After her mother was diagnosed with bladder cancer a decade ago, 44-year-old Heather Malcomb, a medical assistant at Atrium Health, had been consistent with yearly pelvic exams and regular Pap smears.
A Pap smear — also called a Pap test — is a procedure done during a pelvic exam. During a Pap smear, a medical provider uses a small brush or cotton-tipped swab to collect cell samples and mucus from the cervix. The sample is then tested for abnormal cells or human papillomavirus (HPV), which can indicate cervical cancer or precancerous changes to the cervix.
In August 2022, Heather went for an annual exam with her primary care provider, Marleen Traywick, FNP, a family medicine nurse practitioner at Atrium Health Primary Care Lake Park Family Medicine. Heather’s Pap smear results were abnormal, so Traywick recommended she see an OB-GYN for further evaluation.
Heather’s cervical cancer diagnosis
Heather had just started working as a medical assistant at Atrium Health Women’s Care Creek Pointe OB-GYN . Heather talked to the practice’s clinical lead, who suggested she meet with Dr. Natasha Adams-Denny , an OB-GYN in the same practice.
“I was nervous, but Dr. Adams-Denny made me feel very comfortable,” says Heather. “She is straight-up with me about everything. She feels more like a friend.”Adams-Denny did another Pap smear, which also had abnormal results. For further evaluation, Adams-Denny performed a colposcopy (a procedure that checks the cervix, vagina and vulva for precancerous or cancerous tissue) and took three biopsies. The biopsy results indicated high-grade dysplasia (severely abnormal cells in the cervix) and high-risk HPV, which can cause cervical cancer.
From there, Dr. Adams-Denny did the LEEP [loop electrosurgical excision procedure] and removed part of my cervix, which was sent off for pathology testing,” says Heather. “That’s when we found out I had cancer.”
Adams-Denny referred Heather to Dr. Jubilee Brown, a gynecologic oncologist at Atrium Health Levine Cancer.
A few weeks later, Heather then underwent a hysterectomy with Brown to remove her uterus and cervix as the final step in her treatment. Heather needed a hysterectomy because her cervical cancer was microinvasive, which means her cancer was invasive, but at the earliest stage.
“Dr. Brown has taken good care of me — I love her,” says Heather. “She’s very calming too. The first time I went to see her, she explained everything in detail. I can’t say enough about her and Dr. Adams-Denny. Both have been a blessing in my life.”
Because Heather’s cancer was caught early, her medical team says they don’t anticipate her needing additional treatment.
“Heather’s prognosis is excellent,” says Adams-Denny.
Cervical cancer risk factors
Risk factors for cervical cancer include:
- HPV infection
- Smoking
- Long-term use of birth control pills
- A weakened immune system
- Sexual history (including becoming sexually active before 18, having many sexual partners or having a partner who is considered high-risk)
- Having three or more full-term pregnancies
- Having a first full-term pregnancy before age 20
- A diet low in vegetables and fruits
- Inadequate access to health care services, including HPV tests and Pap smears
- A family history of cervical cancer
- Exposure to diethylstilbestrol (DES), a drug given to some women to prevent miscarriage between 1938 and 1971
The importance of cervical cancer screenings
Cervical cancer was once a top cause of cancer-related death in women in the United States. But thanks to Pap smears, the number of deaths caused by cervical cancer has dropped dramatically.
Heather had no symptoms of cervical cancer, which is a good example of why regular pelvic exams and Pap smears are crucial. Because she was consistent with her screenings, her medical team was able to detect her cancer early, when it required less aggressive treatment.
“Please, please, please keep up with your Pap smears and go for your annual pelvic exams,” says Heather. “I caught mine early and mine was able to be taken care of. If you’re a woman, have your Pap smears done. They can save your life in the long run. Early detection is the key. If you catch it early, you can beat it.”
Adams-Denny agrees.
“There’s no way for us to help you if we don’t know about it,” Adams-Denny says. “The only way to know what’s going on is through routine pelvic screenings each year starting at age 21 and Pap smears every three to five years.”
Adams-Denny also recommends getting the Gardasil HPV vaccine if you’re 45 years old or younger, as it can prevent cervical cancer.
“Cervical cancer is easily preventable if you get regular pelvic exams and Pap smears,” says Adams-Denny. “It’s one of the major cancers we can detect early.”
Heather says her diagnosis has changed her life for the better.
“It really made me open my eyes,” Heather says. “This past weekend, my littlest daughter, my mom and I went to Gatlinburg for a weekend away. It’s a memory I’ll have now and hopefully have a lot more to come.”
To schedule your Pap smear, find an Atrium Health women’s care provider near you.
