The test that could save your life

The Peterborough Evening Telegraph - - Fashion -

EM­ME­LINE Collin had no rea­son to think any­thing was wrong when she went for a rou­tine smear test. Al­though she had no symp­toms at all, Em­me­line was di­ag­nosed with cer­vi­cal can­cer – and with­out the smear test, it may have killed her.

Just over a year later, the 33year-old mother-of-one has had surgery to re­move the can­cer, which was caught early enough for her to have an ex­cel­lent chance of a com­plete re­cov­ery.

She’s a prime ex­am­ple of why cer­vi­cal screen­ing can be a life­saver.

Cur­rently, 20 per cent of UK women don’t at­tend cer­vi­cal screen­ing ap­point­ments, putting them­selves at risk of be­com­ing one of the 2,828 UK women ev­ery year who de­velop cer­vi­cal can­cer.

Jo’s Cer­vi­cal Can­cer Trust wants to get the mes­sage across to all women – but par­tic­u­larly those who don’t go for screen­ing – that cer­vi­cal can­cer is largely pre­ventable.

It is es­ti­mated screen­ing saves 4,500 lives a year.

Em­me­line, from Peter­bor­ough, says: “There was no way I knew there was any­thing wrong – I just went for a rou­tine smear as if I was go­ing to buy a pint of milk.

“I had no symp­toms and no wor­ries. If I’d ig­nored the screen­ing let­ter and thought I didn’t need to go be­cause there was noth­ing wrong with me, then good­ness knows what would have hap­pened.

“I had an in­va­sive can­cer grow­ing in­side me that I knew noth­ing about.

“If I hadn’t gone, worst case sce­nario is that I might not be here, or I could have left it so late that I might have had to have much worse treat­ment.”

That treat­ment may have in­volved a hys­terec­tomy or ra­dio­ther­apy, nei­ther of which Em­me­line had to have be­cause her can­cer was caught so early.

In­stead, she had a tra­ch­elec­tomy, a rel­a­tively new treat­ment which is not yet widely avail­able, which pre­serves a woman’s fer­til­ity.

The surgery, which can be per­formed on some women who have very early in­va­sive cer­vi­cal can­cer, in­volves re­mov­ing the cervix and the lymph glands in the pelvic area, but leav­ing the womb in place.

“I’ve been left with the op­por­tu­nity of hav­ing an­other child,” says Em­me­line, “which I would have lost if I didn’t go for the screen­ing.”

Cer­vi­cal can­cer and the im­por­tance of screen­ing was brought to the pub­lic’s at­ten­tion last year when Big Brother star Jade Goody died from the dis­ease.

The 27-year-old mother-of-two had ab­nor­mal cells re­moved from her cervix on sev­eral oc­ca­sions, but is re­ported to have ig­nored a let­ter say­ing ab­nor­mal re­sults from a smear test had again been found.

As a re­sult, she be­came one of around 1,000 UK women a year who die from cer­vi­cal can­cer.

While her un­timely death in March 2009 was tragic, it led to a 12 per cent rise – from 3.2 mil­lion to 3.6 mil­lion – in the num­ber of women hav­ing smear tests. How­ever, the ‘Goody ef­fect’ is now thought to have di­min­ished. Em­me­line says: “I sup­pose some women, par­tic­u­larly the younger ones, might think they don’t need to go for a smear be­cause they’re all right and it’s eas­ier not to go. “But with­out be­ing a doom-mon­ger, there could be some­thing wrong, and if they don’t go for screen­ing they won’t know un­til it’s too late.”

About 300,000 UK women have ab­nor­mal smears ev­ery year, and they will usu­ally be re­called for a col­poscopy, where a doc­tor uses a col­po­scope to mag­nify the cervix to see if fur­ther treat­ment is needed.

The col­poscopy takes just 10-15 min­utes, and is usu­ally per­formed as an out-pa­tient.

Depend­ing on the sever­ity of the ab­nor­mal­ity, no treat­ment may be re­quired as the body’s im­mune sys­tem will some­times deal with the ab­nor­mal cells it­self.

Al­ter­na­tively, the cells may be treated there and then, or a biopsy may be taken.

The biopsy will as­cer­tain whether the cells are can­cer­ous, in which case surgery may be the next step.

Treat­ment af­ter ab­nor­mal cells are de­tected is very suc­cess­ful, with more than 90 per cent of pa­tients re­turn­ing to nor­mal smears.

Nearly all cases of cer­vi­cal can­cer are caused by the hu­man pa­pil­loma virus (HPV), which is trans­mit­ted through sex­ual con­tact. Al­though there is no treat­ment for the virus, 12 to 13year-old girls are now vac­ci­nated against the two most com­mon high risk HPV types.

Em­me­line’s spe­cial­ist, gy­nae­co­log­i­cal on­col­o­gist Robin Craw­ford, of Ad­den­brookes Hos­pi­tal, Cam­bridge, says symp­toms that in­di­cate there may be a prob­lem with the cervix can range from bleed­ing be­tween pe­ri­ods and/or af­ter sex, to post-menopausal bleed­ing.

Such symp­toms can also in­di­cate other con­di­tions. But he warns: “There may be no prob­lem and the ab­nor­mal­ity is de­tected by screen­ing - hence the im­por­tance of keep­ing up to date with smears.”

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