The result of my smear came in the post a few weeks ago. I knew immediately what it was. Something to do with the font Cervical Check uses and the fact that it includes my middle name. I opened it while trying to diffuse a skirmish between my two toddlers, fully expecting a “Nothing to report here, lads. See you again in three years’ time,” response. Instead I got a cryptic “Your result is back. Talk to your doctor. Don’t ignore this letter,” response.
Ouch. Okay. That doesn’t sound good.
When I met her, the GP used a few choice phrases that stuck with me.
“Abnormal cells; changes evident,” and, the worst of the lot, “biopsy”. That innocuous-sounding word made my blood run cold. Most people probably wouldn’t have even noticed it discreetly sandwiched between other clinical terms, but my mind honed in on it like a laser beam.
Before I knew it, my cheeks were wet and my three-year-old was looking at me as if I had grown a tail. Crying was the worst thing I could have done because I was so mortified I wasn't capable of asking anything coherent. Instead I just sniffed and fumbled and half-listened to the GP's reassuring words. But by that point it was all just white noise. I was scared and there was no coming back from that. I couldn't even pronounce the name of the procedure I needed to have done, let alone take in whatever she was saying about it. Col-pos-copy. I kept confusing it with colon-os-copy: Candid Camera up the other way. Even more glamorous.
But then something happened that made me feel better instantly .
The GP told me she had had a col-pos-copy; there, I have it now. A fact that gave credence to her kind reassurances that it was nothing to worry about. A purely pre-emptive strike to make sure that something potentially nasty didn’t get the opportunity to take hold. It normalised it. My cells weren’t necessarily in the fast lane to cancer; they just weren’t as bulletproof as most.
After my first colposcopy I got the call to say I had “severe cell changes” and that I had to go back. I wish I could say that it was like water off a duck’s back – that I was entirely sensible about the whole thing. But that would be a big lie.
Because for some reason, I couldn’t quite manage to file it in my brain along with other “Minor Healthcare Matters”, such as the two benign moles I have had removed, even though the procedure amounts to effectively the same thing. I think it’s because you can see a mole. It is a defined, tangible enemy. Unlike rogue cells inside you.
I wasn’t too bad until the night before I went in and I started to think about whatever it was that was up there that needed to come out. And, as with so many other things, allowing myself to think about it was a mistake. Because it reminded me all too clearly of my own mother going into Holles Street for a biopsy eight years earlier only to be brought back in, 72 hours later, to have the cancer carved out of her.
I knew deep down that I didn’t have cancer. That, in all likelihood, it wasn’t even in the same ball park as what my poor mother went through. But, for the very first time, a part of me understood how she must have felt when she was told that a small, but parasitic, part of her own anatomy had turned against her and had to be removed. Eradicated. And that is not a nice feeling.
The procedure itself is a bit like going to the dentist, only involving a different orifice.
You get a similar injection and what can only be described as a vacuum cleaner is used to remove whatever rotten cells are up there. It’s just like a smear, only it’s entirely painless. And for anyone who’s gone through labour, it’s a walk in the park.
The nurse and I talked about the weather, Garth Brooks, and the patient before me who had asked whether there were any cobwebs “up there”. My, how good it felt to laugh in that clinical environment of blue scrubs, cold metal and harsh fluorescent ceiling lights. It’s hard to feel scared when you’re enjoying a choice piece of no-frills, good old-fashioned Irish honesty.
Afterwards, you feel you’ve been through the wars, but it’s nothing a cuppa and a large Danish won’t fix. A few weeks of no baths, no swims, and no “amour” and, please God, all will be well.
It’s a nuisance, but nothing more than that. And, more to the point, you feel so much better knowing that whatever rogue cells you may have been unwittingly harbouring are gone.
It’s free. It’s simple. It can save your life. So get over the fear, and go and have your smear test. And try not to worry if the result is abnormal. “Candid camera” really isn’t all that bad.
Smear test: procedure and prognosis
Cervical Check completed its first five-year screening cycle on August 31st, 2013, with more than 74 per cent of women aged between 25 and 60 having had at least one smear test.
Once you are in their system you're invited every three years for screening while aged 25 to 44, and every five years once you're over 45. You can keep your details up to date on its website, cervicalcheck.ie.
According to its most recent statistics, more than 87 per cent of smear tests were normal, with 11 per cent showing low-grade abnormalities and 1.6 per cent showing high-grade abnormalities.
If you fall into the latter category, or if you consistently show low-grade changes, you will be referred for a colposcopy. This involves a closer examination of the cervix using a tiny microscope.
Nearly 90 per cent of women who show high-grade changes will require a large loop excision of the transformation zone (LLETZ) procedure during the colposcopy. This involves removing and examining any suspect cells.
Last year, even among the women who were referred for further examination, fewer than 2 per cent actually had cancer, but Cervical Check says it has the potential to reduce mortality rates by as much as 80 per cent.
Claire Micks