At the end of February everything was normal. I was healthy (as far I I knew), work was going well, and I was getting ready for a big vacation with husband and a friend of ours at the end of March. I decided I wanted to get my hair trimmed before the trip, so I made an appointment, and I figured that while I was in town I would go in for my annual exam and I booked that appointment too (I live in a rural area so when we go to town we try to get a few things done at once).
Little did I know this would not be my average annual exam.
I’d been going to the same clinic for years—since before I had insurance. The staff and all the providers were great, and I wanted to continue to support them. I had a new provider that day but she was upbeat and friendly, and the exam was quick and routine. She told me I was due for my PAP smear. My last one had been in 2014 when they began the policy of doing them every three years with healthy patients. I had no risk factors for anything— I’ve never been diagnosed with an STD/STI, I’ve been with the same man for over 8 years, I have no health issues, etc. We even joked about how “boring” I am health-wise. She did the swab and I was on my way.
About a week later she called me and told me the PAP had showed some abnormal cells, so they would need to do another biopsy, called a colposcopy, to see exactly what those cells were. I went back a couple of days after that, and the provider explained that the results of these biopsies would come back as level 0, which is normal, level 1 or 2 which would be mild and moderate changes that they would keep an eye on but would probably go away on their own, and level 3, which was severe abnormalities that would require treatment. The only level above that was cancer, and she said she had never received a cancer diagnosis before. She said she would take two to three biopsies of my cervix, and that she could do up to four but she usually didn’t have to.
Laying the stirrups is never a fun experience, but it was even less fun when that provider went for that fourth biopsy with what was essentially a hole punch for flesh. This is the first time I started to feel truly uneasy about my results.
A few days later I got the phone call that I should come to the office for my results—something I’ve never had to do.
My wonderful husband made the trip back to town with me, and the provider who did my tests was out of town, so another new provider took us back to go over the results.
Diagnosis: Adenocarcinoma in situ of the cervix.
The provider explained that while the cells are cancerous, it looked like they were contained within the cervix and had not become invasive (that’s what “in situ” means). Basically, this is stage 0 cancer. She apologized that she didn’t have any informational handouts to give me, and she told me further treatment beyond what the clinic could provide was going to be needed. She wrote the name of the cancer downs so I could do my own research, and referred me to another doctor.
Before my visit with the new gynecologist, I did do my research. I discovered that adenocarcinoma only makes up 10% of all cervical cancers. I also discovered the treatments could be quite extensive, but I figured I wouldn’t have to worry too much about that. I was 28 and otherwise healthy. I just needed to get rid of some cells.
The visit with the next doctor made everything much more serious. My husband came with me again, and the doctor explained that while it seems like we caught this early, adenocarcinoma is tricky because it creates “skip lesions,” which means it doesn’t start and grow from one place, but it can pop up in different locations. It’s hard to track, and hard to test for. She would do a cone biopsy to make sure the diagnosis was correct, but hysterectomy is the only curative treatment, she said.
I had the cone biopsy April 10th, my first “real” surgery.
My diagnosis was confirmed.
My hysterectomy will be May 22nd.
At the end of February it was life as usual. Next month I will undergo a major surgery—my cervix, uterus, and fallopian tubes will be removed.
It’s hard to come to terms with things like this when you have no symptoms. Nothing physically feels wrong at all. Still, I realize I truly have much to be thankful for in this situation. I’m thankful I had my PAP on time. I’m thankful the cancer has not become invasive. I’m thankful to have a supportive and caring husband. I’m thankful I’ve never felt a desire for motherhood—I know something like this could crush a woman who wanted children. I’m thankful I can keep my ovaries and will not go into early menopause. I’m thankful I have a boss and coworkers who understand that I’ll be taking weeks off of work to recover, and who prioritize healing and health.
Am I nervous about this surgery coming up? Absolutely. I hope my recovery is smooth and there are no more surprises. But I am also nervous about the women out there who don’t get regular PAPs.
Ladies: this can happen to any of us. Please get regular exams. Like I said, I didn’t have any of the risk factors. I didn’t have any symptoms. Making an appointment for a PAP may seem like an inconvenience, or maybe you don’t have insurance and can’t afford the expense. Please, find a clinic that will work with you. Find the time in your schedule for an appointment. It could literally save your life.