00;00;00;18 - 00;00;07;11 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00;00;07;14 - 00;00;08;00 Dr. Winn This is, 00;00;08;00 - 00;00;13;20 Dr. Winn Doctor Robert Winn. And welcome to another episode of Real Cancer Talk. 00;00;13;27 - 00;00;30;17 Dr. Winn We have with us, today, two incredible guests from our VCU Massey family today. And we're going to discuss the important topic, and I think timely topic of particularly this month of cervical cancer. As it's cervical cancer awareness month. 00;00;30;19 - 00;01;05;17 Dr. Winn Now, we are joined by doctor, Katherine Tossas, the director of Catchment Area Data Analytics and I think member of the School of Public Health here at VCU. And Dr. Salyer, who is freaking amazing. She's co-director of the gynecological, oncology group, and is leading that effort. And by the way, Chelsea, if you don't mind me sort of saying when you think of next upcoming rockstars within this field, I think of you, but, that's just my two cents. 00;01;05;17 - 00;01;29;14 Dr. Winn That's just my two cents. But I want to let you know today that I am really excited about having the both of you. And as you know, in the context of cervical cancer, we think of cervical cancer as being totally preventable. We, some of us even think of, well, why is there an issue of cervical cancer? Isn't that something that was, a problem back in the 70s, 80s and 90s? 00;01;29;16 - 00;01;41;06 Dr. Winn So I was hoping that both of you, starting with Chelsea and then with Kathy, that both of you can set the stage for. Why should we care about cervical cancer? 00;01;41;09 - 00;02;15;06 Dr. Salyer Absolutely. Absolutely. Thank you, Doctor Winn. I agree completely. There's a lot of misconceptions around cervical cancer. Isn't this something we've gotten rid of? And it's true. This used to be one of the most common cancers in the United States. But it is an ongoing issue worldwide. It remains the fourth most common cancer worldwide. In the US, we've seen significant declines in rates of cervix cancer thanks to uptake in our rates of pap testing, as well as HPV vaccination. 00;02;15;09 - 00;02;25;20 Dr. Salyer But we still haven't completely closed the gap. And there are certainly populations who are much higher risk get cervical cancer that demand our ongoing attention and efforts. 00;02;25;22 - 00;02;43;28 Dr. Winn So, so in that, you know, you know, Chelsea we have a real numbers person with us. I believe, Doctor Tossas, you are what's called a cancer epidemiologist. Those of epidemiology on me to make me wonder why should I worry about this? And why should people worry about cervical cancer? 00;02;44;00 - 00;03;09;20 Dr. Tossas Well, thank you so much, Doctor Winn for the opportunity to be here and for be here alongside Doctor Salyer. For me, as you know, cervical cancer is personal and I'll talk about that in a moment if there's time. But cervical cancer is again, cancer as we know, is many, many diseases. There are five I always say that have a screening available: breast, colon, cervical, prostate. 00;03;09;22 - 00;03;33;08 Dr. Tossas But for example, cervical cancer is the only cancer that's actually considered eradicable. And is considered eradicable because it has an effective vaccine and it has effective screening. We know cervical cancer is in large part over 90% of cervical cancers are caused by the human papilloma virus. And there is a very effective vaccine for human papillomavirus. 00;03;33;08 - 00;03;59;03 Dr. Tossas So in that sense it is preventable. And then we have the papanicolaou which Chelsea mentioned, that is a very effective screening. So again, as the only cancer that we can actually eradicate. So I think that that's what makes it really interesting because a 100, nearly 100% of cases are preventable and 100% of deaths are preventable. It is also a cancer that affects younger women. 00;03;59;11 - 00;04;19;05 Dr. Tossas And we know that women are the gatekeepers of health in our communities, and our societies are very important. So when you lose a mom, a sister, you know, an auntie that has huge repercussions in our community. So it is, though it is not super common. And as Chelsea mentioned, is one of the misconceptions that you know, it's not a thing anymore. 00;04;19;05 - 00;04;23;25 Dr. Tossas It is still a thing. And there's still work to be done in this area. 00;04;23;27 - 00;04;48;17 Dr. Winn So so doctor Salyer, going back to you. You're on the front lines. You see this disease. Can you tell me, the listeners who are listening to this, for example, saying, you know, if you're not really getting your regular checkups. What symptoms or what should you worry about that would give you the warning signs that, uh oh, something may be happening? 00;04;48;17 - 00;04;52;18 Dr. Winn And, and then what should the next steps be? 00;04;52;20 - 00;05;20;23 Dr. Salyer Absolutely. So for cervix cancer, you know, this is a cancer that does present with symptoms and the most common one is bleeding. So any new or abnormal bleeding, you know, and as Doctor Tossas mentioned, this happens in young women. So it can be heavier periods or bleeding in between menstrual cycles. Or another common symptom is bleeding during intercourse. 00;05;20;26 - 00;05;47;12 Dr. Salyer And then for those women who are older, they may be past menopause. So any new postmenopausal bleeding could also be a symptom of cervix cancer. If this disease does unfortunately progress, it can also present with symptoms like pain. So there may be pain in the pelvis or pain when going to the bathroom. Or some patients even have difficulty with eating and drinking. 00;05;47;14 - 00;06;16;17 Dr. Salyer But the big one is bleeding. And one thing I'll say on that note is, you know, a lot of our women of color, they are more likely to have benign conditions like uterine fibroids or adenoma meiosis. So the bleeding may be something that they've actually been managing their whole lives. So often these women will go and tell their doctor that there may be a problem, and they're used to getting dismissed. 00;06;16;19 - 00;06;26;07 Dr. Salyer So, you know, any sort of new or abnormal bleeding is definitely something that should get evaluated. And, you know, I would want all of our patients and women in the community to know that. 00;06;26;10 - 00;06;27;01 Dr. Winn thank you, 00;06;27;05 - 00;06;53;18 Dr. Winn for putting that, in a framework. Because so often I think people say, how do I know I can't detect it? And I think based on what Dr. Tossas said that, wait a minute, it's one of the five preventable cancers. Number two, that it's not true that, that if you're having either, heavy bleeding or something ain’t right, that you should just blow it off. 00;06;53;19 - 00;07;11;05 Dr. Winn So in that context, I was wondering, Dr. Tossas, you mentioned it at the beginning. Can you tell, from your perspective, the personal story, I think your family member or your mom with cervical cancer, how did that manifest and what lessons have you taken away? 00;07;11;08 - 00;07;34;03 Dr. Tossas Absolutely. Thank you for the opportunity to share. I always enjoy, talking about my mom and sharing her story because I think it's so powerful. I was nine years old and present when my mom was finally diagnosed with cervical cancer, and by the time that she was diagnosed, it was a little too advanced. She thankfully survived that. But indeed, what that was all year mentioned is really interesting. 00;07;34;03 - 00;07;57;16 Dr. Tossas My mom had fibroids. She had all kinds of stuff. So the heavier bleeding she was used to, and there's something that she managed. Therefore, she ignored it until she couldn't ignore it anymore. That is exactly what happened. And so as a result, I'm an only child. She, you know, had her treatment and thankfully survived. Certainly she had other cancers later in life. 00;07;57;19 - 00;08;15;16 Dr. Tossas But that really didn't need to happen, especially today. And we see that all the time, particularly us as women of color. We are so good at ignoring our symptoms. So good at just kind of managing pain, okay. Like when you see us, and most women really, you see us and you're like, oh, what what what what happened? 00;08;15;16 - 00;08;35;12 Dr. Tossas You you're missing your arm. You're like, oh, that thing. Don't worry about it. I'll deal with it later. And it is not okay. And not only that, but for example, not only is cervical cancer of course highly preventable, but Dr. Winn, as I'm sure you've mentioned before, and you likely will during this show, the other thing too is that now we have better treatments, right? 00;08;35;13 - 00;08;51;26 Dr. Tossas More advanced treatments that I'm sure Dr. Salyer can talk about, to treat it. So even if you get a do not feel, this is not a death sentence. Cancer does not have to be a death sentence anymore. So this cancer is preventable, eradicable, and also hopefully in the earlier stages as many cancers very treatable. 00;08;51;29 - 00;08;57;27 Dr. Winn on that point and thank you for sharing that with us. I mean, obviously very powerful. 00;08;58;00 - 00;09;02;11 Dr. Winn doctor, Salyer, can you describe for me, 00;09;02;14 - 00;09;03;28 Dr. Winn ideally when, 00;09;04;01 - 00;09;09;13 Dr. Winn you, see someone and you're in the community, you're talking to your patients. 00;09;09;16 - 00;09;33;11 Dr. Winn Is there a type of patients, at the moment, that you wish were paying more attention, and that... Correlate to that, is there a type of patient right now where you don't have to worry about cervical cancer? So if you have a 90 year old, should they worry about cervical cancer? I'm just trying to get the sense of who, of these groups should really be worried about cervical cancer. 00;09;33;13 - 00;09;57;08 Dr. Salyer Absolutely. Thank you. Doctor Winn. You know, as Doctor Tossas pointed out earlier, this is an unfortunately a disease that commonly affects younger women. So and what happens is you have these young women, they may have families, they may have jobs, they may have other stressors in their life that they just don't have the ability to, you know, put themselves first. 00;09;57;11 - 00;10;23;15 Dr. Salyer You know, how often are these young mothers, you know, putting their children, their their parents, their other community members above their own, you know, above prioritizing their own health? You know, and as Doctor Tossas also mentioned, this is something we can screen for. And when it is caught early, it's curable. So absolutely, I'd say all women that are, you know, of, you know, what we say, childbearing age. 00;10;23;15 - 00;10;49;20 Dr. Salyer So 20s up to about age 60, should be getting regular pap and or HPV testing. Every 3 to 5 years, depending on the testing that's being done. So I'd say my highest risk folks are those who haven't had screening at all. So again, you know, there's lots of resources available in our community to get towards pap testing. 00;10;49;22 - 00;11;02;20 Dr. Salyer And my highest risk are people have never had one. So those are the folks that I would really encourage to go get a pap test, check your HPV status. And it's still applicable. Get your vaccination as well. 00;11;02;23 - 00;11;17;00 Dr. Winn So hold on to that last moment because I'm going to come back in the next segment. We're going to end this segment because listen, I want to get to the real truth here. You know Dr. Salyer, does it hurt when I get my pap? I mean, I want to know I think the inquiring minds want to know. 00;11;17;00 - 00;11;19;23 Dr. Winn So this next segment will be come back 00;11;19;26 - 00;11;26;07 Dr. Winn we're going to talk about again, how painful are these procedures. And then I want to talk about, as we come back 00;11;26;07 - 00;11;41;11 Dr. Winn because I know in cancer epidemiology, is it only the women's responsibility for this? So what role do men play? Anyways I will, well, we'll take a break for this first segment of, real cancer talk, and, I'll see you when we come back. 00;11;41;13 - 00;11;48;16 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00;11;48;18 - 00;11;51;22 Dr. Winn Thanks for joining us for this second part of 00;11;51;29 - 00;12;13;26 Dr. Winn Cancer Talk. Today we have two amazing guests with us, Doctor Salyer from, the department of ObGyn and the Division of GynOnc, one of the co-directors, and with us, Doctor Katherine Tossas, who's from the school of public, the School of Public Health, but also, the director here at VCU Massey of our Catchment Area Data Analysis Group. 00;12;13;29 - 00;12;35;21 Dr. Winn They've had a great discussion. If you couldn't join us in, the first session about talking about cervical cancer, and about why one needs to get screened and the importance of that and how it is not only preventable but eradicable. So to that extent, people want to know. Inquiring minds want to know. Women ask me every once in a while how painful is it to get screened? 00;12;35;21 - 00;12;42;09 Dr. Winn So good. Doctor Salyer, could you talk me and walk me through how painful it is to be screened? 00;12;42;11 - 00;13;08;02 Dr. Salyer Absolutely Doctor Winn. Of course, this is never an exam that anyone looks forward to, and rightly so. But I will say we do our very, very best to make it as comfortable for our patients as possible. Truth be told, the most uncomfortable part about it is often the placement of that speculum itself. That's that, you know, duckbill looking device. 00;13;08;07 - 00;13;37;21 Dr. Salyer It allows us to open the vagina so we can fully visualize the cervix, make sure it looks healthy. After that, we usually pass a brush over the cervix, which tests for HPV, as well as cell changes on the surface of the cervix that causes eye cramping sensation. But some women actually don't feel it at all. All in all, this exam takes 30 45 seconds at most. 00;13;37;24 - 00;13;54;27 Dr. Salyer But I always advocate for my patients. I say, hey, you're the boss. If it hurts you tell me to stop and you're fully in control. So there's definitely ways that we can make this quick, get the information we need, and also prioritize our patients comfort and well-being. 00;13;55;00 - 00;14;13;20 Dr. Winn You know what you just told me something. 30 to 45 seconds? Well, listen, I thought you were going to tell me these takes ten minutes, 15-20. Listen, I think that that is encouraging, but but I have one for you, though I've had an inquiring mind that had caught me once. I won't say which grocery store and said, Doctor Winn... 00;14;13;23 - 00;14;27;00 Dr. Winn Doctor Winn, hold on. You guys got the cologuard or whatever it is you can screen fit test so you don't have to have a colonoscopy. Why can't you do the same thing for women in cervical cancer? What is your answer? 00;14;27;02 - 00;14;52;23 Dr. Salyer You know what, Doctor Winn, that's a great question. And unfortunately, we're trying to catch back up to our, colleagues in the GI world. What we're actually learning is that the best way to screen for pre cancers and cancers in the cervix is to test for HPV alone. This is a swab that can be collected from the vagina either by a doctor or even the patient themself. 00;14;52;25 - 00;15;17;10 Dr. Salyer And therefore if we test for HPV we get to skip the speculum and the brush and all that stuff. So it's actually much more comfortable for the patient. But also increases access. It gives our folks that, you know, as we discussed earlier, we've got young mothers, or folks with jobs that, you know, getting to the doctor for this regular testing is just way too difficult. 00;15;17;10 - 00;15;31;07 Dr. Salyer And those are folks who are at higher risk of developing cancer. So, it's not only more comfortable, but lets us reach, those patients who may be at higher risk through self-testing. So we're getting there. We're getting there. 00;15;31;10 - 00;15;50;12 Dr. Winn I may need to come back to you in another episode, another show to talk about that, because I have seen the commercials for all the stuff with the colon, and I've got the song in my head, but I don't see that at all with cervical cancer. So hopefully you can, hopefully bring us even more information in the future. 00;15;50;12 - 00;16;10;20 Dr. Winn So what I heard was it being developed. We are thinking about it. It's out there in the field and over the next year, or at least the next coming days and months and years, we should have more, hopefully, information about it. So maybe becomes as routine is the color guard of the fit test. So I'm excited about that. 00;16;10;25 - 00;16;13;05 Dr. Winn Now I'm going to turn yes. 00;16;13;07 - 00;16;37;12 Dr. Tossas I can I can add they are that actually there is an approved test and approve, you know, self collection kit for home based testing for HPV has been approved since 2024. And I am proud to say that, we here VCU are part of the National Institutes of Health trial that is called the Last Mile. That is actually recruiting women to be able to to test this, like the self collection. 00;16;37;12 - 00;16;48;21 Dr. Tossas I know there's a lot of concern or like, oh my God, am I going to do it right? Is this, you know, what if I do it wrong and I would rather do, you know, by a doctor because I don't know how I'm going to do it. Right. And, you know, right now preliminary studies are showing this is not a thing. 00;16;48;21 - 00;17;15;16 Dr. Tossas It's not a problem. You can do it on your own. It is so much more convenient. Like, that's what Sonya was mentioning. You don't have to now go to the clinician's office and, you know, deal with that uncomfortable speculum. If you just do it in the comfort of your own home. Right now, the setting that we're using to test that is here in the clinic, you come in, we give you a little swab, you go on the bathroom swab, come back and eventually we will have the same thing as, like you mentioned, other tests like the color guard, but other tests for for colorectal cancer. 00;17;15;16 - 00;17;42;20 Dr. Tossas We just mail people what I call the fit cards or the fit kit as well. So it is really exciting. And by the way, you guys, we are, a little late to the game because there are other places like Australia and New Zealand that have been doing this for a while to incredible, magnificent results. So they are truly ahead, in the, in the world in terms of being the first to be more likely to eliminate cervical cancer as a result of. 00;17;42;22 - 00;18;10;02 Dr. Winn This is this is pretty amazing news. And, and just everybody, as we talk about the discipline of science and why science matters, what you just heard is exactly that. We may have something, but it is now in a study. And once the study actually has overwhelming preponderance of evidence that it's positive, it then gets released and scaled to the general public and it goes into practice and stuff. 00;18;10;02 - 00;18;27;08 Dr. Winn So I'm really excited to hear that there is a study going on now and that, maybe is there any information or can they go to a web page or Doctor Salyer or Doctor Tossas, is there anything that you can give any more information that if people wanted to be included in that study, where to go? 00;18;27;10 - 00;18;56;28 Dr. Tossas Sure, Doctor Winn, I can say that folks that are interested in learning more, we can give them our Community Outreach Engagement teams phone number, which is (804) 628-0896. (804) 628-0896, or they can just email us at engageMassey@vcu.edu just one word. engageMassey@vcu.edu. And we can definitely help connect them with a clinical trial. 00;18;56;29 - 00;19;06;05 Dr. Winn Well that's awesome. So Doctor Salyer I got a tough one for you right now. You ready? I I'm hoping you ready. I gave you a little bit of time to prepare. Are you ready? 00;19;06;07 - 00;19;07;09 Dr. Salyer Oh, I'm ready. 00;19;07;11 - 00;19;33;18 Dr. Winn All right. We say we we've talked all this time about how we can prevent it, how we can screen for it. But if you have cervical cancers, what are the new treatments? Are we doing the same treatments that we used to do in the 1960s and 70s, or have things evolved? Are we effective at the treatment? Can you give me a sense of what happens when you get that, sort of message... 00;19;33;22 - 00;19;47;03 Dr. Winn You have the big C-word. Can you give me where the science or where medicine has advanced since the 70s? And how do we treat cervical cancer now differently than we used to do in the 1970s? Or is it the same? 00;19;47;05 - 00;20;19;20 Dr. Salyer Absolutely, Doctor Winn. I mean, you hit the nail on the head. There's been a lot of changes in the way we think about and treat cervix cancer at all stages of the illness. As I mentioned earlier, most patients, about 70%, are diagnosed at an early stage, which we can, where we can achieve cure. The two most common modalities that we use to cure cervix cancer are either surgery, or chemo and radiation therapy. 00;20;19;23 - 00;20;50;26 Dr. Salyer The good news with the surgical aspect is that we're actually moving towards removing these cervix cancers using a minimally invasive approach. So, using robotic surgery where we make small incisions on the belly, we remove the uterus and cervix and we get nice margins around it so that there's a no hopefully no chance of a recurrence. For other folks, who maybe their tumor is slightly larger or surgery just not the right fit. 00;20;50;29 - 00;21;34;13 Dr. Salyer We can also do curative intent radiation, but this is much, much different than the radiation from the 60s and 70s. My colleague Doctor Fields, uses MRI to really map out the location of the cervix and give concentrated focus doses to the tumor itself and avoid the healthy tissue around it. And again, using this modality, she can also achieve cure. For those patients who may have advanced or recurrent disease, which again is a small percentage, we now use targeted therapies and immunotherapy to both treat the cancer itself and also prevent a recurrence. 00;21;34;15 - 00;21;54;18 Dr. Salyer And of course, you know, I can't go on here and not promote our clinical trial program. We also have options in both phase three as well as our phase one program using new novel therapeutics to again improve on standard of care and do everything we can to fight and cure this disease. 00;21;54;21 - 00;22;17;29 Dr. Winn What I love about what you just said, and thank you for that summary. It's wonderful to sort of know that we A, have made progress since the 70s, 80s and 90s. Number two, that the types of therapy that we use now, we're trying to be very focused on making sure that we can do the minimal amount for the maximum effort, so that you can have the, the best life. 00;22;18;02 - 00;22;39;07 Dr. Winn But I do have a question. Most of the cervical cancers we talked about earlier in the earlier segment that this is happening to younger women. What about women that says, well, you know what, I still want to have a baby. Does this mean if I get cervical cancer in my cervix, out my baby days are over? What can you what can you tell me about those women that might be thinking about that? 00;22;39;07 - 00;22;45;14 Dr. Winn Is there an option or no option, or is this still under research or or what do they do? 00;22;45;16 - 00;23;10;11 Dr. Salyer That's a great question, Doctor Winn. And absolutely, fertility is a forefront of our minds and hearts as well as we try to make sure that not only do these women survive, but they live the lives that they want right. So again, this kind of goes back to the importance of getting routine screening so we can catch it early. 00;23;10;14 - 00;23;35;07 Dr. Salyer If we do catch either pre cancers or cancers early, we can actually remove them completely just by removing a portion of the cervix. This is called a leap where a portion of the cervix is removed with a thin wire or something called a cold knife comb in which we use surgery to take that affected piece of the cervix out. 00;23;35;09 - 00;24;09;06 Dr. Salyer If we do these procedures, women can still go on to have healthy term pregnancies. And there's also a chance they may not need any other surgeries or procedures after. So that certainly, you know, one of the most important options, for other folks, we also think about ways to preserve the ovaries, by either moving them out of the field surgically if we need to, or other techniques to protect ovarian function while women are going through their treatments. 00;24;09;08 - 00;24;24;26 Dr. Salyer So we work with, again, GynOnc, radiation oncology as well as our reproductive endocrinology colleagues to ensure that not only do we treat cancers pre cancers, but maintain women's fertility throughout their lives. 00;24;24;28 - 00;24;25;20 Dr. Winn How awesome. 00;24;25;26 - 00;24;39;01 Dr. Winn We're going to wrap up this segment. We're going to come back to our last segment of the show, and I've saved the most controversial part for last. So Doctor Tossas, Doctor Salyer I'm going to when we come back we're going to talk about what's the role of men in this. 00;24;39;01 - 00;24;42;08 Dr. Winn I'm just saying not to cause any problems. 00;24;42;10 - 00;24;45;29 Dr. Salyer We're here for it. 00;24;46;02 - 00;25;00;10 Dr. Winn So, so so we're going to wrap up the second session, second segment of our, Real Cancer Talk and looking forward to having you all back. Stay tuned. Do not touch that dial. We're going to see you for our last part. 00;25;00;12 - 00;25;07;05 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00;25;07;08 - 00;25;28;17 Dr. Winn Welcome back to Real Cancer Talk. And, for those of you who did not understand, don't touch that dial, that’s an anachronism to the past. That's OG. That's old school. But anyway, we are back for the last segment and for the wrap up segment of Real Cancer Talk. And as promised, I want to put out there this concept of, we've talked about this is a woman's disease. 00;25;28;17 - 00;25;53;06 Dr. Winn We talked about all the things that women can do and girls and young, you know, young teens, etc., etc.. Is there any role for this cancer or with men? I mean, for example, what role, if any, do men play in the context of either spreading cervical cancer or not? I'll take either of you who's ever brave enough to take on that first. 00;25;53;09 - 00;26;13;27 Dr. Tossas I mean, I can go ahead and start this is Dr. Tossas. And I think I will start with, well, for me, what is easiest and most relevant, which is vaccination. Right. So HPV vaccination is, is again, we mention is incredibly effective. And it is not just for girls. It is also for boys. 00;26;14;02 - 00;26;38;12 Dr. Tossas And it is incredibly important because the HPV vaccination for boys and for in general, the HPV vaccination not only prevents, cervical cancer screening, we know that HPV is related to actually six different types of cancer. The cervical, but there's also anal and vulva and vaginal and penile and oropharyngeal. So it is incredibly important for everyone to get vaccinated for HPV. 00;26;38;14 - 00;27;02;07 Dr. Tossas And the last piece that I will say is that it's not only for, young boys and girls, the vaccination is actually approved all the way up to 45 years of age. So if you are out there and you're listening to our voices and you are under 45, I hope that you, after this podcast, ask your doctor about the HPV vaccine and if you're a good candidate for it. 00;27;02;09 - 00;27;10;02 Dr. Winn Dr. Salyer, anything to add to that? I know this is controversial because we talk about it's not only a women's issue. Is there anything you want to add? 00;27;10;04 - 00;27;37;02 Dr. Salyer This is a everyone issue. This is a community issue. Right. So one thing I'll add is how do you even get HPV to begin with? Well, we know that it is, sexually transmitted. But I always like to say the caveat. I don't think this is not like a traditional STD in the sense, because this is someone and this is a virus that 80% of us will actually test positive for at some point in our lifetime. 00;27;37;04 - 00;27;43;29 Dr. Salyer So it's not if you have HPV, just assume you have it. If you're a sexually active person, right. 00;27;44;02 - 00;27;48;23 Dr. Winn Doctor Salyer, hold up, say that again. You said what? 00;27;48;26 - 00;27;58;25 Dr. Salyer 80% of people will test positive in their lifetime. That's why vaccination is so important. 00;27;58;27 - 00;28;24;25 Dr. Winn Oh. Wow. Wow. So so tell me this. You know, a woman comes in, she gets. I'm sure you see, lots of couples and lots of people together. Woman gets, diagnosed with cervical cancer. She gets a treatment. What are the support do you think is important outside of just the medicine for, say, a full recovery? 00;28;24;27 - 00;28;50;29 Dr. Salyer Absolutely. You know, whenever I'm taking care of people with cancer, you know, a cancer itself and the treatments are only a small part, right? This really rocks, you know, the foundations of families and communities at the core. So it is really important that, you know, partners, husbands and other family members are a part of the conversation. 00;28;51;02 - 00;29;19;25 Dr. Salyer Right. Because we don't only have to just support the patients through their treatments themselves, but think about things like transportation, access to food, housing, you know, other family members making sure that kids are getting to school and getting, you know, good healthy food. So really, partners and families play a critical role, in caring for our patients as they're undergoing their cancer treatment. 00;29;19;27 - 00;29;47;20 Dr. Winn You know, I want to thank you both. This has been an incredible, I think, an informative sort of segment. And what I really love about you both is that not only the the passion, that commitment, that clearly the expertise, but the sense of humanity that you bring to this disease. And thank you both for reminding us that this is not a single person's problem. 00;29;47;27 - 00;30;16;00 Dr. Winn It's our community. When one person gets cancer, many of the people are affected by that. And and going back to Doctor Tossas’ story about how she was impacted by her mom having. So again, as we fight cancer with this issue, about one team, one fight still rings true. And I want to thank you both for taking the time out of your very busy day and being with me to actually inform our community about really how we can fight, prevent and eradicate cervical cancer. 00;30;16;00 - 00;30;31;03 Dr. Winn So thank you both. And you know, as as we're wrapping up, we're going to say, with both of you guys, y'all like a force to be reckoned with. We're going to go back old disco style. As I said, don't touch the dial. And we'll go back to McFadden and Whitehead and say, ain't no stopping us now, y'all. 00;30;31;06 - 00;30;46;02 Dr. Winn Listen we are going to keep cervical cancer on the run. So again, appreciate you all. This is, segment of our last segment of, or wrap up of Real Cancer Talk. Hopefully you have learned something and you will join us the next time. Take care.