Attending your regular smear test can be unsettling enough, but waiting for the results can be even more so. It’s easy to get worked up and worry that the results may show something unexpected, but truth be told the majority of smears (around 90%) come back absolutely clear and require no action at all. However, a small number show abnormalities that need to be investigated further and require a follow up appointment – but it’s important to remember that having a cervical abnormality does not mean that you have cancer. It simply means that you have changes in some of the cells in your cervix that require a closer look in order to stop from them to potentially developing into cervical cancer over time. Having been through this process myself I know how scary it can be, but being armed with the right information will help to soothe your anxieties and ensure you’re prepared for every outcome. So what if your smear test shows abnormal results?
HOW WILL I FIND OUT IF I HAVE ABNORMALITIES?
A letter will usually arrive in the post to let you know you test has come back identifying areas for concern, and that you’re required to make a follow up appointment for a colposcopy. In my experience this letter arrived directly from the hospital because my changes were so severe, but my doctor was kind enough to call me and let me know a few days before that it was on its way and I needn’t panic.
SO WHAT’S A COLPOSCOPY?
It’s simply a more detailed look at the cervix using a microscope and good lighting, rather than with the naked eye; the procedure is not dissimilar from your original smear, the main difference being that you’ll be on a bed with your legs in stirrups like you’re about to pop out a baby! The colposcopist will put a number of different solutions on the cervix and look for changes, taking a biopsy to be tested if they feel that’s appropriate. It’s just an opportunity for them to take a much more detailed look at what’s going on and determine whether or not they need to take any action.
WILL I NEED TREATMENT?
Often misunderstood is the fact that not all types of cervical abnormalities require treatment; low grade changes
(often called low grade dyskaryosis, borderline changes or CIN1) usually require no treatment, but may require further monitoring. High grade changes (also called moderate/severe dyskaryosis, or CIN2/3) will usually require treatment to remove the abnormal areas, but can actually be done under local anesthetic within the colposcopy appointment if you and your doctor are happy to do so.
WHAT DOES THE TREATMENT INVOLVE?
My abnormal cells were removed immediately via a LLETZ (a large loop with an electrical treatment running through it to remove cells and seal the skin simultaneously,) but I was prepared for this to happen in advance. The area is numbed using a couple of injections (this was the worse bit!) and then the abnormalities are removed in a matter of minutes; you can’t feel anything and there’s often a television screen available to see what’s happening, although I have to admit I just held the nurse’s hand and looked to the ceiling until it was over! Although I could smell burning, you can’t see what they’re doing because you’re covered with a gown. It’s super quick (my whole appointment lasted about 45 minutes) but you can experience discomfort and bleeding, so it’s best to take it easy for the next couple of days. Alternative treatments can involve a cone biopsy, laser treatment, cold therapy and other forms of electrical current removal, more info on which you can find here. Although it can be scary, treatment has been shown to reduce the risk of cervical cancer by 95%, preventing further procedures and negative experiences further down the line.
IS THERE A LONG RECOVERY PROCESS?
As the cervix heals it’s prone to infection, so you’re advised to avoid sex, tampons and swimming for four weeks. The discomfort experienced varies from woman to woman, but I found that for a couple of weeks I needed to just look after myself and be aware of what had happened to me – sitting down or walking more than a few minutes put pressure on my tummy and caused discomfort. (I’ll never forget walking ten minutes to Nando’s and needing to lie down!) Although I didn’t get bleeding per se, I did experience discharge for a few weeks that required a panty liner; this is totally normal and just your body getting rid of essentially the scab that’s formed internally after the procedure.
WILL I NEED TO ATTEND FOLLOW UP APPOINTMENTS?
You’ll be asked to attend a smear test six months after your treatment to check if the abnormalities have been removed effectively, and to confirm there’s nothing else you need to worry about. It’s extremely important not to forget this, but also not to get overly anxious – it’s just to reassure and clarify that the treatment did the job it was intended to. Up to 95% of women will be absolutely clear, so you just need to attend your next regular smear in 3-4 years time; if there are still signs of abnormalities, you may be required to undertake further treatment. Luckily for me I was given the all clear and have since had a second clear smear too. WHOOP!
Having been through the whole experience of being diagnosed with severe pre-cancerous cells and being checked into hospital to have them removed within a couple of weeks, I know it can be super scary when your smear test shows abnormal results. Because my procedure was so quick, my pre-op information didn’t arrive until two weeks after I’d had it done so I had no clue what to expect or where to look to ease my mind; I went in anticipating the worse and came out with a smile across my face because it was nowhere near as bad as I’d hyped it up in my mind. What’s important to remember that abnormal cells do not mean cancer, the majority of abnormal cells don’t even need treatment, if you do need treatment it tends to be over quickly and the results are super effective.
Knowledge breeds power and control; smear tests are the first step on that journey.
Don’t skip them because of anxieties around the unknown – and don’t panic if your smear test shows abnormal results.
If you’ve experienced abnormalities, a colposcopy, treatment or even cervical cancer, I’d love to hear your experiences and words of advice below.
I’m an ambassador for Jo’s Cervical Cancer Trust. Read all my blog posts here.
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