Going to the doctors - one for the ladies

[Raunioilla]

I'm 27 and should have had a smear test by now but I haven't been able to pluck up the courage to do it yet due to various anxiety issues around doctors' surgeries (phoning to make the appointment, needle phobia, strange people interfering with my lady parts)

Could some of you ladies give me a quick overview of what happens to reassure me it won't be as horrifying as I think? What questions do they ask you, is there any chance a needle will be involved etc.

I know how important something like this is especially is my bf's ex died of cancer last year aged only 29.

Thanks

[Raunioilla]

Thanks millerlou - that's really helpful

[Amber Fyre]

^^ WiIIow, that perfectly describes me too. I'm 29 and have never been. Don't think I ever will. I've stopped telling people I don't go because I'm sick of the lectures I get 'you're going to die' 'look at Jade Goody' 'it's only a minute and they've seen it all before!'. None of it helps. I've researched it thoroughly and it's my choice to make (please no one lecture me on this thread, it's a very personal decision and mine alone). I wrote to the NHS and got them to stop sending me letters because it made me feel anxious every time I got one. It's annoying that if I go to the doctors about anything they bring it up too. Once I went about having blocked ears and they started lecturing me about the smear! I hate doctors enough as it is and it puts me off going even more.

Anyway, sorry for going off on one Raunioilla - I've had the tests explained to me by the doctors and they say for most people it doesn't hurt, it's just a bit uncomfortable. There are no needles and it doesn't last long. If you feel you should go and would feel better having done so then good luck with it

note: please no one quote this as I'll probably end up wanting to delete this.

[Azi]

^ good for you - your body your choice!

OP, they can be a bit uncomfortable but the nurse will be understanding and should help you be relaxed, which definitely helps. I put my last one off for years because I was too scared to make the call - have you got anyone that can make the call for you?

[Belinda]

I thought this was an interesting article by Anna Sayburn weighing up the pros and cons of having a smear test:

The Guardian, Thursday 22 May 2003

For the past 15 years, I have obligingly trotted down to the doctors' every three years, breathed deeply, chatted with the practice nurse and tried to ignore the discomfort as the speculum opens me up for inspection. I have done it because regular cervical screening is what sensible, health-conscious women do. It's recommended. It's better to be safe than sorry.

Except maybe it isn't. Last month, the British Medical Journal published research that suggests that I, and millions of other women, may have been wasting our time. In order to save one life from cervical cancer, the research found, 1,000 women would need to be screened for 35 years. Worse, the researchers suggested that testing might do "more harm than good": women born after 1960, they found, have a 40 per cent chance of having a smear test labelled abnormal at some point in their lives - with all the anxiety, investigation and treatment that implies - even though the chances of this leading to cancer are minimal.

Michael Baum, emeritus professor of surgery at University College London and a cancer screening expert, calls the research "absolute dynamite. Any intelligent woman reading that would make an informed decision not to go for cervical screening".

The paper talks of the anxiety caused to the thousands of women who get borderline or abnormal results every year. Anxiety is the least of it. A friend recently phoned me in floods of tears, to read out her letter from the GP. It said her smear showed "mild dyskariosis". Being an inquisitive type, she had looked it up in the medical dictionary, which told her she had cancer. Mild dyskariosis means small changes to cells, which could, one day, turn malignant. In the vast majority of cases they don't.

According to the BMJ paper, which looks at the 348,419 women screened for cervical cancer in the Bristol area from 1976 to 1996, 156 women in every 1,000 had abnormal results, but only one in a 1,000 showed signs of invasive cancer.

Dr Angela Raffle, consultant in public health medicine in Bristol and author of the BMJ paper, began the research because she was struck by how many women were being referred for colposcopy (microscopic examination of the cervix) after abnormal smear test results.

"Originally, people thought everybody with an abnormality would go on to get cancer, and we have come round to realising it is just a phenomenon of screening," she says. "Cell changes are very common and all of us have them, and they go away; it is impossible to predict who is going to go on and get cervical cancer."

But no one had bothered to tell my friend that. In fact, in 15 years, I don't remember ever being given any information about cervical screening, the accuracy of the test, the possible results I could receive, or having any explanation of the results when they come through in the post, months after the test. Just pop your knickers off and get up on the couch.

There could be a reason for this. Raffle says that the screeners realised in the 1980s that they needed to screen and treat enormous numbers of women in order to make an impact on mortality figures. Most would not have gone on to get cancer - but a very small number would, and it was these women they wanted to catch. If women realised how unlikely it was that they would personally benefit from screening, the screeners might not have got the numbers they needed to reduce cervical cancer deaths.

I tell her that my conclusion after reading her paper is to withdraw from the screening programme. Cautiously, she falls back on the "can't be too careful" argument. "What would I regret most? If I got cancer and I hadn't been for screening, I would never forgive myself," she says. But my chances of getting cervical cancer are minimal, I say.

"Some women would say: 'I loathe hospitals and I'm very confident in my own health. If I had to go to colposcopy I would regret it.' Those women are best not coming for screening," she admits.

The evidence against the usefulness of universal cervical screening keeps coming. An audit in Leicestershire in May 2001 found that a third of the women who did go on to develop cervical cancer had had normal smear test results. The test - microscopic inspection of a few cells scraped off the cervix - is not very sensitive and can easily miss changes, either because the cells sampled don't show them or because they arise in the three to five years between screens.

Then there are the false positives - the number of women worried and upset by "abnormal" results, which put them straight onto a conveyor belt of annual smear tests or further procedures such as colposcopy and biopsy. For every death prevented, acccording to Raffle's research, more than 80 women undergo further investigation and more than 50 are treated.

But while cervical cytology (examination of the cells taken from the cervix) may be far from perfect, there are others who argue that it is better than nothing. "If somebody suggested in 2003 we [should] introduce cervical cytology, no randomised trial would ever show it was worthwhile," admits Dr Anne Szarewski, clinical consultant for Cancer Research UK. "However, it is impossible to turn the clock back. We haven't got anything to replace it with.

"It can be uncomfortable; some women find it humiliating and it is true the majority will not benefit," she admits, but, she says, the 42 per cent fall in the mortality rate from cervical cancer since the 1980s shows that for those who do develop cancer, the benefits are very real. "There are approximately 14,000 women alive to day who would not be if they had not had cervical screening. Women need to realise its limitations and not get so incredibly worried when they have an abnormal smear."

In a letter to the BMJ, Professor Peter Sasieni from the Wolfson Institute of Preventive Medicine in London, says women should view cervical screening not as a test for cancer, but as "a costly and imperfect insurance policy" against the "catastrophic" but unlikely event of cervical cancer.

So it comes down to the level of risk with which we are happy to live. And now that I know my likelihood of an abnormal smear is so much higher than ever having cervical cancer, I think I'll take my chances until the test improves. What does Michael Baum think of my decision?

"You are not being irresponsible or reckless. You are making a serious, thoroughly well-informed choice and I would like to extend that choice to all women," he says. I wonder how long it will take the rest of the medical profession to come round to his point of view.

Sorry it's a bit lengthy.

[misska]

They are a bit embarassing but painless, the alternative is waiting till u have symptoms then having 1. By then it may be to late. I would get 1 it lasts 2mins and done by female doctor/nurse who seen it all b4

[Indigo_]

Amber Fyre I completely agree with you and have had almost an identical experience. They've been pestering me with letters for the last few years and each time I open another one it just makes me feel more anxious and annoyed. I eventually wrote to my GP surgery last year kindly asking them to stop harassing me. They then rang me and left me a voicemail asking me to ring them back As it happens I was at the doctor's about a week later for an asthma review when the nurse brought it up. I explained my reasons for not wanting to have it done (which I feel are perfectly valid) which she was fine with and that was the end of it. At the end of the day it is your body and it is your choice and as far as I'm concerned nobody should make you feel pressurised into doing something you don't want to do.

[Lifebuoy]

I'm not a 'lady', nor a woman, so perhaps I shouldn't be posting in this Thread. But it does remind me of the dilemma I used to face when needing to have an inoculation updated. Like many people I don't like needles, but when I reflected on the amount of discomfort a needle would give me... and the amount of discomfort contracting typhoid or tetanus would give me.. it was a 'no-brainer'. I had to 'bite the bullet' and go for the jab.

There's another factor to be borne in mind. It might be 'your body and your decision' whether to get a Smear done. But if you got cancer other people (ie taxpayers) have to pick up the bill. Millions are spent by the NHS on Scanning and preventative medicine, to help make the NHS affordable to the nation. So, to be fair, it's not just a matter of what's 'right' for you... you have a responsibility to do your bit and help out... despite your possible embarrassment and anxiety about the matter.

I've just turned 60 and was sent a post-it-back poo-sample test to check for possible bowel cancer. It wasn't a particularly pleasant process, spanning 3 days. But I'm very grateful that the NHS sent this out. I credit myself for not being guilty of 'failing to see the wood for the trees'. Anxiety can create havoc in our lives... but there are limits to what sort of nonsense we should allow ourselves to endure.

(Hope I don't get an 'M-Y-O-B' post in return )

[Indigo_]

No M-Y-O-B reply from me Lifebuoy, you're entitled to your opinion, whether you are female or not

I can appreciate what you are saying and in light of young people getting cervical cancer it's great that the NHS are trying to make as many people aware of it as they can. I do still feel like the letters they continually sent me were bordering on harassment (maybe I'm just over-sensitive about it) and ultimately, it is still my decision.

I feel I have valid reasons for not having a smear done and whilst anxiety does play a small role in my decision, embarrassment certainly doesn't.

[Lifebuoy]

Originally Posted by woof

What bill?

Sure might have a screening to confirm I had it but I wouldn't take any meds or anything to try and cure it. I dunno what exactly happens =/

Oh... fair enough, Woof. If you contracted cancer having refused NHS Smear tests and also refused the NHS treatment that was offered to you for the cancer, then you would be on the moral 'high ground'. Somehow though, I have a feeling that if you were diagnosed with cervical cancer, after the shock had subsided you would accept treatment. I could be wrong.

The 'bill' is what it would cost the NHS to treat you, if you consented to having the treatment for cancer.

Incidentally, based on your earlier Post, it sounds like you need to have a think about how your life is going. It doesn't sound too positive. Up to you Woof, but it would be interesting to know more...

[Lifebuoy]

Originally Posted by DefyingGravity

No M-Y-O-B reply from me Lifebuoy, you're entitled to your opinion, whether you are female or not

I can appreciate what you are saying and in light of young people getting cervical cancer it's great that the NHS are trying to make as many people aware of it as they can. I do still feel like the letters they continually sent me were bordering on harassment (maybe I'm just over-sensitive about it) and ultimately, it is still my decision.

I feel I have valid reasons for not having a smear done and whilst anxiety does play a small role in my decision, embarrassment certainly doesn't.

Yes, DF... I can see that you are on top of your game regarding Smears. Ultimately it is a personal decision...

[smog]

I had one done recently having avoided it for a while, it was over with in about three mins, slightly uncomfortable for about 5 seconds but otherwise fine. Tbh though my mind was elsewhere, concentrating on puking into a dish as I didn't feel well that way, so wasn't taking much notice of what she was doing.

Does anyone know how long they usually take to get back to you? I remember the nurse gave me a time frame but I forget how long it is before you get your results back.

[Azi]

IIRC, they only give you results if they're not normal.

[smog]

^Really?! I'm probably thinking too much into this but if that's the case and then say for example your results are abnormal but the letter gets lost in the post... you would never know... you'd just assume your results were normal. Obviously most people would ring their doc to ask about results etc, but still.

[Azi]

Yeah, i always thought that was stupid system really.

[LittleMissMouse]

If you don't want to have to make an appointment over the phone, there are some GU clinics where you can just go along on the day and tell them you'd like a smear test.

It's not horrifying at all, there's no needles and the nurses are used to people being nervous and putting you at ease with it all.

If you haven't had the cervical cancer vaccine, it is worth asking if they will still give it to you (they might, they might not, I think it depends a bit on your age, and whether the catch up thing with older women is still a thing), needle issues permitting ofcourse.

[Lifebuoy]

Originally Posted by WiIIow

Smear tests are not like vaccinations. Smear tests can help diagnose cancer earlier or identify if you are at risk of developing but in themselves they do not prevent anything. Now teenage girls are being given vaccinations that can help prevent them from contracting the virus that causes cervical cancer which is preventative and hopefully will save lives in the future. Women can have regular smear tests, still get cancer and still cost the taxpayers money. Its a valid point but I wouldn't base my decision of whether or not I should have a test on this.

Ten days ago my nan died of ovarian cancer. When she lost 2 daughters to the same disease she had every test possible, they all came back clear, she was not classed as being at risk and 4 years later she is dead. I know this is a different cancer with different tests but to me the principle is still the same.

Thanks Willow... I appreciate that Smears aren't like vaccinations in that they don't protect against contracting cancer. But the principle is the same. A vaccination can stop you contracting an illness. A Smear test can provide early detection of cancer... and that could be decisive regarding life and death. Skipping the test must statistically increase the risk of dying from cervical cancer. It's still a 'no brainer', frankly... even if you can quote lots of anecdotal examples of tests not guaranteeing to detect a cancer. But yes... it's a personal decision, just as all 'healthy lifestyle' choices are personal decisions.

[Belinda]

I don't think it's as simple as that Lifebuoy. I posted a rather lengthy article about the pros and cons of having a smear earlier in the week so here's my attempt at a summary:

Positives: The rate of cervical cancer has fallen since the test was introduced so it certainly has been effective in many cases.

Negatives: There's quite a high margin of error so according to the article I quoted 40% of women who have regular tests will have an incorrect positive smear at some time in their lives with all the anxiety and upset that can cause. Conversely it's quite common for the test to miss a developing cancer completely. It does seem to be one of the less accurate of medical tests.

As it's such an invasive, anxiety provoking procedure I would only have it done myself if I thought it would detect cancer with close to complete accuracy. I also had a friend who had a very bad experience with an insensitive GP who left her in a lot of pain which adds to my trepidation.

It really is a personal decision though and I don't think there's a right or wrong answer because it has saved many lives.

[Lifebuoy]

Originally Posted by WiIIow

I don't believe I have quoted "lots of anecdotal examples" at all. That is my personal experience. Nothing more. I am not saying it is an argument against smear tests, it is my view on the subject and one of many reasons why I don't want any form of tests. I have personal experience of being tested for cancer, it was traumatic and invasive and I will avoid any further tests as much as possible. As you said that is my personal decision. I am not saying it is the right one.

My current emotional state may be causing me to misinterpret your post but it seems very passive aggressive and rather patronising to me. it's not a 'no brainer' at all. People who choose not to have the test often have thought about it very carefully. I agree that if you don't have the test and you contract cervical cancer your chances of dying are increased significantly and I am sure that anyone who chooses not to have the test has considered this.

Anyway, I think that the original intention of the thread has got lost somewhere. It is supposed to be reassuring the OP about the test, not criticising those of us who choose not to have it. I apologise for my part in derailing the thread.

Hmmm. Maybe what I wrote was a bit pushy. What is an 'obvious truth' to me may not be so for others... because for them other factors bear on the issue that I can't and haven't anticipated. So the 'cost' for them of submitting to the smear test might well outweigh the possible benefits. Sorry W It is a sensitive matter and I was a bit clumsy.

Originally Posted by Belinda

I don't think it's as simple as that Lifebuoy. I posted a rather lengthy article about the pros and cons of having a smear earlier in the week so here's my attempt at a summary:

Positives: The rate of cervical cancer has fallen since the test was introduced so it certainly has been effective in many cases.

Negatives: There's quite a high margin of error so according to the article I quoted 40% of women who have regular tests will have an incorrect positive smear at some time in their lives with all the anxiety and upset that can cause. Conversely it's quite common for the test to miss a developing cancer completely. It does seem to be one of the less accurate of medical tests.

As it's such an invasive, anxiety provoking procedure I would only have it done myself if I thought it would detect cancer with close to complete accuracy. I also had a friend who had a very bad experience with an insensitive GP who left her in a lot of pain which adds to my trepidation.

It really is a personal decision though and I don't think there's a right or wrong answer because it has saved many lives.

Thanks B. Your over-view is rather more rounded than my baldly stated 'It saves lives so you've gotta have it done!' Impetuous man sticking his nose into women's matters...

[Indigo_]

Originally Posted by WiIIow

it's not a 'no brainer' at all. People who choose not to have the test often have thought about it very carefully. I agree that if you don't have the test and you contract cervical cancer your chances of dying are increased significantly and I am sure that anyone who chooses not to have the test has considered this.

I agree. It is definitely not a decision to be taken lightly but as I have said before, it's your body, your choice.

Originally Posted by WiIIow

Anyway, I think that the original intention of the thread has got lost somewhere. It is supposed to be reassuring the OP about the test, not criticising those of us who choose not to have it. I apologise for my part in derailing the thread.

I'm going to join you and apologise for the derailing too

[Ember]

I went to have it done because the thought of having to go had me wound up and anxious since I was in my mid teens. Now its over with for a few years I feel much better... About that at least.

It was rubbish but overall better than expected, considering what it involves.

Bleh.

[Silver]

I could never have a smear test ever again. I have a massive hatred of whats 'down there' to the point where I wish I could get rid of it. The idea of letting someone near that area absolutely repulses me. A nurse once told me that virgins don't get cervical cancer. I stand by that!!!

[misska]

Originally Posted by woof

Yes same here.
Sorry to sound blunt but if I get cancer so be it.
I don't have much to live for, no kids, no partner....I don't even have a hobby to enjoy so life is pretty dull. I know going through cancer is horrible but I'd just rather be dead

I think your life would be much worse if you had cancer its not an 'easy' way out. Why so negative about a free test that could help you and many other women yes its a personal choice but saying your not doing it because you have no hobby is silly

[Lifebuoy]

Originally Posted by misska

I think your life would be much worse if you had cancer its not an 'easy' way out. Why so negative about a free test that could help you and many other women yes its a personal choice but saying your not doing it because you have no hobby is silly

Misska, maybe I should let Woof answer for herself, but I've posted here more or less on the same lines of what you just wrote. What I have concluded is that this is not just a simple matter of personal whims versus 'common sense'. There are many aspects to this issue especially if you have problems with anxiety and/or depression. The cost/benefit equation isn't as obvious as you might think. If you have a careful read through the thread, right from the start, I think you'll get to see what I mean.... (?)

[Raunioilla]

Wow - this turned into quite a discussion! Not a bad thing by any means - i've quite enjoyed reading through everyone's comments so no need for apologies.

Thanks to everyone who has spoken up about their experiences. It has definitely helped me feel a bit less nervous about the whole thing.

[misska]

Originally Posted by Lifebuoy

Misska, maybe I should let Woof answer for herself, but I've posted here more or less on the same lines of what you just wrote. What I have concluded is that this is not just a simple matter of personal whims versus 'common sense'. There are many aspects to this issue especially if you have problems with anxiety and/or depression. The cost/benefit equation isn't as obvious as you might think. If you have a careful read through the thread, right from the start, I think you'll get to see what I mean.... (?)

I know it causes anxiety it did when I went for one but I wasn't talking about that I was referring to the 'I hate my life so and don't care if I get cancer' bit. when they/anyone would hate it if they did actually have it.

[helstar39]

Hi just wanted to say it is uncomfortable and a little embrassing but once it is done then you wouldnt have to worry about not having it done. The idea of having it done is the worst point. you have it done mid cycle otherwise the result maybe unreadable and then you have to have it done again.Also you dont have to go to GP you can have done at well women clinic that do this all the time so it may make you feel more as at ease. I would say just get it over and done with and then its one less thing to worry about

[misska]

Originally Posted by WiIIow

It seems to me like you have interpreted Woof's post in a very simplistic way and used the part that seemed most trivial about having no hobbies to illustrate your point.

Accepting the fact that your decision may mean that if you get cancer it might be incurable is not the same as not caring if you get it. Woof acknowledged that having cancer would be a horrible experience, as would anyone.

But what is the point in fighting to survive if you feel you have nothing to live for? The decision of whether or not to have a smear test is only the surface of what for some people is a complex and deeply personal issue. Its not always as black and white as it appears to be and I don't think people should be criticised for the way they feel about it.

They can be criticised when all you need to do is look around and see lots of people worse off. SA isn't life threatening things can improve. Do have black and white view but in the real world most people would say the same people on here just dont like hearing it. Wish i never comment now

[Amber Fyre]

^ SA can be life threatening, it has a high comorbidity with depression and people have taken their lives over it. With depression it isn't as simple as realising that other people are worse off and then 'getting over' it. When you have depression it can remove absolutely all hope and all motivation in life. It isn't always logical and you're not always thinking straight and rationally, but it is what it is. I've been in the position of not wanting tests like this because I didn't care whether I lived or died and it really isn't as simple as you are suggesting. When I was that depressed I really just didn't give a crap what happened to me and wasn't going to intentionally go out of my way to do unpleasant things like this test which would have just made me feel worse.