Every year about 300 people in Ireland will develop cervical cancer, and sadly around 90 will die from the disease. It affects mostly those in the 30 to 50 age bracket and anyone who has ever been sexually active is at risk, despite their sexual orientation.
new report from the National Screening Service, in which over 450 people who identify as LGBT participated, has found that while the majority have had positive experiences of cervical screening, only about two thirds (66pc) said they attended regular cervical screening. This compares to 80pc attendance by those who are not LGBT.
One of the reasons for lower attendance numbers was that heterosexual questions being asked by healthcare professionals did not accurately reflect the gender identity of participants. And many also had a fear of the test procedure itself.
Ruth O’Mahony says knowing that cervical cancer can affect “anyone with a cervix” regardless of whether they are heterosexual, gay, bisexual, or pansexual, is of crucial importance. And as a gay woman who only went for screening after hearing that Big Brother contestant Jade Goody had died in 2009 from the disease, Ruth says she has friends who were unaware of the risk until she told them her own story and encouraged them to get checked.
“In 2008, Jade Goody was diagnosed with cervical cancer while she was a contestant on the Indian Big Brother,” says Ruth, who has two grown-up children from a previous marriage. “I watched her on TV, followed her cancer story and learned of her death in February 2009. At this point I realised that I had to go for screening as I hadn’t been before. I arranged it with either my GP or the Cervical Check programme, I can’t remember which.
“The screening was a little uncomfortable, but it went well. I didn’t think anything more about it until I received a phone call from my practise nurse about six weeks later. She said I had an abnormal test result, but stressed that these were pre-cancerous cells and I should try not to worry. She explained that I would be referred to the colposcopy clinic at St Finbarr’s Hospital in Cork, but this would take a few weeks and I would possibly need treatment to remove the pre-cancerous cells.
“At this point, even though the nurse had tried to put my mind at rest, I was very upset and worried, as I’m sure anyone would be when they receive a call like this. It’s hard not to think the worst and I wondered what it would mean for myself and my children if I had cancer.”
The 46-year-old was referred to a colposcopy clinic and says although she was very anxious and nervous about both the procedure and subsequent results, the staff were very kind and explained everything she would go through in great detail.
“I went in to see the doctor and he explained that most of us have the HPV virus at some point in our lives, and that cells can change over time,” she says. “He then went through my result and said that I possibly had CIN3, which is the most serious type to have. In the case of CIN1 and CIN2, sometimes a period of observation and more screening, to see if the cells would return to normal themselves, is usually the practice. However, in my case, we had passed that point, and I needed a LLETZ (large loop excision of the transformation zone) procedure to remove the cells which would be sent to the lab.
“He offered me the opportunity to have the procedure done there and then, and I agreed. It was pretty painless as a local anaesthetic was administered and I was able to watch it on the monitor next to me. Afterwards, he informed me that I would receive a letter in the next few weeks with the lab results.”
Ruth says she was a little bit uncomfortable for a few days afterwards, but she quickly recovered. However, her biggest concern was whether or not she had cancer.
“I have to admit, I was worried about the results and if the doctors had somehow got it wrong and I actually had cancer,” she says. “It’s hard not to worry, particularly when you have young children as mine were at the time and are self-employed. But a few weeks later my letter arrived, informing me that I did indeed have CIN3 pre-cancerous cells, and would just need a follow-up screening in six months and annually thereafter, for the next nine years.
“The relief was immense, but it was hard not to think about where I might have been at in the next 10 years if I hadn’t gone for that screening in 2009. It is highly probable that I would have been battling cervical cancer, so I considered myself very lucky and wondered how many lives Jade Goody had inadvertently saved by telling her story.”
Ruth, who works as a taxi driver, has continued to attend regular screenings, and despite an issue not long after her procedure, she has thankfully been in the clear ever since. She is keen to get the message across that attending regular cervical screening appointments is vital and if people aren’t already on the system, they should make a point of doing so.
“I went for a screening at six months after the procedure in 2009, and my result wasn’t clear, but luckily I didn’t need any further treatment at that point,” she says. “And for the next nine years all of my annual screening tests have come back clear, so in 2018, I went back to the regular three-year screening routine.
“Women’s health, in particular sexual health, has become more prominent in the last number of years, with organisations, like LINC (Lesbians in Cork which she is very involved with), running health weeks and different projects to create awareness. But I think a lot of lesbian and bisexual women still think that if they are not having sex with men, or are not sexually active, they don’t need to go for screening.
“However, it’s very simple, any person with a cervix, whether they are sexually active or not, regardless of how they identify or their sexual preferences, needs to go for cervical screening from the age of 25 to 69. It could save their life. And the best way to create awareness, in our community I feel, is with visible campaigns, with people who look like us telling their personal stories.
“Since 2009, I have told many friends my story and convinced quite a number of them to go for screening. Some hadn’t gone for a number of years, and some had never gone, while others didn’t realise that they needed to, either because they weren’t having sex with men, or because they didn’t like the thought of the procedure.
“But when I compare going through the procedure or battling cervical cancer, that usually gets the reaction that is needed. I have two close friends, one of whom it took me three years to convince, who didn’t go for screening until their 40s, receive a CIN3 positive result and underwent treatment — and they are now healthy and going for their annual appointments.”
The Cork woman says it is vital for this message to be highlighted as thankfully she is healthy and living life to the full, but if she hadn’t made the decision to have screening done, it may have been a totally different story.
“I believe doctors, practise nurses, and all health professionals need to be well informed and very specific when getting across the dangers of cervical cancer to anyone that has a cervix, regardless of their sexual preferences,” she says. “And also how important it is to be part of the Cervical Check programme, which is free here in Ireland.
“Today, I am well and healthy and due for my next screening very soon. I am very thankful for the cervical screening programme and I would encourage everyone with a cervix to go for screening as soon as possible. I know you may be anxious about the procedure, but it’s over in five minutes, and it could save your life.”
Visit cervicalcheck.ie; cancer.ie; mariekeatingfoundation.ie; and hse.ie
What you need to know about cervical cancer
⬤ Cervical cancer is cancer of the cells lining your cervix.
⬤ In Ireland, an average of 300 women every year are diagnosed with the disease, and it is the second most common female cancer in Europe.
⬤ Cervical cancer takes a long time to develop and often has no symptoms, which is why regular screening is absolutely crucial.
⬤ The main treatments for cervical cancer are surgery, radiotherapy, and chemotherapy.
⬤ Surgery is the most common treatment for cervical cancer and it aims to remove the part of your cervix containing the tumour.
⬤ Radiotherapy uses high-energy X-rays to kill cancer cells in your cervix. It can be given before surgery and after surgery. Radiotherapy to the cervix can be given externally and internally.
⬤ Chemotherapy uses drugs to cure or control your cancer. It can be given before surgery and after surgery. It can be used alone or in combination with radiotherapy.
⬤ The type of side effects you get will depend on the type of treatment you receive, the dose, the duration, and your own general health. Some treatments may cause symptoms like nausea, vomiting, diarrhoea, loss of appetite or hair loss. Many treatments cause fatigue.
⬤ Radiotherapy will only affect the area where the radiation is given.
⬤ Some treatments may cause long-term problems like infertility or difficulty having sex.
⬤ Before treatment, your doctor will discuss any likely side effects.