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Uterine Cancer is the most common gynecologic cancer in the United States. About 65,950 new cases of uterine cancer are diagnosed in the United States each year. The incidence and  the mortality rate have been increasing since 2007. This rise in uterine cancer rates is attributed to the rise of obesity. Obesity is the leading risk factor for uterine cancer. It is most commonly diagnosed between the ages of 55 and 64.There are 2 main categories of uterine cancer. 97percent are endometrial cancers ( a cancer that forms in the lining, also called the endometrium ,of the uterus) and 3 percent are sarcomas. This article concentrates on  the more common endometrial cancer.

Risk factors for the development of uterine cancer are influenced by hormones. Starting menstruation before the age of 12, never having a pregnancy or giving birth  for the first time after the age of 30, and late menopause all expose the body to estrogen for a longer period of time and raise the risk for uterine cancer development. Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC) is an inherited disorder that can be passed from parent to child and is associated with  a genetic predisposition to different cancer types including uterine cancer.  Women who are positive for BRCA1 gene mutation  are at a higher risk for uterine cancer.The use of Tamoxifen for breast cancer patient treatment has about a 1 in 500 risk , obesity (a BMI >30) and increasing age are all risks. Diabetes, chronic anovulation  ( having four or less menstrual periods in a year before starting perimenopause), PCOS, and estrogen replacement therapy after menopause given without adequate progesterone,and diets such as a high glycemic index diet, high saturated fat intake, proinflammatory diets and high meat consumption are all risks for uterine cancer formation. A family history of uterine cancer increases the risk in 1st degree relatives.

Alcohol intake has no known risk for uterine cancer. Postmenopausal women who smoke cigarettes have a decreased risk of developing uterine cancer (although cigarettes contribute to formation of other cancers).The use of aspirin has been shown to decrease the risk of uterine cancer particularly in obese women.  Pregnancy is protective, as is the use of contraceptives like progesterone containing IUDs and the use of oral contraceptive pills ( the longer you take the pill in your lifetime the greater the benefit with 4 years of pill taking cutting the risk of uterine cancer in half) . Tubal sterilization decreases the risk as well as maintaining a healthy weight and being physically active.

Common symptoms of uterine cancer are postmenopausal bleeding, bleeding between menstrual periods, and pelvic pain or pelvic pressure. There is no screening test for uterine cancer. Consult a gynecologist if you are experiencing any of these symptoms.

The diagnosis of uterine cancer occurs with a physical exam, pelvic ultrasound and a biopsy of the uterus ( endometrial biopsy).

Uterine cancer is treated in a number of different ways including surgery, chemotherapy, and radiation.


31/Jul/2022

Everyone has heard of the “Morning-After Pill,” but there are actually a few options to prevent an unplanned pregnancy following unprotected intercourse or a contraception failure.

  • PlanB One-Step is the most widely used pill. It delays ovulation which prevents sperm from coming into contact with an egg. It is not an abortion pill and will not affect an established pregnancy. It can be taken up to 5 days after intercourse, but should be taken as soon as possible. PlanB, if taken within 5 days, is 95% effective in preventing pregnancy. Plan B works best in women under 165 pounds. It can be purchased over-the-counter without a prescription but some insurance plans do cover it. We can send a prescription to your pharmacy without an appointment. Send a message through the Patient Portal if you require a prescription. You may experience some unexpected bleeding after taking PlanB, but that is normal.
  • Ella (ulipristal) is also an emergency contraception pill that can be taken up to 5 days after unprotected intercourse and has the added benefit of making it more difficult for an egg to attach to the uterine wall. It is more effective than Plan B if you have to take it days 3-5 after unprotected intercourse and works better in women over 165 pounds. It is only available by prescription, which we can write without an appointment. Send a message through the Patient Portal if you require a prescription. You may experience some unexpected bleeding after taking Ella, but that is normal.
  • The most effective form of emergency contraception is to insert the copper IUD (Paragard) within 5 days of unprotected intercourse. This has the added benefit of providing birth control for up to 10 years. The Paragard IUD requires approval from your insurance so contact them right away if this is the emergency contraception you desire.

All of these methods are safe and have been approved by the FDA. None of the emergency contraception options affect future fertility or the ability to carry a healthy pregnancy in the future.

*PlanB and Ella are less effective in women taking Tegretol and Topamax. Contact our office right away to discuss the Paragard should you need emergency contraception and are taking these medications.



If you’re one of the 50 million Americans who suffers from allergies, your symptoms may bloom when the seasons shift. Itchy, watery eyes, a tickly throat, and a stuffy, runny nose can make you dread spring. Seasonal allergies — also called hay fever and allergic rhinitis — can make you miserable. Try these simple strategies to keep seasonal allergies under control.

Reduce your exposure to allergy triggers

To reduce your exposure to the things that trigger your allergy signs and symptoms (allergens):

  • Stay indoors on dry, windy days. The best time to go outside is after a good rain, which helps clear pollen from the air.
  • Delegate sweeping, weed pulling and other outdoor chores that stir up allergens.
  • Remove clothes you’ve worn outside and shower to rinse pollen from your skin and hair.
  • Wear a mask if you do outside chores.

Take extra steps when pollen counts are high

Seasonal allergy signs and symptoms can flare up when there’s a lot of pollen in the air. These steps can help you reduce your exposure:

  • Check for pollen forecasts and current pollen levels at pollen.com
  • If high pollen counts are forecasted, start taking allergy medications before your symptoms start.
  • Close doors and windows at night or any other time when pollen counts are high.
  • Avoid outdoor activity in the early morning when pollen counts are highest.

Keep indoor air clean

There’s no miracle product that can eliminate all allergens from the air in your home, but these suggestions may help:

  • Use the air conditioning in your house and car.
  • If you have forced-air heating or air conditioning in your house, use high-efficiency filters and follow regular maintenance schedules.
  • Keep indoor air dry with a dehumidifier.
  • Use a portable high-efficiency particulate air (HEPA) filter in your bedroom.
  • Clean floors often with a vacuum cleaner that has a HEPA filter.

Try an over-the-counter remedy

Several types of nonprescription medications can help ease allergy symptoms. They include:

  • Nasal sprays. The intranasal corticosteroids, Nasacort, Flonase, and Rhinocort, are the most effective OTC medications for the treatment of nasal allergy symptoms. A downside to them is that they will not work on an as-needed basis. Intranasal corticosteroids take time to work. They may begin to give relief to allergy symptoms after about six to 10 hours, but full relief may not be obtained for three to six weeks with daily use.
  • Oral antihistamines. Antihistamines can help relieve sneezing, itching, a runny nose and watery eyes. Examples of oral antihistamines include loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy).
  • Decongestants. Oral decongestants such as pseudoephedrine (Sudafed, Afrinol, others) can provide temporary relief from nasal stuffiness. Decongestants also come in nasal sprays, such as oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine). Only use nasal decongestants for a few days in a row. Longer-term use of decongestant nasal sprays can actually worsen symptoms (rebound congestion).
  • Combination medications. Some allergy medications combine an antihistamine with a decongestant. Examples include loratadine-pseudoephedrine (Claritin-D) and fexofenadine-pseudoephedrine (Allegra-D).

If these measures don’t work, please schedule an appointment.



Colorectal cancer is cancer of the colon or rectum. This year, more than 145,600 people will be diagnosed with colorectal cancer and more than 51,000 will die of the disease.

With certain types of screening, this cancer can be prevented by removing polyps (grape-like growths on the wall of the intestine) before they become cancerous. Several screening tests detect colorectal cancer early, when it can be more easily and successfully treated.

Colorectal cancer is linked to getting older. However, colorectal cancer in adults younger than 50 is on the rise. Even so, it’s seen more in people age 50 and over.

Other risk factors include having—

  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
  • A personal or family history of colorectal cancer or colorectal polyps.
  • A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lifestyle factors that may contribute to an increased risk of colorectal cancer include—

  • Lack of regular physical activity.
  • A diet low in fruit and vegetables and whole grains.
  • A diet high in red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts).
  • Are overweight or obese, especially for those who carry fat around their waists.
  • Excessive alcohol consumption.
  • Smoking.

Colorectal polyps and colorectal cancer may not cause symptoms, especially at first. Someone could have polyps or colorectal cancer and not know it. That is why getting screened regularly for colorectal cancer is so important.

Symptoms, may include—

  • Blood in or on your stool (bowel movement).
  • Change in bowel movements.
  • Stools that are more narrow than usual.
  • Stomach pain, aches, bloating or cramps that don’t go away.
  • Losing weight for no apparent reason.
  • Feeling tired all the time.
  • Vomiting.

If you have any of these symptoms, talk to your doctor. They may be caused by something other than cancer. The only way to know what is causing them is to see your doctor.

Almost all colorectal cancers begin as precancerous polyps (abnormal growths) in the colon or rectum. Such polyps can be present in the colon for years before invasive cancer develops. They may not cause any symptoms. Colorectal cancer screening can find precancerous polyps so they can be removed before they turn into cancer. In this way, colorectal cancer is prevented.

Screening can also find colorectal cancer early, when there is a greater chance that treatment will be more effective. Start screening at age 45 if you’re at an average risk, but if you have certain risk factors you may need to start screening sooner or get screened more often—talk to your health care professional. Continue screening to age 75 if you are in good health, with a life expectancy of 10 years or more. if you are ages 76-85, talk with your health care professional about whether to continue screening. After age 85, you should not get screened.

Screening Guidelines

Stool DNA Test (sDNA)* Every 3 years
Fecal Immunochemical Test (FIT)* Every year
High-sensitivity Fecal Occult Guaiac Test (gFOBT)* Every year
Colonoscopy Every 10 years
Flexible Sigmoidoscopy Every 5 years
Virtual Colonoscopy* Every 5 years

*Follow up a positive test with a timely colonoscopy.

Research is underway to find out if changes to your diet can reduce your colorectal cancer risk. Researchers are studying the role of diet in preventing colorectal cancer, but much still needs to be understood. Generally, experts encourage eating lots of fruits, vegetables and whole grains and limiting red meat and avoiding processed meat for a healthy diet.


References:

American Cancer Society (ACS). (2019) “Cancer Facts & Figures”

Centers for Disease Control and Prevention (CDC). (2019) “What Are the Risk Factors for Colorectal Cancer?”

Centers for Disease Control and Prevention (CDC). (2019) “What Are the Symptoms of Colorectal Cancer?”  



It’s important to understand how your health plan covers different kinds of drugs so you won’t be surprised by unexpected costs at the pharmacy counter. Where you get your prescriptions filled can also affect how much you pay for drugs.
To get the highest level of prescription drug coverage, be sure the pharmacy you choose is in your plan network and your drugs are covered. Plans vary, so be sure to sign in to your member account to see your plan network and the list of drugs your plan covers.

What prescriptions do health plans cover?

Not all health plans cover the same prescription drugs. Your health plan has a list of all the drugs it covers, called a formulary. If you need a drug your plan doesn’t cover, you will have to pay more — possibly the full price — out of your own pocket.

You may also have to share the cost of some covered drugs with your plan. How much you pay depends on the type of drug and the tier the drug is in.

How to save on prescription drugs:

There’s no question that prescription drugs can be costly even when they’re covered by your health plan. Here’s how you can save money without putting your health at risk:

Start with generic. If your medication is available as a generic, try that first. In Pennsylvania, if a generic exists, the pharmacist will automatically dispense the generic unless “brand necessary or dispense as written” is noted on the prescription.
Check the plan formulary. If your drugs aren’t listed, ask your doctor/nurse practitioner for a similar drug your plan will cover. Formularies can change throughout the year. Be sure you’re looking at the most up-to-date formulary or contact your plan to find out if your medication is covered.
Find a pharmacy in your plan network. You’ll pay more for prescriptions you have filled at pharmacies that are not preferred or in your network. Check with your plan to find an in-network pharmacy near your home or work.
Use a mail order pharmacy for drugs you take on a regular basis. You may be able to save money when you use a mail order pharmacy for medications you take for chronic conditions like high blood pressure or diabetes. Your prescription drugs will be sent directly to you by mail.
Ask for 90-day prescriptions for chronic medications. If you are on a stable dose of a chronic medication, ask for a 90-day supply. Co-pays are often lower for 90-day supplies.
Talk with your doctor/nurse practitioner. If you find it difficult to manage the cost of your prescription drugs, ask about alternative medications that may cost less. We may be able to help with discount cards/ patient programs for brand medications
Take medicine as directed. Taking your drugs only half the time or taking just half the dose to save money can put your health at risk and lead to bigger bills down the road.

Making refills easier

Ask your pharmacist to put your medications on auto-refill and sign up for refill reminders. When your prescription is due for a refill, the pharmacist will automatically process the refill, and you will receive a reminder.

Note:  Prescriptions for non-controlled drugs are generally valid for 1 year after the date it was written. Schedule III and IV controlled substances cannot be filled or refilled more than 5 times or more than 6 months after the date the prescription was issued, whichever occurs first. Schedule II prescriptions (stimulants and narcotics) cannot be refilled.


The United States Congress designated January as Cervical Health Awareness Month. More than 14,000 women in the United States are diagnosed with invasive cervical cancer each year, but the disease is preventable with vaccination and appropriate screening.

During January, NCCC and its many local chapters across the country highlight issues related to cervical cancer, HPV disease and the importance of early detection. While NCCC chapters host events throughout the year, January is a month with a special focus as chapters celebrate Cervical Health Awareness Month and work to spread the word in their communities.

NCCC and the American Sexual Health Association (ASHA) also offer a range of resources (listed below) to educate the public and healthcare providers about cervical health, from fact sheets to episodes of ASHA’s Sex+Health podcast.

What Can You Do?

As someone who is interested in educating and advocating for increased knowledge of cervical cancer and HPV disease, you can do a lot. You can contact your local media to encourage coverage of Cervical Health Awareness Month, offering this ASHA/NCCC press release. You can also send this proclamation to your mayor, or local legislative office to publicly recognize Cervical Health Awareness Month.

You can also check out the resources on this page—download, display and distribute our cervical cancer awareness month posters and help NCCC and ASHA get the word out on social media.

Vaccination

HPV vaccines can help prevent infection from both high risk HPV types that can lead to cervical cancer and low risk types that cause genital warts. The CDC recommends all boys and girls get the HPV vaccine at age 11 or 12 as the vaccine produces a stronger immune response when taken during the preteen years. For this reason, up until age 14, only two doses are the vaccine are required. The vaccine is available for all males and females through age 45 but, for those 15 and older, a full three-dose series is needed.

Testing

A Pap test can find cell changes to the cervix caused by HPV. HPV tests find the virus and help healthcare providers know which women are at highest risk for cervical cancer. Pap and HPV tests (either alone or in combination) are recommended for women over 30: each woman should ask her health care provider how often she should be screened and which tests are right for her.

Take Part in a Clinical Trial

Clinical trials for cervical and other cancers can be of tremendous value but how do you find one that’s right for you? Our page on research studies gets you up to speed and links you to opportunities.

Promote Cervical Health on Social Media

You can help NCCC promote the importance of cervical health and cervical cancer prevention by sharing prevention messages throughout the month that cervical cancer is preventable!

Twitter logo
Faceboom logo
  • January is Cervical Health Awareness Month. Visit NCCC to learn more. Get involved and make a difference! http://ow.ly/MdJb30760xc
  • During Cervical Health Month in January ASHA is offering a free download of the fact sheet Ten Things to Know About HPV. Get yours today. http://ow.ly/VKdY307APzi
  • During Cervical Health Month in January you can download free posters and more from NCCC. For more go to NCCC. Get involved, make a difference! http://ow.ly/jgj730760D4
  • Not one single woman ever needs to die from cervical cancer. We have the tools we need to prevent this disease so let’s use them. Get involved. Make a difference! Visit the National Cervical Cancer Coalition online http://ow.ly/jgj730760D4

Visit this link for downloadable content: https://www.nccc-online.org/cervical-health-awareness-month/



Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.



We are expecting flu vaccines to be available for patients in the office in early September.
As a reminder, the flu vaccine is recommended for everyone 6 months of age and older with rare exceptions. Flu vaccines will be offered to all patients when you come in for routine appointments in the office or you may schedule an appointment. This year we are offering online scheduling during our flu vaccine days which are scheduled for the dates listed below.
You may schedule via the Healow app or portal, by going to our website, or by calling 215-735-7992. Please complete the influenza vaccination questionnaire prior to your appointment.
About the flu vaccine:
  • It takes about 2 weeks for protection to develop after vaccination.
  • There are many flu viruses, and they are always changing. Each year a new flu vaccine is made to protect against the influenza viruses believed to be likely to cause disease in the upcoming flu season.
  • Even when the vaccine doesn’t exactly match these viruses, it may still provide some protection.
  • Influenza vaccine does not cause flu.
  • Influenza vaccine may be given at the same time as other vaccines.
  • Influenza vaccine can be administered at any time during pregnancy.
  • People with minor illnesses, such as a cold, may be vaccinated.
COVID Vaccine and Other Vaccine Administration
You can get a COVID-19 vaccine and other vaccines at the same visit. You no longer need to wait 14 days between vaccinations. Experience with other vaccines has shown that the way our bodies develop protection, known as an immune response, after getting vaccinated and possible side effects of vaccines are generally the same when given alone or with other vaccines.
Walk-In Clinic Dates at RWWC
September 7th, 8AM-12PM
September 10th, 8AM-12PM
September 11th, 9AM-1PM
October 4th, 8AM-12PM


BMI, or body mass index, has long been used as a way to assess body weight in the United States. The federal government uses the calculation to track obesity rates nationwide, and according to this scale, 42.4 percent of American adults age 20 and older are obese, notes the Centers for Disease Control and Prevention (CDC).

Adults can measure their BMI by taking their body weight in pounds, dividing that value by the square of their height in inches, and multiplying the result by 703, or using an online calculator. The numbers are then used to determine weight categories:

  • Below 18.5 is underweight
  • 18.5 to 24.9 is normal
  • 25 to 29.9 is overweight
  • 30 and over is obese

If this formula seems complicated and somewhat arbitrary, that’s because it is.  Body fat percentage, not BMI, is largely responsible for a person’s health. Too high a number can result in obesity related complications, including diabetes, heart disease and increase your risk for many cancers. By relying on a person’s overall weight, BMI may overestimate body fat in athletic, muscular individuals or those with large or tall frames, labeling them as overweight or having obesity when they are not at increased risk. 

However, the reverse is also true, you can have a “normal” BMI but still have a high percentage of body fat—and the associated medical complications. More than half of U.S. adults currently considered to have a normal BMI actually have a high body fat percentage (more than 30 percent fat for women.) 

The way in which fat is distributed in your body has major health implications, yet it’s not taken into account by the BMI calculation. Belly fat, or fat that accumulates around the waistline and abdominal organs, greatly heightens a person’s risk of heart disease, type 2 diabetes, and other obesity-related complications, as well as death. But a person could easily fall into the “normal” BMI category (18.5 to 24.9) and have a waist circumference that puts them in a risk health category.

Individuals with “normal,” or non-obese/non-overweight BMIs, but with a large waist circumference (known as central obesity) are much more likely to die prematurely compared with people who are deemed obese via BMI but don’t have a large circumference. For women, central obesity is defined as a waist circumference greater than 35 inches for women. Waist circumference should be measured at the smallest area of one’s waist, just above the belly button. 

Waist-to-hip ratio can also be used to estimate risk.  This number divides waist circumference by hip circumference (measured around the widest part of your buttocks). Anything below 0.9 is considered healthy. A ratio of 1.0 or above is correlated with a two to three times increased risk of dying. Someone with a larger waist than hips will have a waist-to-hip ratio of 1.0 or above.

Understanding Your Risk: Talk with your healthcare provider to come up with a plan to assess your risk- this may include your BMI, waist circumference, hip measurements, blood pressure and lab results.


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1632 Pine Street
Philadelphia, PA 19103
Phone: 215-735-7992
Fax: 215-735-7991
Email: info@rwwc.com

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Sun: Closed

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