"There are different types of cells: healthy ones, slightly ugly ones.....and then there are the really dodgy-looking kind. As you have stage three pre-cancer, well.....yours are the type you'd cross the road to avoid....."
My GP carried on talking, but, having dropped the C-bomb, all the other words she was saying seemed to be dissolving like sugar in tea. A few seconds passed and I realised I was looking at her lips moving but I wasn't really absorbing what was coming out of them. I made a conscious effort to focus my racing mind. One, two, three.....aaaaaand you're back in the room.
"....So you'll need to go to the hospital for an operation to remove the affected area. They'll perform what's called a Loop Cone Biopsy - you'll get a letter with all the details shortly. Any questions?"
It's very rare for a motormouth like myself to be rendered mute but here I was, aged 24 and uncharacteristically lost for words, muttering a simple "No" before gathering my things and walking back to the flat I shared with my boyfriend Liam, clutching the leaflet she'd given me.
Liam and I had met late in the summer of '98, when I was living in Ibiza and he was on a lads' holiday. We went on our first "date" to Amnesia, danced all night and the rest is history; when he went home at the end of his holiday we kept in touch by phone and post (yes, actual letters!) and were reunited the moment I arrived back in the UK that October. He was from Essex, I'm from Kent, and after a year or so of dating we began renting a little place together in Brentwood and were blissfully happy. The only reason I'd had the smear test that had set off this rollercoaster chain of events was because we'd registered with a new GP after moving home; the accompanying nurse appointment was standard procedure.
In those days, cervical cancer screening was offered to women from the age of 20 every five years. I'd previously had one smear test at 21, which had come back fine, and wasn't due another until I was 26. So it was by pure chance a few years later that I'd had the extra test that had detected these aggressively mutating cells.
The result letter had dropped on the mat: "abnormal."
I'd had a further investigation at hospital via a colposcope (basically a telescope for ladybits) whereby they put iodine on the cells of the cervix, explaining that the bigger the area that changed colour (from black to yellow) with the iodine, the worse it was. The gynaecologist and I peered at the screen as the entire area instantly lit up like a Christmas tree. Oh.
Hence that dreaded follow-up appointment with the GP and then the operation to remove the cells using a hot wire. Had I not moved surgeries and just waited to be called for my next smear, two more years would have passed and they said I'd almost certainly have had full-blown cervical cancer due to the rapid rate of mutation - yet I'd had no symptoms.
Time passed, I was closely monitored with extra smears: every six months at first, then yearly. All clear. Liam and I bought a house, got married, and turned our attention towards starting a family, safe in the knowledge that there would be no repercussions from my earlier treatment. Wrong!
When months turned into years and no double blue lines appeared on the pregnancy stick, more tests revealed that, having had a sizable chunk of my cervix removed, the area was more prone to infection and my fallopian tubes had subsequently been completely damaged by an undiagnosed infection. I wasn't prescribed antibiotics after the treatment as a precaution; I had no symptoms of infection, just as I'd had no symptoms of pre-cancer. I was left infertile.
I had to have a partial hysterectomy during which both fallopian tubes were removed (salpingectomy) and parts of my ovaries (oopherectomy). Attempting pregnancy with damaged tubes can result in potentially fatal ectopic pregnancy. We both took a sabbatical from our jobs and backpacked around the world for 6 months, before throwing ourselves headlong into the IVF process.
The subsequent years of treatment proved fruitless whilst everyone around me effortlessly popped out sprogs at an impressive rate. It was like a baby-making conveyor belt; it made my head spin. My marriage broke down under the strain after fifteen years together and at 37 I was eventually diagnosed with premature menopause as a result of all the treatment and surgeries (approximately fifteen years earlier than is normal) and prescribed HRT, which was a godsend after suffering years of menopause symptoms, and essential when weighing up my age against the considerable health problems associated with not taking it. Even with the hormone replacement therapy, my life expectancy is reduced.
Why am I telling you all this? Who gives a rat's ass about your medical history, I
hear you cry. Because I don't want you, or your friend/sister/daughter to go through what I have.
There are 3 things I feel I have to share with you, and apologies if I'm stating the obvious here:
1. Use condoms to prevent cancer.
At school, we were told to use condoms to avoid pregnancy and STIs. We were NEVER told that unprotected sex causes cancer. Almost everyone will get the HPV virus, certain strains of which cause cervical and other cancers, at some point in their lives - that's how common it is. Even condoms don't guarantee protection, since HPV is also passed on simply through skin-to-skin contact - but they help. Teenage girls are routinely vaccinated against HPV these days, but the injection doesn't provide complete protection, and obviously it's still fairly recent. And what about those young women aged 19-24 who missed out on/declined the vaccine and are still too young for routine testing?
2. Go for your smears, my dears!
These days, women aren't called for their first smear test until they are 25 years old. For many that's too late: a woman may have been sexually active for up to a decade by then, and even then abnormalities can be missed. It's just a human looking at a slide, after all. If you have any concerns or symptoms and are under 25 OR if you're not yet due your routine smear test the doctor will flat-out refuse to do it (I know, I pleaded to have one last year and was declined, despite my history), so pay to have it done privately if you have to, at around £80. At the very least get an HPV test from Superdrug online for less than £50, since almost 100% of cervical cancers are caused by the virus. The test arrives quickly in the post, is easy to perform, and the results are emailed to you just a few days later.
It still amazes me that about 40% of women don't go for their smears. Attendance rates are in continuous decline, with women in the 25-49 age group least likely to attend, despite the fact that cervical cancer is the most common cancer in women under 35. Worryingly, it seems the "Jade Goody effect" is wearing off, as this recent article in The Telegraph highlights. Are you crazy, girls?!
3. Don't ignore symptoms.
I didn't have any, but cervical cancer symptoms include bleeding after sex and/or between periods and severe abdominal pain are the main ones and shouldn't be dismissed.
I hope this post doesn't make me sound all little-miss-preachy-pants, that's not my intention at all. I find most things in life are improved with a generous dose of humour served up with a side order of silliness; I don't really do serious if I can help it.
But since this has been one of the biggest game-changers of my life, I guess it's an issue close to my heart. If it means that even one woman swerves the evil HPV, or goes for a smear test who may not otherwise have bothered, then it's worth the embarrassment of sharing such personal details with you all.
I may have missed out on being a mother, but thanks to the screening I'm lucky enough to be alive to tell the tale.
And that, after all, is what counts.
September is Gynaecological Cancer Awareness Month #KnowYourBody
https://www.jostrust.org.uk (cervical cancer info and support)
http://gynaecancerfund.com/ (gynae cancer info and fundraising)
https://www.daisynetwork.org.uk/ (premature menopause support)
http://gateway-women.com/ (support for childless women)
www.eveappeal.org.uk (all 5 gynae cancers info and support)
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