Feature Articles

Women’s Health Watch
Preventive Care Gets Personal

By Annie Stuart

What to Expect: From a Breast Cancer Screening From a Cervical Cancer Screening Examine Your Excuses

When you’re in good health, life may feel as free and easy as a stroll on the beach. Making an appointment for a health screening may be the furthest thing from your mind.

If you’re looking for a reason to pick up the phone, here’s a powerful one: Having regular screenings can significantly lower your risk of dying from breast or cervical cancer. These screenings check for cancer and other health problems long before symptoms show up, so if a screening does uncover a health problem, treatment is much more likely to be successful.

Here are three women who have regular screenings to protect their health. Learn how and why they keep up with this healthy habit. Perhaps their strategies will inspire you to schedule a screening for yourself.

Conquer Your Fear
Jill Breckenridge, age 59, knows what it’s like to worry about whether a health screening will uncover cancer. She was first diagnosed with cervical cancer at age 22. Later health screenings caught breast and ovarian cancers, which were also treated successfully. Breckenridge knows firsthand that cancer does not come with an automatic death sentence. “If you deny the possibility of cancer and aren’t screened and treated, you could die. But the earlier you find it, the easier the treatment and the better the maintenance can be,” she says.

Breckenridge acknowledges that it’s normal to be afraid of cancer. She also realizes that regular screenings have helped make her a three-time cancer survivor. Because she had that first cervical cancer screening, Breckenridge has lived 37 years longer than expected.

Find Peace of Mind
Monica Olsen, a 68-year-old retired teacher, says her first Pap test and pelvic exam as an 18-year-old helped her establish a positive attitude toward screenings. “I started out with a trust in the medical profession because my father was a physician and my mother was a nurse, so I didn’t mind having the exam. Now I enjoy the peace of mind it brings, knowing I don’t have cancer,” Olsen says. She also takes steps to reinforce her initial positive feelings about screenings. Olsen plans to reward herself with something nice following her next exam.

Look at the Big Picture
Bobbi Stokes, a 46-year-old New Jersey resident, remembers her first gynecological exam as a much different experience from that of Monica Olsen. She says, “I knew it was part of the package deal. I’d have to have a Pap test, pelvic exam and breast exam too. But the first time I went, I was shaking so much.” Years later, she’s motivated to continue having regular screenings because of a sense of responsibility to her daughter and husband. “If something were to happen to me, it would have this horrible ripple effect on my family,” she says.

Search for Satisfaction
It was years before Stokes found a doctor with whom she felt comfortable. She says, “That made all the difference in the world for me.” She hopes that someone else will learn from her experience of searching for the right doctor. Stokes has some good advice that applies to any doctor-patient relationship. “Be proactive and find someone who will treat you like a person, not a number. Having a good rapport with your doctor could be the difference between being alive and not.”

If you’ve been putting off getting screened for breast or cervical cancer, knowledge can be a meaningful motivator. The boxes on pages 9 and 10 explain what to expect from breast and cervical cancer screenings. You can also call the American Cancer Society at 800-ACS-2345 (800-227-2345) or go to www.cancer.org to learn more. You’ll feel better about scheduling a screening — and better about your health.

What to Expect From a Breast Cancer Screening Clinical breast exam. Your doctor, nurse practitioner or other trained health care professional performs this exam, usually as part of your regular gynecological or physical exam. A thorough clinical breast exam takes less than 10 minutes to perform. You will be asked to undress from the waist up and wear a gown. Your provider will ask about your medical history, including information about your family history, menstrual cycle and any symptoms you may be having. Your provider will then visually examine your breasts while you’re standing, seated or lying down to see if they have changed in shape or size. Your provider will use the pads of his or her fingers to slowly palpate each breast — including around your collarbone, under your arms and along your rib cage —while you’re lying on your back. Providers often do this again while you’re sitting up to check for lumps or anything else new or unusual. The National Cancer Institute (NCI) recommends that women ages 30 and older have a clinical breast exam every year. Mammogram. Mammography uses X-rays to check for lumps in the breast that are too small to feel by hand. A mammogram can also detect lumps that do not have a definite shape. You probably won’t have your mammogram in your regular doctor’s office. Usually mammograms are performed at radiology centers or special clinics that specialize in mammography. The entire procedure for both breasts takes about 15 minutes. On the day of your mammogram, you should not wear deodorant, powder or lotion because they can show up on the mammogram. Wear a two-piece outfit to make it easier to undress just from the waist up. You will stand in front of the X-ray machine while a trained technician places your breast between two plates. These plates flatten the breast tissue to get the best possible picture. This part of the process takes only about 10 seconds, but it may be a bit uncomfortable. To reduce discomfort, schedule your mammogram about a week after your period. A radiologist trained in mammography reads the film to look for any abnormalities. Dean Health Plan (DHP) recommends that women ages 50 and older have a mammogram at least every two years. If you’re at high risk for breast cancer, talk with your doctor about when you should start having mammograms.

What to Expect From a Cervical Cancer Screening A Pap test is usually part of a pelvic exam. During the test you will lie on a table with your feet in stirrups. A plastic or metal instrument (called a speculum) will be inserted into your vagina to make the opening of your uterus, called the cervix, easier to see. Your provider will lightly scrape your cervix with a small swab or brush. The cells then go to a lab to be examined. After the Pap test, your provider will probably do a manual pelvic exam by inserting gloved fingers inside your vagina and pressing on your abdomen. This checks for abnormalities. DHP recommends that women ages 18 and older (or younger if sexually active) have Pap tests and pelvic exams at least every three years. Ask your doctor how often you should have them.

Examine Your Excuses Now that you know more about breast and cervical cancer screenings, what’s holding you back from having them? Take a look at the four excuses listed below and see if they sound familiar. I don’t have time. Clinical breast exams and cervical cancer screenings are usually part of a physical exam, so you don’t need to make a separate appointment. And each of the screenings takes 15 minutes or less to perform. Ask your doctor about evening or weekend office hours. I keep forgetting to make an appointment. Make your appointment for your birthday or another day that’s special to you and easy to remember. Call several weeks in advance to make sure that the date is available. Then make sure to write down the date and time of your appointment on your calendar. No one in my family has ever had breast or cervical cancer. It is true that having an immediate family member who has had breast cancer puts you at a higher risk of developing the disease. However, many women who get breast or cervical cancer do not have a family history of the disease. That’s why cancer screenings are so important for all women. I’ll be too embarrassed. Talk with your doctor about how you feel, and remember that conversations with your doctor are confidential. Ask questions and try to be open and honest about your concerns. Just talking about it may help you feel more at ease.

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