A year ago tomorrow, Jade Goody died of cervical cancer. She received the initial diagnosis while appearing on the Indian version of Big Brother, so the world knew about it from the start. Watching her go through months of treatment and her last days with her young sons was moving. But her tragic early death had one positive result: after a sustained decline in the number of young women attending surgeries for smear tests in the UK, there has since been an increase of more than 20 per cent.
Cervical cancer is one of the more preventable variants, we are told, if you just go for your smear. I do, whenever I am called for the appointment. In February last year, as I watched Jade reeling from the news that her cancer was terminal, I had recently had my latest test. What I didn't know was that a letter was in the post to tell me that, for the first time, the results were abnormal. The date on the letter was Friday the 13th (of February).
It told me that there were "abnormal changes (known as moderate or severe dyskaryosis) in the cells of your cervix". It said I needed treatment to "help prevent cancer developing in the future". There was a leaflet with the letter, and my panicked eyes focused on the highlighted line that said that even with moderate or severe dyskaryosis it is "unlikely that you have cancer". Which of course meant it was possible. I had a hospital appointment booked for me – for Friday the 13th (of March).
I cried on the train to work. I was scared. I thought about my daughter, who was four, and my son, who was eight. I knew it would be a catastrophe for them if I died. And my partner, how would he cope?
A friend came with me to the appointment. The first doctor we saw laughed away my worries. He said that pre-cancerous cell changes are totally different to cancerous cells, and that anyway cancer would be visible on my cervix and he could see nothing. I then went on to a colposcopy, where a consultant obstetrician explained that the cervix lies at the border between two types of tissue, which makes it more vulnerable to cell changes that can be a precursor to cancer. If those changes are mild or moderate, they often right themselves. If severe, they need to be removed. Severe dyskaryosis left untreated would have a one in three chance of developing into cervical cancer within 20 years.
He studied my cervix using a colposcope, a sort of magnifying glass, and removed a polyp. He also took a biopsy for further tests. Was it painful? The leaflet said it should be like a smear, which for most women is uncomfortable. For me, I have to say, it hurt, but that was probably the polyp being tugged off rather than the biopsy.
Jade died on Mothers' Day, 22 March 2009. I received the results of my tests days afterwards. It turned out that the cell changes were severe and I would have to have a further treatment to remove them.
Early on in Jade's illness, various media sources reported that she had received this same call for treatment and ignored it. In fact, she said in an interview, she had the treatment three times, after cell abnormalities recurred, and it was only when she was called back for a fourth time that she was "too scared" to go. She had her first treatment when she was 16. "Even before I was sexually active, I had to have pre-cancerous cells removed," she said. "And that nearly traumatised me for life, it was so painful."
I wasn't scared that I had cancer any more. But I wasn't looking forward to the procedure. A Lletz treatment is conducted under local anaesthetic, and involves cutting away the area of abnormality with a small wire loop and an electric current. There are some "small" risks attached (excessive bleeding, infection, burns) and when my appointment had to be changed from May to July, I was relieved to be able to forget all about it for a while. Except, of course, that I didn't.
Stupidly, I scanned the internet. One minute an NHS or cancer charity website would reassure me that now I was in the system I was safe. The next I had read the words of some pundit declaring that you are more likely to die from an infection after this procedure than from cancer. Why was I listening to some conspiracy theorist from Texas?
The procedure only took a few minutes and, with the anaesthetic, was less painful than the biopsy. But it felt like a grim exercise in endurance. Afterwards I just wanted to burrow away, so off we went to a seaside caravan. No swimming for me, of course – no sex, baths or strenuous exercise until the bleeding had stopped, which would take about a month. I didn't feel like doing anything in any case. I wasn't in pain – it was an ache, rather, and a subliminal acknowledgment that I had a wound inside, a bit of my flesh cut away. I felt subdued, under par.
Soon after this, my daughter developed alarming flu symptoms. This was mid-July, the height of the swine-flu scare, so for a week we were isolated at home. Then my temperature shot up too. I was sneezing but the wound was also showing signs of infection. The consultant had warned me about the sort of discharge to look out for.
Apparently, 3 per cent of patients develop an infection. It was my biggest fear. I imagined a superbug eating me up from the inside. I rang my GP, who was barricaded in her surgery against swine-flu desperados. She wouldn't allow me to come in, but sent anti-biotics. They cleared the infection up within days. It took a month, but by mid-August the bleeding had stopped, the dull pain had gone away and I felt well again. Soon afterwards I got a letter from the hospital saying the procedure had been successful. It had all happened exactly as they said it would.
In January of this year I returned for a smear test, which came back clear, and I was discharged. For the next 10 years I will have six-month and then annual tests at my GP. Hopefully they will continue to come back clear. If not, like Jade I may have to go through it all again, and maybe again after that. But there is no way that I would stop turning up. And that is thanks to her. n
Cervical cancer: The facts and figures
2,900 women are diagnosed with cervical cancer every year. It is the second-most common cancer in women under 35.
4.4 million women are called for screening annually; 24,000 results show severe abnormalities. About one in 20 smear results shows borderline cell changes, and one in 100 shows moderate cell changes.
The main cause of cervical cancer is the human papillomavirus, or HPV, which is sexually transmitted. There are many variants of HPV, and four out of five adults has been infected at some point. Factors that increase risk include smoking, taking the Pill, and having mothered several children.
The HPV vaccine, which protects against HPV 16 and 18, the most dangerous variants in terms of cervical cancer, is now offered routinely to all girls aged 12 to 13.
The NHS in England offers regular smear tests to all women aged 25 to 65. The argument for not screening under-25s is that cervical cancer is rare in this age group. The NHS in Wales, Scotland and Northern Ireland screen women from the age of 20.
Source: Cancer Research UKReuse content