Don’t Neglect Routine Pap Tests, Woman Urges Others

Diagnosed at age 32, a former patient speaks out to help other women know the signs and symptoms of cervical cancer — and to get screened regularly.

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Author | Beth Uznis Johnson

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.

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That news prompted LaLonde to ignore some new symptoms a year later.

And, more detrimental, she put off her routine Pap test.

"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 Pap."

But the Pap screening is crucial.

When it comes to diagnosing cervical cancer, other gynecological exams cannot replace a Pap test — in which a small sample of cells are collected from the cervix to be examined for abnormalities.

LaLonde was less than one year past due for her Pap 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 get a Pap test

Federal guidelines suggest women begin getting a Pap test at age 21 and to be screened regularly until age 65.

SEE ALSO: When Should You Get a First Mammogram? It's Personal

Women between the ages of 21 and 29 should have a Pap test every three years. Women between the ages of 30 and 65 should have both a Pap test and HPV test every five years. HPV, human papillomavirus, has been linked to cancers of the cervix, vulva, vagina, penis, anus and throat.

For some women, it can begin to feel a bit routine. For others, like LaLonde, a Pap test 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."

Performed in tandem, the Pap and HPV tests can help doctors determine if further review is needed. (LaLonde's HPV screening tested positive for malignant cells).

"If a woman has a normal immune system, she and her medical providers should adhere to current Pap test screening guidelines," Johnston says. "Even if you had a recent normal Pap test with negative HPV co-testing, if you are having abnormal symptoms, you have a right to be evaluated with an exam and should be."

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 Pap, 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.

SEE ALSO: Should Young People Get a Colon Cancer Screening? It Depends on Their Risk

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 Pap tests, 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.

More Articles About: Cancer Care Cervical Cancer Cervical Cancer - HPV Cancer Screening Abnormal Pap Test Abnormal Vaginal Bleeding Cancer: Cancer Types
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Department of Communication at Michigan Medicine

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