Saturday 21 July 2018

Dr Ciara Kelly: We finally have a vaccine to prevent cancer - you'd think people would be delighted about it

Dr Ciara Kelly. Photo: David Conachy
Dr Ciara Kelly. Photo: David Conachy
There are few enough things worse than a cervical cancer diagnosis

Ciara Kelly

I'm heading for a smear test later. It's not something I relish. Oh, I'll grant you there are worse things in life, but no woman enjoys hearing the words "little bit of pressure now" as a hard plastic tube, covered in cold KY jelly is inserted into their nethers and then its jaws are opened so what started as a narrow pointy shape ends up like the open beak of a large-mouthed duck. And that's before they take a toothbrush-like instrument to your cervix (the neck of your womb - for those of a biblical disposition) and rub vigorously, usually until they draw blood. I'm not trying to put you off, I'm merely saying it isn't pleasant.

Add that to the fact that I, like tens of thousands of other Irish women, have previously had an abnormal smear - in my case a thing called CIN II, which has a 43pc chance of regressing back to normal and a 22pc chance of progressing towards cervical cancer over time - so it isn't just the mechanics of the smear I'm anxious about, it's the actual result that's worrying me. So the whole thing is something I try not to think about. In fairness our colposcopy clinics and the national screening programme are well run. And as anyone who's attended colposcopy and sat in the stirrup chair while a chatty gynaecologist has dug at their cervix with lasers and metal instruments knows - a smear test is not the worst thing that can befall your cervix.

And truth is that even a colposcopy is not the worst thing that can happen to your cervix as the 300 women who're diagnosed with cervical cancer here every year will tell you - just over a third of whom will be dead within five years of their diagnosis. Most of them will have gone through chemotherapy, radiation therapy and usually radical hysterectomies before succumbing to the disease. I know of a 42-year-old mother-of-three and a 36-year-old mother-of-two who have died this month already - leaving behind devastated families.

So now I'm starting to think my slightly uncomfortable smear test is no big deal at all when you think about why we have them - even though we know that women put off having them because they're embarrassed about someone seeing their naked bits. And even though we know that they cringe and usually apologise about their bikini lines to doctors and nurses, who genuinely couldn't care less if they follow the latest pubic hair fashions. No, there are many things worse than a smear test - although there are few enough things worse than the diagnosis of cervical cancer.

If only we could do something to protect women and girls from this fate. From a cruel course of painful treatment and a one-in-three chance of premature death in their 30s or 40s - snatching them away from their families - when they should have their whole life ahead of them.

But, of course, we can. We have a vaccine. A vaccine against cancer. A medical breakthrough. A vaccine that prevents girls contracting the HPV virus that causes almost all cases of cervical cancer. A vaccine that has had hundreds of millions of doses given globally and has been shown to be safe with no major side effects. A vaccine that could save the lives of the 250,000 women who currently die from cervical cancer worldwide - and even better could prevent 4.5pc of ALL cancers around the world because HPV is also responsible for large proportions of head, neck and other anogenital cancers in both men and women.

Yes we have finally got a vaccine against cancer, so you would think people would be delighted about preventing their daughters - and hopefully soon their sons - from being at risk of dying from cruel HPV-related cancers. But no.

Instead we have a junk science smear campaign on social media against the vaccine. We have ill-informed TDs who should care about their electorates' health but actually care more about parish pump politics, scaremongering about the vaccine's safety and we have a vaccine uptake rate that's dangerously low.

Ninety young women will die from cervical cancer this year - now a preventable cause of death. Those who are willing to leave their daughters unprotected are sadly afraid of the wrong things.

@ciarakellydoc Ciara presents Lunchtime Live on Newstalk radio weekdays from 12-2pm

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