In November 2009, my doctor’s office called and asked me to discuss my recent Pap test. I didn’t think too much of it at the time and agreed to come in the following day.
At my appointment, my GP advised that my Pap test had come back abnormal. I still wasn’t alarmed. I work in women’s health research, in the area of infectious disease. Many of the studies I work on involve participants getting Pap tests, so I see these results all the time. Although I am not a doctor or a nurse, I know that many things can cause an abnormal Pap test. Things like infection… perhaps I have a yeast or bacterial infection? An STD? Unlikely, but it’s good to get checked and be sure… Perhaps when my doctor did the Pap test, she didn’t get enough of the right cells and the Pap test was unreadable? All these thoughts ran through my head as likely causes.
However, this wasn’t the case. My doctor said that my Pap test indicated CIN II/III. Hmmm…. Cervical intraepithelial neoplasia, grade 2 or 3, or moderate to severe cervical dysplasia. This is the point in my visit where I forgot everything I had learned in my career and lost the plot. I HAVE CANCER!!!! “No, my doctor assured me, “you do not have cancer. However, there are some changes on your cervix that, over time, could turn into cancer.” My doctor advised me that, as Pap smears are not diagnostic tests, simply a very effective screening tool, she was referring me for a colposcopy to take a closer look at these changes.
A few weeks later, I arrived at the Colposcopy Clinic for my appointment. I was very nervous and still convinced I had cancer. After watching the extremely dated, but very reassuring video, I was led into the clinic. The nurse asked me a few questions (date of birth, last menstrual period, any allergies? That sort of thing) and led me to get changed. I was provided with two gowns (I never know whether to do them up at the back or the front!) and some very stylish paper booties.
After waiting what seemed like forever, I was led into an exam room. I was greeted by a lovely nurse and the gynecologist who let me know what I could expect during the exam. A colposcopy is much like a Pap test. Same fabulous position (bottom so far down the exam table that it feels like it’s going to fall off, let your knees just “flop” open, please, feet in the always cold stirrups), and mostly the same procedure. A speculum was inserted, just like a Pap test, but a colposcope was used to take a really close look at my (I’m convinced) cancer-ridden cervix. (A colposcope is a large, electric microscope that is positioned approximately 30 cm from the vagina. It has a really bright light on the end which helps the doctor see the cervix (and any changes) really clearly)
The very cool thing about this procedure was that I could watch the entire thing on a monitor mounted on the wall to the right of me. It’s not every day a girl gets to see her cervix, and let me tell you, it was very cool!
The doctor then washed my cervix with a vinegar solution so that any abnormal areas would show up more clearly. And there it was… a white blob that looked like a jelly fish had exploded on my lovely pink cervix. Now I was really scared. Surely this was cancer! However, the doctor advised that his impression was that I did not have cancer. Yes, there were some moderate changes that he wanted to take a biopsy of so that the pathologist could look for changes in the cells that might indicate that cancer is present or likely to develop.
The biopsy felt like a little pinch. Unfortunately, I did watch the biopsy being taken on the monitor and I wish I hadn’t. As the cervix is quite vascular (has a lot of blood vessels), it does bleed a bit when a biopsy is done. Magnified about 4 billion times, it looks like it should really hurt. I honestly felt like a little pinch, but that picture told me it should hurt a lot more than it did. The biopsy itself was about half the size of a pencil eraser. My doctor would have the results back in a few weeks, the gynecologist said.
Off I went with some mild spotting and cramping that would last a day or two. A little less frightened and reassured that I likely did not have cancer (although I still wasn’t entirely convinced). And VERY relieved that I am religious in getting my annual Pap test! What if I had skipped a couple of years??? You know, things get busy… life takes over…
A few weeks later, back at my doctor’s office, I was told that the biopsy showed CIN II or moderate dysplasia. This meant that the abnormal cells involved about one-half of the thickness of the surface lining of the cervix. It also meant that I did not have cancer! It did, however, mean that these changes would need to be treated. If the biopsy showed CIN I, these changes likely would have gone away on their own. I would have another Pap test in 6 months or so and my doctor would have kept a close eye on things. But, with CIN II, treatment is usually required.
Several weeks later, I was back at the Colposcopy Clinic for a LEEP. A LEEP procedure uses a thin wire loop electrode to painlessly and quickly cut away the affected tissues on the cervix.
After watching another dated but nevertheless informative video, I was taken into the clinic room. I opted not to watch this procedure! Again, it’s much like having a Pap test. Nothing hurt, but the freezing that they put in my cervix felt “pinchy” and the adrenaline made my heart pound a little. Other than that, it was pain free and I was out the door in 15 minutes. Three days of mild cramping and spotting followed. No sex, exercise, or swimming for three weeks to prevent infection and to allow my cervix to heal, and no strenuous exercise for one week. NO PROBLEM!
About six months later, I had a follow up colposcopy appointment. Everything looked great and there were no abnormal cells remaining. Hooray! Since that time, I have only had normal Pap smears.
This whole experience taught me that I have been doing a great thing for myself in getting my Pap tests done faithfully. I am very thankful I live in a place where access to Pap testing is free and encouraged. It is one of the most important things we women can do to protect ourselves from cervical cancer. Along with Pap testing, those of younger generations will also have the HPV vaccine. My young daughter, hopefully, will not have to go through the same worry that I did.
I only wish that other women, in less fortunate places, had the same access to these live saving screenings and diagnostic procedures, not to mention the HPV vaccine.
Thanks for allowing me to share my story with you. I sincerely hope that it will encourage you to call your doctor, and book an appointment to get your Pap test today!
Melissa Lambrecht, WHRI Research Assistant
For further reading, I have included some links below to a few great websites that discuss HPV and Pap testing.