SMEAR CAMPAIGN
It’s easy to take your body for granted. Jessica Knowles did. But after a gruelling battle with cervical cancer, she has a new appreciation for what it’s capable of
How a smear test led to a swift cervical cancer diagnosis that saved Jessica Knowles’ life
W e all like to think we know our own bodies and that we give them what they need. You recognise when your stomach is asking for something hearty, you’re aware of the moment your brain starts shutting down on a Friday afternoon and you know when your limbs are begging you to sack off your dinner plans for a date with the sofa. So, what about when there’s something off with your period, you’re bleeding after sex, or you have a change in your discharge? Do you ignore it and hope it goes away, or do you see a doctor? I chose the latter, and it saved my life. The spring of 2016 was tough, to say the least. At 28 years old, I was in the process of separating from my husband of four years. It involved moving back to the UK from Spain, where we’d been living, with my son Eddie, and I was still grieving the miscarriage I’d had months earlier. So when, that May, I had a period that lasted six weeks, I put it down to stress. But in the weeks that followed, other symptoms made me pause. I felt so run-down – I was permanently exhausted and my limbs felt oddly heavy. Everyday activities like going to the supermarket sapped my energy. I made an appointment with my GP and, when I mentioned the abnormal bleeding, she suggested a smear test. I’d had one before, so I thought little of it. Only this time, the results came back as ‘abnormal’ and doctors suggested a follow-up colposcopy. Almost immediately, the doctor called me back into her office. Assuming some kind of bacterial infection was the worst-case scenario, I’d gone to the appointment alone. Then I heard her say ‘pre-cancerous cells’. I felt like I’d been punched in the stomach; the wind struck out of me. Cancer wasn’t a word that had crossed my mind. Now there it was, let loose, swimming in the air.
THE CLUB NOBODY WANTS TO JOIN
A couple of days later, I returned for a biopsy, followed by an agonising week-long wait for the results. With Eddie to look after, my life continued as usual. It was only when I climbed into bed alone each night that I let myself cry. With each day that passed, I became more and more convinced that I had cancer. I just knew. I took my mum along to the next appointment. We’d barely sat down when the doctor started speaking. ‘I’m not going to beat around the bush,’ she said. ‘I’m sorry, but you have cancer.’ It was exactly what I’d prepared myself for. Except I wasn’t actually prepared at all. When a doctor tells you that something has taken over your body – something you had no knowledge or control of – it’s a unique feeling of terror. It was as if I had travelled outside my body, like I was watching it happen to someone else. I just kept thinking: ‘This is not my life. This isn’t happening to me.’ And yet it was. With those few words, I was suddenly a member of the club nobody wants to join and thrown into a world I knew nothing about. Within 15 minutes, I was lying in an MRI scanner so the doctors could find out if the cancer had spread. The rational part of my brain told me it was necessary, but – left alone for an hour inside a giant, clanking, whirring mechanical tube – all I could think of was the disease that had invaded my body without permission; wondering whether it was going to kill me. I was diagnosed with 1B1 cervical cancer, which meant the cancer hadn’t spread. It was a huge relief, but I would still need an invasive procedure called a trachelectomy to remove my cervix, the surrounding lymph nodes and the upper part of my vagina. They weren’t body parts I was ever acutely aware of, but they belonged to me, and now I had to lose them. The more I learnt about the operation, the more anxious I felt. Complications ranged from incontinence to infertility and there were no guarantees the operation would even get rid of the cancer. The five-hour procedure was done using robotics – five incisions were made across my stomach, through my belly button and under my ribs. When I woke, I felt wrecked; like I can imagine it hurts after being in a car crash. The holes in my stomach were so big, it looked like I’d been shot, and there wasn’t a single part of my body that wasn’t in pain. Four days later, I was discharged and allowed home, but my body had a long way to go. It was just days before my 29th birthday, and I remember looking in the mirror and barely recognising myself. But what was going on with my body was nothing compared with what was going on in my mind. I became convinced that I’d done something to deserve this. I’d gone from being a strong, capable woman to depending on my mum for everything – from making a simple meal to looking after Eddie. After a few weeks, Eddie stopped crying out for me at all, and started asking for Nanny. I remember thinking that if I died, it wouldn’t even matter. Happily, the news that the operation had been successful came when I needed it most. Surgeons had managed to remove all the dangerous cells and the margins around it were clear – my body was cancer-
‘I KNEW HOW IT FELT TO BE CONVINCED THAT YOU’RE GOING TO DIE’
free. For days afterwards, I couldn’t get my head around it. I kept waiting for the phone to ring with news that someone had made a mistake – that they’d given me another patient’s results. However, recovery from cancer is rarely a simple process; you can’t tie it up in a neat little bow. Several months after my operation, just as it felt as if life was returning to a semblance of normality, I woke up at 5am in agony. The pain in my legs and groin was excruciating – there’s no other word for it. I was drifting in and out of consciousness and it felt as if my body was shutting down. I knew how it felt to be convinced that you’re going to die. I felt certain that if I fell asleep I’d never wake up. For three days, doctors tried to figure out what was wrong with me and even warned my mum that I could be dying. It was only when she mentioned I used tampons that they diagnosed toxic shock syndrome, which had developed into sepsis. It meant they were able to give me the correct antibiotics. I was going to be okay.
FINDING JOY
Learning to love myself has been a battle. While I was recovering, I forced myself to get up every day and do my make-up, just like I would normally. I was desperate to start moving again and fought through pain to go out for walks. Exercise was probably what kick-started my confidence, because it made me feel physically and mentally strong. Two unbelievably close calls have left me with a renewed focus to get what I want out of life. I used to run about six miles a day, but it’s difficult now as I still get a lot of fluid build-up in my legs thanks to a condition called lymphedema, which is a common side effect of cancer surgery. But I’m learning to adapt and integrate exercise into my life in a manageable way. A year on, I go to bootcamp and do Strala yoga once a week – both leave me feeling amazing. My working life is as stress-free as possible. I run a parenting and lifestyle blog called Mum Plus One, where I write about my life with Eddie. I practise daily mindfulness, too. When I was recovering from surgery, I did it for 10 minutes every morning and evening. It helped to give me a sense of control over my mind at a time when I had none over my body. I spend time with my family; I cook for my friends, mostly vegan food these days, and I try to find joy in everything I do. The idea of living your best life has been hijacked by social media but, for me, it is so much more than a meme – it’s a mantra. Going to the doctor that day was the difference between life and death for me. It’s incredible that most of us wouldn’t miss a hair appointment, but some will happily skip a smear test. Gynaecological cancers kill, and part of the reason they’re so dangerous is that women feel embarrassed to go to the doctor with their symptoms. There’s nothing embarrassing about taking your health seriously – you owe it to your body. One in four women don’t attend their smear test. Join Jo’s Cervical Cancer Trust during Cervical Cancer Prevention Week in January by taking part in their #Smearforsmear campaign. Find out more at jostrust.co.uk/smearforsmear