By Sheila Dwyer, MedTech1 Staff
Following a routine gynecological exam, 24-year-old Carolyn was informed that results of her Pap smear were abnormal. Assuring her that there was no reason to panic, her primary care physician recommended a follow-up test. After a second Pap smear still indicated that something was wrong, Carolyn’s internist sent her to a gynecologist, who recommended a biopsy of her cervix to check for cancerous and precancerous cells.
Early cervical cancer usually shows no symptoms. In most cases, it is discovered during a routine pelvic examination and an abnormal Pap smear. When Carolyn’s Pap smear first reported abnormal results, her doctor found no cause for alarm—abnormal Pap smear results do not always signify a serious health problem. Over the next few months, however, she found herself getting a real-life education on cervical cancer.
She started by reading up on the disease on the Internet. “I was thinking, okay, I’m going to die in the next six months,” she recalls. “But I found out that people as young as 16 or 17 and people as old as 80 or 90 can get have precancerous cervical cells and be fine.”
Carolyn’s doctor first had to take a cold cone biopsy of her cervix. Though the biopsy took very little time, Carolyn was unprepared for how uncomfortable she felt during the procedure. As she puts it, “You’re not talking about your arm here.”
The biopsy revealed the presence of abnormal, precancerous cells on Carolyn’s cervix. These cells, though not yet cancerous, need to be removed when detected because of their propensity to become cancer.
Her doctor scheduled Carolyn for a loop electrosurgical excision procedure (LEEP) to remove the abnormal tissue. Carolyn’s LEEP was performed in her doctor’s office and took only five minutes. Her doctor told her that, after a successful LEEP, her Pap smear results in the future would probably be normal.
Carolyn needed about a month to recover fully from the LEEP. During that time, she experienced some vaginal bleeding and was unable to exert herself. The uncomfortable recovery period was forgotten two months later when the results of her next Pap smear came back normal. She will be tested every four months for the next year, until her physician is satisfied that the abnormal cells were eradicated.
Carolyn’s doctors could not say why an otherwise healthy young woman would develop abnormal cervical cells. In many cases, cervical cancer is caused by a sexually transmitted disease such as human papillomavirus (HPV), which causes venereal warts. Carolyn tested negative for HPV and considers herself lucky that the precancerous cells were detected before they caused a real health problem.
By age 18, all healthy young women should have their first annual pelvic exam. Girls who are sexually active before this age need to undergo pelvic exams and pap smears as soon as they become sexually active.