Jo­han­nes­burg ther­a­pist Kate Parker was 24 when she was di­ag­nosed with cer­vi­cal cancer. She is one of the 80% of women car­ry­ing HPV – here’s what you need to know

Marie Claire (South Africa) - - HEALTH REPORT -

‘YOU HAVE CANCER.’ No one ex­pects those words, es­pe­cially at 24. And cer­vi­cal cancer? I ate all the right things, ex­er­cised daily, didn’t smoke, hardly drank, went for all my check­ups – and I’d had only one sex­ual part­ner. I’d even had the Gar­dasil vac­ci­na­tion at specif­i­cally to pre­vent cer­vi­cal cancer, for good­ness sake. Dis­be­lief gave way to cold fear as I joined the dots. A few months ear­lier I’d started hav­ing some ab­nor­mal bleed­ing – spot­ting and heavy bleed­ing mid-cy­cle. I hadn’t thought much of it be­cause the gy­nae check-ups I’d been du­ti­fully go­ing for each year since 18 had al­ways been un­event­ful, and pap smears had come back nor­mal.

The gy­nae him­self was un­con­cerned. He put down my symp­toms to any­thing from a bac­te­rial in­fec­tion to hor­mones, the pill, or al­ler­gies. But none of the med­i­ca­tions he pre­scribed worked, and nei­ther did chang­ing, then stop­ping, my pill. In Fe­bru­ary last year, when I started dat­ing a new boyfriend, I in­sisted on another ap­point­ment to sort things out. When there was a heavy bleed dur­ing the ex­am­i­na­tion, the gy­nae sud­denly re­ferred me to a gy­nae­co­log­i­cal on­col­o­gist. Even then I was un­pre­pared for those words.

Healthy and care­ful me – with cancer? Surely some mis­take! But the biopsy re­vealed stage IB1 ade­no­car­ci­noma of the cervix, a growth al­most 4cm wide. The words ‘hys­terec­tomy’, ‘ra­di­a­tion’, ‘fer­til­ity’ and ‘sur­ro­gacy’ were tossed about, and I bat­tled to take them in. Days be­fore, my big­gest wor­ries had been plan­ning an out t for din­ner with the new boyfriend. Now none of that mat­tered. Would I ever have kids? Would I even have life?

When I told my mom and she started cry­ing, I fell apart. I had con­tracted the ag­gres­sive HPV16 virus that causes most cer­vi­cal cancer. I was an­gry, and afraid – not just of my fu­ture, but of the fact that un­like if this had been breast or other can­cers, peo­ple would judge me. Af­ter all, HPV is a sex­u­ally trans­mit­ted in­fec­tion (STI). Fran­ti­cally re­search­ing it, I learned that 80% of women will have the virus at some point in their lives, passed on by asymp­tomatic sex­ual part­ners. It causes cancer in only some cases.

Why mine? I had to ac­cept that not even top doc­tors knew. HPV is highly con­ta­gious and spreads through skin-to-skin con­tact. But get­ting it doesn’t mean your part­ner is cheat­ing on you, as it can stay dor­mant in the body for many years.

It took time to get my head around it, but I’ve come to ac­cept that it wasn’t my fault – and although I was an­gry at rst, it wasn’t my ex part­ner’s, ei­ther. The only way HPV can be pre­vented is by both par­ties hav­ing no previous sex­ual part­ners at all, or be­ing vac­ci­nated be­fore be­com­ing sex­u­ally ac­tive, even orally. I’d been ex­posed to HPV be­fore hav­ing my shot.

Even us­ing con­doms is not fail-safe, as there is skin con­tact from the un­cov­ered bits. Treat­ments aren’t fail-safe ei­ther, but I was re­lieved to dis­cover that they’re get­ting bet­ter. Within a month I was booked for an op­er­a­tion with one of a hand­ful of gy­nae­co­log­i­cal on­col­o­gists in South Africa who can per­form a spe­cialised, fer­til­ity-sav­ing cer­vi­cal cancer pro­ce­dure I’d never heard of – a tra­ch­elec­tomy.

In­stead of re­mov­ing the uterus (a hys­terec­tomy), the go-to treat­ment in the past, the sur­geon cuts the can­cer­ous cervix o the uterus. And some­times, if the tu­mour is larger (as in my case), she re­moves the cer­vi­cal lig­a­ments, up­per few cen­time­ters of the vag­ina and lymph nodes too, in a ‘rad­i­cal tra­ch­elec­tomy’. But sex is un­af­fected, thank God – and you should still be able to have a kid some day.

How­ever, my doc­tor would only know when I was un­der the knife if the pro­ce­dure would be suc­cess­ful, or if a full hys­terec­tomy would be needed. There was also a -10% chance my lymph glands would be af­fected by the cancer, or the doc­tor might not get all of it out – I might not sur­vive to try for a child.

The op­er­a­tion took four hours and a hip-to-hip cut. I woke to hear it had been suc­cess­ful – but my glands were af­fected. y heart froze as I heard that my right ovary had been moved un­der my ribs in case I needed ra­di­a­tion, which would oth­er­wise make me in­fer­tile. I spent seven nights in hos­pi­tal. Alone, I mostly cried, but vis­its from fam­ily and friends made me de­ter­mined to stay pos­i­tive. As the cancer was in my lymph sys­tem, there was no way of know­ing if or where it had spread. A de­ci­sion was taken not to do ra­di­a­tion, but I needed chemo­ther­apy.

For ve hours at a stretch I would sit in the chemo lounge. A fort­night af­ter my rst ses­sion, my hair be­gan fall­ing out in clumps. I cut it short to make the ex­pe­ri­ence less trau­matic. A week later I shaved it o , be­cause it was fall­ing out so rapidly. Eye­brows and eye­lashes fol­lowed.

y cancer could no longer be hid­den: an in­tensely per­sonal part of me was ex­posed to the world. I got stares and whis­pers, but no one would ask – I’d see them si­lently as­sume. Some days I was ne. thers, tears owed. I ex­pe­ri­enced emo­tions in a way I didn’t think pos­si­ble: sad­ness, fear, hope, love, em­pa­thy and new awe for the frag­ile beauty in life.

I com­pleted my treat­ment in Au­gust 2014, and my PET scan and pap smear came back clear. y hair has grown back and I feel bet­ter than I have in a long time. I am also in a new re­la­tion­ship with a good man who is help­ing me through my jour­ney. I’m still scared for the fu­ture and a life­time of check­ups and uiet worry. But mostly I’m just grate­ful to be alive.

Dur­ing treat­ment, I strug­gled to nd other women go­ing through the same thing, es­pe­cially at my age. So I cre­ated a Face­book com­mu­nity to o er sup­port to those a ected by cer­vi­cal cancer. Ev­ery young woman needs to ed­u­cate her­self about HPV, go for pap smears, and if you’re lucky enough to have chil­dren some day, as I hope to, vac­ci­nate them young – girls, but also boys, who pass on the virus. Be­cause cer­vi­cal cancer is pre­ventable, we just have to take the nec­es­sary steps to keep it that way.


Kate and her part­ner, Ar­jun

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