Everyman Male Cancer Month

Happy Monday one and all. I hope you are all well.

June is Everyman Male Cancer Month and I wanted to do a post to reiterate the information I have previously posted regarding male cancers.

If you have Twitter then I would recommend checking out @one4theboys as they encourage men to be more aware of their health. Samuel L Jackson is one of their advocates and you can read his views here:  http://www.bbc.co.uk/newsbeat/23013161

This post is dedicated to my wonderful friend Stuart Pilcher, a survivor after fighting testicular cancer as a teenager. Stuart is one of the most amazing people I have ever met and my friend of almost eight years! You can read about Stuart here: http://pennysophia.blogspot.co.uk/2011/12/stuart-pilcher-survivor-story.html

The post is also dedicated to the wonderful Nigel Lewis-Baker. Nigel is one of my fellow cancer campaigns ambassadors and he suffers from prostate cancer. However, his diagnosis has not prevented him from getting involved and becoming a powerful advocate for several cancer charities including Prostate Cancer UK, Macmillan and of course, Cancer Research UK.

Prostate Cancer:

The Prostate:

The prostate is a gland found only in males. It surrounds the urethra, the tube that carries urine from the bladder to the penis. It also carries semen. The prostate is responsible for creating the fluid part of semen. The prostate needs testosterone (the male sex hormone) to grow and function.

Symptoms of Prostate Cancer:

Having to rush to the toilet to pass urine

Difficulty in passing urine

Passing more urine than normal, especially at night

Pain when passing urine

Blood in urine or semen (very rare)

These symptoms are the same for prostate cancer and an enlarged prostate so it is important to go to the GP as soon as they appear. The symptoms are usually caused because the growth is pressing on the urethra and is blocking the flow of urine. It is important to remember that early prostate cancer does not usually cause any symptoms because the growth is too small to affect the flow of urine.  Prostate cancer usually grows quite slowly, especially in older gentleman. They may only suffer mild symptoms and they may occur over a number of years.

Causes and Risks:

Prostate cancer is the most common cancer for UK men (not counting non melanoma). There are some risk factors:

* Age is the most significant of these risk factors. Prostate cancer is quite rare in men younger than fifty – in fact more than half of all prostate cancer cases are found in men aged seventy plus.

* Having a family history of breast cancer or prostate cancer will also heighten your risk of developing this type of cancer

* If you are of African ancestry then your risk is also higher as this type of cancer is more common in men of black or mixed race descent then white or Asian men

Screening:

The aim of screening for prostate cancer is to diagnose the disease in the early stages when it is usually easier to treat and most likely to be curable. At the moment a national screening test is not available but research is being carried out and trials are taking place all the time.

Diagnosing Prostate Cancer

If your GP suspects prostate cancer then they will:

* Examine your prostate by placing a gloved finger into your back passage

* Get you to have a blood test to check your PSA levels (PSA = Prostate Specific Antigen)

This is not as painful or as embarrassing as it sounds. GP’s do this all the time and although having a finger inserted into your bottom may sound horrific, I am told by reliable sources that is really isn’t as bad as it sounds. Please don’t let the fear or embarrassment stop you getting this test if you feel you have a problem with your prostate – it could save your life.

With PSA levels, it is usually the higher the level, the more likely you are to have cancer. However, don’t be too alarmed by this fact – there could be another reason, for example an enlarged prostate or an infection. In fact, two out of three men with a raised PSA level do not have prostate cancer. It is possible for a man to have prostate cancer but not a high PSA level – this is where the gloved finger comes in handy.

Treating Prostate Cancer:

This is where my post will get complicated so I will try and keep it as clear and concise as possible!

Prostate cancer is divided up into stages. These stages will inform the doctor of how developed the cancer is and this information will help them decide on the best treatment plan for the patient in question. The stages are numbered 1-4 and your doctor will talk to you about your “TNM” which stands for Tumour, Nodes and Metastases. Basically this means they will discuss the size of the tumour, whether is has spread to any nearby lymph nodes and whether it has spread (metastasised) to anywhere else in your body.

Prostate cancer tends to spread to your bones rather than other organs. It is possible for it to metastasise even when the original prostate tumour is very small. This means early diagnosis is key to treating it and controlling it.

There are several factors doctors consider before deciding a treatment plan. These factors are:

* The stage of the cancer

* The grade of the cells (how they look under a microscope)

* Your Gleason score

* Your PSA levels

* Your age

* Your general health

Once these factors have been considered, your treatment options will become clearer and your doctor will discuss them with you. Please ask questions and make sure you feel comfortable with the treatment plan you are offered. Don’t be afraid to get a second opinion.

If the cancer is low risk and is localised to the prostate area only, then active monitoring is likely to be your treatment option. This means the cancer will be monitored and the doctors will wait to see if it develops. If it does start to develop then surgery may be an option and the prostate gland could be removed. Radiotherapy is also an option at this stage.

If the cancer is classed as an intermediate risk but is localised to the prostate area then surgery to remove the prostate gland may be an option. Radiotherapy may also be considered.

A high risk, localised tumour will usually be treated with surgery and external radiotherapy.

If the cancer has broken through the capsule that surround the prostate gland then this is known as locally advanced prostate cancer. This will usually involve surgery or radiotherapy which will be combined with hormone treatments.

There are many types of surgery for prostate cancer; it is worth taking a look at www.cancerresearchuk.org to read about them. I would also recomend contacting Prostate Cancer UK at http://prostatecanceruk.org/

Testicular Cancer:

The Testicles:

The testicles are part of the male reproductive system and are two oval shaped organs that hang just below the penis in a skin pouch called the scrotum. From puberty, sperm is produced in the testicles as is the hormone testosterone.

Testicular Cancer Symptoms:

The most common symptom of testicular cancer is a lump or a swelling. PLEASE DON’T PANIC BECAUSE MOST TESTICULAR LUMPS ARE NOT CANCEROUS. A cancerous lump can vary in size but is usually not painful although some men will find they have a dull ache in the affected area or in their lower abdomen. The scrotum may feel heavy.

GUYS CHECK YOUR BALLS!

As I may have mentioned several hundred times before, cancer is easier to treat if it is caught early. Check your testicles often (once a month) and get to know how they feel normally. This will make it easier for you to notice and lumps and bumps that may appear. Get your partner to check them too so you have a second opinion if you need one.

The best time to check your testicles is after a warm bath because your scrotum skin will be relaxed. Here is a rough guide on how to check your testicles:

-         *  Hold your scrotum in the palms of your hands and use all your fingers and thumbs.

-          * Gently feel one testicle at a time.

-          * A noticeable increase in size or weight can be a sign that something is not right.

-          * You should be able to feel a soft tube at the top and back of the testicle. This is normal

-          * The actual testicle should be smooth with no lumps or swelling.

IF YOU DO FIND A LUMP OR HAVE CONCERN ABOUT YOUR TESTICLES, PLEASE MAKE AN APPOINTMENT WITH YOUR GP ASAP. IT MAY BE SLIGHTLY UNCOMFORTABLE FOR YOU BUT DETECTING ANYTHING WRONG AT AN EARLY STAGE COULD SAVE YOUR LIFE AND YOUR TESTICLE!!!

Risks and Causes of Testicular Cancer:

Cancer of the testicles is quite rare in the UK and not much is known about what causes it. However, there are several factors that can increase a man’s risk of developing the disease:

-     * If a young boy has an undescended testicle than it should be corrected by the time they turn eleven to avoid an increase risk of testicular cancer.

-     * Some men have Carcinoma in situ (CIS) which is basically abnormal but not cancerous cells in the testicle. These cells will have to be monitored to ensure they do not develop into cancer and are caught early if they do.

-     *  If you have a brother that has suffered from testicular cancer then research suggests this could increase your risk of developing it too. Around 20% (1 in 5) testicular cancer cases are caused by faulty inherited genes.

-     * Ethnicity is also a factor. In the USA, white men are 5 times more likely to be diagnosed with testicular cancer then black men. In the UK, testicular cancer is also much more common in white men. As yet, not much is known about why this is.

Treatment for Testicular Cancer

There are many factors to consider before your specialist will decide on a treatment plan for you. They will consider the stage, grade and position of the cancer as well as your general health and whether or not the cancer has spread to other parts of the body.

Treatment by Stage:

Stage One – If you have very early testicular cancer then the likelihood is that you will have surgery to remove the whole of the affected testicle. This is called an orchidectomy. You may also be offered Radiotherapy or Chemotherapy.

Stage Two - The treatment of stage two testicular cancers depends on the size of the affected lymph nodes.  It may be treated with chemotherapy or radiotherapy. Surgery to remove the lymph nodes may also be an option.

Stage Three – After surgery, stage three testicular cancers are always treated with chemotherapy to shrink the lymph nodes. If they don’t shrink back to a normal size then they may be removed or treated with radiotherapy.

A LITTLE SIDE NOTE – I NOW WORK IN A FERTILITY CLINIC AND HAVE LEARNT LOTS ABOUT FERTILITY. AS SPERM IS PRODUCED IN YOUR TESTICLES – I STRONGLY URGE ANYONE DIAGNOSED WITH TESTICULAR CANCER TO ASK THEIR SPECIALIST ABOUT FERTILITY BEFORE THEY START THEIR TREATMENT. IF YOUR FERTILITY WILL BE AFFECTED BY YOUR TREATMENT THEN STORING YOUR SPERM IS A VERY EASY PROCESS AND CAN BE DONE BEFORE YOU START YOUR TREATMENT. IT IS VITAL TO PROTECT YOUR ABILITY TO FATHER CHILDREN IF YOU WOULD LIKE TO HAVE A FAMILY IN THE FUTURE.

So guys, I’m actually encouraging you to regularly have a good old feel of your testicles! It’s hugely important to know your own body and what is normal for you so abnormalities can be detected ASAP should they arise. This could save your life! Please do go to your GP if you have any worries about anything mentioned in my blog post today.

For more information about testicular cancer please visit www.cancerresearchuk.org or visithttp://www.orchid-cancer.org.uk/ which is a specialist charity for male cancers.

If you have testicular cancer and would like to preserve your sperm by freezing it – please speak to your specialist or visit http://www.londonwomensclinic.com/

xxx

Sarcoma Awareness Week 2013 - Bone Sarcomas

I mentioned the most common type of bone sarcoma yesterday. Osteosarcoma is most commonly found in the arm of leg (specifically the thigh or shin bone) and is usually found in young people or the very elderly.

The next most common form of primary bone cancer is Ewing’s sarcoma, which I have written about previously. This can affect any bone but is most commonly found in the pelvis, thigh and shin bone. Ewing’s sarcoma is commonly found in teenagers and is very rare in those over the age of thirty.

There are other types of bone cancers that affect adults more then children for example histiocytome affects connective tissue and chondrosarcoma originates in the cartilage.

Rarer types of bone cancer are Chordoma which forms in the spine in adults and giant cell tumour (GIST) which can affect any age.

Treating Bone Sarcomas:

The initial aim of treatment would be to remove the tumour completely but the approach would depend on the type of bone cancer, for example osteosarcoma is usually treated with high dose chemo before and possibly after surgery whilst Ewing’s sarcoma responds well to radiotherapy in most cases so that may also be included in the treatment plan. 

Chondrosarcoma does not normally respond well to chemo so surgery is usually the main treatment option for this type of bone cancer.

Amputation is an option but is not considered lightly and is no longer commonly used to treat bone cancer. Limb salvage techniques are used in most cases should it be possible.

New drugs are developed all the time to help patients with certain kinds of bone tumours. Mifamurtide can be given to patients with osteosarcoma after surgical chemotherapy and clinic trials have shown an improvement in long term survival.

England has some specialist treatment centres for bone sarcoma:

*Newcastle Upon Tyne Hospital NHS Foundation Trust

*Robert Jones and Agnes Hunt Hospital

*Birmingham Royal Orthopeadic NHS Trust 

*Nuffield Othopaedic Centre NHS Trust

*Royal National Orthopaedic NHS Trust Stanmore

Scotland's managed sarcoma network has three centres for surgery for bone tumours - Aberdeen, Glasgow and Edinburgh. Chemotherapy may be provided in Inverness or Dundee if one of these is closer to the patient's home.

In Wales it is most likely that a patient diagnosed with a primary bone cancer will be referred to Birmingham for surgical treatment, although chemotherapy may be provided closer to home.

For patients in Northern Ireland a referral to Birmingham is also the favoured routine for treatment

Evidence appears to show that these specialist treatment centres deliver the best results for patients and these centres are leaders in the development of new techniques for bone tumours to try and avoid amputation whilst improving survival rates.

I hope you have found this blog post informative, please contact Sarcoma UK if you have any questions or are worried about anything you have read here today

xxx

Sarcoma Awareness Week Part One

Sarcoma is a type of cancer that I know all too well. This week is all about raising awareness of this cancer type and the inspirational people that have fought it/are fighting it. I hope you find this weeks blog posts interesting and informative.

What is Sarcoma?

Sarcoma’s are rare cancers that develop in the supporting tissues of the body, for example muscle, bone and nerves. They are some of the most common childhood cancers. About 55% of sarcoma’s affect the limbs and about 15% affect the head and neck, the remainder will be found in the abdominal area inside your body.

There are three main categories of Sarcoma: Soft tissue cancer, Primary bone cancer and Gastro-Intestinal Stromal tumours. There are also about seventy different sub types of sarcoma which fall into these three main categories. Osteosarcoma falls under the primary bone cancer category.

Sarcoma UK

Sarcoma UK is the main UK charity dealing specifically with all types of sarcomas. In March 2011, The Sarcoma Trust and Sarcoma UK officially joined together to become known collectively as Sarcoma UK.

Sarcoma UK has one main aim: to get the best possible level of treatment and care for patients suffering from sarcoma. They achieve this through three different means:

·         They fund scientific and medical research into discovering what causes sarcomas and how to treat them

·         They deliver various types of support and information services which cover all aspects of sarcoma

·         They raise awareness of sarcoma with members of the public, healthcare professionals and policy makers.

The fact that sarcoma affects a lot of children is horrifying, especially when it could mean having limbs amputated. Georgie had to have his jaw replaced; such a horrific and painful experience for anyone, let alone a sixteen year old boy. However not many people are aware of this type of cancer, I wasn’t until it affected someone close to me.

Sarcoma UK has a small team of hard working staff who work alongside doctors, nurses, researchers and other cancer charities. It has a board of trustees, many of whom have had personal experience with sarcoma. It is a fantastic charity working hard to bring awareness to such a terrible form of cancer. It is so important to bring awareness to such a worthy cause and to get this charity as much publicity as possible. It provides much needed support and information to sarcoma patients and their families as well as much needed research into ways of preventing and curing the disease.

Sarcoma UK relies on voluntary donations as its sole means of funding their hugely important research projects into sarcoma. If you know of a way of fundraising for a charity then I really do urge you to bear Sarcoma UK in mind. Every little really does help in the battle against sarcoma cancers.

Osteosarcoma and Georgie

Osteosarcoma was the type of cancer that killed Georgie. He was fifteen when his jaw swelled up. At first he had a numb lip and weird tingling sensation. It took a while to get to the bottom of what was wrong but we eventually found out it was a tumour in the right mandible. After years of treatment and numerous surgeries, Georgie passed away just months before his eighteenth birthday.

On average thirty children per year in the UK develop osteosarcoma. This kind of cancer is more common in teenagers and is usually found in boys. It is rare to see it in a child under the age of five.

Osteosarcoma starts in the bone, usually at the end where new bone tissue forms as you grow. Any bone in the body can be affected, with Georgie it was the jaw, but it is commonly found in the arms and legs. The knee joint is a particularly common site for osteosarcoma.

The cause of osteosarcoma is unknown at the moment but there are some risk factors to consider: people with Li Fraumeni Syndrome are at more at risk of developing osteosarcoma, as are children who have hereditary retinoblastoma. If a child has had radiotherapy or chemotherapy in the past then they also have an increased risk.

INJURIES THAT DAMAGE BONES DO NOT CAUSE OSTEOSARCOMA. THEY CAN, HOWEVER, DRAW ATTENTION TO ANY TUMOURS THAT ARE ALREADY THERE.

Pain in the bone is the most common symptom of osteosarcoma. This may be on and off for a while at first and then become more severe and constant over time. Swelling may also occur. The bone can weaken and break, which is how many osteosarcoma cases are discovered. Most symptoms can be caused by something else so it is hard to know when to go to the doctor but if your child has persistent pain and swelling in the bone – I would recommend taking them for a check up.

To diagnose osteosarcoma, the doctor will do a series of tests including x-rays. If a bone tumour is suspected then a specialist will be needed to perform further tests such as biopsies. A physical examination of the affected area and a blood test may also be required. Bone scans, MRI’s and CT’s may also be required.

Treatment for osteosarcoma would depend on the size, position, grading and stage of the tumour. Surgery is usually a very important part of the treatment as is chemotherapy. Chemotherapy is usually used to destroy the cancer cells and shrink the main tumour before surgery is performed. It is then used again when surgery has been performed to blast away anything microscopic that may have been left behind. This is to try and reduce the chance of the cancer returning.

Radiotherapy may also be considered as it can destroy cancer cells with high energy rays but do little damage to the normal surrounding cells.

Surgery would depend on the size and position of the tumour. The whole limb may need to be amputated, especially if the cancer has spread to the surrounding nerves and blood vessel. A prosthetic limb will be fitted. Obviously this is a major thing and I don’t want to appear to not take this seriously. Your child’s doctor should discuss this in a great amount of detail with you and both you and your child should receive lots of support if amputation is the only option.

In other cases, limb sparing surgery can be used to preserve the limb. This may involve replacing the limb with a bone graft using part of another bone in the body or it may involve replacing the bone with prosthesis. Georgie has his jaw replaced with another bone part TWICE.

Even with amputation, it should be possible for your child to adjust and still be able to participate in “normal” activities and sports are still a possibility. Long term effects should be discussed with you before surgery.

Osteosarcoma can be a very aggressive type of cancer, and unfortunately, survival rates are not very good. I have a particular hatred for this cancer type and I am hopeful clinical trials and research will discover new ways of treating, curing and preventing osteosarcoma. Please do visit my uncle’s site www.anticancer.org.uk for more information as he is a fountain of knowledge on the subject, and as a parent of a child, who had cancer, he is well informed and able to explain things much better then I ever could.

This is just an introduction to the theme I will be exploring this week but please contact Sarcoma UK if you are worried about anything you have read here today.

Sending lots of love and positive thoughts to anyone currently battling osteosarcoma or anyother sarcoma cancer.

Cervical Cancer Screening Awareness Week

Happy Monday!

This week is Cervical Screening Awareness Week and I wanted to use this opportunity to recover cervical cancer, the screening processes and what to do if you have an abnormal smear test.

CERVICAL CANCER IS PREVENTABLE!

I hope you find this post informative and interesting. Girls – please get your smears done regularly, it could save your life!

The Cervix:

The cervix is basically the neck of the womb (uterus). It is the opening to the womb from the vagina. The cervix is a very strong muscle which is usually tightly shut but it does open during labour so the baby can come out. The outer surface of the cervix has a layer of cells which are almost skin-like. When these cells become cancerous it is known as squamous cell cervical cancer. There are glandular cells lining the inside of the cervix producing mucus. Cancer of these cells is called adenocarcinoma of the cervix. There is an area of the cervix known as the transformation zone. This is around the opening of the cervix leading onto a narrow passageway that runs into the womb. This zone is where cells are most likely to become cancerous.

Risks and Causes of Cervical Cancer:

* Human Pampilloma Virus (HPV) is the most common and biggest cause of cervical cancer. HPV is passed on from person to person via sexual contact. There are many different types of HPV and not all of them cause cervical cancer. One type causes genital warts but not cervical cancer. However other types are considered high risk. These types can lead to cells in the cervix changing and becoming cancerous. Most women who have HPV and develop cervical cancer will have had other infections caused by HPV in the past. However, not every woman with HPV will develop cervical cancer.

* Smoking can lead to cervical cancer; women who smoke are more likely to develop this type of cancer then women that do not smoke.

* Taking the pill can also increase your risk but the reason for this is not yet known

* Women that have bore a large number of children also have a slightly higher risk as are women with a weakened immune system.

Symptoms:

Before I start listing the symptoms, please note that pre cancerous cells do not produce symptoms. This means having a smear test is hugely important – you can catch the cancer before it even develops. It is also important to know that the following symptoms do not instantly mean you have cervical cancer but it is important to go to your doctor if you have any of these symptoms:

* Bleeding between periods

* Bleeding during or after sex

* Bleeding at any time after the menopause

* Discomfort or pain during sex

Jo’s Cervical Cancer Trust

Jo’s Cervical Cancer Trust is also known as Jo’s Trust and it is the only UK based charity to focus solely on women that have been affected by cervical cancer and their families. They also help women dealing with cervical abnormalities. They aim to offer information, advice, friendship and support to these women, regardless of their age and status. They also try to educate women on the importance of cervical screening and to provide support for the women that have abnormal screening results or ladies that have a cervical cancer diagnosis.

Jo’s Trust has a mission: “Our mission is to see cervical cancer prevented, reduce the impact for everyone affected by cervical abnormalities and cervical cancer through providing the highest quality information and support services and campaigning for excellence in cervical cancer treatment and prevention."

The trust also has some core values and all the work they do is based around them. These qualities include remaining people focused, providing the highest quality, valuing and respecting others and empowerment.

The trust provides support groups, allowing women to come together, bond and share experiences. They also have a helpline to provide support, they have an online forum for people to come together in the comfort of their own home and a yearly meeting for women to get together and enjoy themselves. They also provide many helpful information leaflets which can be found on their website.

Jo’s Trust is a fabulous charity which does amazing things for women in the UK. I whole heartedly agree with their mission and their core values and I would love to see them succeed and help make cervical cancer a thing of the past. Please do check out their website and find out ways to help them achieve their goals. You can also find them on twitter @JosTrust

Smear Tests:

It is hugely important to have cervical screening as preventing cervical cancer from developing is vital. Cervical cancer is actually one of the only cancers that is preventable because if pre cancerous cells are detected through screening then they can be treated before they have a chance to become cancerous.

Women between the ages of twenty five and sixty are encouraged to have smear tests every three to five years to detect any changing cells in their cervix. During a smear test, a doctor or nurse will insert a speculum into your vagina and scrape anyway a sample of cells from your cervix. These cells are then placed into a small pot of liquid and send to be analysed. You will then be contacted with your results and any abnormal smears will require further investigation.

You don’t have to be over the age of twenty five to develop cervical cancer; some younger women do develop it as well. However, in the UK, smear tests are not encouraged until twenty five because your cervix is still developing in your teens and early twenties. This means the likelihood of you getting an abnormal result is more common but usually nothing to worry about. After Jade Goody’s horrifically young death, a campaign was launched to lower the smear test age limit but medical professionals do not agree with this. If you are under twenty five and are concerned about your cervical cancer risk – please do speak to your GP and get some advice. A private gynaecologist may allow you to have a smear test but it would depend on your individual circumstances.

PLEASE DO NOT BE SCARED TO HAVE A SMEAR TEST – THEY ARE UNCOMFORTABLE AND UNLADYLIKE BUT THEY DO SAVE LIVES! A FEW MINUTES OF DISCOMFORT IS BETTER THEN A BATTLE WITH CERVICAL CANCER!!!

It is also important to note that an abnormal smear result does not mean you have cervical cancer. If you are contacted and told your test was abnormal then please do not ignore it, go and see what your doctors have to say.

I’m approaching my twenty third birthday so I am not entitled to smear tests yet. I’ve heard horror stories about them and I am slightly worried about them. However, I will be forcing myself to attend my smear tests appointment when they are available to me. If I do develop pre cancerous cells – I will be finding them and I will be stopping them from developing.

Points to Consider:
You can have a smear test at several different places:
* Your GP’s surgery should offer them
* A family planning clinic
* A genito-urinary clinic
* An antenatal clinic
* A private health clinic
* Marie Stopes

You are well within your rights to request a female doctor or nurse performs your test but any male doctors will be chaperoned by a female staff member anyway. It is important to state if you require a female at the time of booking your appointment. 

A smear test should be scheduled whilst you are in the middle of your menstrual cycle (between periods) as it will be very difficult to see your cervix and get a cell sample whilst you are bleeding.

Age Limits:
There are varying age limits for women in the four nations of the UK.
* Women between the ages of twenty five and sixty four are screened every three to five years in England and Northern Ireland.
* In Scotland, cervical screening is offered to women aged between twenty and sixty.
* Wales offers cervical screening to women aged between twenty and sixty four.

Research has shown that screening every three years prevents 84/100 cases of cervical cancer that would develop if they weren’t caught by the smears. So getting a smear test every three years is recommended by the NHS up until you are fifty years old. Abnormal cells develop at a much slower rate in women over fifty so screening is recommended after five years for women in that age group. Your local primary care trust will contact you whenever it is time for a screening for you. I cannot stress the importance of attending these appointments enough – it could save you from a battle with cancer.


The Screening Process:
Cervical cancer is preventable. This is because pre cancerous cell changes can be picked up before they have a chance to develop. A cervical cancer screening test is known as a smear test. This involves a doctor or a nurse using a speculum to take a small sample of cells from the surface of your cervix. It sounds horrific and it can be very uncomfortable but I am going to try and explain it as clearly as I can!
You will need to take off your underwear and lie back on the couch/bed. Being as relaxed as you possibly can be will make the procedure less uncomfortable. 

Occasionally, the person doing the test will perform a vaginal examination first. This means they will place two gloved fingers inside your vagina to make sure your womb is in the correct position and that it feels like it’s a normal size. They will use their other hand to press down on your abdomen and gently feel your womb.

Then comes the actual smear test: The speculum is placed inside your vagina and has two arms which are used to spread the sides of your vagina apart so the cervix can be clearly seen. A small brush is then inserted and used scraped along the surface of your cervix to collect a sample of your cells. The brush and the cells are then sent to a lab in a pot of liquid and examined under a microscope. Any abnormal cells are reported and further investigation on these cells will be needed. 

The Results:
The important thing to remember with smear tests results is: DON’T PANIC!!! Cancer is not the only cause of abnormal cells or an abnormal result. Sometimes you may be asked to go back for a repeat test, again don’t panic, it could be because:
* You were on your period and the blood meant your cells weren’t visible enough
* Your cervix was inflamed and the cells weren’t visible enough
* An infection was blocking the view of the cells
* There were not enough cells collected in the first test

You may also be told that your test was borderline. This means cell changes have been noted but they were so very close to normal that they are probably nothing to worry yourself about and they will probably return to normal by themselves. You may be asked to go back and have another test in a few months to monitor the situation. You may also be offered a HPV test as HPV is a cause of cervical cancer. If you do test positive for HPV then you will probably been sent for more tests, including a colposcopy to monitor your cervix and the cell changes.

Cervical erosion can be picked up by smear tests. This is not cervical cancer. This means the glandular cells which are normally found inside your cervical canal are now visible on the surface of your cervix and it can be inflamed. This is a common condition for teenage girls, pregnant women and women on the pill. It can make you bleed slightly but it usually goes away by itself with no need for treatment.

Abnormal Tests Results:
Abnormal results are usually reported like this:

Mild Dyskaryosis or CIN 1(mild or slight cell changes)

If you are told that you have mild cell changes then you will probably be told to get a colposcopy straight away or to wait and have another smear in six months. Sometimes mild cell changes will go back to normal by themselves but it is important to monitor them and go back for any tests advised by your medical team. If a second test shows abnormal cells then a colposcopy is definitely needed to assess the situation. 


Moderate Dyskaryosis or CIN 2 (moderate cell changes)
Treatment will be needed if you have moderate cell changes but you only usually need it once. Then you will have follow up tests to monitor the cells in your cervix. If you have successful treatment after an abnormal smear and carry on having regular smears then you are unlikely to get cervical cancer. If you do not have treatment then you are at real risk of developing cervical cancer

Severe Dyskaryosis or CIN 3 (severe cell changes)
This is also sometimes known as carcinoma in situ (CIS) which sounds like cancer but it isn’t. This means some cells in your cervix look cancerous but are all found in the skin layer which covers your cervix. It won’t be “true” cancer until it breaks through the layer and starts to spread into the surrounding tissue. Urgent treatment is needed for this kind of smear result but if it is moved ASAP then cancer can be prevented.

All these results mean the cells found are pre cancerous meaning if they are left to go untreated, they could develop into cancer of the cervix. YOU DO NOT HAVE CERVICAL CANCER IF YOU ARE TOLD YOU HAVE ABNORMAL CELLS.

9/10 smears come back normal. 1/20 shows a borderline or mild cell change. Most of the time these cells will return to normal by themselves. 1/100 shows moderate cell changes whilst 1/200 show severe changes. Less than 1/1000 shows cancer. 

First Steps:

If you have mild cell changes then you may be told to wait six months and have a repeat test. This is because mild cell changes usually sort themselves out. If you have moderate to severe cell changes then you will probably be referred to your local hospital for a colposcopy. This is an outpatient procedure and it is basically a close examination of your cervix which doesn’t actually go inside your vagina. The doctor or nurse specialist uses something like a magnifying glass to look at the cells on your cervix in more detail and takes a biopsy to send to the lab for further examination.

Types of Treatment:

Laser Therapy (Laser Ablation): some cells can be burned away by a laser in an outpatient procedure. For this kind of treatment you will lie on a bed with your legs in stirrups whilst a doctor places a speculum into your vagina to hold it open whilst they point a laser beam at the abnormal areas. You will be given local anaesthetic to numb the area and prevent pain. The laser is a very strong and hot beam of light and it burns away the abnormal cells. This can cause a slight burning smell whist you are having the treatment but that just means the laser is working so try not to worry. You should be able to go home as soon as the treatment is finished. You may experience period type pains but they should go away with the normal paracetamol or ibuprofen and some bed rest.

Cold Coagulation: This name is a little misleading as the treatment isn’t cold at all! You lie on a bed with your legs in stirrups whilst a doctor inserts a speculum to hold your vagina open. A hot probe is then used to burn away the abnormal cells. You shouldn’t be able to feel the probe but it can cause some period type pains which should go away a few hours after the treatment has finished.

Cryotherapy: This is basically cold coagulation but with a cold probe instead of a hot one. The cold probe freezes the abnormal cells. The procedure is exactly the same as the cold coagulation.

Diathermy: This is done under local anaesthetic. An electronic current is used to cut away the tissue that contains the abnormal cells. It is a fairly quick procedure and it usually done as an outpatient case which means you should be able to go home afterwards. It can cause bleeding or discharge for about four weeks after the treatment but sanitary towels will have to be used as tampons have to be avoided for four weeks. Sex must also be avoided for four weeks following a diathermy procedure.

Cone Biopsy: This is a minor operation that can be used to diagnose cervical cancer or to treat abnormal cells. The entire area containing possible abnormal cells is removed. It is called a cone biopsy because a cone shaped area of tissue is removed from the cervix. This is called the transformation zone. This can be done under general or local anaesthetic.

Hysterectomy: If you are past menopause, or have had all your children, then your doctor may suggest removing your uterus. This is usually suggested if you have had abnormal cells more then once or if the cells are severely abnormal.

These treatments do sound rather uncomfortable and scary but it is massively important to have abnormal cells treated to prevent them developing into cervical cancer. Please do remember to book yourself in for a smear if you are due one. As I’ve said before, a little discomfort is nothing compared to a battle with cervical cancer.

HPV Vaccines

Some cervical cancer cases are caused by the human papilloma virus (HPV) which is also sometimes known as genital warts or the wart virus. There are over one hundred different types of HPV and some cause genital warts. Lots of types of HPV are passed on through sexual contact and most women will be affected by HPV at some point. Most of the time the virus will just go away with no treatment but some types can increase your risk of developing cervical cancer.  HPV types sixteen and eighteen cause about 70% of cervical cancer cases, which is roughly about 7/10 and most of the other 30% are caused by other high risk types of HPV.

Extensive research into HPV has been done over the years and two cervical cancer vaccines have been created. These are celled Gardasil and Cervarix. Research is on-going into these vaccines and their effects will become clearer as time goes on but here is some information on the two vaccines:

Trials have been done with Gardasil, using women between the ages of sixteen and twenty six. Some were given the vaccine and some were given placebos. They were all monitored to see if they went on to develop HPV. Research has shown that Gardasil protects against some types of HPV including types sixteen and eighteen. Since then Gardasil has been given a licence in the UK and can be used on young girls and women between the ages of nine and twenty six.

Cervarix has also gone through rigorous trials involving women under the age of twenty six. They discovered that Cervarix can prevent HPV. It has also been licenced for use in the UK and is used to prevent pre cancerous cervical changes in women between the ages of ten and twenty five.

UK schoolgirls aged between twelve and thirteen (year eight at secondary school are currently being offered the Cervarix vaccine as part of the HPV vaccination programme. This involved the girls having three injections over a six month period. Their parents have to sign a consent form before their daughter can have the vaccinations and they should discuss the vaccine with their daughter so she can decide whether or not she would like it. From September 2012 the vaccination programme will switch to the Gardasil vaccine as this protects them against genital warts as well as cervical cancer. It is also possible to have the vaccination done privately should you wish to do so.

The vaccines are given to twelve year olds because they are unlikely to have already become sexually active and caught HPV. Research has shown that the vaccine works best in younger women. You can still have the vaccine if you are already sexually active; it won’t get rid of HPV if you already have it but it can protect you from developing other types of the infection. It may be worth having if the type you have isn’t type sixteen or eighteen as these are the two that are most likely to cause cervical cancer. It is vital to have all three injections to make sure you are properly vaccinated.

Side effects of the vaccine are usually very mild but they can include:

Headaches and aching muscles, dizziness, fever, diarrhoea stomach pains and itching and soreness around the injection area.

IT IS IMPORTANT TO REMEMBER THAT YOU STILL NEED TO HAVE REGULAR SMEAR TESTS WHEN YOU REACH THE MINIMUM AGE REQUIRED. WHILST A VACCINE WILL HELP PROTECT YOU, SCREENING IS STILL NEEDED!!

If you are interested in having a cervical cancer vaccination – please contact your GP or Jo’s Trust.

I hope this blog post has given you all the facts. I hope it has persuaded you to have a smear test if you haven’t already.

xxx

Guest Post: Rosa MacPherson - My Cancer Journey

Happy Friday!

Another one of my fabulous ambassadors has written a piece for this blog. I've featured the lovely Rosa on this blog before (http://pennysophia.blogspot.co.uk/2012/09/cancer-research-uk-ambassador-showcase.html). I hugely admire Rosa's spirit; she is incredibly brave and very proud to stand up for what she believes in. She is also a wonderful supportive person and very interesting too. She fully deserves her commendation at the Flame of Hope Awards, she is a wonderful asset to Cancer Research UK. I'm honoured she has allowed me to share this incredible piece of writing with you. Rosa has been through some horrific things and I think she is hugely inspirational. xxx

It was 2008, just a few months before I was diagnosed with uterine cancer. I walked up the steps into the chapel and took a deep breath. I didn’t feel ill but I felt far from well.

I looked at the face of my dead mother lying in her coffin. Strangely enough she looked more like herself than she had done in recent years. The Funeral Director had applied her lipstick and painted in her eyebrows and I had made sure she was wearing a pair of her favourite earrings: multi-coloured parrots. She had on her bright beads and her flowered shawl was draped across her shoulders.

Every part an elderly Polish peasant, once more restored to an image of herself she was happy with.  And which made me smile.  At last she seemed like herself.

She had not had an easy death: she starved slowly over a long period, unable to live following the death of my father four years earlier in 2004.  He’d endured amputations, gangrene and late onset diabetes following a lifetime of smoking about 60 a day. He died a heroic death in 2004; facing death squarely and cursing the fact he had ever smoked.

At that time he’d urged me to stop smoking but I didn’t. In fact when he died, my mother, then aged 83 took up smoking; half-heartedly I admit.

Six months following his death my husband George was diagnosed with lymphoma. An ex-smoker he faced chemotherapy with determination and courage and urged me to stop smoking -- but I didn’t.

He was dead within six months of my father and I kept right on smoking.

I developed pre-cancerous cells in my cervix and had treatment to remove them. I was warned that smoking increased my chances of the cells becoming abnormal again. But I kept on smoking.

I took a year out of life and escaped to Poland where I lived on a writer’s grant and tried to trace my parents’ family. I tried to make sense of my family history and myself. I think I felt a deep introspection growing inside me and I felt the loss of those I loved. I tried to fill it with opera and theatre and vodka and cigarettes. In Poland smoking was almost compulsory.

So I kept right on smoking. What was the point?  Anybody could drop dead at anytime. You ‘ve got to die of something, right?

Then in 2008, a full year after I had returned from Poland I decided to finally quit. My son had lost his father and his grandfather and watched as I was smoking my life away. At the same time I watched as my mother withdrew from life; day after day renewing her determination not to eat; me renewing my determination not to smoke. One wanting to die, the other determined to live.

And then that day she died and I looked at her painted smile and thought , ‘how strange that she looks more like herself now, finally.’’

And then I suddenly started to bleed. I felt the blood gush from me and in shock rushed home from the chapel. I decided it was just the trauma of seeing her like that, looking happy to be dead, which had caused the spontaneous period. That’s all it was.

I had been off cigarettes for almost two years. A few weeks after her funeral I walked up the Ochil Hills, a guest member of a group of ramblers enjoying an Indian summer.  The walk was tough.  I was less fit than I ‘d realized and was desperate to get home even though I was enjoying walking to the summit, then down into the ravines at Dollar ‘s Vale of Gloom. The village of Dollar derives its name from Doilleir, an Irish and Scots Gaelic word meaning dark and gloomy. It perfectly suits the place – wild, savage at times but splendid in its greenery and energy. Looking over the Vale I felt the deep desire to connect with the place; to get a feeling for the lives lived here, the dark romance of the land and thinking about the turbulent histories of the age-old inhabitants of nearby Castle Campbell.  I thought of my husband, Georgie, as he fought for every  last breath he had remaining; his desire to be outdoors , just one last time, before  his life was gone.

I wanted to take all of it in.  For him. For my dad. For my mum. All the friends I had lost through cancer.

And then I felt it – the gushing of blood once again.

I wondered if I was going to make it back without any of the other walkers noticing my discomfort and distress.

Back home I crawled up the stairs on my hands and knees and joked about how unfit I was.

I was on the verge of the menopause; that’s all it was.

A surprise opportunity to see Leonard Cohen in an open-air concert at Edinburgh Castle later that Autumn should have filled me with excitement but something stopped me. My friend Anne sensed it as I suddenly jumped up during his rendition of Hallelujah, one of his most memorable songs. I rushed to the temporary portaloo pouring with blood.

It was the excitement of seeing Mr. Cohen and hearing him sing so mournfully. That’s all it was.

That’s what I told the Doc when I finally went to see her. She listened to each of the three occasions when I had bled but when I told her I walked out of a Leonard Cohen concert she shook her head.

“We’re going to have to see about this ,’ she said.

Still no word of cancer.

I was checked for fibroids. Yes, I had them. ‘Best get you a scan,” Doc said. So I did.

“Best get a wee bite out of you,” she said.

So I did.

And still I refused to accept anything was wrong with me. Menopause. Stress. Anxiety. Depression. Loneliness. Anything. Not cancer.

Cancer.

It was cancer. A phone call on the evening of Friday December 5^th 2008 changed my life.

I went out and got drunk. Then I went home and cried and cried, all of Saturday and Saturday night. On Sunday I sat on the couch, red-eyed and swollen. I listened to myself breathing, aware of my breath rising and falling, the oxygen filling my body with energy.

I was still alive. And I suddenly felt a calm descend on me and fill me with quietness and stillness.

I had no idea what was going to happen to me but I knew at that point I would survive this.

There is such a relief when you hit rock bottom.  With nowhere else to fall there is only a deep acceptance and a gentle relief.

I found I was very lucky: Stage 1 uterine cancer, spotted by my eagle-eyed and understanding Doc who, over the years, had taken the time to understand me; who knew that for me to walk out of a Leonard Cohen concert was not normal. It made her move, check me out.

Others are not so lucky.

I have a survivor’s guilt I think.  I lobby, I raise funds, I promote Cancer Research UK. I talk to doctors, scientists, fellow survivors but Georgie is still gone. Family and friends still gone:  Werner is gone. Donnie. Mary. Reiner. David. Ian. Margaret. Jean. And yet I have many survivors in my life too: Olive, Sheena, Rae, Alexandra, Karen. Linda. Me.

I wasn’t close to them all, but enough of them.

Cancer kills. Part of me thinks, well we need to die of something; why not cancer? But cancer is, in part, a manifestation of disharmony in nature, mutation in our bodies, our diets, our hearts, and our spirits. It has pervaded human life and set us challenges to fight back; find answers; change the way we live our lives, to encourage us to offer help, kindness and time to finance and support our fellow humans. Cancer is giving us the opportunity to feel wholly human.

Cancer changed my life. Took people I loved. Changed me. Made me strong. But I still feel I am not doing enough, for others, for the cause, for myself.

Four years on and I remain clear of cancer. I still drink too much,; I don’t walk enough and am overweight. I am not a saint but cancer has changed me. It’s made me realize my mortality. It has helped me reach out for my own humanity. And in doing that I found so much more.

Rosa Macpherson