Two women share their stories of cervical cancer — a cancer that rarely causes symptoms until it’s advanced. A Pap smear is the best way to diagnose cervical cancer. HPV vaccination can prevent it.
Cervical cancer may not be the first cancer you think of when talking about women’s cancer risks. Breast cancer, which is diagnosed in
But cervical cancer, which is diagnosed in
Despite recommendations for regular screenings, the number of women overdue for screening is growing, according to the
“No you don’t!” Those were the first words Ashley Shaffer’s mom said to her when the certified fitness trainer from Southern California told her she had been diagnosed with cervical cancer.
“It took a while after receiving the news for it to really sink in,” she said. “My husband was there when I received the call, and after I told him I cried.”
But Shaffer admits the news wasn’t a total shock to her — even if it was to her mom — because she had been experiencing symptoms for a while.
“I was actually a little relieved because I now had some answers,” she says.
Prior to her diagnosis, Shaffer had been experiencing breakthrough bleeding.
“I attributed it to stress, but it was becoming more frequent. I also began having pain during and after sex, so I decided it was in my best interest to go see my gynecologist and get an exam.”
The gynecologist told her she was experiencing side effects of the birth control pill. She told her to take a break from the pill. But, while she didn’t think the symptoms were related to anything else, certainly not cancer, the doctor did go ahead and do Shaffer’s annual Pap smear and tested her for HPV.
“The results came back a week later with my first abnormal pap and a positive for high-risk HPV,” Shaffer says. “A few weeks later, I went in for a colposcopy and had four biopsies taken from my cervix and cervical canal. A few days later, the pathology came back from the biopsies and they found adenocarcinoma on my cervix.”
For Anisa Shomo, MD, a family medicine doctor and professor at the University of Cincinnati College of Medicine, her cervical cancer diagnosis came after a regular screening. Her results showed stage 0 cervical cancer, the earliest stage and one unlikely to cause any symptoms.
“The number one thing that helped me get detected early is that I was raised in a family where preventative health care was always important,” Dr. Shomo says.
“I am one of nine children. My mom spent a lot of time at the doctor for pregnancy appointments and taking kids for check-ups, so we were always at the doctor. We were raised in a culture of routine check-ups, so it was caught on a routine check-up. I didn’t have any symptoms.”
Dr. Shomo’s cancer was a rare, aggressive form of cervical cancer, which made early detection even more important.
Both Shaffer and Shomo have human papillomavirus (HPV), a virus that is responsible for 95% of all cases of HPV.
“I tested positive for HPV 16 and 18, which is the cause for most cases of cervical cancer,” Shaffer says.
Shomo knew she had been exposed to HPV because she had experienced cervical dysplasia at a younger age. She knew that meant her risk for cervical cancer was higher.
As a doctor, Shomo says, “We need to talk about it because 95% of cervical cancer is caused by HPV. A lot of people don’t talk about cervical cancer because it has a lot of stigma because a lot of cervical cancer is caused by HPV and because people think of HPV as an STD. But pretty much everyone has HPV.”
In fact, the U.S. Centers for Disease Control and Prevention (CDC) says
Dr. Shomo says that the good news for people diagnosed with cervical cancer is that discussion around it often centers on survivorship because treatment can be successful, especially if it’s caught early.
But many women need to consider things like their fertility and reproductive choices when deciding on a treatment. Both Shomo and Shaffer did.
“Making treatment decisions was easier for me than other women. My husband and I had already decided not to have children, so I was fortunate not to have to worry about trying to maintain my fertility. That’s such a big factor for many women my age,” Shaffer says. “Of course, there were still many discussions, but my husband and I remained focused on getting rid of the cancer and following my doctor’s recommendations.”
Shaffer chose to have a loop electrosurgical excision procedure (LEEP). But the margins still showed signs of cancer, so she returned for a cone biopsy, which removed a larger section of the cervix. The procedure worked well.
However, Shaffer ultimately decided to have a full hysterectomy because “we had also found during an ultrasound that I had uterine fibroids and adenomyosis, as well as wanting to decrease the chance of the cancer coming back.”
Dr. Shomo had a cone biopsy, too, and it was successful as well, but like Shaffer, she ultimately chose to have a hysterectomy.
“We were ambivalent about having kids. They said if you absolutely know you don’t want to have kids, then you can have a hysterectomy, but we were ambivalent, so I got the cone biopsy” Dr. Shomo says.
After 3 years of Pap smears every 2 months and after consulting fertility specialists about her chances of starting a family with her husband, Dr. Shomo decided to have a hysterectomy.
“It could have been worse, I know that, “Dr. Shomo says. “I was grateful that it wasn’t.”
Dr. Shomo had the HPV vaccine when she was in medical school at age 25. “I got the HPV vaccine when it first came out. I had already been exposed to it, but when they came out with the vaccine, I was like I want to get that,” she says, adding that she believes the vaccine may have prevented her cancer from returning or being worse and spreading.
“I can use this knowledge now, so I use it to advocate for my young patients. We give [the HPV vaccine] at age 11 and 12, hopefully, before you get really exposed to it. That’s why we are seeing the numbers decline,” she says.
HPV vaccination — early is best
According to the
Encouraging young people to get the vaccines fits into a three-prong strategy for making people more aware of cervical cancer.
“We have to decrease the stigma around HPV, give HPV vaccines, and the other piece is, for people who’ve missed out on the boat for vaccines, we just got to get women to prioritize their health and go see their doctor.”
Shaffer echoes that, “You have to be your own biggest advocate. Nobody will ever know your body like you do. If you feel like you aren’t getting the care you need, then find another doctor. Cervical cancer can be preventable. HPV vaccines are available. Always go to your screenings.”