LOVE or loathe Jade Goody, you can't fail to be moved by her fight for life as she struggles against cervical cancer and recovers from an emergency hysterectomy.
Aged 27, when she could have expected to be swithering over whether to relaunch her perfume, have her breasts reduced or launch a Christmas single on the back of her Indian Big Brother appearance, she is instead embarking on a year-long course of che
motherapy and radiotherapy, and wondering if she will still be alive this time next year.
Katrina Guckian, a nursery nurse from Edinburgh, is the same age as Goody, and, like her, was diagnosed with cervical cancer a year ago. Since then, she has undergone surgery. The treatment has saved her life but it has also rendered her infertile.
"I was very sorry to hear about Jade Goody," she says. "The publicity is a good thing because a lot of women don't understand why they have to have smear tests. Like her, I had a large tumour on my cervix and the cancer had spread. When I was diagnosed, I thought, 'Why me?' If only it had been caught sooner. There's a lot the surgeons can do with lasers but I was way beyond that stage."
Each year in Scotland, there are 280 new cases of cervical cancer, and around 100 lives are lost. The risk of developing it is 1 in 124 and it is the second most common cancer in women under 35 years old. Occurring in the cervix – the entrance to the womb – it is caused by the human papilloma virus (HPV) and is mainly spread by direct skin-to-skin genital contact. Up to 80% of sexually active women will become infected in their lifetime, although most don't go on to develop cancer.
While some cervical cancers are symptom-free, most cause bleeding between periods or after sex. Pre-cancerous changes of the cervix can be detected by a smear test, which saves 4,500 lives every year. Treatment depends on whether the virus has spread, but most include a radical hysterectomy – removal of the uterus, cervix, a small portion of the upper part of the vagina and some soft tissue from within the pelvis. Radiotherapy may also be used to destroy invisible tumour cells, and the cure rate depends on the extent to which it has spread.
In a bid to cut the number of sufferers, the Scottish Government last month launched a £64 million HPV vaccine programme in schools, for all girls aged 12 and 13.
"My mum says if I was 12 years old again, I would have been one of the first there," says Guckian. "I can imagine some parents saying, 'My daughter's not having that', but that's ridiculous. Here we have a vaccine against a cancer! There isn't one for breast cancer. I am very disappointed the Catholic Church has come out against it. So are my parents, who are Catholics."
When health ministers made the announcement about the screening programme in August 2006, a spokesman from the Catholic Church warned it could be seen by teenage girls as a "green light" for sexual activity. However, the Church later decided to back the programme as long as girls were not given any accompanying sexual health advice.
"I know parents don't like to think of their children becoming sexually active, but if they have this vaccine, it could stop them dying young," says Guckian. "It's not about morality, it's about saving lives and preventing disease."
According to the Scottish Government, the side-effects of the immunisation are mild, including soreness, redness and swelling in the arm receiving the jab. Other occasional reactions are headaches, tiredness, aching muscles and raised temperature. Very rarely, someone might have an anaphylactic reaction and find it hard to breathe.
As well as being given in schools, the jab is available privately at health providers such as Medicalternative in Edinburgh, where an increasing number of parents are happy to pay the £450 cost for their daughters. "Mothers and daughters have been coming together to ask about the vaccine since before it was available on the NHS," says Dr Lyndsey Myskow.
"We really like to catch girls before they are sexually active, as you only need to have sex once to be exposed to the virus. Why risk developing cervical cancer if you don't have to?"
Guckian agrees. "As well as the vaccine, girls should be told at school why it's so important to go for a smear test. I had missed some of mine."
Because she had always wanted children, Guckian had some eggs frozen privately – in the time between her hysterectomy and starting chemotherapy – at a cost of £4,000.
Unfortunately, the cancer had spread into her pelvis and was advanced. "The doctor said, 'You need to forget about having children and concentrate on saving your life.'"
The subsequent treatment to kill the cancer was invasive and painful. "The chemotherapy made me sick and upset my bladder and bowels; and the internal electro treatment was horrendous," says Guckian. "Afterwards, I had hot flushes, night sweats and aching bones. And the emotional impact was huge.
"With no womb, I will need a surrogate to have children for me, so it may never happen. And I don't even know if I'll be able to have sex in the future, as I have to use a dilator because of the damage the surgery and internal radiotherapy did to my vagina. But I'm alive."
As if cervical cancer patients haven't enough to endure, they also find themselves in the ridiculous position of having to defend their reputation at a time when their focus should be on staying alive. One of the most invidious aspects of society's medieval attitudes to cervical cancer is that women feel judged just for having the disease.
The fact is that cervical cancer has nothing to do with promiscuity or sleeping around. Guckian says, "Finding out that 70% of cervical cancers are caused by a virus was devastating because I thought, 'How can that be? I've not slept with lots of people.' I don't know if I'd had HPV, but I'm presuming that was the cause.
"There's a taboo about cervical cancer. A lot of men find it difficult to talk about – my dad, my uncles, friends' boyfriends… My dad didn't tell anybody at his work, and I was ashamed of that. I said, 'Are you embarrassed because it's a gynaecological cancer? Would you have preferred it if I had a brain tumour?' But I'm not embarrassed, I'm alive.
"I was so scared I was going to die but now I'm officially in remission. I'm one of the lucky ones."
For more details and support, contact Jo's Trust (www.jotrust.co.uk), Maggie's Centres (www.maggiescentres.org) and www.fightcervicalcancer.org.uk
THE jab will see around 30,000 girls aged 12 and 13 receive a course of three injections over a six-month period in the next year, with an extra 120,000 of those aged up to 17 immunised in a three-year catch-up campaign.
The vaccine, which protects against two strains of HPV, has been highly effective in stopping cervical cancer if given to girls before they become sexually active. However, girls will still be at risk from other sexually transmitted infections, including HIV, chlamydia and gonorrhoea, and they should practise safe sex.
The full article contains 1237 words and appears in Scotland On Sunday newspaper.
