A smear test can save your life

Experts at Guy’s and St Thomas’ are urging women to get regular smear tests or visit their GP early if they experience signs of cervical cancer. Their plea comes in Cervical Cancer Prevention Week (22 to 28 January).

Around 3,000 women are diagnosed with cervical cancer in the UK each year but early detection and treatment can prevent 75% of cervical cancers developing.

In England nearly 73% of women aged between 25 and 64 were screened for cervical cancer in 2015/16, but locally in Lambeth and Southwark around 68% of women in this age group were screened.

Cervical cancer develops in a woman’s cervix, which is the entrance to the womb, but symptoms are not always obvious. The most common symptom is abnormal bleeding from the vagina, which often occurs after sex, in between periods or after the menopause.

Danielle Calabrese, 34, who lives in London Bridge, has a less common form of cervical cancer which develops in the glandular tissue (inner part) of the cervix. She was diagnosed after having a routine smear test in October 2015.

Danielle, who was living in Deptford at the time, was sent to a local hospital for a colposcopy, a procedure to check whether the cervix contains any abnormal cells. Following a biopsy, CT and MRI scans she was told that she had stage one cervical cancer.

In May 2016, Danielle transferred her care to Guy's and St Thomas’. Women with cervical cancer are generally offered three treatment options depending on the size of the tumour. A hysterectomy removes the womb and cervix. A radical trachelectomy removes the cervix, surrounding tissue and the upper part of the vagina, but leaves the womb in place. A cone biopsy removes the area of abnormal tissue.

Danielle says: “I don’t have a family of my own yet. Mr Rahul Nath, my consultant at Guy’s, said if I were his daughter he would be telling me to have the radical trachelectomy, which leaves the womb in place, so I could still have children. This also gave the best chance of removing the cancer.

“I’d never even had a stitch before and now I would be in hospital for a week and possibly losing my womanhood. The decision I was having to make was overwhelming. I chose to have a radical trachelectomy."

Three weeks after the surgery in July 2016, doctors at Guy’s found that the tumour was more advanced than expected, and that Danielle would require additional treatment with chemotherapy and radiotherapy. At this point Danielle was offered the opportunity to have fertility treatment at the Assisted Conception Unit at Guy’s to freeze her eggs.

She says: “I really want to be a mum so it was such a happy moment when they told me that during my egg harvesting they had managed to collect seven eggs. I knew I had done all I could do for the future, now it was time to focus on me and my health.”

In September 2016, Danielle started a five-week course of radiotherapy and chemotherapy followed by brachytherapy, which treats the cancer by inserting radioactive material directly into the affected area. Since treatment Danielle has had scans and continues to be monitored.

Talking about the gynaecology oncology team in the Cancer Centre at Guy’s, Danielle says: “These people have given me a chance at life. I know they do this every day but they make it feel like they are in this for you, making sure they are on top of it. The staff are absolutely amazing.”

Lorna McGrath, one of the clinical nurse specialists who cares for Danielle, tells other women: “If you are concerned about your symptoms, please do not wait. Even if you are not due for a smear test, it is important to see your GP for advice and examination."

Last year Guy’s and St Thomas’ Colposcopy Unit saw more than 2,500 new patients with abnormal cervical screening results or abnormal bleeding. Most abnormal results (changes in the cells of the cervix) are caused by an infection - the Human Papilloma Virus (HPV) - or pre-cancerous cells that can be treated.

Aggie Jokhan, the lead nurse colposcopist at Guy’s and St Thomas’, says: “A smear test can save your life. It takes just five minutes. Some women may find it a little uncomfortable but it doesn’t hurt. The aim is to detect any abnormalities or cell changes before it progresses to cancer.

“That’s why it is so important to have your regular smear test and to attend any follow-up appointments if necessary.”

For more information about cervical screening, go to www.nhs.uk or www.eveappeal.org.uk.