My Battle with Cervical Cancer

January is Cervical Cancer Awareness Month. 

Yes, yes, I know, it's not January yet... But Christmas is fastly approaching and soon the new year will arrive!

And when it does, I want you all to remember that the first month of 2014 is Cervical Cancer Awareness Month. 

Why share my story?

Awareness: if my story helps someone get their annual exam or helps someone through their fight, it will be worth it. 

Cervical Cancer is caused by something so common, by the human papiloma virus, better known as HPV. 79 million Americans are currently infected with HPV, with 14 million people become infected every year. The CDC even says that it is so common that almost every sexually active individual will have some form of HPV in their lifetime.  90% of individuals fight off the infection without ever realizing that they have it.  A healthy immune system can fight off HPV in just a few months.  However,  the infections that don't go away can lead to cancer.  In fact, 26,000 American cases of cancer caused by HPV are diagnosed each year. 

Cervical cancer and HPV can be caught early with a yearly womens examination, or a Pap smear.  Every sexually active female should have a Pap smear every year.  Sure, it's uncomfortable.  And yeah, it's embarrassing.  But let me tell you from experience, a 10 minute exam is much easier than having multiple cervical surgeries. Trust me.

HPV is preventable!  Abstinence can prevent HPV 100% of the time (when followed by both partners).  There is also the HPV vaccine, either Cervarix or Gardasil. Both of these vaccines prevent the two cancer causing strains of HPV, strain 16 and 18.  There are more than 40 strains of HPV, some classified as LG low grade and some classified as HG high grade, or cancer causing. Only 4 strains have been tested for a vaccine, but there is more research being done every day.  The vaccine does have side effects, but in my opinion the benefits outweighs the risks.  This vaccine is for girls and boys, as boys can get more rare types of cancer caused by HPV but can also pass along HPV to their female partners if they are infected. 

AND don't forget, girls who get the vaccine should still have annual paps! Early detection is the only way to prevent HPV from causing cervical cancer. 

It's culprit is treatable, but prevention is always better than treatment. 

DISCLAIMER!  This story may be gross at parts... Read with this in mind.

Ok, so on to my story.

In 2009 I had my first abnormal pap. 

I was being seen at a free clinic as I did not have health insurance.  I was in college and this was before the dependent age was changed to 25. I was told that I had HPV, a STI. I was terrified.  I had a STI!? I was disgusted, angry, scared.  My doctor told me that 90% of people my age had it and that it would likely clear on its on and be gone before my next annual.  They told me that I was good to go and that I should come back in one year.  I skeptically left the office, returned to work, and was told by a few of my coworkers that they had been told they had HPV but that it went away, no problem.  I felt a sense of relief, and forgot all about it until my next pap.  

In 2010, I had another abnormal pap.

I was still at the free clinic.  This time, I was told that i would need to have a colposcopy, or a cervical biopsy.  This is a procure where the doctor uses a speculum to inspect the cervix for abnormal changes.  A vinegar solution is normally used on the cervix as it helps show abnormal changes.  If changes are found, the doctor will take a punch biopsy of the area.  This punch biopsy is basically a small core sample of the cervix.  This appointment, I had 4 biopsy areas.  The doctor uses this gel called Monsel's liquid to stop the bleeding.  I watched my doctor go through 4 bottles of this gel... Her face becoming more concerned as she asked for each new bottle.  The colposcopy that was a "simple procedure" had gone from it's allotted 15 minutes to 1 hour.  Once they got the bleeding stopped, I was told I could sit up and that I could get dressed.  I sat up, saw a pool of blood on the floor, and fainted.  My nurse came in to check on me when I didn't answer to her knock, helped me get dressed, and sent me on my way.  I barely made it out to the car.  When I got to my car, I called my dad and asked if he could come give me a ride home.  There was no way I could drive when I had tunnel vision and ringing on my ears.  

About a week later, I received a call from my doctor saying that I had low grade strains of HPV, and that my body just needed "more time" to clear it. 

Looking back, I should've been more proactive, I should've gotten another opinion.  But I didn't have health insurance, I didn't have money, I didn't know what to do.  So I trusted their advice.  I was told to wait another year and it would "likely be gone".

In early 2011, I returned for my 3rd pap since my first abnormal one.  Again, I had HPV.  The doctor wanted to do another colposcopy, and this time I opted to see a specialist.

I found a wonderful doctor in Templeton CA.  He looked over my records from the clinic and agreed that I did need a colposcopy.  I was not happy.  I had a horrible experience with my first one, and I was not about to be calm about another one.  He told me that the procedure would take only 15 minutes, that I would feel minor cramps and that I might have light bleeding.  I told him about my first colposcopy and he promised me that it would be nothing like that.  Luckily, he kept his word.  He took 2 biopsies and an ECC (a sample from the endocervical canal, basically a sample from the deepest part of your cervix) and I was walking out the door in under 15 minutes, as promised.  This man was amazing.

A week later I returned to the office for the results.  I was informed the biopsies came back positive with CIN 1 on my cervix and that my ECC was positive for CIN 2. 

CIN stands for cervical intraepithelial neoplasia, and basically means that there is premalignant changes and abnormal growth in the squamous cells on the cervix.

CIN 1 is mild, effecting 1/3 of the epithelium, the first layer of the cervix.

CIN 2 is moderate, effecting 2/3 of the epithelium. 

My OBG decided that as I had CIN 2, I needed a procedure called a LEEP. 

A week later I had my first LEEP.  

A LEEP, a loop electrosurgical excision procedure, is when a wire loop that has an electric current passing through it is used to cut away effected tissues.  It basically shaves off a layer of your cervix, in my case 15 mm thick. 

I was first given a shot of lidocaine with epinephrine - a block, a numbing agent - directly into my cervix.  This basically made me feel like my heart was going to pound out of my chest.  He explained that the cervix directly absorbs the drugs and that they are very quickly directed to the heart, hence the extreme pounding and racing heart beat.  The shot was very painful, but indeed made me numb to the cutting.  

The procedure wasn't very long, and I had my best friend and hubby in there with me, supporting me every moment. 

About my week later, I returned again for a follow up.  All was healing well.  He discussed that the LEEP is normally very good at clearing CIN 2.  However, if I was still found to have a high grade lesion, I would need another procedure.  

He discussed the possibility of having another LEEP or cryotherapy, which is basically the freezing off of bad cells. 

I was to return in 3 months to get another pap. 

3 months was perfect timing for me... None of this, "let's wait a whole year and see if your body gets rid of it" business....

So, 3 months later I retuned to his office for my pap.

By this time, paps were a walk in the park, they still are.  Love them!  Literally, they saved me... I love them. But I digress...

My pap was done and a week later I returned for the results.

This time, my pap again showed HGSIL (high grade squamous intraepithelial lesions) - the HPV was still there, even after the LEEP. 

My OBG informed me I would need another colposcopy to get more biopsies taken.

He seemed surprised that the LEEP did not rid my cervix of HPV.  I was scared at his concern... 

We again went over the need for another LEEP or cryotherapy, but this visit he also discussed a possible cone biopsy with me.

A cone biopsy is when a scalpel (aka knife) is used to remove a thick cone of tissue from the cervix.

He discussed that if I did indeed have another CIN 2 biopsy, I would likely need this cone biopsy done.

Fabulous.... More surgery.

A few weeks later I had another colposcopy.

This time, the biopsies revealed both CIN 3 and cervical carcinoma - yep, cancer. 

My HPV, treated, had progressed from CIN 1 to cancer in less than 3 years. Unheard of. 

Cervical cancer takes years to form.  HPV takes years to morph into cervical cancer.  

Not in my case.  

Being a newly wed, fertility was a big concern.

Would I be able to have children?

My doctor explained that this was the least fertility harming procedure available for my recent lab results.  If I had already had children and was 35<, the standard procedure with this diagnosis would be a hysterectomy. 

That wasn't an option for us.  But even after this surgery, my chances of having kids would remain decent.  75% of women go on to have normal pregnancies. 

Radiation would only hurt my eggs, creating more fertility problems. 

It was my only option to stay healthy and to preserve my fertility.

Surgery was a go.

I was scheduled for my cone biopsy.  

It was an outpatient surgery done in the surgery center near the hospital.  It took about an hour and a half, and I didn't feel a thing.  The beauty of anesthesia.  

(The not so beautiful part of anesthesia is what you say when you are coming out of it.  I guess I asked every nurse I could find if i could still ride my horse, and I asked the doctor the same question repeatedly.  Everyone got a kick out of it!  I guess it could be worse, I've see some pretty hilarious videos!)

When I awoke, my OBG informed me that the CIN 3 and carcinoma was worse than he thought, and he ended up doing a very large cone.  In fact, it was a cone so large that the surgery was actually coded as a simple trachelectomy, or removal of the cervix.  

The cone had removed 80% of my cervix! 

The only parts that remained were the edges. 

I was chauffeured home by my lovely husband, and slept the rest of the day.

I had very minimal pain and very minimal bleeding.

Picture on the left is the intact female anatomy, picture on the right shows the anatomy after a trachelectomy

At my post op visit, I was told that I was healing well, that the sutures were all in place and holding, and that they would dissolve. 

He also told me that the labs from my surgery were back, and that the 80% removed was riddled with CIN 3 and carcinoma all the way to the margin.  This means, that the cancer spread all the way to the edges of what he had cut.  He explained that this could mean the he might have left some cancer behind.

Gulp.

However in good news, the ECC was negative. So the deepest part of my cervix was still healthy, which meant good things for the future health of my uterus, ovaries, etc. 

I was to have a pap in 4 months.  He again told me the possibility of having another abnormal pap due to the margins. If I was found to have CIN 2 or 3 or carcinoma, I would have need another LEEP. 

In March of 2012, I arrived for my pap.

My OBG decided to do a pap and a colpo just to be safe and to get it all done at once.

He took 3 biopsies and an ECC. 

A week later, I returned for my results.

To his amazement and mine, the results were normal!

No pathology, no changes, no HPV, no CIN, no carcinoma, no cancer!

It was gone!

He did tell me that there was a slight possibility that all the scar tissue could hide the HPV, but that the results were very promising that it was gone.

Thank you Jesus, what a blessing! 

I didn't need another pap for 6 months!

He had cured me.  Him and God of course.

6 months later my pap was normal.

6 months after that my pap was again normal.

And both of my paps in 2013 were normal.

With 4 normal paps, I have even been put back on the "annual exam"!!!!!

It was a long process, a scary process, especially with my fertility in mind, but we made it through.

I have been cervical cancer free since March of 2012! 

Yes, I have had fertility problems since then. 

My OBG instructed us to begin trying for kids as soon as we were ready because we would likely require extra time. Even extra help.

Matt was ready right away, so we began.

And I'm so glad we did, because it took 2 years of trying to conceive for my doc to start us on fertility treatments. 

The path ahead of us is still bumpy, but I am healthy! I am alive!

this is a group of women who have all had a trachelectomy to treat their cervical cancer - all women who went on to have these perfectly healthy babies! 

What have I learned from all of this?

I have learned that nothing is worth risking contracting HPV.  If I could do it all over again, I would definitely wait until marriage to have sex.  Not only is it something that would be wonderful to share only with your lifelong partner, but if doing so would have spared me from getting cervical cancer, I would've been all in!

I discovered that when your 18, you don't think that anything you do will affect your future marriage, your possibility of having a family.  I wish I would've been aware of the consequences of my actions.

The HPV vaccine came out in 2006, and at that time, they were only suggesting it to young women under 19. I was 20, so my general practitioner said that I was not a candidate.  

There is really nothing I could've done to get the shot... It wasn't given to girls my age. 

Now, they are giving the vaccine to girls ages 13-26. 

Obviously, this disease was in Gods plan for me.

I was supposed to fight this, and I was supposed to win.

My husband and I were supposed to conquer this together.

And we did. 

I hope that by writing this, someone might read it and decide they need to get their pap done.

Someone might decide that they will get the vaccine, or that they will give it to their daughters. 

And mainly, I hope that you are now more aware of the danger that HPV can be.

I hope that you are more aware of cervical cancer, and that you will support it's research and it's campaign every January.  

I wear teal because I fight like a girl.

I won this battle, and I support all the women fighting it now. 

In January, wear teal with me, and help prevent your mother, your sister, or your daughter from having to fight this fight.