Tuesday 16 July 2019

Cervical cancer: Get to know the symptoms

Heather Keating (27) from Tipperary got the all-clear from cervical cancer in December 2015. She urges all women to look out for the tell-tale symptoms, even if their smear test results are normal

Heather Keating survived a cervical cancer diagnosis. Photo: Dylan Vaughan
Heather Keating survived a cervical cancer diagnosis. Photo: Dylan Vaughan

When I was 24 I noticed that I was bleeding in between periods and after sex. I was on the contraceptive pill at the time so my GP assumed it was a hormonal imbalance of some sort.

When the bleeding didn't stop, I went back to my GP and I was then referred to a gynaecologist in my local hospital. The appointment was a few months after the referral and, in that period of time, the bleeding became a lot heavier and a lot more frequent.

As soon as the gynaecologist examined me he knew that something wasn't quite right. He did an internal examination and he could tell by my cervix that there was something wrong. I thought it was endometriosis or some sort of hormonal imbalance - I still wasn't linking it to cancer.

The gynaecologist referred me to a colposcopy clinic where they could take a smear and look at the cervix through a microscope. This was my first smear. I was too young for the CervicalCheck programme, which is free for women aged 25-60.

‘It’s not common for women under 25 to develop cervical cancer, but it does happen,’ says
Heather Keating, pictured in hospital after her diagnosis
‘It’s not common for women under 25 to develop cervical cancer, but it does happen,’ says Heather Keating, pictured in hospital after her diagnosis

During this appointment, the doctor decided to take a biopsy. I was reassured that the majority of biopsies that come back are absolutely fine and they just wanted to make sure everything was okay.

Four weeks passed before I was called back in. I was told that I'd get a letter but when I got a phone call instead I knew that something was going on. The doctor told me that I had 'very high grade changes'. They also told me that the gynaecologist in my local hospital wasn't comfortable doing any procedures on me because of my age and because he wanted to preserve my fertility. He advised that I be referred to Cork University Hospital, where I was put under a new gynaecologist who took more biopsies.

It was about a week after the second biopsy when me, my Mum and my husband were brought into a room in the hospital and told that I had cervical cancer.

At this stage they didn't know how extensive it was. They didn't know if it had spread to other areas of my body so they sent me for an MRI and explained that the results would determine the type of treatment I would have and, regardless of the treatment, my fertility would be affected.

The best case scenario, they said, was that the cancer would be confined to my cervix and I would have a radical trachelectomy. That's when they remove the cervix and nearby tissue but the womb is left intact.

I was sent for the MRI and I had to wait a week for the results to come back. That was by far the worst week of my life.

A week later, I was told that I had Stage 1 cervical cancer, which meant that it was confined to my cervix. During the surgery they removed the tumour, the cervix and the lymph nodes and, afterwards, they told me that I wouldn't need chemotherapy or radiation.

The surgery I had has preserved my fertilty to an extent. It may still be possible for me to have children: we don't know yet.

When I was first diagnosed, I was scarred more mentally and emotionally than physically. Being told the word 'cancer' is absolutely traumatising and nothing can prepare you for it.

But as time has gone on I have learned a way of coping. There is always a fear of reoccurence but you just have to learn to cope and be grateful.

In terms of my health, everything is going well. I now go back to the clinic every three months for a smear and check-up. It's looking good. In fact, my check-ups are so good that they might start pushing it out to every six months.

It's not common for women under 25 to develop cervical cancer, but it does happen. That's why I'm trying to raise awareness of the symptoms so women know what to look out for.

If they are experiencing irregular bleeding - in between periods; after sex or after the menopause - they need to go to their GP to get it checked out.

I think the CervicalCheck misdiagnoses are very unfortunate. It's concerning for women who have a fear about going for a smear to discover that it may not have been read properly. But hopefully with the review coming up, people can build up their confidence in the system again and not be afraid of going for a smear.

I really do hope that this doesn't prevent women from going for smear tests because they save lives.

When I went to my GP first I was told, 'You're okay, it's only a hormonal thing', but my body was telling me that something was wrong.

So that's my advice. As women, we need to listen to our bodies: we know what's normal for us, and we know what's not."

When to seek medical advice

You should contact your GP if you experience:

  • Abnormal vaginal bleeding. For example, bleeding in between your periods, after sex or after the menopause.
  • Blood-stained vaginal discharge that may have a foul smell.
  • Discomfort or pain in your pelvis.

Advanced cervical cancer symptoms include:

  • Constipation
  • Blood in your urine (haematuria)
  • Loss of bladder control (urinary incontinence)
  • Bone pain
  • Swelling of one of your legs
  • Severe pain in your side or back caused by swelling in your kidneys, related to a condition called hydronephrosis
  • Changes to your bladder, bowel habits
  • Loss of appetite
  • Weight loss
  • Tiredness and a lack of energy

Vaginal bleeding is very common and can have a wide range of causes, so it doesn't necessarily mean you have cervical cancer. However, unusual vaginal bleeding is a symptom that needs to be investigated by your GP.

Irish Independent

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