This week is European Cervical Cancer Awareness. The aim of the week, which takes place from January 24th to 30th, is to raise awareness that cervical cancer is one of the main cancers that affects women.
It particularly affects young women, says Dr Catriona Henchion, medical director of the Irish Family Planning Association.
Many women avoid having a smear test because of the fear of the result, but only about 5 per cent of those who have a smear test will be asked to undergo further tests, says Henchion.
Every woman will hear back, though. This can take up to six weeks, so if you don’t hear back, ring your smear provider, she says.
“In 2014, 95 women were reported as dying from cervical cancer and 71 per cent of those women were aged from 30 to 59,” she says.
And this is why screening is so important, she says, because, unlike breast cancer, cervical screening involves detecting cancer before it happens.
“When you do breast screening, you are detecting cancer. With cervical smears, you can change natural history and by intervening early, you can stop a person developing cancer.”
In only 5 per cent of screening cases, cell changes will be detected. “The changes that show up are all pre-cancerous and although they can be high or low grade, it does not mean you actually have cancer. “If it’s high grade, you will be referred on for a colposcopy [an examination that is carried out in the same way as a smear test],” Henchion explains.
The National Cancer Screening Service tries to get every woman’s name and address to write to them and invite them for a free cervical smear, women should register with their GP or family planning clinic if they do not get a call.
“This is a condition that doesn’t always show symptoms, so that is why we have a screening programme and work on pre-cancerous detection,” says Henchion.
For some women, embarrassment puts them off going to their GP. But Henchion’s advice is not to be embarrassed. The person doing your smear will be highly skilled and used to doing the procedure. And it may be uncomfortable, but it shouldn’t hurt, she says.
“It is best to detect it before it has developed, or in the early stages before it has really developed. It is all about prevention, about preventing women from getting this disease.”
We spoke to three women who have benefitted from cervical screening and these are their stories.
Katie O’Brien (28), Dublin
‘I just didn’t expect to have cancer’
Katie O’Brien has a story to tell. But it is not a sad one. She insists it is not a sad one.
Yes, she had cancer. Yes, she has had to visit hospitals and doctors. Yes, she has had many tests and some procedures. But she has recovered and, yes, her life goes on – very happily, thank you very much.
Three-month-old Olivia is gurgling in the background and Katie couldn’t be happier, she says. “I was 25 when I went for a routine smear test. I got a letter in the post, so in November 2013 I went to my GP for a smear.” It was routine. O’Brien thought no more about it.
“After a few weeks, they called to tell me it was ‘abnormal’ and I should go to Holles Street for a colposcopy. There, they took more tissue from her cervix.
“I was away on holiday and I got a call to come back in to the hospital. They had found a tumour and they told me it was cervical cancer.” She was shocked. “After that I went for an MRI scan to find out the size of the tumour.”
O’Brien didn’t need to have a hysterectomy. She didn’t need chemotherapy or radiotherapy “because I had caught it in time”. The only reason she caught it in time was because of the smear test, she says.
“I just didn’t expect to have cancer. I just didn’t. From there I had a cone biopsy to take the cancer out of the cervix.
“They did that in December and I had Christmas to recuperate before they removed some of my lymph nodes from my groin in February. That was a more precautionary thing.”
O’Brien cannot recommend enough that women go for their regular cervical smear test. She is the living proof that early detection works, she says.
“They have told me I am now cancer free,” she says. “I have to go back every six months for the next five years to be checked over, but that is a routine I am happy to participate in.”
Baby Olivia arrived three months ago on September 28th and “she is perfect”, her proud mother says.
“I got such a scare, though, that I was worried that I wouldn’t be able to have children.” Katie conceived naturally but “I can’t give birth naturally, that is the downside, so I had to have a Caesarean.”
Is O’Brien going to have any more children? Quite rightly, she tells me that she gave birth only four months ago, so she hasn’t even thought of that yet. Fair point. It looks like everything is well and truly back to normal, then.
Carla Duggan (40), Galway
‘I was scared, but at the same time it was all rather surreal’
Carla Duggan was diagnosed with cervical cancer in June 2015.
“I had a hysterectomy in August and have now had the all-clear. Of course, I will need regular check-ups for the next five years, starting with one every six months or so,” she adds. Duggan says she “was lucky that the hysterectomy got everything and that is enough”. The cancer had not spread to her lymph nodes, which was a relief, she says.
Like O’Brien, Duggan “found out just through having my regular cervical smear,” which she had in February 2015.
“I have always gone for regular smear tests – always – and they were all normal up until the last one,” she says. “I got a call about six weeks after I had had it done in my doctor’s surgery. The nurse told me that the results had come back and they indicated a ‘severe abnormality’.”
Duggan was sent to University Hospital Galway for a colposcopy. "I got a call about eight weeks after that. They asked me to come back in."
She took her husband with her and she was glad she did. “I was glad he was there when they told me that it was cancer. I was scared, but at the same time it was all rather surreal. It was really weird. I kept thinking: is this really happening?”
It was the Cancer Care West leaflets that she noticed in the doctor’s hand that really scared her. Treatment moved quickly, “so it kept me going”.
The fact that Duggan felt just fine made everything stranger.
She had a hysterectomy at the end of August and she is almost back to her old self now although it has taken her a while to recover, she says.
Duggan has only this to say: “Go for your smear. I used to say that I was lucky. I was caught early, but it wasn’t luck, it was down to the smear.”
Duggan says she doesn’t need to undergo chemotherapy or radiotherapy and that is because it was picked up early and treated swiftly. “All my friends have gone for smear tests now,” she says.
“You can forget about it. You can forget that the letter has come through your door. Also for a lot of people a smear is an uncomfortable process so they put it off. You may be daunted or embarrassed by it, but it is worth it.”
Theresa Hade (61), Dublin
‘After having my 10 children, I didn’t want a smear test’
Theresa Hade from Rathfarnham in Dublin had been having pains in her lower back. They were bad enough to persuade the Dublin mother and grandmother to see her GP.
He referred her to Holles Street and within a week she was attending an appointment in the hospital accompanied by a son and daughter.
Hade has given birth to 10 children. She now has 10 grandchildren and one great grandchild as well, so she was well used to doctors making their presence felt in her most intimate of places.
She was also tired of gynaecological intervention and had declined the offer of a cervical smear on more than one occasion. That was a big mistake, she says.
“I would definitely tell any woman never to miss a smear test. Always go and get checked up.
“After having all my children I didn’t want to get checked up, but if I had gone for my smear tests, this would never have happened.” What happened was to consume Hade’s life – from her diagnosis with cervical cancer at the age of 54 in 2009 to her discharge from St Luke’s in Rathgar with the all-clear just before last Christmas.
She was glad she had her family with her when the doctor at Holles Street told her that the lump in her stomach she had felt, but ignored, was cervical cancer. Everything was happening very quickly.
“I thought that maybe I just needed a hysterectomy; being told you have cancer is a different matter. You jump to the conclusion that that is it. It was such a shock. Anyone who has ever been told that they have cancer will tell you that.
“The hospital staff took me aside and explained that having cancer didn’t necessarily mean dying and that I stood a good chance, but I don’t know how much of that I heard.”
She was booked into St Vincent’s hospital, where she had one ovary, her cervix and both Fallopian tubes removed. After that Hade had to undergo a regime of chemotherapy and radiotherapy at St Luke’s hospital in Rathgar.
Hade has spent the past five years waiting and hoping to get the all-clear.
It was the best Christmas present she ever got to be told last year that the cancer had gone and probably wasn’t coming back.
Hade is enjoying her grandchildren and great grandchild and she feels “great”. She has a message for all women, though.
“Definitely never miss a smear. Always go. Always. I wish I had and then I wouldn’t have had to go through what I went through because they could have caught it much earlier and nipped it in the bud.”