Over 300 women are diagnosed with cervical cancer in Ireland every year and while the majority of these are under the age of 35, it can and does affect older women.
Having religiously gone for routine smears throughout her adult life, in her mid-fifties, Mary McAuliffe didn’t think she was still in the risk bracket, but some irregular spotting caused her to seek medical advice.
“In April 2013 my life changed,” says the Limerick woman. “Having always attended routine smear tests and always with clear results, I was a bit concerned when I had a small bleed after sexual intercourse with my husband. That, combined with back ache and feeling a bit off, made me go to the doctor even though I was extremely healthy, with a good diet and I walked each day.
“I was referred to a gynaecologist — and thought it was just a big fuss about nothing. But when I had another big bleed after intercourse, I was glad I had the appointment coming up.”
After an examination with a consultant, it was decided that Mary (now 61) probably had a polyp, but further tests were scheduled to be ‘on the safe side’.
“I am blessed to have private insurance so got seen fairly quickly and was in great spirits when I went into the day ward for investigation the following week,” says the mother of three. “So I wasn’t ready for the blow when I opened my eyes in the recovery room and the consultant said it was more than a polyp — I asked her if it was a tumour and she nodded.
“I couldn’t understand how this could happen after always having clear smear tests.”
Joan Kelly, Cancer Support Manager for the ICS says most cervical cancers are caused by the HPV virus.
“This is a very common virus that is passed on during sex,” she says. “Most women will get this infection and it usually clears up by itself, however, if you smoke, it can prevent the infection from clearing up. Ongoing HPV infections can cause abnormal changes in the lining of your cervix and these, if left untreated, can lead to cervical cancer.
“Not having regular smear tests can increase your risk of getting cervical cancer, as well as not getting the HPV vaccine.”
A week after the internal investigation, Mary, who has five grandchildren, was called back for another consultation where she was given the official cancer diagnosis.
“It was confirmed the tumour was malignant and the next step was an MRI scan,” she says.
“When these results came back I was told that my tumour was 5cm and I would have to have radiation treatment for 28 days and chemotherapy once a week. This would be followed by three sessions of brachytherapy.”
Mary, who works as a civil servant, started treatment in June 2013 and says she got through it with the help of family and friends.
“The whole thing was surreal, with my family in bits and me trying to maintain independence and keep up a positive attitude,” she says. “I got up every morning for a session of radiation, dressing as if I was going to the office and with my earphones in I listened to the radio during treatment. The care and attention I received from staff made it a little easier to face each day.
“My family surrounded me with love and attention and my husband travelled up and down to Dublin each day when I was an in-patient in for the brachytherapy which was a very difficult treatment. The support of family and my few close friends was very important and I will always be grateful to those who made the extra effort to be there for me.”
Cervical screening can detect abnormal cells early when they are easier to treat and before symptoms develop — and CervicalCheck recommends all women — aged 25 to 60 — attend cervical screening when they are due.
Dr Caroline Mason Mohan, Director of Public Health at the National Screening Service says some women will still develop cervical cancer despite regular screening but it is still vital to attend screenings.
“We know that women over the age of 50 are less likely to attend cervical screening than younger cohorts of women but cervical cancer is still a risk for women as they get older,” she says. “This is why it is important for those who are still eligible to continue to attend screening tests.
“We acknowledge the concern women in Ireland have had about cervical screening during the last year and are working to strengthen CervicalCheck in order to provide a screening programme of the highest possible standard. Our efforts to address the smear test result backlog; our implementation of Dr Scally’s recommendations; and our ongoing planning to introduce HPV primary screening are key parts of this work.
“Like all screening programmes, cervical screening is not perfect. But it does save lives and can prevent 75pc of cervical cancer cases. Since it began, CervicalCheck has detected and treated over 100,000 cases of pre-cancerous abnormalities, many of which could have developed into cancer if not detected through screening. And the programme diagnoses one case of cervical cancer every two days. So we encourage women to continue to engage and attend their regular cervical screening, as we work to improve this invaluable public health programme.”
Helen Forristal, director of nursing at the Marie Keating Foundation agrees: “Early diagnosis of abnormal cells can be treated and prevent changes in the cervix developing into cancer,” she says. “So it is really important to see your GP if you are experiencing any of the symptoms at any age — and the cervical screening programme is for women without symptoms.” It has been five years since Mary was given the all-clear after her cancer diagnosis and she would advise all women, to avail of screening services and visit their doctor if they have any concerns.
“I am five years clear now and it does take that time to get back to full health,” she says. “The radiation did an amount of damage to my cervix, bladder and rectum, causing me to have a lot of bleeding from those areas but in the next few weeks I hope to have hyperbaric oxygen therapy to help to heal this.
“I would advise all women over 50 to continue with their smears and to see their GP even if they only see a spot of blood, as the earlier the diagnosis the faster the treatment and it is very treatable at an early stage.
“I am alive well and still with my family — I value each day and time with my family and feel blessed.”