Content Warning: Cervical Screening and Cancer
There has been a post I’ve wanted to write for a while now, about the importance of maintaining your cervical health. But the time just hasn’t felt right. I’ve missed the point in the story of me, and, well, there are so many things bubbling around in my head, I just haven’t gotten round to it. Fortunately, The Erotic Journal Challenge has given me the strong reminder that I needed. January is Cervical Health Awareness month. And this week is also HPV Prevention Week.
Both of these awareness campaigns are US-based, but that doesn’t mean a woman from the UK can’t jump on her soapbox, does it?
Where to begin?
When I was in the sixth form they started the HPV vaccination program for teenage girls. My memory of this is that the country was split into two. On one side the parents were yelling “how dare you to encourage my 14-year-old daughter to have sex” and on the other, there was relief that something was being done to prevent this ticking time bomb of sexual health. The vaccine was thought to be effective before exposure to HPV. Human Papillomavirus (HPV) is one of the STDs that hadn’t been spoken about when I was at school. The NHS website explains the condition much better than I can, but, essentially, it is a virus that affects your skin. It has no symptoms as such unless you are infected with a strain that causes warts or… cancer.
I’d been with my boyfriend for a year. We’d been having unprotected sex as I was on the pill and he was clean. This was the nail in the coffin of my request to be jabbed. So, I went along with my life. But for all of the parents of youngsters coming to an age where they may be offered this… do it. It won’t encourage promiscuity, but…
I’ve always been careful when it comes to sex, even though I was a slut. Or maybe because of that? I’d haunt the sexual health clinic, for regular checkups as well as free condoms. It encouraged my friends to go too because if I was going it couldn’t be that bad. But HPV was never mentioned as something they could test for. In fact, it still isn’t. On my regular visits, I haven’t been asked if I would like testing for that. Maybe I should ask next time I go? Anyway… Roll on a few years and I met P.
We married, and 5 years later we had our oldest child. I had always been punctual when my smear test invitation arrived. But shortly before I was due to give birth is not the time to take up the offer of a smear test. I was recommended to wait until he was 6 months old to book in, which I did. It wasn’t a worry for me. The nurses were always friendly, and professional. I’d always laugh at the chip-fork style testing “swab” and they would politely agree while cranking the speculum open to get a good view of my cervix. As quickly as they started it was over with, and as usual, I got dressed and went on my merry little way. I knew I’d get a letter within a couple of weeks saying that I was ok and that they would see me in 3 years.
The letter I was expecting arrived just a few days later. And the envelope was thicker than normal. I’d read that they were changing the swab style soon, to a brush that would collect more cells and cause less discomfort. My assumption, as I left for work, was there was a leaflet explaining the changes.
As it happened, there was a leaflet explaining changes inside, as I discovered at my work desk later that morning. Only, the changes didn’t involve the swabbing instrument. They involved the cells removed during my smear. My cells were Cin3. Let me explain what this means. A normal, healthy cervix doesn’t have its cells categorized in any way other than “normal”. But when the cells start to change they are said to be Cervical intraepithelial neoplasia, Cin for short. This is categorized into three levels. Cin1 is the least troublesome. Cin3 is, I discovered, is when two-thirds or more of the cervical swab cells are affected.
And so I went to the hospital, met the consultant, and had some biopsies taken during a colposcopy. They wanted to decide what course of treatment to take, and that would involve seeing how deep the cells went and what they had to work with. If you ever have to go for an appointment like this, try to be brave and look at the screen. (If you’re able to!) I was fascinated by the way everything lit up under inspection, even when the doctor explained that he had painted my cervix in a special solution and it was lighting up where my troubled cells were.
So the biopsies came back and I was invited (?) in for a procedure a few weeks later. This was called the Lletz procedure, and they excise the top layer of your cervix with a metal loop that has a current passing through it. I was happy to have it done under local anaesthetic, the normal way. Unfortunately, I had only ever had one local anaesthetic- an epidural that didn’t work particularly well and needed some massive top-ups! But I had been so out of it on labour pain endorphins I hadn’t remembered.
I don’t think any of us were prepared for the failure of the anesthetic. Any future Lletz procedures will be done under general, but with the help of a well-placed crossword, a high pain threshold, and some deep breathing they were able to complete the process. I got to have a look at the screen again, and he showed me an area the size of a 50p piece. Initial observations looked promising, but they would send everything off to the laboratory for analysis.
The nurse took me to a side room and left me alone to cry (at my request.) My emotional funk took longer to heal than the physical recovery. However, as I nervously opened the hospital letter 4 weeks later I was relieved to see that everything had been removed. I’d need to return every six months for the next five years, but this meant I could keep a watchful eye on any changes before they developed to scary-cin3.
A year later, on two tests, I received a results letter. This time I was all clear of abnormal cells. I was also free from HPV. This, they informed me, has been picked up in the initial biopsies. With the discovery that I no longer had HPV, my risk had significantly reduced and I could return to three-yearly inspections. Unless, of course, I have any changes between times. And since then, I have been fortunate enough to have no abnormalities detected.
I did have some strange discomfort and bleeding two years back. The GP had a look, then referred me back to the clinic. All perfectly healthy, I just have a “friable cervix”, potentially as a result of the procedure all those years ago.
Sadly, both of my children have a friend who has lost their mum to cervical cancer. In the early primary years. One mum “didn’t get round to booking [her] smear” she didn’t think it would happen to her. The other was afraid of attending the clinic. In both cases the family has set up campaigns locally to increase awareness of smear tests; quicker, easier, and less uncomfortable than missing the cells before they become cancerous. It is much harder to treat cancer than it is to remove abnormal cells.
Early last year I discovered a friend, approaching 50, hadn’t had any cervical screening, aside from one smear when her daughter was born 26 years earlier. She had been too embarrassed to have any intimate medical care. And she works for the NHS! If it is hard for someone on the inside, so to speak, then I know that it will be difficult for those with a pre-existing fear of medics. Or maybe there is skepticism over the care they will receive if they do make that appointment.
Cancer Research UK statistics (2015-2017) show around 3152 new cases with 852 deaths after diagnosis. Did you know that 99.8% of these cases are preventable, through regular screening and getting peculiarities checked out immediately? Suddenly it becomes a winnable fight! In fact, as the uptake of the HPV vaccine protects generations of cervix owners the number of new cases and avoidable deaths is predicted to fall.
My course of treatment took less than 8 weeks, from smear to Lletz procedure. It’s been 10 years since the letter telling me to return to 3 yearly screens, and 2 since a quick check-in with the gynecological team again. Had I not booked in for my smear it is unlikely that I would be here now. And as the years go by the procedure seems to get quicker, and less uncomfortable. Especially now they’ve replaced the chip forks with little brushes! So please:
It could well save your life!
Based on what others are reading
Tatyannah King, Apr 10 2020