00:25:51:09 - 00:25:54:09 What is problematic? What is abnormal? 00:25:54:15 - 00:25:56:14 Do you have any suggestions? 00:25:56:14 - 00:26:01:00 Again, I get for postmenopausal women, there might be some, you know, 00:26:02:00 - 00:26:03:21 red lights that are going off. 00:26:03:21 - 00:26:07:08 But for the menopause, women, what should they be looking for? 00:26:08:04 - 00:26:11:22 No. That's so important, to bring up and actually really timely 00:26:11:22 - 00:26:15:23 because there really is in recent years, there's an increasing incidence 00:26:15:23 - 00:26:16:19 of uterine cancer. 00:26:16:19 - 00:26:20:01 And endometrial cancer in younger premenopausal women. 00:26:20:05 - 00:26:24:22 So kind of one thing of like what you said to be attention to is, 00:26:25:08 - 00:26:29:15 you know, being in your at own advocate for when you notice something 00:26:29:15 - 00:26:33:15 that seems unusual about your body or you're bleeding your cycle, 00:26:34:03 - 00:26:37:21 go to your doctor, talk to your friends, talk to your family, get advice. 00:26:37:21 - 00:26:40:02 But really, it's important, you know, to seek medical care. 00:26:40:02 - 00:26:43:11 And if you don't feel comfortable, continue to be your own advocate. 00:26:43:11 - 00:26:45:06 You know if you know something is not right, 00:26:45:06 - 00:26:48:00 please don't take no you know as the answer. 00:26:48:00 - 00:26:51:13 There are certain risk factors that are important and especially, 00:26:51:13 - 00:26:55:22 you know, for in both premenopausal and postmenopausal women for uterine cancer, 00:26:56:08 - 00:26:59:09 we know that some of these are, you know, can be hereditary. 00:26:59:10 - 00:27:02:22 There's a small subset of uterine cancers, where you inherit a gene 00:27:02:22 - 00:27:06:10 from your parents that may make you more likely to develop a cancer of the uterus. 00:27:06:10 - 00:27:08:16 So, again, important for premenopausal women. 00:27:09:21 - 00:27:12:09 And other thing is, you know, there's a syndrome 00:27:12:09 - 00:27:15:11 that a lot of people know about, but many don't called PCOS 00:27:15:11 - 00:27:19:00 or polycystic ovarian cancer or polycystic ovarian syndrome. 00:27:19:00 - 00:27:19:15 Excuse me. 00:27:19:15 - 00:27:21:21 This is really common in women. 00:27:21:21 - 00:27:23:22 It can cause irregular cycles. 00:27:23:22 - 00:27:28:13 It's, associated with weight gain, and some other hormonal changes. 00:27:28:13 - 00:27:31:08 But that is a risk factor for endometrial cancer as well. 00:27:31:08 - 00:27:33:09 So if you're not sure if you have that, 00:27:33:09 - 00:27:35:06 that's important to talk to your doctor about. 00:27:35:06 - 00:27:41:05 There are some associations with diet and lifestyle, obesity 00:27:41:05 - 00:27:44:21 and having increased weight is a risk factor 00:27:44:21 - 00:27:48:16 for endometrial cancer as well, particularly in premenopausal women. 00:27:49:06 - 00:27:51:20 That's because of the way that the fat tissue in your body 00:27:51:20 - 00:27:56:10 can actually stimulate the lining of the uterus to grow without regulation. 00:27:56:11 - 00:27:58:11 Because of the way that hormones 00:27:58:11 - 00:28:01:21 are kind of metabolized and processed in the fat tissues of your body. 00:28:02:06 - 00:28:05:19 And so that's important in those things all kind of combine 00:28:05:19 - 00:28:07:19 that if you notice changes with your cycles 00:28:07:19 - 00:28:11:22 or any other of your, gynecologic kind of complaints or 00:28:13:10 - 00:28:16:18 function, it's just important to talk to your health care providers about, 00:28:16:22 - 00:28:20:17 to, you know, make sure that you can be treated in a timely fashion. 00:28:21:23 - 00:28:25:04 I also want to piggyback on that and encourage 00:28:25:23 - 00:28:28:12 women to actually communicate with other women, 00:28:28:12 - 00:28:34:01 because maybe heavy long periods is your norm, right? 00:28:34:01 - 00:28:35:24 So you don't know what's abnormal. 00:28:35:24 - 00:28:40:04 And so sometimes just being more transparent 00:28:40:04 - 00:28:44:14 and being more open about what's going on with you can help you realize, hey, 00:28:44:14 - 00:28:49:11 maybe this isn't right and your heavy is not someone else's heavy. 00:28:49:22 - 00:28:52:22 And so yeah, that's another thing to discuss. 00:28:52:23 - 00:28:56:00 You know, when you go to the guy and they ask you, are you experiencing 00:28:56:00 - 00:28:59:00 heavy bleeding? Well, what's heavy. 00:28:59:07 - 00:29:01:11 And I think we as guy. 00:29:01:11 - 00:29:01:22 Well do you want. 00:29:01:22 - 00:29:07:03 And colleges and and it needs to be more quantified a pad count tampon count 00:29:07:03 - 00:29:11:21 that would give you much more of an idea of what heavy is versus 00:29:12:10 - 00:29:13:14 are you having heavy bleeding. 00:29:17:16 - 00:29:20:16 The first thing we normally ask people 00:29:20:16 - 00:29:24:24 when when they call in triage is like okay, how many pads are you going 00:29:24:24 - 00:29:29:22 through in an hour or how many tampons have you used in like the last hour? 00:29:29:22 - 00:29:33:10 Because if you're soak in a pad every hour on the hour, 00:29:33:21 - 00:29:37:17 you need to come in faster than you may think. 00:29:38:13 - 00:29:42:18 So a lot of the, people need to feel comfortable 00:29:42:18 - 00:29:47:23 in calling, because a lot of our women, I will say that they're embarrassed by it. 00:29:48:07 - 00:29:51:20 But, you know, it shouldn't be an embarrassment. 00:29:51:20 - 00:29:54:14 It should be. Something's wrong with me. I need help. 00:29:54:14 - 00:29:58:12 And so when they call in and we have to triage them, it's 00:29:59:08 - 00:30:02:22 trying to walk them through the steps and be able to explain 00:30:02:22 - 00:30:05:02 to them and calmly explain to them. 00:30:05:02 - 00:30:06:19 I understand you're scared, 00:30:06:19 - 00:30:11:02 but we're going to have to go through this step in this step and possibly a biopsy. 00:30:11:02 - 00:30:14:22 So sometimes we say that and sometimes we know because sometimes 00:30:14:22 - 00:30:16:23 some people say biopsy and the run in quick. 00:30:17:22 - 00:30:20:14 But more times than not. 00:30:20:14 - 00:30:24:18 But, I think it all goes into the compassion you have for them. 00:30:25:05 - 00:30:29:05 Especially to like, you know, all the providers that are on here 00:30:29:05 - 00:30:33:21 and all of the nurses, you know, you have to approach women 00:30:34:02 - 00:30:38:05 in a different way, because we're built to take care of everybody. 00:30:38:05 - 00:30:41:05 But it's weird when someone asks you, how are you? 00:30:41:06 - 00:30:44:01 So you need to be able to have 00:30:44:01 - 00:30:47:01 that compassion to say, I know you're tired, I know you busy. 00:30:47:12 - 00:30:50:10 And Monique always likes to say our to our patients. 00:30:50:10 - 00:30:53:17 We didn't do all this to you, so you don't, so you don't have to live. 00:30:54:08 - 00:30:58:03 So live and live well and be able 00:30:58:03 - 00:31:01:23 to, you know, come to us with any issues or concerns. 00:31:02:19 - 00:31:06:02 Well, saying is, sometimes I think the one thing that that's kind 00:31:06:02 - 00:31:09:05 of developed throughout this conversation is that we're too easily embarrassed. 00:31:09:09 - 00:31:12:12 First, get a nurse. Right. 00:31:12:19 - 00:31:14:17 We're not that special. 00:31:14:17 - 00:31:15:12 I mean, you're you're unique. 00:31:15:12 - 00:31:18:03 You're God's child, all those things. 00:31:18:03 - 00:31:21:15 But for some, like the, the, the day to day things that we're dealing with, 00:31:22:10 - 00:31:25:10 let's just sort of be more open, more transparent 00:31:25:10 - 00:31:30:00 and take up the mantle of Monika to be guess what? 00:31:30:01 - 00:31:32:20 Just bold about your genitalia, right? 00:31:32:20 - 00:31:33:16 It's very important 00:31:33:16 - 00:31:36:18 that we talk about these things in the church outside of the church. 00:31:36:18 - 00:31:40:14 So with that, thank you to both of you for being here. 00:31:40:14 - 00:31:43:17 And Join us for the next faction Faith Fridays 00:31:43:17 - 00:31:46:18 session on October 17th at 3 p.m. 00:31:46:18 - 00:31:48:10 with Doctor Sheila Brown. 00:31:48:10 - 00:31:50:15 We're going to be talking about, again, 00:31:50:15 - 00:31:54:13 something that makes people uncomfortable, but we need to have these conversations. 00:31:55:00 - 00:31:59:00 It's about intimate partner violence and mental wellness. 00:31:59:09 - 00:32:02:19 The topic is breaking silence, finding strength. 00:32:03:08 - 00:32:06:21 Doctor Brown will talk to us about her work as a mental health professional 00:32:06:21 - 00:32:10:18 and her new book, Healing and Thriving After Domestic Violence 00:32:10:18 - 00:32:12:15 A Practical Guide for Black Women. 00:32:13:14 - 00:32:14:14 Again, 00:32:14:14 - 00:32:17:08 that's a session that you don't want to miss. 00:32:17:08 - 00:32:21:03 Huge thanks for all the people we had on the call today 00:32:21:09 - 00:32:25:07 Monika Brown, Erika Brown, Doctor Jacqlyn 00:32:25:07 - 00:32:28:03 Wall, who just jumped out of nowhere with just all of this. 00:32:28:03 - 00:32:29:19 Just some facts. 00:32:29:19 - 00:32:34:05 Thank you so much for being here, Doctor Winn, for taking time out of your 00:32:34:11 - 00:32:37:24 incredibly hectic saving the world schedule to be with us. 00:32:38:07 - 00:32:42:18 Really appreciate you, and Doctor Whitehead, for for having our opening 00:32:42:18 - 00:32:43:01 prayer. 00:32:43:01 - 00:32:47:08 But, is there anything else before I turn it over to Doctor Ponder 00:32:47:13 - 00:32:50:13 to close this out in prayer? 00:32:51:24 - 00:32:53:15 Wow. We might thank you. 00:32:53:15 - 00:32:56:19 On behalf of Gyn Onc. I guess I'm okay. 00:32:57:01 - 00:33:00:10 I think they're okay when we speak for them and the entire team. 00:33:00:10 - 00:33:02:19 Thank you very much for having us. 00:33:02:19 - 00:33:03:18 We appreciate it. 00:33:03:18 - 00:33:06:03 And we think this is a wonderful, you know, learning 00:33:06:03 - 00:33:09:03 opportunity for the community and for us to get some outreach. 00:33:09:09 - 00:33:13:06 My, my church likes to say, from the neighborhood to the nation. 00:33:13:06 - 00:33:15:01 So this is wonderful. 00:33:15:01 - 00:33:17:20 But yes. 00:33:17:20 - 00:33:20:20 So, we appreciate you guys for having us. 00:33:20:20 - 00:33:22:02 And thank you so much. 00:33:22:02 - 00:33:25:18 Just tell your people, don't be afraid to talk about their girl parts. 00:33:27:12 - 00:33:29:07 Erika, 00:33:29:07 - 00:33:32:10 Doctor Wall, we're going to have you back because we need to talk. 00:33:32:10 - 00:33:34:12 For sure. 00:33:34:12 - 00:33:35:01 Yeah. 00:33:35:01 - 00:33:39:09 Get the both of them that you all have talking about our lady bits. 00:33:39:15 - 00:33:41:03 So with that, 00:33:41:03 - 00:33:44:24 doctor, Reverend, Doctor Ponder, could you please close this out in prayer? 00:33:45:06 - 00:33:46:12 Absolutely, absolutely. 00:33:46:12 - 00:33:48:09 Let us pray again to God. 00:33:48:09 - 00:33:52:03 We're so thankful for the scientists who do the research and provide 00:33:52:03 - 00:33:55:15 the information that helps us in our work of faith, 00:33:55:15 - 00:33:59:01 to be instruments of communication and conduits 00:33:59:01 - 00:34:02:07 of information for the communities that we are called to serve. 00:34:02:18 - 00:34:06:18 We're grateful for Doctor Winn and Doctor Brown and Doctor Sutton. 00:34:07:11 - 00:34:10:06 We're grateful for the information that has been shared. 00:34:10:06 - 00:34:11:16 We're thankful for Reverend Rachel. 00:34:11:16 - 00:34:14:09 And in continuing to keep us together. 00:34:14:09 - 00:34:17:22 And now to God, we ask that you would help us as faith communities to 00:34:17:22 - 00:34:22:06 to grab this information, run with it, share with whomever we can 00:34:22:11 - 00:34:25:19 that we might be faithful partners in this great work. 00:34:26:05 - 00:34:29:08 Dismiss us now from this time of sharing, this time of meeting, 00:34:29:08 - 00:34:30:22 but never from your presence. 00:34:30:22 - 00:34:32:23 We offer this prayer in Jesus name. 00:34:32:23 - 00:34:35:08 Amen, Amen, Amen, Amen, Amen. 00:34:35:08 - 00:34:37:11 Reverend doctor, thank you all. Is it that. 00:34:37:11 - 00:34:38:20 Enjoy the weekend. 00:34:38:20 - 00:34:40:00 Thank you!