Pam - Interview 23

Age at interview: 40

Age at diagnosis: 38

Brief Outline:

Pam had CIN1, which progressed to CIN2. After having a LLETZ in 2008, she was diagnosed with CIN3, aged 38.

Background:

Pam is a divorced mother of three and does some voluntary work in her spare time Ethnic background / nationality' White British

More about me...

Pam had her first child at seventeen and a smear test shortly afterwards. Results showed abnormalities and she was given annual cervical screening for about ten years. In 2004, Pam broke her coccyx and, when she received an invitation for cervical screening, she said she ignored it because she was not very mobile. She also had a marriage break-up around that time and said that going for screening was, at that point, not a priority.

Shortly after her marriage break-up, Pam met someone new but, later, found out that he had cheated on her. After they broke up, she went to see her GP because she was concerned that she might have caught an STI (sexually transmitted infection). She was given tests, including cervical screening, and results showed that she had CIN1. The test was repeated six months later and results showed it had progressed to CIN2. Pam was given a colposcopy and biopsy and, in a following appointment, a LLETZ. Results showed she had CIN3.

Pam said she experienced a lot of pain during and after surgery and would have liked more information about CIN, treatment, what would happen at each appointment, and about follow-up. Not having this information, she said, made her experience of CIN3 more worrying than it needed to be.

Pam’s older daughter was 21 at the time of interview and had two children of her own. Pam said that, having had CIN3 herself, she was now concerned about her daughter, who would not be screened until she was 25. Her younger daughter was 14 at the time of interview and Pam was keen for her to have the HPV vaccine. When she made enquiries about it at her daughter’s school, however, she was given very little information.

Pam said she wondered how she got CIN3 and, at first, felt a lot of blame and anger towards her ex-boyfriend. She also worried that she could have cancer. She would now like more information on what can be done to help prevent a recurrence.

Pam would have liked to have had LLETZ under a general anaesthetic because she found it very...

I had electrical diathermy. I wasn’t given the choice; I wasn’t told you could have a local or a general. So they booked it under local and I found it absolutely horrendous.

And half way through the doctor actually said to me, “Did you not know you could have it under general?” And I said, “No. But if I ever have this again, make sure it’s on my notes that I will be having a general.” Because it was quite painful.

Were you happy with the care when you were there?

Definitely. Except for the fact that I was angry that I wasn’t told about the anaesthetic. Even if I’d known that it, not obviously, not knowing how much it was going to hurt. But if I’d known I would still would have opted for the general anaesthetic because the whole thought of all that sort of thing going on while you’re awake, knowing they’re going to cut bits off you, or burn you and, you know, it’s scary.

And you’d had general anaesthetic before, so…

Yeah, I’d had loads.

…that doesn’t worry you?

No. Not at all. I would much rather and if I, if I do ever, God forbid ever have to go through this again, then I will definitely be having a general. That is one thing I would advise people. And I wouldn’t say I’ve got a low pain threshold because I’ve well, you know, I’ve had three kids and various operations and stuff.

Pam wondered how she got HPV. She was pregnant when she was sixteen and her ex-boyfriend had multiple partners. She worried she could have cancer and felt anger and blame towards her ex-partner.

All I was told was that, obviously that I had to explain my situation, and they said to me it might just be the fact that I’d had a change of partner. I was also told that, obviously I went and I looked on the internet as well. And I remember reading that it could also be caused by having early sexual relationships or children early.

Now obviously I was pregnant at 16 and had my child at 17, so you know I started to think is it that?

Then I also found out that men who’ve had multiple partners can give it to you, and I knew he’d had a bit of a history. And that’s why I panicked and then I started to think, “Oh well it must be his fault. It must be his fault.” You know I’ve been clear for so many years, in a monogamous relationship; it’s got to be his fault.

I did, and there were obviously periods where I would sit here and absolutely, I was going to swear then sorry. Just sit here and cry and just think, “Oh my God,” you know, “Have I got cancer?” You know, and the blame, just the blame, thinking it was my ex-boyfriend who had given it to me. You know just the anger of that. And not knowing what, if I did have cancer, whether it could actually be treatable. You know and stuff
like that.

Pam's family tried to reassure her that there was no need to panic or worry because CIN wasn't...

Perhaps I shouldn’t, but I’m going to go to Jade Goody. And it’s like when you tell people, unless you say, I mean if you say to them that you’ve got CIN 1 or CIN 2 or CIN 3, they’re like, “What you talking about?”

If you say to them, “I’ve got cancer,” they’ll know. So all the time I’m telling abnormal smear, CIN 1. Yeah I could talk to them and tell them I was worried. But I’d always get, “Don’t worry, don’t panic.” Because only because of their ignorance as well.

As I say, it was just like, well you haven’t got cancer, you know. It’s only, you know.
They were sympathetic in as far as if I wanted to talk. I was worried they wouldn’t listen. But at the end of it, it was all like, you know, “You’ll be alright, it'll be fine.”

Pam said she was unsure about how much to tell her new boyfriend. When they first met, she was...

I wasn’t allowed sex for a few weeks, so the annoying thing was that I’d met someone else and we met in the August. And in September, I think it was September, I got sterilised. Then in the November I had something else done, and it was all like, “Don’t have sex.” Oh I think it was the biopsy, you know, “Don’t have sex” again. And then it was this, and it was, “Don’t have sex” again. And I went, oh I’m in a new relationship, this is really awkward.

We got through it. We’re still together now.

So did you talk to him about it?

Yeah I did.

And was he quite understanding or…?

I think he was a bit worried.

Did he find it hard to understand?

Well he never had taken account of women’s problems before in that sort of respect, but, I don’t know I’ve never actually really asked him. He’s in the kitchen. Do you want to ask him? I don’t know. I mean he listens all the time, and he’s very reassuring and comforting.

But I think at the time I didn’t actually, I didn’t go to, I went to more depth with my children than him, because obviously it was a new relationship. And it looks a bit strange doesn’t it? “Oh well I might have cancer.” “Oh why have you got cancer down there?”

It’s a bit, you know, not knowing enough about it, and you know. It’s hard. I mean obviously he knew that my ex-partner had cheated on me and stuff like that, and I’d told him how it all happened.

Pam has been trying to persuade her friend to go for cervical screening. She would like her...

I have a friend at the moment who told me a while back, about a year ago, that she’s had a coil in for 10 years and she hasn’t been for a smear in that time either. And she’s older than me, and I said to her, “Please please.”

It was when Jade Goody and all that come out as well, and I said to her, “Look if you won’t listen to me, you know, it happens as quick as me, to me as it did to Jade Goody,” basically, “Please go and see your doctor and do something.” I said. And she kept saying, “I’m scared, I don’t want to. My dad died of cancer. I don’t want to, I don’t want to know.”

But I said to her, I told her about the consultant that I’d been seeing, a woman, and she was, and I told the woman about her as well. And she said to me, “Give her my number. Tell her to ring me anytime.” And I am still to this day trying to convince this woman to go to the hospital. And she keeps on saying, “I will, I will.” But she knows she’s only got to ask and I’ll give her the number, and the woman will see her.

Yeah, a lot of women are quite scared of going aren’t they? In case…

Of going full stop. I mean on the flip side of it, my daughter is 21 years old; she gave birth to her second child last week and her eldest is 11 months. So she’s had two pregnancies really, really quickly, and yet she will not be getting a smear test until she’s 25, which I think is absolutely preposterous. They are trying to say that girls are having sex earlier these days, and yet they’re making it longer before they test them. So I have told her to tell her GP when she goes for her six week check, “My mum had CIN3, I want a smear.” And I’m hoping and praying they will give it to her.

When Pam's ex-boyfriend cheated on her, she was worried she might have caught a sexually...

Basically my husband left me in August ’05 after 16 years. Obviously again it wasn’t priority for me to go to the hospital and get that done [cervical screening]. Then I met someone, and within ten months of being with him I found out he’d cheated on me. So I decided to go to the doctors to get just checked out, and to make sure I hadn’t caught anything because he didn’t give me the opportunity to tell me that he’d, before we you know slept together again.

So I went and had my smear, and it came back and said I was CIN1. So, asked me, I think I had it repeated six months later. And it was CIN2. So then they said to me, okay, well they need to, you know re-do this. I had a biopsy.

Pam found out about the HPV vaccine from her mum. She was concerned about when her fourteen-year...

The other good thing is that my fourteen year old, I mean my mum was looking on the internet and she, oh I think she heard it on the radio and then looked on the internet. And it was something about this injection for teenagers, to the parents, well the mothers had cervical cancer or whatever, or CIN1, 2, 3, whatever, and I looked into that. I spoke to my GP and my GP said yes, she can get it done privately for about four hundred and fifty quid.

And I thought, “Well I haven’t got four hundred and fifty quid. But this has to be done.” I made further enquiries to find out that the school are implementing it. But at this stage in her life, it doesn’t, it’s not her year group. And it won’t be next year, so it won’t be till the next, the following year. Now the only comfort I can get from that, knowing that my daughter is sensible and I know one hundred and fifty percent that she will not engage in any sexual activity before she’s probably 30! No, she wants to be a lawyer, she wants to be, she’s very headstrong, she’s very intelligent. So I’m hoping she’s, so long as, because there’s something about, that’s what apparently it is, they have to have the injection, and it has to be before they’ve had sex or something.

So I mean she knows all this, so hopefully it’ll be next year she will get the injections and she’ll get them for free. But I don’t think that’s good enough. I did ring the school and said to them, “You do realise I’ve literally just had CIN3.” And they said, “It’s out of our hands. You can get it done privately but she will get done before she’s 16.”

Pam worries more about cancer now. She wonders whether she is more likely to get it and whether her daughters are at a higher risk too.

I’m very impressed with the way the treatment was done quickly; you know obviously it was taken seriously, which now obviously I realise why it was taken seriously. What was I going to say? There was something that crossed my mind as well at the time. I started thinking well, when my mum told me about this injection for children or the set of three injections whatever it is.

I started to think about well, if I’ve had it, and she might catch it, does that mean that I might be able to catch, well not catch, but hereditary, get the breast cancer from my Nan.

So now I’m thinking to myself, do I go to my GP and insist on a mammogram? Because I’m not one of these people that regularly checks myself, and I wouldn’t know exactly what to check for. So I’m thinking that I don’t know how cancer works, even now I still don’t know exactly how it works and I don’t, if my daughter can get it because I’ve had it. Then I feel that maybe I should go and get my boobs seen to really.

So you’re thinking more now because of this, you’re thinking much more about cancer?

In general yeah. I think its, because I don’t know, yeah even to this day I don’t know whether the fact that I’ve had cervical cancer, or nearly cervical cancer, means that I am more prone to get it again. Whether I’m more prone to get a cancer somewhere else. I really don’t know. I don’t know what to look for. I haven’t got a clue.

Pam was worried she'd caught a sexually transmitted infection. She didn't know what was wrong...

When this boyfriend, ex-boyfriend had cheated on you, it was only then that you thought, “Right I’d better get myself checked out,”?

Yeah.

“Because he might have given me something,”?

Well yeah. Having been married for 16 years and been monogamous and you know all the rest of it, I never ever entertained the thought that I’d you know. And I was just so angry that he’d put me in a position where he hadn’t, I didn’t find out till afterwards. Slept back together, that he’d been unfaithful and I was terrified that I’d caught something.

So you went to the GP and he said you need to be tested, and they, did they do quite a few tests?

I think they did blood tests and maybe a urine test and a smear.

And those were all fine apart from the smear…?

The smear yeah.

And then did you get a letter or a phone call saying…?

I got a letter.

Saying…?

And of course as soon as I read it, I rang the doctors and I thought, “What the hell?” You know, why, what’s going on?

Because this would have said that there was an abnormal result or….?

Yeah it didn’t, I don’t think it said CIN1 at the time. I think my GP told me that afterwards.