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Cervical cancer: A silent killer

Written by Noluthando Mkhize
Reynolda Makhutle only found out that she had cervical cancer when the disease had already advanced to stage three. If she had done a pap smear earlier in life, her fate could have been different.

A pap smear is a quick, painless test used to detect early cell changes in the neck of the womb, which may later become cancerous.

Cancer does not develop suddenly in the cells. There is a gradual change from normal, through various levels of abnormality to pre-cancer and eventually cancer. This process can take many years.

A pap smear detects these changes. Treatment can be given at an early stage to prevent the later development of cancer.

Finding out about cancer

Makhutle (58), who lives in Kagiso in Gauteng, had to have her womb removed after doctors found three tumours in her ovaries.

All her life Makhutle, who is also known as “Mama Ray” in her community, experienced severe abdominal pains and a heavy flow during menstruation.

“During my teenage years when I was menstruating I could not go to school because my period was very painful and my menstrual flow was very heavy.”

She had never been to a gynaecologist, but had been seeing a family doctor for 10 years. A pap smear was never suggested.

“When I turned 40 in 1998, I decided to get a second opinion from another doctor who suggested that I do a pap smear.

“The words pap smear were new to me but the doctor explained that the procedure would be quick and painless.”

“When my results came back I was
afraid because I did not know what to expect.

I was told that I have cervical cancer and that it was very aggressive and in stage three. I had to have surgery to remove part of the cancer.”

At stage three, the cancer had spread to the lower third of the vagina or onto the pelvic wall, causing kidney problems.

She said luckily, when she contracted the disease, she already had two daughters.

Her battle with cancer lasted five years and she had to go through chemotherapy to fight the disease.

“The cancer advanced and I had to have a second operation to remove the whole womb because I had three tumours. This was the biggest operation and I sank into a depression. I also suffered a minor stroke.”

In her battle against the disease, depression and a stroke, she also had to deal with being stigmatised.

“In my culture there is a misconception that if a women removes her womb she is half a woman or she has lost her femininity. My late husband was influenced by his family and left me because in his eyes I was only half a woman.

“I was at my lowest. I had two daughters to support, medical bills were piling up and I had quit my job as a banker because of the disease. My faith was the only thing that kept me going.”

Makhutle eventually won her battle against cancer.

Today she works in cervical cancer advocacy and teaches the community about the dangers of the disease and the importance of doing a pap smear.

What the experts say

Oncologist Dr Carolyn Noel from Charlotte Magxeke Hospital in Johannesburg said the biggest problem that she comes across when treating her patients is late diagnosis.

“Patients don’t understand the importance of doing a pap smear. By the time they get treatment the cancer has usually already advanced to stage three.”

Dr Noel said some of the symptoms of cervical cancer include irregular vaginal bleeding, vaginal discharge with an unpleasant odour, pelvic or back pain, pain during intercourse and more.

“Patients diagnosed with cervical cancer have a misconception that it’s a death sentence but it’s not, the sooner the disease is detected the better the chance of curing it.”

“The survival rate when cervical cancer is detected early is 92 per cent, as opposed to a 50 per cent when it is already at stage three,” Dr Noel said.

She added when a pap smear’s results are abnormal it does not necessarily mean that a person has cancer. It means that precancerous lesions have been identified and they could develop into cancer over time.

“The timeframe for cancer to develop can be anything from five to 20 years. It does not develop overnight.”

Dr Noel also said that the common ages that she treats for cervical cancer are between 48 and 50. However, there is a growing number of young people in their late 20s and early 30s who are also receiving treatment for stage three cancer.

She said this could be related to the fact that some of the young patients are HIV positive.

“In some patients the cancer is related to HIV. It is extremely important for patients living with the virus to go for pap smears.”

She said cervical cancer was a sexually transmitted disease, which comes from the Human Papillomavirus (HPV).

According to Dr Noel women should always ensure that they use condoms and do not have multiple sexual partners.

She said a pap smear should be done in intervals of 10 years in your 20s, 30s and 40s, but if a woman is HIV positive she should have it done once a year.

She also advised parents on the importance of ensuring that young girls receive the HPV vaccine to protect them from the virus.

Makhutle stressed that cervical cancer is treatable and women should love themselves and look after themselves. “As a woman you are woman enough even if you lose your womb.”