My battle with cervical cancer lasted almost a year. It began with an abnormal pap. I was referred to a gynecologic oncologist for a colposcopic exam and a punch biopsy which seemed to confirm the results of the pap. An appointment was made for a laser cone procedure in 3 months.
During the months leading up to the cone, I was experiencing pain, tiredness and having copious amounts of purulent discharge (especially after intercourse). Part of me thought the symptoms might be psychosomatic. Part of me feared the worst.
As luck would have it, my period began the day before I was to have my procedure. While I knew the cone couldn\^t be done during my period, I kept my appointment so that I may grab a moment with my Dr. to discuss the symptoms I\^d been having. I was dismissed with \"I don\^t treat discharge. I treat cancer.\" and shuffled off to the receptionist where another appointment was scheduled for the following month. Just in time for my period to begin...again.
Finally, after some begging, I had the cone done the next week. After examining the removed tissue my Dr. said everything looked good and that there was NO cancer. I was told that the tissue would be sent to the lab for pathology to confirm the findings and I would hear from my Dr. in a week or two.
The evening of December 10, 2009 I received a call from my Dr. with the pathology results. Cancer. A 6.5mm x 5.5mm tumor (as I would find out later, the tumor was larger than that) was found in the cone specimen. What the hell?! I thought I was in the clear! It didn\^t help to hear her tell me that she hadn\^t seen a cancer like mine in her 20 years of practicing. She scheduled an appointment for me after the Christmas holidays to discuss my treatment options.
It was explained to me during my appointment that, despite regular paps, my cancer had gone undetected for years because it was hidden far enough in the cervical tissue to even escape the detection of a punch biopsy. Also, the tumor itself was unusual as it was not a solid mass but more like a bunch of cancer cells \"hanging out\" near each other which made it look like normal tissue without a microscope.
The standard treatment for my stage 1B1 cancer is radical hysterectomy with pelvic lympadenectomy. I had done a lot of research about this disease and the treatment options. In addition to being terrified of a radical hysterectomy and what it meant to me as a woman, I hoped, if possible, I would be able to preserve my fertiltiy. While I already had 2 older children, I was recently married to a wonderful man who didn\^t have children and we desperately wanted to have one together. So, I brought all the articles and printouts I had from my research with me to discuss with my Dr. We decided on a more conservative fertility sparing procedure. A simple trachelectomy with pelvic lymph node dissection.
My surgery was scheduled for January 29, 2010. I was terrified but happy to get this whole ordeal over with. The surgery seemed to go well. My Dr. came to see me after I was out of recovery and in my room. She said the lymph nodes looked clear and that the chunk of my cervix that was removed also looked good. Within an hour of being in my room I felt a warm gush of fluid between my legs. I rang for the nurse and she called in my Dr. As I was being helped to a gurney, the blood just started pouring out of me. I didn\^t think it was possible to lose that much blood and still be alive. I had to be rushed back into surgery so they could try to stop the bleeding. I had to sign a consent form so that should they not be able to stop the bleeding they could perform an emergency hysterectomy to do so. Luckily, they were able to stop the bleeding and once again I dodged the hysterectomy bullet.
Waiting for the pathology results over the next couple of weeks was worse than the recovery. Finally, I got the call. Good news and bad news. The good news was that my lymph nodes were clear. Thank God! However...there was more cancer. 1.5cm x 6mm with resection margins positive for invasive squamous cell carcinoma. Again, my Dr. was shocked and amazed. What I now find shocking and amazing is that, after receiving my pathology reports from my family Dr., giving myself a crash course on pathology and comparing and reviewing those reports, there was little to be shocked and amazed about. The first report clearly indicated that the margins were positive for cancer, that the size of the tumor was only based on the available tissue and that they could not determine the actual tumor size.
At my post op appointment about a month later, my Dr. told me that, at this point my only option was a radical hysterectomy. We had discussed the possibilty of a radical trachelectomy at our initial appointment to discuss my treatment options when she inaccurately conveyed that the size of my tumor was small enough for the even more conservative approach that we went with. She explained to me that there simply wasn\^t enough of my cervix left to be able to perform a radical trachelectomy and even if it could be performed it was highly unlikely that I would have enough clear margin to properly treat me. I confronted her about what I had learned from my pathology reports and that I didn\^t really trust her judgement after I added up her mistakes. Being as I had seriously begun to lose faith in my Dr., and knowing the fact that she herself had no personal experience with this type of surgery, I persisted for a referral to a Dr. that performed this relatively rare surgery. In Canada there are only 3 centers that perform a radical trachelectomy, Vancouver, Toronto and Montreal. I opted for Vancouver as it was the closest city to my home in Edmonton. She said she would talk to a Dr. there, discuss my case and see what he thought.
The very next day, I think my intimidation factor had something to do with this, I received a call from my Dr. saying that she spoke with Dr. Mark Heywood at The BC Cancer Agency and that he would meet with me pending the outcome of an MRI, but even with that he couldn\^t promise anything until he examined me also. It was also mentioned to me that given the \"sneaky\" nature of my cancer it was unlikely that the MRI would show any cancer, but that it would help judge what there was left of my cervix to work with. The MRI was clear so we scheduled my appointment for 3 weeks later.
My husband and I were concerned about how we would fund the trip. He was singlehandedly supporting our family as I was unable to work. I thought perhaps we could have a fundraiser with family and friends to try and raise the money. Tyler, my husband, talked to one of his managers, Charles Rothman, at work if he had some ideas on putting a fundraiser together as he apparently had some experience in fundraising. In under 24 hours Charles had organized a fundraiser at their place of business Casino ABS in Edmonton so that Tyler and I didn\^t have to worry about anything more than we were. Within the next couple of weeks the casino had raised enough money to fund the trip. I am forever grateful to Charles and the generous staff at Casino ABS.
April 19, 2010 I met the man who would save my life and my fertility, Dr. Mark Heywood. At my appointment he and his student intern examined me. I was told that based on the exam and my MRI report, he didn\^t feel there was enough cervix left for me to be a candidate for the radical trachelectomy and that typically the surgery was done on women with tumors smaller than mine. I was crushed. I told him about some of the research I had done whereby Dr.\^s were operating on tumors a little larger than mine and that they were able to completely amputate the cervix to allow for greater clear margins, put a cerclage in the lower uterine segment and then re-attach it to the remaining vagina. While I wasn\^t telling Dr. Heywood anything he didn\^t know, he told me that it came down to a clinical decision. I don\^t know if was my tears, my persistence, divine intervention or something else, but Dr. Heywood said, \"You know...in all honesty, I read over your MRI report, but I didn\^t talk with the radiologist. If you want to wait here awhile, I\^ll go have a chat with him before I make my final decision.\" I couldn\^t believe what I was hearing. Even if he came back with the same decision, at least I knew I (and he) had done all we could. To my surprise he came back and told me that after speaking with the radiologist, he felt comfortable enough to do the surgery even though he still felt the radical hysterectomy was the more appropriate choice. He left the choice up to me and added that no matter which surgery I chose, if I had close, positive or not enough clear margin, I would have to undergo adjuvant radiotherapy as this would be last surgery I could have. Even though I wanted to perserve my fertility, there was no question that saving my life was of utmost priority. After weighing my options, I thought that whatever cancer they were certain was left, if it were in the trachelectomy specimen, it would also be in the hysterecomy specimen. Also, since I already had my pelvic lymph nodes removed during my previous surgery, the trachelectomy would be the least invasive as it could be done completely vaginally. I opted for the radical trachelectomy.
My wonderful parents and grandfather graciously came up with the money to fund the trip to Vancouver for my daughter Eden (who came to take care of me so my husband could stay behind and work) and myself. Unfortunately, my surgery had to be rescheduled as an infection I had kept my surgery from going on as planned. That meant another trip to Vancouver, but this time it was all systems go. The surgery went brilliantly despite a fair amount of blood loss that left me anaemic. I returned to Edmonton 5 days after surgery to continue recovering.
June 17, 2010 the phone rang and it was Dr. Heywood with my pathology results. My heart was in my throat. Everytime a Dr. called me it was to tell me bad news. I will never forget these words as long as I live, \"There is no residual cancer in your surgical specimens. There was some low grade squamous intraepitheleal lesions (SIL) that was removed. So April...that should take care of that.\" I fell to the ground and cried like I have never cried before. I cried out all the pain, all the fear, all the anger, absolutely every emotion I\^d had over the last 11 months. It all came out of my eyes as this deluge of tears that seemingly had nowhere else to escape from.
I am now exactly 8 weeks post op. The recovery has been slower than I had hoped, but it is a small price to pay. During my post op follow up last week I was referred to an Ob/Gyn that specializes in high risk pregnancies as well as a fertility Dr. should I have difficulty conceiving. My husband and I can begin trying to have the child that we\^ve dreamed of in 6 months.
I am so thankful for all the support I received from my friends and family. I am so thankful for the great medical care I received from Dr. Heywood, his staff and all the wonderful people at the BC Cancer Agency, Vancouver General Hospital and UBC. I am thankful to myself for being an integral part of achieving the outcome I desired. I am thankful to all the women who came before me and battled this disease with such courage and strength. It was through their suffering that women like me have the options we do today. Crazy as it may seem, I am thankful to cancer. Because of it I learned who I am and what I\^m made of. I learned the true meaning of love. I learned that there is strength to be found during times of weakness. I learned that courage is gained by persevering through the pain and the fear. I learned that it is an honor to live this life. I learned that by surviving cancer I can do anything.