MENUDon’t Neglect Routine Tests for Cervical Cancer
A former patients wants all women to know the importance of routine pap test
This article was updated 12.2023.
After experiencing heavy bleeding in 2015, Sandy LaLonde went to her doctor right away. She was diagnosed with polycystic ovarian syndrome, a hormonal disorder, and an ultrasound came back clear of anything more serious.
That news prompted LaLonde to ignore some new symptoms a year later.
And, more detrimental, she put off her routine cervical exam.
“I feel like that ultrasound offered me a false sense of security, at least for a period of time,” the 34-year-old from Livonia, Michigan, says. “I honestly didn’t feel any sense of urgency to get back in for that exam.”
But cervical cancer screening is crucial.
One of the most common and trustworthy tests used to detect precancerous and cancerous gynecologic conditions is the HPV test. All cervical cancer screening is HPV based. The old Pap test is no longer standard of care. When a woman is positive for HPV, cervical cytology can inform her risk of pre-cancer (CIN3) and cancer disease.
LaLonde was less than one year past due for her screening when she finally had the test, which revealed that she had stage 2A cervical cancer.
“It’s amazing the games your mind will play on you, and the excuses you can come up with to avoid new symptoms,” says LaLonde, who couldn’t believe she had cancer at the age of 32. The doctor explained my high-risk HPV test came back positive and I tested positive for malignant cells.”
Her doctor referred her to Carolyn M. Johnston, M.D., an oncologist at the University of Michigan Rogel Cancer Center.
“Cervical cancer is characterized by abnormal bleeding, often after vaginal intercourse. It can be light, heavy or just irregular and outside the time of an expected menses,” Johnston says. “Women may also have a foul-smelling discharge.”
A transvaginal ultrasound can help examine a patient’s uterus and ovaries, she adds, but it doesn’t tell doctors about what is going on in the cells of the cervix.
When to begin cervical cancer screening
Most women should begin between the ages of 21 and 25. If the screening results are normal, she repeats the screen in 3 years. If the results are abnormal, she is tested for HPV to determine her risk of cervical cancer.
Women between the ages of 25/30 and 65 should have a HPV test. If the test is negative, she can repeat her screening every 5 years. If the HPV test is positive she must have further testing to inform her risk. HPV testing is the preferred approach.
Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with Cervical intraepithelial neoplasia (CIN) or cervical cancer should continue to be screened every 5 years, unless currently infected with HPV.
For some women, this testing can begin to feel a bit routine. For others, like LaLonde, the tests can be stressful. She always felt anxious about getting one.
“In my case, my body had been talking to me for a long time and had I only listened, things might have been different,” she says. “If you’re nervous, your doctor should be able to help make you comfortable during the screening — whether it’s prescribing a sedative or just talking you through it.”
The screening tests can help doctors determine if further review is needed. (LaLonde’s HPV screening tested positive for malignant cells).
Cervical cancer treatment brings challenges, relief
To treat her cancer, LaLonde underwent eight rounds of chemotherapy, 25 rounds of external radiation and four rounds of internal radiation. She is now cancer-free and thrilled.
Still, the path to wellness was rough and she lost her ability to bear children in the process.
Cancer treatment can affect fertility in women and men. The most common way is damage to a woman’s eggs or a man’s sperm, which was the case for LaLonde from radiation therapy.
“I cried every day for the first week when I was laying on the radiation table,” she says. “It was just hard to comprehend. It was astounding to me that even though I was only nine or 10 months past due for my screening, I had stage 2A cancer.”
Johnston assured LaLonde the goal for her treatment was to cure her disease. During a small procedure before internal radiation started, the treatment appeared to be working.
“Studies have shown that the combination of radiation and chemotherapy led to the best overall survival for more-advanced stage cervical cancer,” Johnston says. “Without internal radiation, survival is considerably lower, so this is an integral part of the treatment.”
LaLonde now sees Johnston every three months for checkups.
The value of testing and prevention
LaLonde enjoys a renewed appreciation for her health and joined a women’s exercise boot camp she attends four to five times per week. She enjoys spending time with family, friends and her dog.
She has also connected with other cervical cancer survivors through Cervivor School, an educational retreat, and now advocates on behalf of the cervical cancer movement that aims to help the approximately 12,000 women diagnosed in the U.S. each year.
“When I was first diagnosed, I immediately started searching for support groups, LaLonde says. “I had the opportunity to meet 30-some other women who were going through this or had gone through this. If you’re newly diagnosed, there are people out there in the same situation. It helps reaching out to them.
“I feel an immense amount of personal responsibility to make sure this doesn’t happen to someone else.”
Beyond screening, getting the HPV vaccine is a lifesaving preventive measure.
“The single most important thing that can be done to reduce and potentially prevent cervical cancer in America is to get all children, male and female, vaccinated,” Johnston says.
The Centers for Disease Control and Prevention recommends children who are 11 or 12 years old should get two shots of the HPV vaccine six to 12 months apart. Those who didn’t start or finish the HPV vaccine series can still be vaccinated as young adults. The CDC guidelines recommend women be vaccinated through age 26 and men through age 21.
For questions about cervical cancer screening, prevention or treatment options, call the Cancer AnswerLine at 800-865-1125.