Women should have pap tests

I had a pap test. This is a test that is done to ascertain whether a woman has cervical cancer. It looks for changes in the cells of the cervix and a small sample of cells from the surface of the cervix is collected and sent to be tested at a laboratory.

It was my second pap test, the first was done many moons ago so I was clearly due.

An assignment at the Cancer Institute of Guyana prompted me to make an immediate appointment to have the test done. January is designated cervical cancer awareness month and the institute, in encouraging women to have the test done, was offering free pap tests for this month as opposed to the $3,500 that is usually charged for this procedure.

I made my appointment for one week later and on my return to work I encouraged other women to take advantage of the free service. Some seemed interested, but as far as I know none seized the opportunity. I could not help but ponder why enlightened women would not have pap tests done at the stipulated time when cost is not an issue.

Cervical cancer is one of the most treatable cancers once it is detected in the early stages. Pap test and Visual Inspection with Acetic Acid (VIA) are both offered in Guyana; the latter is administered free at the Reference Lab and results are given immediately and if needed treatment can also commence.

However, the institute advocates that the pap test is more effective than the VIA (I had this procedure done some years ago and was given the all clear) and so I decided to make the appointment.

On the morning of the appointment I awakened with anxiety and hesitantly headed to the institute located in the compound of the Georgetown Public Hospital Corporation (GPHC) facing the Lamaha Street entrance.

As I approached the door, several women sitting outside turned and looked at me. I don’t know if it is my imagination, but I saw pity (for me) on their faces.

Inside, there were mostly sad-looking women and I ensured that I made no eye contact, I am not sure why. As I awaited my turn to approach the reception area, I found I was hugging myself; it could have been the coldness of the air conditioner or fear, I am not sure.

I was told to sit and listen for my name, but I did not sit. For some reason, I did not want to feel comfortable. The woman behind me approached reception and while I could not hear what she said, I noticed that her hands were shaking as she spoke, which indicated that she was nervous. She was told the institute was already booked for the rest of the month and if she wanted a pap test she would have to pay the $3,500.

She did not pay for it and she left, I wanted to approach her and offer to cover the cost, but she exited quickly, and I was not comfortable since I had eavesdropped on the conversation.

I finally sat. Across from me was a woman, who I assumed was about my age or younger; she was obviously in pain and almost in a fetal position.

As I looked around, I realized that most of the women were alone, no male companions. It is exactly what you see when you visit a prenatal clinic, except that in the latter space the women appear to be happy.

Shortly after I sat down, a man joined the woman seated opposite me and for some reason my heart felt glad.

My name was called. As I got up, all eyes were on me and I quickly entered the room.

I sat across from a woman dressed in scrubs and she informed she would taking the test.

My heart raced.

I was asked some rudimentary questions and in a kind, encouraging voice she informed that I was doing the right thing.

“Early detection can save your life,” she commented.

I did not respond but robotically followed her instructions in preparation for the test

Here is how it is done:

The doctor (in my case it was a medic as I later found out) inserts a speculum camera into the vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined. Several samples of cells are collected from the cervix with a cotton swab, brush or small spatula. Cells are collected from the visible part of the cervix as well as from its opening (endocervical canal).

The procedure must have lasted for less than a minute, but it felt like an hour. Every time I felt it was done, it continued and if the medic—who repeatedly told me to relax and that the test was simple and would not hurt—had listened keenly, she would have heard my rapidly beating heart.

It was finally over! I did a Usain Bolt off the hospital bed and out of the room.

I was sorely disappointed shortly after when I was told to call the institute by the second week in February for my results.

While conversing with the medic, who is retired but has been doing pap tests and VIA for a number of years and was at the institute just for the month of January because of the volume of appointments, I learnt that many women do not return for their results.

I prefer VIA where women are given the results immediately.

My medic for that day told me that she is a woman of faith and she loved helping and she wanted women to take better care of themselves.

“Cervical cancer is treatable, women just need to have the pap tests and VIA so it can be detected early,” she said.

Asked her if she had any bad experiences during her years she answered: “The only bad experience is sometimes women don’t take good care of themselves and so when doing the test it is really not a good experience and at one time I said I am not doing anymore because it is upsetting. But then I say God if this is what you want me to do I would do it and here I am.”

We spoke some more, and I learnt her son who is a medical doctor was celebrating his birthday that day and she had to go get him a gift.

I left the room feeling better but still thinking about that call next month. I wished I could have gotten the results instantaneously. It is long wait, but I am one of the women who will be returning for my results, which will have to be read by my gynaecologist as is stated on the flyer given by the institute. But the medic advised that women can visit the oncology department of the GPHC and have the results read for free.

I wait.

If you are a woman and you have never done a pap test please call the Cancer Institute of Guyana on 225-5701 or 225-5703 and make an appointment. The cost is $3,500. You can also have a VIA done and this is free of cost at the National Public Health Reference Laboratory located at the corner of Thomas and New Market streets.

Do the tests, early detection saves lives. Next week you will read of the experience of a woman who is being treated for cervical cancer.