Thursday 19 October 2017

'I can't understand why anyone wouldn't want to avail of the HPV vaccine for their child' - Cervical cancer survivor

Around 300 women in Ireland are diagnosed with cervical cancer every year. A grateful Ann Hogan was treated after a routine smear tests revealed abnormal cells

Former midwife Ann Hogan at her home in Tramore, Co Waterford. Photo: Dylan Vaughan
Former midwife Ann Hogan at her home in Tramore, Co Waterford. Photo: Dylan Vaughan
Vaccination
Cervical cancer

Arlene Harris

Ann Hogan is 69 years old, has five grown up children with her husband Jim, and two grandchildren, of whom she is hugely proud.

But while all grandmothers delight in spending time with the next generation, family time is extra special for Ann; because if an aggressive form of cervical cancer hadn't been treated while she was in her thirties, she may not be here today.

Around 300 women in Ireland are diagnosed with cervical cancer every year, and almost one third do not survive. Initial symptoms can be vague, so it was thanks to a routine smear test after the birth of her last child that the Waterford woman received the diagnosis and subsequent surgery that saved her life.

"By the time I was 35, I had five children under the age of seven," she says. "I had been working as a nurse and midwife and was very aware of gynaecological issues, so when I went for a smear test a few weeks after giving birth to my fifth baby, I wasn't surprised to be told that some abnormal cells had been detected.

"Not long after the birth of my fourth child, I had noticed a foul-smelling discharge that no amount of showering would fix. I had also been passing some dark brown blood, so as a midwife I knew that this wasn't normal.

"I didn't mention it to my doctor but the day after the smear test he rang me at home and suggested that I come back in for a follow-up visit - it was at this point that I knew something was wrong."

With her medical background, the former nurse was prepared for the worst, so when results revealed that she had cervical cancer, her first thought was not for her own life, but for the well-being of her infant, who was still being breastfed.

"It was decided that I should have a hysterectomy as with five children, I was not planning on having any more," she says. "But I was adamant that I had to continue feeding for another couple of weeks as I wanted my baby to have the same start in life as I had given the others. So it was agreed, and two weeks after being diagnosed, I was brought in for surgery.

"Luckily, my ovaries weren't affected by cancer, so they remained in place, which saved me the added stress of going through menopause in my mid-thirties. But because of where the cancer was in the cervix, I also had to have a radical vaginectomy - removing the top third of my vagina.

"This was the early 70s and there was very little by way of diagnostic tools, so it wasn't possible to tell exactly how extensive the cancer was without removing the area around it."

Ann, who is also a speech and voice coach, was concerned about how such extensive surgery would impact her life both as a woman and the mother of such a young family.

"When I discovered how much had to be removed during surgery, it was a bit of a shock to say the least," she admits. "I worried about how it would affect my sex life and even other bodily functions, but the vagina is very flexible and everything settled down after a while. I was also concerned about how I would be able to cope post-surgery, but it's funny that when you have five small children, you just really have to get on with things, no matter how tired or sore you are.

"I had help for two weeks after being discharged, but then I was back into the thick of things - which in some ways was great, as it didn't give me too much time to dwell on anything negative.

"But if ever I had a quiet moment, I would worry about the children and what on earth would happen if I didn't recover as all I wanted to do was to be around to rear them until adulthood - I didn't really worry about myself at all."

Donal Buggy, head of services and advocacy with the Irish Cancer Society, says the HPV virus is the most common cause of cervical cancer - but there are also other risk factors.

"Most cervical cancers are caused by the HPV virus," he says. "This is a very common virus which is passed on during sex and while most people will get this infection in their lifetime, it usually clears up by itself. But one of the biggest risks (of the virus becoming cancerous) is not having regular smear tests as these ensure that abnormal cells can be found and treated early.

"But smoking also increases the risk of abnormal changes as the chemicals in cigarettes can affect how the cervix fights HPV infection. For this reason, if someone smokes, they can have trouble getting rid of the virus."

Luckily for Ann Hogan, her surgery was a success, and she didn't need further treatment. But she is concerned that some parents are 'shunning' the free HPV vaccine available to their daughters - she also believes that steps need to be made to offer this vaccine to boys as prevention is always better than cure.

"Going through cervical cancer is not a nice experience, I can tell you," she says.

"It is something which can affect women of any age and symptoms are often difficult to spot. So I was delighted when I heard that the Government was offering a HPV vaccine to teenage girls free of charge - and as I parent I can't understand why anyone wouldn't want to avail of it for their child. But they really should offer it to boys too as they do in many other countries around the world because they can also get cancers which arise from HPV.

"I have been very lucky as, believe me, no one would like to go through what I did. And if a vaccination can prevent this, then I am a big advocate for having it done, for both boys and girls. So I would encourage parents to research the benefits of getting the HPV vaccine and ensure their children get it done - because the alternative is far from pleasant."

Buggy agrees and says vaccination can help prevent the disease, while screening can detect it early which, in turn, increases the risk of survival.

"Testing for abnormal changes in the cervix when you have no symptoms is called screening and a National Cervical Screening Programme CervicalCheck is available," he says.

"The Government funds this service and provides free smear tests to women aged 25 to 60 years.

"The HPV vaccine will make antibodies that will protect you against many HPV types. This vaccine is licensed for girls and women aged nine to 26. But it is proven to work best for those who have not been exposed to the virus.

"But if anyone has any symptoms they are worried about, they should get them checked out by their doctor, as early detection is vital."

* For more information on:

- Cervical cancer, see cancer.ie or Freephone the Cancer Nurseline on 1800 200 700

- The HPV Vaccine, see hpv.ie

- CervicalCheck, see cervicalcheck.ie or Freephone 1800 45 45 55

About cervical cancer

2017-09-11_lif_34344932_I3.JPG
Cervical cancer
 

Symptoms of cervical cancer include:

* Abnormal vaginal bleeding; in between periods, after sex or after the menopause

* Blood-stained vaginal discharge that may have a foul smell

* Discomfort or pain in pelvis

Surgery is the most common treatment for cervical cancer. It aims to remove the part of the cervix containing the tumour.

There are different types of surgery, which include:

* Cone biopsy: a cone-shaped piece of tissue is removed from the cervix

* Trachelectomy: cervix and nearby tissues are removed but womb is left in place

* Partial hysterectomy: cervix and womb are removed

* Radical hysterectomy: cervix, womb and top of vagina are removed

* Bilateral salpingo - oophorectomy: ovaries and fallopian tubes are removed during a hysterectomy

* Lymphadenectomy: the lymph nodes in pelvis are removed

* Radiotherapy can also be used to treat cervical cancer. It uses high-energy X-rays to kill cancer cells in the cervix and can be given before surgery and after surgery

* Chemotherapy uses drugs to cure or control cancer. It can be given before surgery and after surgery and can be used alone or in combination with radiotherapy

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