Christina Fagerstrom - A Part of My Story Forever: The Ongoing Impact of Cervical Cancer 

Christina Fagerstrom, from Vantaa, Finland, was diagnosed with aggressive human papillomavirus (HPV)-related cervical cancer in her early thirties. 

Although she received support from her family and friends and her workplace, she could not escape the emotional impact of the disease, especially the realisation that it could have implications for her desire to have children and give birth naturally. 

She stresses the importance of maintaining balance in life, especially with something so negative as a cancer diagnosis. She also emphasises the need to learn from her and others' stories and make sure that HPV vaccination and screening tests are available to all and, more importantly, taken up. 

A happy and simple life 

I am a 32-year-old woman from Vantaa, Finland. I grew up next to stables full of horses and other animals. I am proud of this background, as it taught me about hard work and life, from the beginning to the end. 

Now I work as a recruiter and, I must say, I am at a point in my career I had only dreamed of. I live with my partner and a cat, and our life is happy and simple. I just started swimming again, which I've always loved – my fondest memories in childhood are of swimming with my family.  

Something was not right 

When I turned 30, I was invited, as are all women in Finland, to have a Pap (Papanicolaou) test. 

I forgot about it. 

A year passed and I called the local clinic about some unusual changes in my cycle and some other problems. They asked me to go for the Pap test and I did. 

It was Christmas time and my intuition said that something was not right. One thing that made me feel this way was that, at the Pap test,  the doctor said to the nurse that the results won't take long and “it's going to the fast track”, or something like that. 

Then things went quickly. Within weeks, they performed a colposcopy and then Loop Excision of Transformation Zone (LETZ). That really stayed with me, as you could watch it on the monitor while they were doing it.  None of the treatments hurt. 

After the LETZ, I read everything I could online on a medical service called Omakanta and Googled multiple keywords. The next day, I received a phone call from an oncologist at Helsinki University Hospital, who told me they found cervical cancer and it was aggressive (grade 3-4), but thankfully it was small. 

The next step would be surgery to remove the cervix, a procedure called trachelectomy, as well as the lymph nodes in my hips. The surgery went well and I felt quite good. I think I was still in some kind of shock and it helped me to stay positive. 

Trying to stay positive 

I felt quite well and balanced. I told my supervisor at my office immediately and it helped, as she was extremely supportive. 

For me, obtaining knowledge about cervical cancer and surgery was useful. I was extremely happy that I would probably still have the opportunity to have children. I'm quite extroverted and open as a person and telling people helped me a lot. 

But sometimes I think it made it more difficult for me to stay positive, as some of those close to me took it even harder than I did, or didn't show enough empathy. I think that, for me, getting empathy from others felt good, but I was really strict about how I would like to be comforted. 

I still find it strange how calm I was the whole time. I cried around the time of the surgery and had probably only one crying meltdown a while later. I still felt lucky after reading stories of other women. 

I think the biggest thing I mourned was the possibility of giving birth naturally. I had always dreamed of that experience and now I know I will never do it.  

Sometimes you need to accept help 

The surgery went well. I stayed in the hospital for two days and the recovery was quite easy emotionally. The biggest lesson came three weeks later, when I suddenly got a high fever and went back to the hospital. 

They found that the spot where the right lymph node was had a blood clot. I couldn't lift my right leg and my C-reactive protein level (a marker of inflammation) was over 270 at its highest, meaning the clot was infected as well. 

The doctors put a catheter through my hip, without any pain medications, and it hurt way more than the surgery or recovery. It was International Women's Day and all I can remember is the empathy from my nurse when she said “no one gets better with pain”, after I refused to take pain meds (I didn't like the way they felt). 

Afterwards, I realised she was right and it made sense: Sometimes you need to take advice and help from others. I had fantastic roommates at the hospital who had undergone huge surgeries, with their uteruses removed, and we still talk about this experience. 

For me, this period was also emotionally memorable because my bed was just under the part of the hospital where women give birth and I could hear the midwives' wooden shoes clacking on the ceiling. I could also see from the window new families leaving the hospital with newborns. It really showed me how unfair this can all be for many women.  

A part of my story forever 

I was on sick leave for six weeks after I had the surgery and going back to work was quite challenging. As I mentioned, my workplace and especially supervisor was extremely supportive and it made it easier. 

I'm quite optimistic,  so for me life has been going well. At the same time though, my personality means I'm quite bad at concentrating, as I get excited about several things at the same time. So, having cancer and other things on my mind hasn't helped. 

After the summer holidays, I was able to reboot myself and now I feel like the ‘cancer period' has ended, but it definitely comes to mind daily and will be a part of my story forever. I'm also sure that I will think about it whenever it's possibly my time to be pregnant.
  

Having children and cancer 

Six months after the surgery, I got the results from my first check-up and everything was okay. The next check-up is in 12 months. Unfortunately, removing the lymph nodes has weakened the circulation of blood and fluids to my legs, so this has had a negative impact. 

I'm also a bit concerned about the future when it comes to having children and whether I'm able to have any and/or if the pregnancy will go well. I used to want to have two kids but now I would be happy to have at least one someday. 

To sum up, I would say there have been two things I've been thinking about separately: Having children; and cancer. In my story, these two happen to be related and, if I'm able to get pregnant someday, I'm sure it will be a bit more stressful  than for someone  who hasn't  experienced this.  

Shaken to the core 

I think life is at its best when there is balance, and being sick or having cancer shakes a person to the core. Some cancers arrive for no reason but when it comes to cervical cancer, I think it is crazy that there is actually a treatment (plus the screening), so people can avoid repeating mine and others' stories. 

And yet they don't take the steps to avoid it. If I could travel back in time, I would attend the Pap test ASAP when I was first offered it.  

Unfortunately, I was a couple years too old when they started giving the HPV vaccination to kids in Finland. I would definitely like the vaccination and cervical screening to be seen as important as other vaccinations and screening tests.   

Learn from our stories 

To other people with cancer, I would tell them to remember to have balance. Cancer can be an extremely painful and negative thing in one's life but it is important to make decisions that make us feel complete in other ways. I'm sure everyone knows what this means in their case. 

For policymakers, I would like to say that, even though for me and many others it was too late to be vaccinated and something quite extreme had to be done, we don't have to do the same thing over and over again. We can learn from this. 

There is help at hand and it would be foolish of people and policymakers if they did not to take it.