'You Need To Get It Done': Cervical Cancer Survivor's Plea For Women To Get Tested
Emma Micallef was young, healthy and just weeks away from meeting her baby boy when she was diagnosed with cervical cancer in 2016.
After experiencing clotted bleeding she assumed was related to the baby, Micallef's obstetrician sent her for a biopsy.
"I was assuming he was going to tell me everything was fine and baby was fine or maybe baby needed to come out earlier, not that I was very unwell," she told 10 daily.
The teacher, then aged 29, was diagnosed with an advanced form of cervical cancer which had spread to her lymph nodes. She was immediately booked in for an early caesarean section so she could undergo treatment.
"I remember being really calm and asking [the obstetrician] really rational, sensible questions," she said, recalling the moment her life turned upside down.
"But as soon as I walked out of his office, I just broke down... I sat outside and cried. No one expects to hear that, not ever, not when you're young and not when you're pregnant."
After giving birth to baby Felix, Micallef's cancer spread rapidly, and her symptoms immediately began to worsen. Five weeks later, she began undergoing five rounds of chemotherapy and 27 rounds of external radiation across her abdomen, as well as internal radiation.
The treatment was so aggressive, Micallef went into early menopause and was told she would never have another baby.
"I was told I wouldn't ever be able to have children again because they needed to zap basically all of my reproductive system in order to kill the cancer in its entirety," Micallef said.
"I don't think [the hurt of not carrying another baby] will ever go away."
Spending most of her days in hospital, struggling with the symptoms stemming from the treatment and not being present for her newborn son, meant that Micallef soon fell into depression.
"I didn't know how to get out of this deep black hole because it was all-consuming," she said.
"I went from being a full-time teacher, just loving what I did and being a wife and loving that to all of a sudden not even being a mum and being a cancer patient -- it was tough."
Now in remission for close to three years, Micallef admitted she is desperate for another child. Not all hope is lost -- she has her fingers crossed she will eventually be able to give Felix a sibling, with the help of medical trials and a surrogate.
Cervical cancer is one of the most common cancers that can affect women of reproductive age, but it is also one of the most preventable cancers.
In 2016, 259 women died of the cancer. However, with the introduction of a new screening program and an increase in awareness, researchers are confident Australia can become the first country in the world to eliminate cervical cancer entirely by 2035.
To do that, it's vital that women between 25 and 74 have regular cervical cancer screenings, and that both girls and boys are vaccinated against the human papillomavirus.
The screening program replaced the pap test in 2017. It is safe to be carried out every five years -- instead of the previously-recommended two -- and can protect up to 30 percent more women. It is however, still taken in the same way as a pap smear.
The screening detects HPV, a very large and very common family of viruses with more than 100 different sub-types.
"Roughly 80 percent of sexually active adults by the time they were 30 would have had an HPV infection," pathologist Jason Stone told 10 daily.
For most people, the virus doesn't mean a thing. They don't know they have it and the body's immune system will neutralise it within a matter of months. However, for some people, the virus doesn't go away and can turn cancerous without early detection.
That's where the screening comes into play.
"We're only really interested in 14 sub-types of HPV which are known to cause cancer. Types 16 and 18 are the big bad boys that are more likely to cause cancer," Stone said.
If these particular strains of HPV are found, any pre-cancerous cells can be removed before the cancer is formed. If you don't have the screening, there is no way of detecting them.
"By the time you know you have cervical cancer it is too late," Stone said.
He explained that types 16 and 18 are responsible for 75 percent of cervical cancer cases. A vaccination made for these particular strains was rolled out nationally in 2007. Now, 12 years later, the vaccinations cover 90 percent of cancer-causing strains.
While its hoped these vaccinations will help eradicate the cancer, Stone said the current 2035 is "very ambitious".
"We will never totally eradicate the disease because there will still be people who don’t get vaccinated and don’t get screened, but it will be so rare that it won't be at the forefront of the people's minds," he said, urging women to keep up with their screening.
"While women used to have about 25 or so pap smears in their lifetime, now with the new test, they can get away with about 10."
Micallef urged women to set aside embarrassment, laziness or fear and suck it up.
"You need to go and get it done -- it's really as simple as that. It's very dangerous and you're putting yourself in a position where you're vulnerable and susceptible," she said.