As Tamika Felder puts it, "There’s never a good time to get cervical cancer." But it happened at what felt like the worst time: She was 25 years old and had landed her dream job, working as a television producer in Washington, D.C., her whole life and all of its possibilities stretched out before her.
Before her diagnosis, Felder remembers her mom telling her to get screened for cervical cancer before she aged out of her mother’s health insurance plan. But, Felder tells Yahoo Life, "at 25, I honestly didn’t care. You’re thinking, 'I'm 25, what’s going to happen to me?' My view now is totally different."
But that wasn’t the only reason Felder put off heading to her physician for a checkup. Felder shares that she was body-shamed by her physician while in her early 20s. "I’m not a small woman, and I was all for body positivity before body positivity was a thing," she shares. But during the exam, her doctor started "poking and pushing on my abdomen and said, 'You know if you were pregnant you wouldn’t know,'" she recalls. "I felt so defeated and ashamed. You can tell me that I need to take care of myself and lose weight — this is not the way to do it."
Felder adds: "It was traumatizing." She quickly changed back into her clothes and left her doctor’s office. "I was out the door and that was the last time I had my feet up in stirrups," she says.
A trip to the emergency room for a boil under her arm changed that. While filling out health forms, Felder struggled to recall when her last physical and Pap test were. An ER doctor suggested that Felder get up-to-date on her screenings and recommended a health care practitioner. "He encouraged me to schedule it immediately, especially since I had started a new job with health insurance," she says.
That long overdue routine Pap smear revealed that Felder had cervical cancer. "It was April 2001," recalls Felder, who is now 46 years old. "I’m in this office and [the doctor] starts going over this and that, and I remember my mind trailing off. And then I heard that word. I heard her say a word that grabbed my attention. It’s like the Charlie Brown cartoon with the teacher you never see, that whamp whamp. She was saying 'carcinoma this' and you have to see a specialist.”
When Felder realized she had cancer, "I would tell you, the bottom dropped out," she says. "The bottom completely dropped."
At that moment, Felder thought, "'I'm going to die,'" she shares. "And I haven't truly been in love. I haven't had my heart broken. I haven’t traveled the world. I haven’t had pasta in Italy. I haven’t been to Africa on safari. I was a scared 25-year-old girl who was just starting her life and the bottom fell out because of cervical cancer."
Felder says that "when you're diagnosed with cancer, you're thrust into this world" of medical care. She immediately started getting second opinions from other doctors. "I got so many second opinions because I wanted one doctor to tell me it’s all been a mistake," she says. “But they all said in order to survive I needed to have a radical hysterectomy immediately."
Like Felder, Tracy Jimenez had put off getting screened for cervical cancer but for a different reason: She didn’t have health insurance. However, "I did keep going to the emergency room because of really bad back pain I was having," Jimenez, who was 46 years old at the time, tells Yahoo Life. "They told me I had sciatica in my back … They didn't check me to see if I had anything below so I had no idea what was going on."
After putting up with back pain for about three years, Jimenez started experiencing pain in the back of her legs, along with fatigue, hair loss, vaginal bleeding and pain during sex. "One night I went to the bathroom and something fleshy came out and it was not a blood clot," she recalls. "I was so scared I didn't know what to do."
Jimenez went to the emergency room where a CAT scan revealed a mass. The next day, she saw a doctor who performed a gynecological exam. "Her first words out of her mouth were, 'I'm sorry Miss Jimenez, but you have cervical cancer," Jimenez recalls. "I did not know what she was talking about, and I didn't know what cervical cancer was."
Like Felder, Jimenez says the first thought in her mind was, "'I didn't want to die.'"
Jimenez, who is now 51, says she felt scared and devastated after her cancer diagnosis. "I left her office in tears," she says. "I sat in my car and cried."
However, when Jimenez was diagnosed, she didn’t know what HPV was. "I had never heard of HPV my whole life, and I knew very little about what cervical cancer was," she says. "I was one of those people who thought that it could never happen to me. So I never really looked into what cervical cancer was because I never thought I would get cervical cancer or cancer in general."
What causes cervical cancer?
Cervical cancer is caused by HPV (human papillomavirus), which is the most common sexually transmitted infection in the U.S., according to the Centers for Disease Control and Prevention (CDC). "Some people have called it the common cold of the genital tract," Dr. Debbie Saslow, managing director of HPV & GYN Cancer at the American Cancer Society, tells Yahoo Life.
Saslow adds: "Just about everybody who has ever had sex has had HPV. It’s unfortunate in this country there is stigma often attached to sex and how many partners you have had, particularly for women. [But] most cervical cancer cases caused by HPV are in women who have had only one partner. Yes, the risk does increase with more partners, but many have had only one partner."
There are more than 100 types of HPV and at least 14 of them are cancer-causing, according to the World Health Organization (WHO). However, two HPV types (16 and 18) in particular are responsible for 70 percent of cervical cancers and pre-cancerous cervical lesions, according to WHO.
In the majority of cases, HPV goes away on its own. But when it doesn’t, the virus can cause health issues, including cancer and genital warts, depending on the HPV type. Even if you are infected with HPV, you likely wouldn’t know it. According to the CDC: "Most people with HPV do not know they have the infection. They never develop symptoms or health problems from it."
The telltale signs of cervical cancer — such as pain during intercourse and abnormal bleeding — are more common in advanced cancer cases and "in people who just haven’t been screened or haven’t been screened in a really long time or had an abnormal result and didn't follow up," says Saslow.
However, if detected early, cervical cancer is one of the most successfully treatable cancers, according to ACS.
How to prevent cervical cancer
First and foremost, get screened. Updated guidelines from both the American Cancer Society and the National Cancer Institute (NCI) now recommend that, starting at age 25 and through age 65, women (as well as transgender individuals with a cervix) should get the HPV test every 5 years.
The HPV test, which differs from the Pap smear, checks for the virus itself to see if cells in the cervix are infected with the high-risk types of HPV. The Pap smear, on the other hand, looks for abnormal changes to cervical cells caused by HPV "that may — if left untreated — turn into cervical cancer," according to the NCI. “It can also detect cervical cancer cells.” The HPV/Pap co-test combines both screening methods.
The preferred screening method by both organizations is the HPV test every 5 years, while "acceptable" tests include the HPV/Pap co-test every 5 years or the Pap test alone every 3 years.
"Evidence shows the HPV test is more accurate than the Pap test and can be done less often; one HPV test every five years is more effective than a Pap test every three years," according to ACS.
Along with screenings, Saslow encourages parents to get both their daughters and sons the HPV vaccine, which significantly lowers the risk of HPV-related cancers — including, notes the CDC, not only cervical cancer but also cancers of the mouth/throat and penis. In fact, the vaccine reduces the risk of cervical cancer by nearly 90 percent, according to Saslow.
"The best time to get the vaccine is between ages 9 and 12," says Saslow. "If you have a kid that’s older than 12 and they didn’t have it yet, they should still get it until age 26." However, some adults ages 27 through 45 can, after discussing it with their doctor, get the HPV vaccine if they weren't adequately vaccinated when they were younger, according to the CDC. The HPV vaccine requires two doses spaced six to 12 months apart for those 14 and under, or three doses for those 15 and older.
What cervical cancer survivors want people to know
Both Felder, who had a radical hysterectomy and radiation, and Jimenez, who went through multiple rounds of radiation and chemotherapy, hope that sharing their stories will motivate women to get screened for cervical cancer and to not put off those doctor appointments. They also encourage parents to get the HPV vaccine for their children, regardless of their gender.
"I want to raise awareness because it is very necessary and not enough people know about cervical cancer or any cancer that can happen from HPV," says Jimenez.
Felder also urges women not to ignore the signs — even subtle ones — that something might be affecting their health. "Now that I know more about the disease, there were times I had bleeding during or after sex," shares Felder, who also experienced lower leg pain. "Nothing that made me feel too alarmed. You think, 'Oh, I have bad menstrual cramps.' Now my message is, 'Your body whispers.' You have to listen and even when it doesn’t whisper you have to be proactive with your health."
Above all, Felder says: "I want people to know that you can die of cervical cancer. And if you’re lucky enough to survive, it breaks you; it bends you. It’s with you forever. It doesn't leave you."
She adds: "I want people to put their feet up in stirrups. I want doctors not to shame people in general because it hinders them from getting screened. I want people to vaccinate their children… I believe we could have a world without cervical cancer. And you can’t say that about any other cancer."
Felder, who founded the nonprofit organization Cervivor, which supports cervical cancer survivors, says her life is more fulfilling now — adding that her legacy "will be the lives I've saved." But she doesn’t sugarcoat what she’s been through — "cancer has truly taken so much from me," Felder says — and stops short of calling cancer "a gift."
"I have a beautiful, wonderful life," Felder says. "But there’s a part of me that always wonders, without cancer, what would it look like? We’re supposed to be grateful — and I am — but I wonder, what would that life look like? I know I’m lucky because I think about Laura who died in her 20s. I think about Erica who did in her 30s. I think about Lisa who died before she was 30. They ran out of time. They all ran out of time. And it could have easily been me."
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