Thursday, 3rd


May 2018


info@eastcorkjournal.ie


27 The Silent Killer that is Cervical Cancer - Personal Perspectives’ by DR ROSARII GRIFFIN


Introduction I can still remember, as


if it were yesterday, the day when I was told I had cer- vical cancer, and especially now when cervical cancer is making the media again for all the wrong reasons. It brings my brush with cancer back into perspec- tive.


Tests With the birth of my


second baby, I was to take a routine smear test as is the norm. Unfortunately, I somehow missed that Gy- naecological appointment. When I realised this and rang up the office, the sec- retary told me I could go to my local GP instead. I had no intention of doing so as my smear test was all part of the medical package already paid for, so I re- quested to be rescheduled instead. Although my own GP was great, I wanted to complete all those tests with my Gynaecologist, given he had successfully delivered my two children. I was duly rescheduled. Although Irish women are recommended to get a smear test annually, in the USA they are recom- mended to get them every six months. The reason for this will become clearer as you read on. This should become the norm in Ire- land too.


Appointments I endured the


routine


smear test, and headed home. Some days later, I got a phone call from the office to say that the test results were back, but they needed to perform further tests as the results were un- clear. Would I be available to do a repeat test soon? ‘Yes, I would’, so they set a new date, possibly May. Following that test, I was called in again for more advanced tests, just to be sure. No problem.


be safe than sorry. Again, I did the necessary. It was pushing well into the sum- mer when I was called in yet again for an overnight stay, so that they could un-


dergo a more invasive pro- cedure taking out part of the cervix. They explained this procedure might cre- ate difficulties if I were to get pregnant again, as I would now run a higher risk of having a miscar- riage. So a female Gynae- cologist from India asked me about my children - if I planned on having any more? I smiled and said, ‘who knows, maybe next time, I’ll try for a boy!’. She smiled back and walked away (later she told me she went to her office and cried). I was subsequently released from hospital and went home.


‘the


The Call I still remember getting call’. I was driving


from Limerick to Cork on a Friday evening when I got an unexpected call on my mobile. My Bluetooth, hands-free device was on in the car, as I often used commuting time to


take


work calls. ‘Hello Mary’, I said to the secretary, whom I came to know quite well, ‘can I help


you? ‘Yes’,


Mary said, ‘I’ve been try- ing to reach you for ages’. I said my mobile phone had been giving trouble, but to ‘go ahead’. Mary blurted out ‘I’m ringing to let you know you will have to come into the hospital soon for urgent major sur- gery. Are you OK to come in for a chat about it with the doctor next week? If so, I’ll make an appoint- ment straight away’. I was in complete shock. To this day, I can still remember the section of the road I was driving when I got that call. In fact, I nearly crashed the car, with the shock of


receiving such


unexpected news whilst driving. ‘What does this mean?” I asked her in a state of distress. “The Doc- tor will explain everything to you next week at the ap- pointment. ‘Oh, and, can you bring your husband with you? The Doctor has requested to see you both’. Yes, I said, noting the time and date. We’ll be there’. She thanked me and hung up. As for me, I was left reeling.


Best Calls I rang my husband who


was still at work. He did not like to be disturbed when teaching. When he answered I asked him to


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leave the room, to take the call privately, outside. As this was an unusual re- quest, he complied imme- diately realising something was up. I relayed the con- versation to him and was quite upset. However, we both agreed not to jump to conclusions before meet- ing the Gynaecologist. I rang my mother next, and then my best friend. It was going to be a long weekend until


Monday morning.


The only consolation - I was going home to be with my adorable babies, look- ing forward to spending time nurturing them.


Meeting The Gynaecologist be-


gan the meeting by telling me that I probably would not


remember part, or


even any, of the conversa- tion that was about to com- mence. I disagreed saying ‘fire away’. Although he had warned me previous- ly of possible ‘worst case scenarios’, he said the re- sults were conclusive: I had cervical cancer. He didn’t know how bad it was, but that


it was an aggressive


type. In other words, since my baby was born nine months earlier – an ag- gressive tumour had begun to grow in my cervix and they did not know if


it –


the cancer - had spread. I bore the information calm- ly. ‘OK’ I said, ‘what does this mean?’ ‘This means’, he said solemnly, ‘that you have to have radical sur- gery soon i.e. a complete hysterectomy immediately. “What


Choices I knew then I really did


not have a choice - but what if it was all a big mis- take? After all, I had no signs or symptoms of hav- ing cervical cancer. I asked him – ‘not withstanding the


fact that you are a


great physician, and I have great faith in you, but can I get a second opinion?’ He agreed it was my right and entitlement to do so. But when I gave some names to him, they had already been on the multi-disci- plinary team that took the decision to operate. This decision was based on my X-rays, ultrasounds, blood tests, smear tests and bi- opsies. This multi-disci- plinary team consists of consultant


oncologists,


oncology nurses, other medical staff taking a ho- listic approach to the de- cision-making around the patient’s diagnosis. Still, my consultant advised me to go think about it. We did. It became apparent that I didn’t have any real options open to me but to go along with the plan, especially given the calibre of the multi-disciplinary team. So, after due con- sideration, I told him to go ahead, and a date was set for the operation.


wanted to ation


for if I want another


child first?” I queried. He looked me straight in the eye and said, ‘at your stage of cancer, you would not live to see your new baby, and there is also a strong possibility that


the baby


would not survive either’. ‘Hmmm, I thought, that’s pretty definitive. ‘And’, he added, ‘there is no guaran- tee even if you had a third child, it would be a boy’. I nodded, getting the point. ‘No, he said gently, you need to treasure the two babies you have now, and be there to see them grow up’. ‘If you try for another baby, you certainly will not live to see them grow up, and they need their moth- er’. That, too, was pretty definitive, and difficult to hear. Yet again I nodded, getting a clearer sense of the gravity of the situation.


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Date The Gynaecologist set


the


the oper- following


week but I requested the week after. I explained I had a big group coming from Lesotho, Africa, to attend workshops I had been planning for months. I was the group leader re- sponsible for everything. Besides, I had loose ends to tie up, given my recov- ery could take


months.


The Consultant looked at me in disbelief, and then pleaded with my husband to talk to me, but he said, ‘there’s no point’. Reluc- tantly my surgeon agreed, and booked me in Tues- day the


following week.


During my week with the Africans, it was work as usual. I distracted myself by becoming immersed in the workshops. On the fi- nal day – at a Board meet- ing - I announced I would absent for a few months for medical reasons, but there was lots of work for everyone in my absence. This news came as a sur-


prise to everyone, except the Chairperson who was already briefed. He nod- ded sagely and everyone, taking their cue from him, wished me well. The work- shop had been a great success, and now I could be operated on in the full knowledge that I did my very best for the project. Although my medical con- dition was not mentioned, one of the Africans relayed to me the tragic news about my African driver’s wife who had just unfortunately died of what, but cervical cancer. She was diagnosed too late! That news sent me into a tailspin, though I tried to reason with my- self, I was living in Ireland not Africa, and my diagno- sis was made at an earlier stage.


Preparation I did, however, cancel


my last teaching class on the Friday evening, and instead, drove to Galway with the children to their Grandparents house. They were going on an unexpected


holiday, and


were delighted to be with Granny and Grandad. Indeed, they were thrilled to


have them too! On


Saturday evening, I over- heard Granny explain to a cousin on the phone, that I was going into hos- pital ‘for an operation for cervical cancer’. Once she had put down the phone, I got up and asked her di- rectly ‘who said I had cer- vical cancer?’ ‘What are you saying?’, my husband asked, who was also in the room. ‘Nobody told me I was going into hospital for an operation for cervical cancer’ I said loudly, visi- bly upset. ‘But I was there’, he insisted, ‘I was with you when the doctor told you that you had cervical can- cer. You were there too, you heard him. You un- derstood everything. You said you did. So, why do you think you are having an operation next week then?’. I was now the one who was bewildered.


‘I


don’t know. All I know is, I DO NOT HAVE CER- VICAL


CANCER’, poor I


sobbed and stormed off. The


Grandparents


were as bewildered as was I. The enormity of what was about to happen had actually just hit me.


Psyche Later, it was apparent


to me that this is what the Consultant meant when he said that I may not take in part, or any, of what was said. I think the brain doesn’t


process ‘cancer’


too well. Despite being the eve of my return to Cork and signing myself into the


the following day, still, the severity


hospital for surgery of my diagnosis


was only just hitting me. My brain was processing information on a ‘need to survive basis’. The fact that I was given a Grade 3 (CIN 3) prognosis hadn’t sunk in either. Grade 1 is when pre-cancerous cells are identified. Grade 2 is cancerous cells. Grade 3 aggressive cancerous (ex- tent unknown), and Grade 4, terminal. I was grade 3. It was all an unknown territory for me. Certainly, my brain was on ‘surviv- al’ mode. I clearly was in denial when I overheard Granny say the words out loud to her cousin. But to me, to hear those words were


shocking, because it hit me! I had cervical cancer, my lifespan now uncertain.


Pre-Op The night before the


operation was worse. I was sharing a room with someone. There was a flood of ‘get well’ cards and flowers from friends and family. But at 3am in the morning, I was essen- tially facing death. I was listening non-stop to my iPod connected with my earphones. Leonard Co- hen’s ‘Hallelujah’ song gave me great comfort. I put it on ‘replay’ all night. Eventually, when I had worked through the anxi- ety and the fear of dying, I finally reached a place of acceptance.


It was then I


felt a deep sense of peace. Somehow, I knew whatev- er happened, live or die, it would all be OK. And with that thought, I fell into a peaceful sleep.


Op and Post-Op The operation took


longer than expected: six hours. The prognosis af- terwards - still unknown. I had faith in my surgeon who had previously de- livered my two babies by C-section, and this was his third operation on me. I knew if anyone would do a good job, he would.


My recovery was slow and painful. They prepared my body for radiotherapy and possibly chemo. The oncology nurse had talked me


through everything.


All we needed now were results. When the good news came through some days later, we were


all


so relieved. I would live, barring any other missiles coming my way, to see my baby girls grow up! I now only had to recover. As Lymph nodes came back clear, it meant that sur- prisingly, despite the size and aggressive growth of the tumour, the cancer had not spread. I was, however, left with a condition called ‘lymphedema’


especially


in my legs – but I felt that was a small price to pay given the serious prognosis that it was. Thankfully, it was all caught just in time. That was due to a wonder- ful medical team, support- ive family and friends, and a belief that whatever hap- pens, it would all be fine.


Reflection If there is a post-script


to this, it is the following: women, get your smear tests done, and men, pros- tate tests, and daughters - get the HPV vaccination. Prevention, as we know, is much better than cure! My sisters-in-law got their smear test done follow- ing my prognosis, and one had stage 1 cervical cancer! Early detection is key to survival and ul- timate cure. But if diag- nosed with ‘the


big C’,


stay hopeful and positive. That will get you through the worst of it. Most of all, keep the faith. It is during trials like this that great goodness of others shines through, especially family and friends. We should all live every day like it is our last, for who knows what can ever befall any of us at any time? Life is a game of chance: we have to take our chances every day, and give thanks for the lovely times we all share together. Profile: Rosarii is a Lectur- er, Researcher and UCC Governor and a Fellow of the Royal Society of Arts, London. All opinions ex- pressed here are her own personal viewpoints. You can contact Rosarii


on:


info@eastcorkjournal. ie or @rosarii_griffin. Thank you.


Tel: 021 463 8000 • Email: info@eastcorkjournal.ie • Web: www.eastcorkjournal.ie


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