The Importance of Cancer Screening, and How To Prepare For It

Look at this beautiful photo. Look at that huge smile, how happy my Mum was on her wedding day. All her dreams came true that day. She had married the man she adored and could now start thinking about one day becoming a mother. She was around 23 years old in this photo. A long happy life lay ahead of her. Except sadly it didn’t.

My mum was very old-fashioned in her beliefs, and very prim and prudish. My father noticed during their marriage that she had lumps in her breasts and told her to go to the doctor, but embarrassment at the thought of a doctor seeing her topless prevented her from going. She kept making excuses when he begged her to get checked, and nothing could change her mind. Unbeknownst to them both, those lumps would later turn out to be breast cancer.

I don’t know how her cancer was finally discovered.  I remember Mum going away for a while but as I was very young I wasn’t told anything about where she went. I remember staying at a step-relative’s house (Mum and Dad were divorced at this point) and when I went back home, Mum was in bed. I was told she wasn’t very well but not what was wrong with her. I only realised something was very wrong at a later date when I came home from playing with my friend. I walked into the living room and saw Mum standing in front of the fireplace topless, rubbing talc on to her very scarred flat chest. I remember the shock of seeing her like that, and really not understanding what had happened. She had had a double mastectomy and it hadn’t been explained to me. Finally the cancer word was used, but I still didn’t know how serious it was. I remember her losing her beautiful black hair and wearing an awful mousy brown wig that the hospital gave to her. I wish I’d been told how ill she was. I would have spent more time with her. Asked her questions about her childhood. But I didn’t know, and being so young, I spent most of my time out in the fresh air playing with my friend.

Circumstances not for this post meant that I had to go and live with a foster family, and only got to see Mum one more time. It was Christmas 1986, and I was taken to see her in hospital. She was by now extremely ill, and the sight of her shocked me beyond belief. She was so thin and frail, and she wasn’t wearing her wig. She had wanted to give me a Christmas gift, a jumper.  I didn’t know at the time, but this visit was also to say goodbye.

My foster family had a self-contained flat behind their house, and my father used to come and visit and stay there every weekend. On Saturday 31st January 1987 the phone in the flat rang. Dad answered and I remember him talking very quietly. He told me to come and sit down, knelt in front of me taking my hands at the same time, and told me that Mum had passed away. My world crumbled and I broke down. The tears that day just didn’t stop. Or the next. In fact it is 32 years today since that conversation and the tears still flow now. I remember standing round her grave 4 days later. Trying to sing The Old Rugged Cross with everyone else but being unable to due to how much I was crying. Seeing her coffin in the ground and throwing a handful of soil on to it as prayers were said.  I just wanted to lie in there with her. I couldn’t bear the thought of her being cold and alone. I so badly wanted this all to be just a terrible nightmare. It was a nightmare, but one that couldn’t be woken from.

Her death certificate says she died of breast cancer primarily, and also cervical cancer. She was just 40 years old. She never got to see me become a teenager, pass my exams, get my first job, get a boyfriend, have a child. I miss her every single day.

 

Advances in medicine and medical technology now mean that these two types of cancer have fantastic screening programmes. At the moment these programmes are mainly for women who fall into the age bracket deemed most at risk, although in some circumstances they are available before this.

For breast cancer, women aged over 50 are invited for mammogram screening every 3 years. However, if you have a family history of breast cancer, like I do, and are younger than 50, have a chat with your GP. They will then refer you to a breast clinic, who will assess whether you are at a higher risk so need more regular screening. As my Mum had it so young, and my sister also had it at a young age (thank God she is clear of it now), I am at a higher risk of developing it too, so I have annual mammograms or MRI scans to make sure it would be caught at an early stage if it did develop. Surprisingly, only around 75% of women who are invited to attend screening actually do go for it. But with statistics showing that someone in the UK is diagnosed with breast cancer every 10 minutes, early detection is crucial. Breast cancer survival rates have doubled in the last 40 years, and this is partly due to our screening programme being able to identify problems early.

Some women worry that mammograms hurt. As someone who has had one every year for the last 7 or 8 years, I can honestly say they can be a little bit uncomfortable, but nothing unbearable. They don’t squash you as flat as a pancake, just enough for them to get a clear picture of your breast tissue. The part that I find slightly uncomfortable is the machine pressing under my arm. They need to get as close to your breastbone as possible, and to do that sometimes you need to stand in such a way that the machine digs in a bit under your arm. But as I said, any discomfort quickly passes, and can potentially save your life. Around 80% of people who are diagnosed with breast cancer now survive beyond 10 years! Surely that makes it worth being screened.

If you haven’t had a mammogram yet, here are a few tips to help you prepare. Try to book your appointment for about a week after the end of your period. Your breast tissue is less dense then so your pictures will be clearer, and your breasts won’t be tender. You will need to strip down to your waist, so wear a skirt or trousers rather than a dress. You will be given a hospital gown to wear until you have the mammogram. Don’t use deodorant, particularly the aerosol ones, or talc, as these can show up as little flecks or blobs on the result, which would then need further investigation and tests. If you have long hair, you might find it easier to tie it back so it doesn’t get in the way. And remember, the radiographer will have seen every size and shape imaginable, every day, so there is no need for embarrassment.

 

Cervical screening, on the other hand, is available to women aged between 25 and 64. There are calls for this age limit to be lowered though after cases of women being diagnosed younger than 25. Ten years ago, a famous TV star called Jade Goody died from cervical cancer at the age of 27. This cancer is a slow growing one, and early screening might have been able to detect it before it had advanced and become terminal. Jade’s death shocked everyone, and led to thousands of women booking smear tests (as they were then called). Sadly though, as time has passed, less and less women are going for cervical screening. Around a third of women invited for screening ignore it and don’t book an appointment. This is mostly due to embarrassment. Let’s get a bit of perspective on this though.

Many of those women who are too embarrassed to go for screening will get pregnant at some point. Having a baby means countless people having to look “down there”, and these people will possibly witness some things that you would find excruciatingly embarrassing if you weren’t in so much pain trying to push your baby out. I’m thinking back to when my son was born and how many people were in the room at the time. A midwife kept checking how far dilated I was. Another midwife had to feed a clip up to my unborn baby’s head to monitor him as he had very kindly had a poo in my womb which could have caused big problems. A student was in the room watching everything. There was someone there doing a medical survey. The anaesthetist was there trying to give me an epidural (it didn’t work for me). Another nurse had to come and start preparing me for a Caesarian as it was all taking so long (23 hours). Someone else had to give me an episiotomy to try to help me push my son out. Another midwife came in with the suction cap to help to pull him out. And then someone stitched the episiotomy back up. And my best friend was there. The room was buzzing with people. All these people watching the events unfolding down below. Not every birth will need that many people present. Some might even need more! But the fact is, you are seen with your legs open by more than one person, for quite some time.

Cervical screening takes just a few minutes and is done by just one person. This person will have done hundreds of these and really won’t care whether you have shaved or not, whether you have a bit of cellulite (most women do) or what underwear you wear (they won’t see that anyway). All they will care about is gently getting the cells needed to be tested, and potentially saving your life. The test doesn’t hurt at all, although some people say it feels slightly uncomfortable. It doesn’t detect cancer, but it does detect abnormal cells in your cervix, if there are any. Most times, these abnormal cells are nothing to worry about. Sometimes though they can become cancerous. Finding and removing these cells can prevent cervical cancer. Most changes to cells are caused by the HPV virus, which is very common. Cervical screening now checks for HPV too.

Thanks to cervical screening detecting abnormalities so early, and the HPV vaccination, cervical cancer is now largely preventable. Around 9 people are still diagnosed each day in the UK. The earlier it is detected, the more chance there is of it being successfully treated.

As well as having mammograms every year, I have had to have cervical screening every year for as long as I can remember. That is nothing to do with my mother though. Mine tend to come back with an abnormal result, or not enough cells were caught. This means I have had to have repeat ones 3 months later, and then annually after to make sure everything is OK. My last one last year though came back with a normal result, and for the first time I was then told I can wait 3 years before my next one, just like everyone else. Happy days!

If you have never had cervical screening for whatever reason and are worried about how to prepare for one, here’s a few tips. One of the things that has made women too embarrassed to go is the worry about how they might smell. If that is a worry to you, it is fine to have a shower beforehand. I will say from experience though, don’t have a bath! I didn’t know this before my first one. In fact I knew nothing about them before my first one. I just knew that I didn’t want to end up like my Mum. Bathing or washing too thoroughly before screening can affect the sensitivity of the test and result in you being asked to have a repeat one a few months later. You’ll probably feel more relaxed about having the test if you feel clean and fresh, so a quick shower or even a wet wipe will be just fine. Don’t have sex the day before your test as this can affect the result. The best time to go is mid-cycle, so 10-14 days after the start of your period. If you don’t like the thought of lying there naked from the waist down, wear a skirt, as you will be able to keep that on. Regardless of what you wear though, you will be given a large paper towel sheet to cover your modesty. That is all the preparation you need. You really don’t need to shave or wax. The nurse will have no interest in your appearance whatsoever.

 

I will always keep up to date with screening appointments. I owe it to my son. I want to be here for him and do all the things my mother wasn’t able to do with me. I want to be there when he leaves school, I want to be there for every special event in his life. (OK, I’m not looking forward to seeing him leave home, but I still want to be around to help him). Hopefully, cancer screening will mean I will be.

(By the way, a cervical screening test takes less time than the time it has taken you to read this post).

If you have been putting off having your screening tests for whatever reason, please, make that appointment. Your future self will thank you for it.

 

 

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