Cancer: a survivor's guide

By Maria Moynihan.

Live always "did everything right". She didn't smoke, only drank in moderation, ate healthily and exercised. And most importantly, she made sure to have a smear test every year.

So when a test in June 2001 showed up some abnormalities in the cervix, she wasn't too worried. Even her gynaecologist assured her that all that was needed was a minor operation to scrape the cells away. They just needed the biopsy to confirm it.

"A week later, my phone rang and he said: 'Will you come down for your results,'" recalls Olive. "I remember going in to the consultant myself and he said, 'Olive, sit down. I'm terribly sorry. I didn't expect it, but you've got cancer.' I didn't even cry. I just said, 'This is it. I'm going to die.'"

Olive, now 45, is from Shrinrone, Co Offaly. Married to a German, Helmut, she lived in Berlin for 16 years and ran a successful contract cleaning company before returning to Ireland in January 2000.

While in Germany, Olive had been very conscious of the dangers of cervical cancer and the importance of regular smear tests, partly because of the country's national screening programme. Every year, her health insurance company would invite her for a check-up, and infections and inflammation of the cervix were picked up and treated successfully.

However, the stress of the move to Ireland meant that it was only when Olive returned to Germany for a wedding in May 2001 that she visited her doctor again. While the smear test showed up some abnormalities, he told her not to be alarmed, but to visit her gynaecologist at home.

Two months later, at the age of 40, Olive was diagnosed with invasive cervical cancer.

An MRI scan had located a tumour in the cervix. The only treatment was a radical hysterectomy, as well as chemotherapy and radiotherapy to treat the lymph glands to which the cancer had had already spread.

While Olive admits that it was a "fearful" time, she negotiated the hysterectomy and treatment on autopilot. It was only when it was all over, in November 2001, that the impact of what she had gone through hit home. She is still coming to terms with it today.

"When you're going through it, you accept everything," explains Olive. "The patient is being looked after, and you sort of float along in this little egg, and it's all fine. But it's not as easy as that. My maternal instinct probably came out after the hysterectomy because it was finalised. 'You're definitely not going to have any children now.'

"Your hormones go crazy, because you've has a change of life overnight. I could say quite openly that since the hysterectomy I've had no sex with my husband, because my feeling is I don't know what's there. This is quite normal.

"Five and a half years later, I'm still attending a psychiatrist. And I say this because I don't want people to say, 'Sure, she's got over it. She's fine.' I'm not fine. I just put up a very good façade."

Olive completed her treatment in November 2001 and has had no relapse since. However, she has used her experience as a survivor of cervical cancer to support other patients going through the same ordeal.

"It's an experience I could have done without, but I'm very much the richer for it," she explains. "Cancer has become my life. Not that it's at the back of my head: 'Oh cancer, poor me.' The whole thing of being a patient has changed my life for the positive.

"Before that, everything was so important; things that are not important. If it's not life threatening, don't worry about it. The Hoovering will be done, the painting will be done. I've learnt that my life is important and other people's lives are important."

As well as founding The Offaly Cancer Friendship Circle for cancer patients, their families and friends, she is fiercely passionate about the Save Dublin's St Luke's Hospital campaign. The Dublin hospital, where Olive underwent chemotherapy, is going to be shut and its services moved to St James's if government plans go ahead.

"They need to cop onto themselves," she says. "I know there's an election coming up and certain ministers are cock sure they're going to get in. It's not politics. We're talking about people here.

"We need a hospital of excellence. It doesn't make sense to move it to another hospital within Dublin. The Government should be working more on centres for treatment, but still keep the central hospital. They're talking about closing a hospital that is working."

Olive is also committed to the Irish Cancer Society's Cervical Screening Awareness Program. According to the society, one in five Irish women have never had a smear test, an extraordinary statistic given that Ireland has one of the highest cervical mortality rates in Western Europe and that it is one of the most curable cancers if caught early.

She hopes that by sharing her story, more Irish women will take their health in their hands and have a smear test. It could, after all, save their lives.

"There's nothing wrong with getting cancer. You needn't be ashamed of this disease," says Olive.

"I think there's an awful lot of beating around the bush. It amazes me. You speak to married women who have children about going for a smear test and they say, 'Oh, it's uncomfortable.' I say what's uncomfortable about a smear test. Have you not had children? It doesn't hurt; it's only a few seconds; it's no worse than getting your blood taken. I think a certain amount of that thinking goes back to the old Ireland, where you didn't speak about things like that.

"Women need to go along and get their smear tests and take their life in their hands. Because early detection can save your life."

Cervical Cancer: The FactsThe numbers

• Cancer of the cervix is the second most common cancer among women worldwide.
• Ireland has one of the highest cervical cancer mortality rates in Western Europe.
• The National Cancer Registry estimates that there are 1,000 new cases of cervical pre-cancer, 200 cases of cervical cancer and 70 deaths from cervical cancer in Ireland each year.
• One in five Irish women has never had a smear test.

What Is A Smear Test?

The smear test checks if a woman's cervix, or neck of the womb, is healthy and identifies early abnormal changes that, if left untreated, could lead to the development of cervical cancer.

What Does It Involve?

A smear test takes about five minutes. While lying on your back, the nurse or doctor inserts an instrument called a speculum gently into the vagina to show the cervix. Cells are then scraped off the surface with a small brush and sent to the lab to check for abnormalities. While some women find it uncomfortable, it is nothing to be feared.

Who Should Have A Smear Test?

All women between 25 and 60 who have been sexually active should be tested every three to five years.

What Are The Risk Factors ?

A virus called human papilloma virus (HPV) and smoking are the two most important risk factors. Most sexually active women have been exposed to HPV. For most, the virus disappears naturally over time, but some have difficulty getting rid of it.

Where Can I Go For A Smear Test?

Free cervical screening is currently available for women in the Mid West region aged 25-60 as part of Phase 1 of the Irish Cervical Screening Programme. If you are not already registered with this service, contact the ICSP on 1800-252-600 or visit www.icsp.ie.

The Government has stated that this service will be rolled out nationally in 2008. In the meantime, however, you can get a smear test done with your GP, local family planning clinic, Well Woman centre, some HSE clinics and gynaecology clinic.

For further information about cervical cancer and smear tests, contact the National Cancer Helpline on Freefone 1800-200-700 or visit www.cancer.ie.