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Farewell 2013

30 Dec

It’s that time of the year when there are lots of shows on TV looking back on the year, and starting to look forward to 2014. So I thought I would do the same – it’s been an eventful year!

Going back exactly 12 months, this time last year I was just home from Australia and preparing for my first MRI on NYE 2012. Even thinking about it now reminds me of how frightening that whole time was. It seems bizarre now to be afraid of scans, but I suppose they held my fate at the time. Nowadays I enjoy a good MRI! I can even provide tripadvisor style reviews of the facilities in various hospitals.

Reviews

January was the month of appointments and IVF. And probably most importantly I was referred to Dr Shepherd

dr-shepherd-photo

Ahem.. I mean, Prof Shepherd. 😉

I think it was when I had my first appointment with Prof Shepherd, and got the all clear back on the MRI and CAT scans that things felt different. It was from then that I felt optimistic that it was going to be all right, that the cancer was small and early and I was in good hands. Maybe the 9 embryos helped, but my normal optimism came back sometime in January, after really struggling in December. I actually had a bit of a breakdown at work in January and went to see a counsellor. She told me to stop doing anything I ‘should’ and only what I had to. That was a great relief, as I think I needed someone to say to me – stop trying to keep everything normal. This isn’t a normal situation, so stop trying to make it seem normal! It was great advice.

January to June:

Well, that’s all covered in the rest of this blog really. Operations, and another one , lots of daytime TV (including a wedding!), some travel, fundraising for Macmillan and Cancer Research UK (thanks!) and then back to work.

After June:

The last post I had was in June, and a lot has happened since then. My MRI in June came back clear, but I was really knocked sideways when my friends didn’t.  It just feels so incredibly unfair for me to be fine, and for her to have to continue down the next steps. It reminds me both how lucky I am, and how random and heartless cancer is. But that is not my story to tell.

Then things got a bit quiet as I returned to reality. Getting back to work was ok. As always I rushed it a bit, thinking I would be able to hit the ground running, but it did take about 3 months (my manager may say more!) to get back into the rhythm of things. My boss said he struggled to manage me to start with as my attitude has changed – which I would have to agree with. I enjoy my work, but I’ve definitely got less desire to constantly be pushing ahead. Things that would annoy (such as missing out on an important project or meeting) just don’t bother me much anymore. I think I appreciate more now that I have a nice job, lovely people, not too many hours and well paid. Why was I ever pushing for more!!?

October:

As the year progressed a minor problem/side effect from the operation has become more and more of an issue. I understand now that treatment for cancer means the cancer goes away, but your body will be changed by it forever.

(Warning – Womens parts discussion approaching!) 

Basically there is now scar tissue causing a partial blockage where my cervix used to be. That has resulted in blood being trapped inside me, random bleeding/hemorrhaging (oh what fun that day at work was) and generally the need to have another operation to try to fix it.  I’ve now had two quite minor operations to try to fix it with limited success. But I’m optimistic the doctors will find a way! The procedures themselves are not too bad, and easy to recover from, it’s just frustrating that I am not allowed to move forward until it is finally resolved.

We did in fact look at attempting IVF, but after much excitement it all came to a grinding halt due to this blood blockage  issue. We will hopefully get to try it in 2014, but I think we have learned not to try to plan too much, as plans fail and it’s just depressing. Hope can be very cruel!

But – despite such negativity – I know things will improve – so BRING ON 2014!

201314

2103 has been a tough year overall for my family. Without going into details, Cancer wasn’t the worst thing we had to deal with! Generally everything that could go wrong did go wrong. On the flip side, I was also successfully treated, my sister found her dream job, and while there are still problems lets hope 2014 brings better luck!

But – back to the point of this post – basically Happy New Year!!

I will celebrate the New Year tomorrow with a hope for a better 2014, and a celebration that 2013 is finally over, thinking particularly of all the ladies who have contacted me through this blog, who are at various stages of their treatment and recovery.

So, to everyone who passes by this blog – here’s to a healthy and happy 2014!

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Hospital Week

6 Mar

Monday

So the week at hospital was educational. Easier in some ways (less pain), harder in that it was much longer.

We arrived at 7.30 on Monday, feeling much more comfortable after the trial run and full of knowledge as some people were wandering around trying to find the admissions area. The start was all pretty much the same, lots of basic questions to confirm I knew I was there for the right thing, checking of weight etc.

I was much calmer than last time, which I can tell for sure as I got my blood pressure done. Something normal like 117/70ish.

Straight into theatre this time, and again as I was calmer I wasn’t given a mild sedative while we waited for the surgeon to sweep in and say hello! So I had the standard small talk with the anesthetists and then next thing I am waking up in the recovery room. It was actually quite a stressful wake-up unusually. I was really nauseous, and so woke up feeling like I wanted to throw up, and in a fair bit of pain. I ended up in recovery for about 3 hours I think.

Annoyingly, the doctors AGAIN didn’t contact Susan and Eric. So they were sitting around from about 12 (when they expected a call) to about 3.30 getting more and more worried about me. While I was happily getting bored in recovery. Finally they were told that the nurse was coming down to get me, so at least they knew I was ok, and it still took an hour to come back up as there was a shortage of porters. I was getting a little frustrated by then, but I didn’t know they were sitting about worrying! The doctor I had been speaking to in the morning (who was assisting) made a point to get Erics number, and double check it was correct, but still didn’t call. Remember that Mum in Australia was sitting around at 3 in the morning at this stage!

Anyway, annoying – but not something to dwell on.

When I got back to the room, I was much better than I was the last time. Much more alert, and in less pain. The support team (Eric and Susan) commented immediately that I looked much better! And I felt better. Surgeon came to visit and said all went well, and that it looked like clear margins, but it would take 7-10 days to find out.

The rest of the evening was pretty calm. I had a light, and very slow, dinner, which included a short nap during dinner, as you do. When Eric and Susan left, so must have been quite late, I got quite nauseous and had to get the nurses in. They changed all my meds to drips as a result, which was good for nausea, but bad for sleeping.

However, the first night was ok. Slept a bit, despite the  normal constant monitoring and drip changes. I think I gave up at about 6am and turned on the TV.

Tuesday

(don’t worry – they won’t all be long!)

I stayed on the PCA (Patient controlled Analgesic) all Tuesday. That is kind of nice in that you can control your own level of fuzziness, but I probably could have done without it, and it tended to make me nauseous  It’s Fentanyl on a drip directly into a canula on my right hand. When I woke up I had four canulas in – two in my right hand and one in the left, and one on the inside of my left arm on the artery. The arterial one is removed immediately.

I started to have problems with the canulas on day 2. Every time they wanted to use one they had to flush it through, and it was incredibly sore each time, as well as whenever they started a new type of drip. I’d had no problem with that in the past so I’m not sure why, but all three of them hurt. They stopped using the left one totally, and one on my right was devoted to the PCA – so they ended up with only one available choice which kept getting blocked, and clearing it was painful each time.

They seemed to initially try to do the arterial catheter on my right arm first, as there was a massive bruise covering my wrist inside wrist and down my arm, with a few needle holes in it. Mustn’t have worked, and I’m glad I wasn’t awake for the attempts! I had spectacular bruises down the inside of both arms from all the various injections and canulas.

I had the initial wound dressings removed on Tuesday as well. Odd, but painless. Lets leave that there!

Wednesday – Friday

So, not much more really happened from then on. They removed the PCA on Wednesday, and on Thursday they were happy to remove the canulas (yay!). I was running a temperature on Wednesday night I think, and consistent low blood pressure, so worth staying in to be monitored. I think they added some extra drips to try to up my pressure.

They also removed one of the catheters on Thursday, and gave me the option to go home on Thursday. I could have, but to be honest I wasn’t keen on managing the bladder catheter at home, and I would have had to come in on Saturday to have that removed and have the bladder function tests done.

I started to walk as soon as possible, from the Tuesday onwards. Starting with little walks down the corridor of the ward, and then on Thursday and Friday I went for a long (!) walk around the inside of the hospital. I felt quite like a real sick person then – I was wandering around carrying the catheter bag (nice!), very slowly in hospital blue booties. And when I was walking I was hanging onto Eric’s arm, which wasn’t just for show, I did need him to hang onto from time to time as I either lost my balance, or just got tired.

On Friday, when Eric finished his shift and went to work, he ran into Susan on the street (starting her shift) and they discussed that I was ready for an exciting visit to the outside world. The handover had become very efficient by that stage – much like the nurses handover each shift! Susan had dropped my rings into a jeweler across the road to be replated, and I went with her to pick it up. Here is the walk:

Walk

So, I estimate something like 150m all in. The ward lift is right beside the exit, so no long walk in the hospital either. This was the walk that wore me out! I got back, had to take some pain killers, and basically dozed then for a couple of hours. I was completely shattered! Up to that point on Friday I had been fine and chatty sitting on the bed. It was a shock to realise how tired I could get!

Visitors:

Eric and Susan were there pretty much all day every day, which was fantastic. I discovered that hospital can be very boring, despite various computers and TV options. I wasn’t as distressed as I was after the last operation (where I was in more pain), but I was in for much longer, as so it was great to have people come and visit.

Jess dropped in on two morning, which was great to get me up (well, awake) and moving. And Michael and Josh came one evening to play Uno. I felt I had to shush them, as we were having far too much fun for a hospital ward!!

Things you learn about yourself with a weeks monitoring. 

  • I drink a LOT of water when it’s available. I got sort of sensitive about it, as someone had to empty the catheter from time to time! 
  • I have very low blood pressure when sleeping. Which may explain the odd dizziness in the mornings, something that’s sort of useful to know.
  • You can ‘play’ the observations. On Saturday I wanted to leave, so I knew I needed good blood pressure and Oxygen levels. So I sat up, woke myself up properly, and took a few big breaths. Makes a huge difference to the results!
  • Very small amounts of oxygen on those odd looking nose things has a big impact on blood oxygen levels. Took them to 99%, rather than the normal 94ish%

Also, weirdly, I didn’t see any other inpatients in the whole week I was there. I was in the private wing, so everyone had their own room, but even on my little walks I never say anyone. There were 8 rooms in my area, and I only got the odd glimpse in the room next door. Otherwise it was all oddly patient free. Last time I was next to a normal ward so there were a number of people just behind curtains. It’s not surprising in the area I was I suppose, but it felt slightly strange. My room was lovely and quiet – I didn’t hear all the beeps and things that I heard last time – apart from my own noisy machines.

Nursing staff

Nurses are wonderful people.

Without exception, for all my operations, they have been wonderful, and caring, and always patient and helpful. They have a difficult and sometimes intrusive job, but always done with good humour and can make the difference between a good and a bad time in hospital. It was very sweet when someone would come back on shift, and be genuinely pleased to see me looking so much better. So thank you to all the nurses!

Saturday

So, on Saturday I was woken at 6am to have the catheter removed, and so started the pee test! I never wanted to pass a test so much. 🙂

I had to go to the loo, and then they would do a scan (with something like a sonar) on my bladder to ensure it was empty. Test 1 was fine, but I failed the second test – oh no! I think it was because it took them 10 minutes to do the second test, and the aforementioned excessive drinking meant I was refilling the bladder to fast.

So, that meant delays… the nurse had to get the registrar to see if they would let me go with one bad result. They decided to do one more test (the alternative was going home with a catheter) and I had called them to the room, then went to the bathroom, then back for an immediate test, and I passed easily! As Eric said, I’ve never been so keen to pee!  We had already packed, so made a swift exit.

Took a cab home, and went to sleep again. Another three hours sleeping to recover from the excitement of the day!

So that’s all. Now we are just waiting for results, and taking it slowly at home to get better. Fingers crossed the results come back well, and then I can start to return to real life.

Getting ready for tomorrow

24 Feb

I’m at home tonight, getting around to packing for the hospital. It’s very easy to pack I must admit – select a variety of granny nighties and the dressing gown… throw a few toiletries in and it’s done!

I went for the pre-operation assessment on Friday, and all went fine. It was the normal set of blood tests, blood pressure, lung function, height weight etc. I’m very used to it all these days!  I asked to speak to the surgeon as I hadn’t spoken to anyone in weeks about anything. It’s been strange going from appointments virtually every day in the middle of January to long periods where I am just left alone these days. So I felt a little unprepared for the operation on Monday.

One of Prof Shepherds surgical fellows came, and she was much nicer than the one who spoke to me before the last operation – who gave the feeling like talking to me was a necessary evil! She actually listened, and went through all the potential complications, and took into account what I was worried about – even if they are minor things. She also said there was no chance this operation could change into a hysterectomy on the table as far as she was aware, and that she promised I would wake up with my uterus intact. Which was really good to hear.

The main risks are to do with moving the other things out of the way, as I mentioned in my last post.

Then she talked me through all the other potential complications. I’m not really sure why they go through the full list of complications. There isn’t anything I can do about them as I have to go ahead, and it is a little scary. They are low risk, like 1-4%, but I can’t help thinking that with Prof Shepherd having done 250 or so surgeries, that means between 3 and 10 real women have had each of these bad complications. As I’ve been on the wrong side of a few stats recently, it feels much more real. I know the risk is low… but if it is you – then it’s a 100% impact! But, I can’t worry about something I can’t really influence, so I’m trying not to.

With the tumor, they are really only looking at the margins to ensure it has clear margins, and perhaps to assess the aggressiveness  but she said the margins where the main thing to worry about.

The surgeon also said this operation should be less painful from a recovery point of view, as they are not cutting through the abdomen.  However, it is still 4-6 weeks… so I’m not sure what takes so long. I suppose I will find out! The other operation was 2-3 weeks, and it did take 2 weeks, so I can only assume they know what they are talking about.

So, fingers crossed please everyone! The support really does make a big difference to me and it’s great to know that people are thinking of me – wherever you are.  Lucy – I’m also thinking of you, and while I can’t see you before your trachelectomy on Wednesday, hopefully I can give some kind of update here before you go in, and let you know that it all went well.

One minor thing. While I do love pressies as much as the next girl, I think there are others who can make much better use of the funds! So, can I please request that from now could you please make a donation in my name to Cancer Research UK. I have relied a huge amount on their very helpful website, and this new surgery is only possible due to years of research.

Thanks! Donation Page

Cheers all. I will handover control of the Blog to Susan and Eric so they may update over the next few days.

Radical vaginal trachelectomy

19 Feb

Ok – if you have made it past the title, then hold onto your hats and I will explain the excitement that awaits me next week!

I posted a while back about the potential treatments I may have, and one of them was the Radical Tracelectomy.

As a result of all the various tests, the surgeons are happy to do the Trachelectomy. That is what I had been hoping for, so it’s a good result, although still quite scary.

Extract from the earlier post

Name Treatment Intended Effect Side effect
Radical Trachelectomy Remove cervix and surrounding tissue. Remove area affected by the cancer. Can still carry a baby, but not give birth naturally. Very high risk of late miscarriage.
Lymphectomy Remove as many lymph nodes as they can find in the groin area Lymph nodes are normally the first areas impacted by spreading cancer. Best to get rid of them! Leg swelling. Not sure if that is forever.

As you know, I’ve had the lymphandectomy. It seems that in a lot of cases they do both these operations at the same time, but I have had it done separately. I’m fine with them being done separately, as I believe it reduces the uncertainty with this next operation. They know at this stage that the lymph nodes look clear, so it is more likely that the trachelectomy would go ahead as planned without any surprises.

So, a bit more here about the Trachelectomy for those that want to know.

Trachelectomy:

The goal of this surgery is to remove all the cancer, as well as surrounding tissue to try to reduce the chance of recurrence. The team keep reminding me that getting rid of the cancer should be the primary focus, and in the past,  surgeons would just perform a full hysterectomy – ie the removal of pretty much everything from the cervix up – including ovaries, womb, cervix and the surrounding tissue to be sage. That’s a pretty intense operation in itself, and clearly it completely removes any chance of having children. Plus immediate menopause and other fun things.

So, being human beings, doctors looked to create a less extreme surgery, especially as cervical cancers are regularly found a lot earlier these days due to pap smears.

Radical Trachelectomy was developed (in part by my actual surgeon) to try and be a little more conservative for early stage cancers. It is becoming more common, and my surgeon has done the operation about 220 times, but he said there have only been about 1000 worldwide.

The image below is a summary of the operation. The cervix is a link between the womb and the vagina, so if the cervix is removed then those two elements have to be stitched together instead. The surgeon will make an assessment during the surgery as to how much cervix to remove. They will try to leave some cervix (at the upper end) if possible, as reduces the risk of early miscarriage.

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Now, the NHS website says that no surgeon can promise that they won’t have to change and do a hysterectomy once they get started. However, one of the other surgeons said he had never heard of that happening… but he wasn’t a specialist. So I will ask the surgeon on Friday if possible. Maybe the fact that I have had the lymphandectomy reduces the risk of there being a change mid operation.

You can see from the image that there are blood vessels and things that need to be moved and re-routed where necessary.

Without a cervix (or only a partial cervix), the surgeons also have to put in a new ‘tie’ at the bottom of the womb. It’s called a a cerclage – which is a permanent stitch. I believe that if I do get pregnant, I would have to have another small procedure to close up the stitch properly to try to, again, reduce the risk of miscarriage.

Image4

So, that’s it really.  Remove a bit in the middle, and tie the remaining bits together! Easy. I don’t know how long it will take, maybe a couple of hours. There is no surgical scar – the whole thing is done via.. ahem.. the existing access point! I can’t understand how, and have decided not to investigate.

Sometimes they do the lymphandectomy at the same time, but I had mine done last week. So they KNOW that it hasn’t spread – I think therefore the risk of them widening the surgery is low, as they already know it hasn’t spread. Well.. that’s what I hope anyway.

The image above also highlights a few of the other risks. The white ‘blobs’ in front of and behind the cervix area are my bladder and bowels. These have to be moved out of the way. One of the reasons for a longer stay in hospital is that normally women have trouble with their bladders for a while, as it’s near impossible to avoid the nerves around the bladder.

There are other nerves that run in the area, specifically the nerves for upper legs. I have heard stories from women recently (via the Macmillan site) who have had quite bad upper leg pain from damaged nerves, either due to direct surgical damage, or from the position you are in for the operation. That is also something I would rather not know about. As far as I am concerned, I go to sleep on a nice trolley, and wake up on a bed. I don’t want to know how they manhandle me in between!

But, overall the complication rates for this surgery are much lower than for a hysterectomy, and the long term prognosis is good. I will continue to have 3 monthly checkups for the first year, then 4 monthly for a few years… etc until at 10 years they discharge you back to your GP. The only potential fly in the ointment is if they do further analysis on the tissue removed and decide the trachelectomy isn’t enough. I’m not fully sure what they are looking for, but so far most results have come back clean, so I’m hoping that will continue.

As I said, this should be the beginning of the end. I’m pretty healthy at the moment, so that will stand me in good stead for the operations. I’ll be in hospital for 3-5 nights, and I think the main reason is that I will have various tubes in me which will stop me moving – mainly related to the previously mentioned ‘blobs’ above!

After that – recovery is 4-6 weeks, and they say you tend to be weaker and more tired etc for up to 6 months.

I think that’s all… any questions?

Edited to ad: I think you can see the video now. I’m made it public. Nina… I apologise in advance!

phone blogging

18 Feb

As I have a shiny new phone today, I thought I would access my inner nerd and use it to post!

Its been an up and down weekend. Was sorry to miss the wedding on Friday,but thanks to modern churches, we got to watch it on webcam! Certainly a relaxing way to go to a wedding. Feet up, and ceremony on the big telly.

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Then a great day on sat with Jess, Gary and Caitlin – who knows how to win me over. ‘Where do you want to sit Caitlin’. ‘Next to Auntie Kath!’. me? Wrapped around a little finger? Never!! 🙂

I saw my niece win a silver medal on Sunday in taekwondo also, so not a bad weekend.

Being honest though, there are still tough times. I hurt my stomach again in the weekend, and so back on the painkillers for a day or so. Plus I think stress will increase this week, so after a few bad nights I’m also back on the sleeping pills. What would I do without modern pharmacology!

I’ll tell you what I do do… I turn this on when I don’t feel great. You can’t help but smile!

And also here are some lovely cards and gifts I have received. Truth be told… There was more chocolate before. 🙂

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Why all these operations?

7 Feb

First posted 3 Feb:

http://community.macmillan.org.uk/blogs/b/kaths_cervical_cancer_blog/archive/2013/02/03/why-all-these-operations.aspx

The previous post covers the lymph system, but I think I am getting closer to understanding why they keep wanting to remove parts of me. When it still feels like this is a pretty small tumor.

Micrometastases

Micrometastases are areas of cancer spread (metastases) that are too small to see. If there are individual cells, or even small areas of growing cells elsewhere in the body, no scan is detailed enough to show them.

For a few types of cancer, blood tests can detect certain proteins released by the cancer cells. These may give a sign that there are metastases too small to show up on a scan. But for most cancers, there is no blood test that can say whether a cancer has spread or not.

For most cancers the doctor can only say whether it is likely or not that a patient has micrometastases. This ‘best guess’ may be based on the following factors.

  • Previous experience of many other patients treated in the same way. Doctors naturally collect and publish this information to help each other.
  • Whether cancer cells are found in the blood vessels in the tumour removed during surgery. If they are found then cancer cells are more likely to have reached the bloodstream and spread to somewhere else in the body.
  • The grade of the cancer – the higher the grade, the more aggressive the cancer and the more likely that cells have spread.
  • Whether lymph nodes removed during an operation contained cancer cells (for example in breast cancer or bowel cancer). If the lymph nodes contained cancer cells this shows that cancer cells have broken away from the original cancer. But there is no way of knowing whether they have spread to any other areas of the body.

This information is important. If the doctor thinks it is likely that there are micrometastases, they may offer further treatment such as chemotherapyradiotherapybiological therapy or hormone therapy. Treatment after surgery is called ‘adjuvant treatment’. The aim is to kill the areas of cancer cells before they grow big enough to be seen on a scan.

Some doctors call this ‘belt and braces’ treatment. In other words, the treatment is to try to make sure the cancer does not come back. But no one can know for sure if all the cancer cells have been destroyed when someone has finished treatment. It is this uncertainty that can make cancer difficult to cope with for many people, even if they seem to have been successfully treated.

This is copied directly from: http://www.cancerresearchuk.org/cancer-help/about-cancer/what-is-cancer/grow/how-a-cancer-spreads 

Clearer now?

It is to me at least. It’s all about working out if the surgical solution will be enough. I suppose the worst case will be that after surgery they decide they still want to do the chemo/rad, but there is a good chance the surgeries will be enough.

The only other thing I’m not clear on is that I believe the section of tumor taken during the cone biopsy already indicated that my tumor has passed through a blood vessel. Maybe there were no cells in the blood? I’m not sure – and I suspect seeing the report wouldn’t help me. But the fact that they are still giving me the surgery must mean it wasn’t too bad.

FYI: The first place cancer in the blood gets too is the heart and lungs, as all blood goes directly back to the heart and into the lungs to be re-oxygenated once it leaves cells. So the micrometastases will most likely appear in the first place they can find somewhere to catch onto. That’s why the chest CAT scan is the first test they do.  

On a more personal note:

I’m pretty calm about the surgery tomorrow. I’m as ready as I can be, the only big problem is that it is so early! We will have to leave the house about 6.30, and there are a few things I have to do in advance, so I will be up around 5. At least I can watch the superbowl! May need to learn some of the rules though.

I’ve gone shopping and bought some proper granny style nighties, as otherwise I will end up in hospital gowns all the time. I don’t fully feel like I have all the information I would like though. But I’ll bring a few questions written down with me, and get some answers. It surprisingly hard to speak to the actual surgeon, and I still get a feeling they are not properly talking to each other about various test results. I’ll make sure I know what I want to tomorrow, and will update when I get home.

 

How did I get cancer?

7 Feb

First posted 19 Jan: http://community.macmillan.org.uk/blogs/b/kaths_cervical_cancer_blog/archive/2013/01/19/how-did-i-get-cancer.aspx

You may expect the answer to this is ‘nobody knows’, but actually in the case of Cervical cancer, the causes are known.

In the 1980’s doctors noticed that cervical cancer seemed to spread like a STD. There was virtually none in communities of nuns, and a big increase after the 60’s when women were, shall we say, given more freedom to do what they wanted!

They then started to review tumors, and found that in virtually all cases they found a particular virus. HPV.

Since then it has been identified that the cause in most cases, including mine, is HPV.

Harsh maybe, but true.

However, it would be hard to go through life and not get HPV. Something like 75% of us will have HPV at some stage in our lives, and in most cases you would never know. Many of the 40 strains have no symptoms, and most people will fight off the infection after a couple of years, perhaps never aware that they had it.

Many others will have the virus living in their body, doing little or no damage.

So what can you do to avoid it?

Not much really – other than abstinence, but since the cause was identified as HPV, most first world countries have started a large scale vaccination program. This,combined with widespread pap smears, is proving to be very effective in eradicating a disease, and it is expected that cervical cancer rates will drop rapidly as the vaccinated population rises.

Investigation into HPV is still on-going, as it is suspected in a range of cancers.

HPV doesn’t always cause cervical cancer, but most cervical cancers come from HPV.

HPV (Human papullomavirus) is responsible for about 90% of cervical cancers, and HPV 16 or 18 are responsible for about 70% of total cervical cancers.

I have HPV 16, which is the most dangerous for cervical cancer. It is also one which would have had no symptoms at all when it was acquired.

Small rant:

How is it that we are not tested for HPV?

It frustrates me that the NHS allows for 1 smear every 3 years, but they don’t test for HPV. If you are found to have HPV 16 or 18, it seems sensible to increase the regularity of smear tests. Had I known I had it, then I would have been there every year (for what is an uncomfortable test) without complaint!

In theory it is very unlikely that you can move from a clear smear to cancer in the three years, but that is essentially a cost/benefit decision by the NHS. Unlikely doesn’t mean impossible, just statistically unlikely. I think that is why doctors keep asking me about earlier smears – but this is genuinely the first time I had any kind of negative result.

end of rant.

What else has to happen?

There are lots of types of HPV, and only a few have direct links to cervical cancer (and a range of other cancers.) So you have to have the right one, and you probably need to add in a few other risk factors. Such as smoking (yep) and long term use of the pill (yep).

Then the virus has to get through the protective coating on the cervix. That means the virus has to be active, and at the same time something slightly negative had to be happening with me. Maybe a cold, maybe a small yeast infection, maybe a few weeks of overwork and stress causing my immune system to be lowered… whatever it was… something happened and the virus got through, and started to settle in and start to cause changes in my cells, and then they start to replicate in an uncontrolled manner.

As I understand it, the next step is the virus has to disable the normal activities of the woman’s own suppressor genes, which make suppressor proteins that do “damage surveillance” in normal cells. These cells would normally find, and stop, excessive growth of cells.

As an aside, isn’t it amazing that these things even exist?! The idea that our bodies have so many well controlled functions and specialized cells and proteins is really amazing. 

And finally:

This has to happen between pap smears, otherwise it will be noticed and removed. As my small rant above covers, this is unlikely, but clearly not impossible.

Edited to add: I mean the growth must have happened over the last 3 years. The infection probably happened over 10 years ago. I’ve also stopped smoking many years ago – don’t worry mum!

BUT – IT IS NOT ALL BAD NEWS

As I said above, now we know this, there is a vaccine against it. The vaccines only cover the main HPV culprits that cause 70% of cervical cancers, so you will still need to get a pap smear, but the risks will be massively lower.

There are lots of posters up on the tube at the moment about getting the vaccination. Maybe they were always there and I never noticed? But either way, I find my eyes drawn to them, and only wish it was known earlier.

I also have to resist the urge to grab any teenage girl and shout GET VACCINATED, but I have a sneaking suspicion that would get me arrested! It is a three injection process to get vaccinated, and when you are young you don’t believe these things really happen, but hopefully more people will get it over time.

 

Useful Links:

http://medicalxpress.com/news/2013-01-cervical-cancer-vaccines.html